The superolateral approach for aspiration of total hip arthroplasties

Hip aspiration for exclusion of infection is a common procedure prior to revision arthroplasty. Some patients with total hip arthroplasties develop superomedial migration of the prosthesis, while others can have extensive heterotopic bone formation. The traditional approaches may be contraindicated due to overlying bowel or bone anterior/lateral to the prosthesis. These patients are candidates for the superolateral approach. With the patient supine marks are made on the skin at (i) the greater trochanter and (ii) a superior site that aligns with the neck of the prosthesis and soft-tissue window. The needle enters the lateral skin parallel to the table top. Usually only one pass is necessary.