Revision Total Hip Arthroplasty with Femoral Component Retention

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Surgical Techniques

Background:

• Revision total hip arthroplasty (rTHA) with femoral component retention poses challenges for surgical exposure.
• Adequate exposure is crucial to minimize iatrogenic complications during rTHA.
• A systematic approach to surgical release can improve exposure and patient safety.

Purpose of the Study:

• To describe a systematic approach for achieving adequate exposure during rTHA with femoral component retention.
• To detail the steps of a posterior approach for acetabular revision while retaining the femoral component.
• To highlight techniques that reduce the risk of iatrogenic injury.

Main Methods:

• Utilized a posterior surgical approach for rTHA.
• Systematically released the gluteus maximus insertion, iliotibial band, and posterior capsule/external rotators.
• Employed specific retractor placements and controlled hip dislocation for visualization and access.

Main Results:

• The described systematic approach allows for adequate visualization of the acetabular component for revision.
• This technique facilitates acetabular revision with retention of the femoral component.
• The method aims to reduce the risk of iatrogenic complications associated with rTHA.

Conclusions:

• A systematic posterior approach with meticulous releases is essential for successful rTHA with femoral component retention.
• This technique enhances surgical exposure and safety, crucial for acetabular revision procedures.
• Careful execution and attention to anatomical landmarks are key to minimizing complications and ensuring stability.