Techniques in Revision Hip and Knee Arthroplasty

Femoral Bone Loss Classification

Chapter Preview Chapter Synopsis This chapter reviews classification systems for femoral bone loss in total hip arthroplasty. Important Points Preoperative radiographic evaluation of bone loss helps to evaluate intraoperative findings. Extended trochanteric osteotomy should be used with little hesitation if…

Surgical Techniques: Socket Removal

Introduction Removing a solidly fixed, cemented or cementless acetabular component with minimal bone loss while avoiding further structural damage to the pelvis can be technically challenging as well as time consuming. The success of total hip arthroplasty (THA) depends in…

Recommended Acetabular Reconstruction Options

Algorithm Treatment algorithm for acetabular revision proposed by Paprosky. Introduction Numerous steps and technical issues are involved in performing an acetabular revision. Success depends on intimate contact between the implant and the remaining host bone and on creating a stable…

Acetabular Bone Loss Classification

Introduction The demand for primary total hip arthroplasty (THA) is expected to increase during the next few decades, ensuring a concomitant increase in revision THAs. Revisions are projected to increase from 40,800 cases in 2005 to 96,700 cases in 2030.…

Acetabular Bone Loss: Case Presentations

CASE STUDIES Case 1 A 39-year-old man had a right total hip arthroplasty (THA) in 1996 at the age of 26 for degenerative changes of the hip caused by osteomyelitis he had as a child. Pain developed over the course…

Magnetic Resonance Imaging of the Painful Total Hip Arthroplasty

Introduction Magnetic resonance imaging (MRI) has proved extremely useful for evaluating the painful hip prosthesis. MRI with excellent soft tissue contrast offers significant advantages over computed tomography and plain radiography for evaluating periprosthetic soft tissues and adjacent osseous structures. MRI…

Soft Tissue Coverage

CASE STUDY A 65-year-old man presented with complaints of wound drainage, pain, and infection of his left knee replacement lasting 2 years. He had undergone a primary knee replacement 3 years before presentation. One year after knee replacement, he underwent…