J Korean Hip Soc.  2010 Dec;22(4):247-252. 10.5371/jkhs.2010.22.4.247.

Preoperative Planning for Revision Hip Arthroplasty

• Sung YB

• KMID: 1461178
• DOI: http://doi.org/10.5371/jkhs.2010.22.4.247

Abstract

Revision after primary total hip arthroplasty is usually much more difficult than the first time, and the results are typically not as satisfactory as that after most primary total hip arthroplasties. Revision requires more operative time and more blood loss, and there are higher incidences of infection, thromboembolism, dislocation, nerve palsy and perforation/fracture of the femur. The complexities of revision surgery underscore the importance of precise technique when performing primary arthroplasties. Thoughtful and thorough preoperative planning will certainly provides the patient with the best opportunity for long-term success.

Keyword

Revision; Total hip arthroplasty; Preoperative planning

MeSH Terms

Arthroplasty
Dislocations
Femur
Hip
Humans
Incidence
Operative Time
Paralysis
Thromboembolism

Figure

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  Fig. 1 CT scan for pelvic osteolysis. (A) Pelvic osteolysis is not documented well in plain film, but, (B) it is remarkable in axial and (C) coronal CT scan.

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  Fig. 2 Explant Acetabular Removal System (Zimmer®).

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  Fig. 3 Checklist for revision total hip arthroplasty proposed by American Academy of Orthopaedic Surgeons.

Reference

1. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009. 91:128–133.

2. Canale ST, Beaty JH. Campbell's operative orthopaedics. 2008. 11th ed. New York: Mosby-Elsevier;430.

3. Fehring TK, Cohen B. Aspiration as a guide to sepsis in revision total hip arthroplasty. J Arthroplasty. 1996. 11:543–547.

4. Barrack RL, Harris WH. The value of aspiration of the hip joint before revision total hip arthroplasty. J Bone Joint Surg Am. 1993. 75:66–76.

5. Howie DW, Neale SD, Stamenkov R, McGee MA, Taylor DJ, Findlay DM. Progression of acetabular periprosthetic osteolytic lesions measured with computed tomography. J Bone Joint Surg Am. 2007. 89:1818–1825.

6. Bono JV. Digital templating in total hip arthroplasty. J Bone Joint Surg Am. 2004. 86-A:Suppl 2. 118–122.

7. Whiddon DR, Bono JV. Digital templating in total hip arthroplasty. Instr Course Lect. 2008. 57:273–279.

8. Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL. A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty: is digital templating accurate and safe? J Arthroplasty. 2009. 24:175–179.

9. Mitchell PA, Masri BA, Garbuz DS, Greidanus NV, Wilson D, Duncan CP. Removal of well-fixed, cementless, acetabular components in revision hip arthroplasty. J Bone Joint Surg Br. 2003. 85:949–952.

10. Lieberman JR, Berry DJ. Advanced reconstruction hip. 2005. 1st ed. Rosemont: AAOS;287–288.