CASE STUDY A 42-year-old man presented with bilateral hip pain 1 year after undergoing staged, bilateral total hip arthroplasties (THAs). The patient had his right hip replaced first, with good early results, followed 6 weeks later by a left THA.…
CASE STUDY An 81-year-old woman presented with pain in the right hip and thigh that was associated with progressive difficulty in ambulating and putting weight on the right leg. She had undergone a hybrid total hip arthroplasty (THA) approximately 13…
Chapter Preview Chapter Synopsis In this chapter, we review the indications and techniques for successful removal of the femoral components in revision total hip arthroplasty. Important Points Before femoral extraction, a full workup is performed to assess component loosening. Cortical…
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…
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…
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…
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.…
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…
CASE STUDY A 50-year-old man underwent left total hip replacement to treat osteoarthritis. Because of his age and activity level, a large resurfacing socket was used to maximize stability and minimize wear ( Fig. 41.1 , A ). The patient…
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…