Total hip revision: indications and surgical technique

Specialized techniques for evaluation and treatment of failed total hip arthroplasties were developed in the management of 171 patients from 1972 through 1978, using an integrated, interdisciplinary approach. Various surgical techniques were tailored to the individual and directed at the specific etiology of failure. Intraoperative biplanar fluoroscopic monitoring of a high-speed, low-torque pneumatic drill facilitated removal of femoral acrylic and reaming of the distal shaft. Coordinated use of instrumentation for autotransfusion, cement fragmentation, bone debridement and acetabuloplasty, together with new advances in the diagnosis and management of various intraoperative complications are described.An average follow-up of 36 months was obtained in 91 cases. Good to excellent hip ratings were seen in 83%.