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Related Experiment Video

Updated: Jul 14, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

Minimizing Instability in Isolated Head and Liner Exchange With the Direct Anterior Approach Using a Capsular-Sparing

Ricardo J Torres-Ramirez¹, Jose A Rodriguez¹

¹Adult Reconstruction and Joint Replacement Department, Hospital for Special Surgery, New York, NY, USA.

Arthroplasty Today

|July 28, 2025

Summary

Head and liner exchange (HLE) using a capsular-sparing direct anterior approach (DAA) resulted in zero dislocations. This technique offers favorable short-term outcomes for hip revision surgery, demonstrating high survivorship.

Keywords:

Direct anterior approach Dislocation Head and liner exchange Revision total hip arthroplasty

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Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears

Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears

Published on: May 9, 2025

Area of Science:

Orthopedic Surgery
Arthroplasty
Revision Hip Arthroplasty

Background:

Dislocation is a frequent complication following hip head and liner exchange (HLE).
Surgical approach and soft tissue management may influence instability after revision hip surgery.
The capsular-sparing direct anterior approach (DAA) for HLE has not been extensively studied regarding its effect on stability.

Purpose of the Study:

To evaluate the postoperative stability and short-term outcomes of a capsular-sparing HLE technique using the DAA.
To report the dislocation rate and survivorship after revision hip surgery with this specific approach.

Main Methods:

Retrospective case series of isolated HLE procedures performed between 2017 and 2022.
Utilized a capsular-sparing direct anterior approach (DAA).
Included patients with a minimum 2-year follow-up, excluding those with prior ipsilateral hip revision.

Main Results:

Zero dislocations were reported in 39 hips (36 patients) at a mean follow-up of 29.8 months.
Two patients (5%) required re-revision for acetabular loosening, resulting in 95% survivorship free of re-revision.
High patient-reported outcomes were observed, with an average Hip Disability and Osteoarthritis Outcome Score for Joint Replacement of 80.81.

Conclusions:

The capsular-sparing DAA for HLE demonstrates favorable short-term outcomes.
This technique achieved a 0% dislocation rate and 95% survivorship free of re-revision at 2 years.
The DAA with a capsular-sparing technique is a viable option for revision hip arthroplasty to enhance stability.