TOTBİD Dergisi

TOTBİD Dergisi

2021, Cilt 20, Sayı, 6     (Sayfalar: 686-694)

Revision hip surgery: surgical approaches

Alican Barış 1, Yusuf Öztürkmen 2

1 Sağlık Bilimleri Üniversitesi, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul
2 Sağlık Bilimleri Üniversitesi, İstanbul Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2021.104
Görüntüleme: 64
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İndirme : 41

Total hip arthroplasty (THA) is a surgical procedure with a high success rate of improving the functional status of the patients. The number of THA is increasing even among young patients, and this issue has also an important impact on the increase of total hip arthroplasty revisions. Success of revision THA is associated mostly with the quality, volume, and shape of the rest bone after removal of the components. Removal of well-integrated cemented or cementless components of total hip prosthesis must be performed with a minimum bone loss. Moreover, the bony anatomic structure should also not be damaged during this procedure. Therefore, removal of components in revision hip arthroplasty may be technically difficult, and time-consuming. Appropriate preoperative planning is mandatory for these procedures. Instruments for removing components should be determined and all required equipment (high-speed drills and metal cutters, long curved, flexible and rigid osteotomes, femoral stem extractors, polyethylene insert extractors, cup extractors, screw drivers and devices to separate modular head/neck junctions etc.) should be ready before the operation. Most of the loose components may be easily extracted but several techniques are defined to remove well-fixed cemented and cementless components. Depending on these techniques, the surgical approach to be chosen also differs. The approach to be chosen should be as safe, simple, and anatomical as possible. The surgical approach to the hip joint is classified as anterior, lateral, or posterior according to the anatomy of the joint capsule. This article describes the most commonly used approaches in revision hip surgery, and the techniques for removing components during these approaches.

Anahtar Kelimeler : surgical approach; revision hip arthroplasty; component removal technique