Key Points Patients undergoing hip surgery pose specific challenges to the anesthesiologist. Anesthetic options for hip surgery include general and regional techniques, but options will vary depending on patient- and procedure-specific characteristics. Patients undergoing hip surgery commonly suffer from arthritis…
Key Points Blood transfusions remain relatively common following both primary and revision hip arthroplasty procedures and are associated with significant risks. Comprehensive blood management strategies reduce the need for blood transfusions; thus, they should be considered an integral part of…
Key Points The risks and benefits of minimally invasive surgical approaches for total hip arthroplasty (THA) remain controversial. There is no single definition of “minimally invasive” THA, but the term has been used for approaches with a shorter skin incision…
Key Points Always plan for an extensile exposure on the femoral side, and template that plan preoperatively. Isolated acetabular revision with retention of a well-fixed femoral component requires extensile exposure. Femoral revision for removal of well-fixed implants and femoral canal…
Key Points Contemporary uses include difficult exposure and soft tissue tensioning. Multiple techniques are available; use a method that achieves surgical goals, allows the greatest chance of healing, and is easiest for surgeon and patient. Locking plate technology may allow…
Key Points The posterior approach to the hip allows excellent exposure of the femur and acetabulum for total hip arthroplasty. The extensile nature of the posterior approach makes it an important tool for primary and revision surgery. Minimally invasive surgery…
Key Points The anterolateral approach to the hip retains the posterior capsule and external rotators, which may enhance hip stability. The anterolateral approach reduces hip dislocation compared with the posterior approach. Patients at higher risk for postoperative dislocation—such as those…
Key Points The direct anterior approach (DAA) is the only intermuscular, internervous approach to the hip. A specialized orthopedic table enables facile exposure of the femur for implantation. Early functional recovery may be gained by patients with the DAA. Care…
Key Points The direct anterior approach (DAA) provides a safe approach to the hip joint with the advantages of using both an internerve and intermuscular plane and avoiding abductor muscle disruption. It allows for early patient mobilization and fast recovery.…
Key Points The ilioinguinal approach allows access to visualize the entire anterior column of the acetabulum, as well as palpable access to portions of the posterior column. The Stoppa approach can be used for exposure of the anterior pelvic ring…