Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J....

Preoperative Planning for Revision Total Hip Arthroplasty

by Robert L. Barrack, and R. Stephen J. Burnett

J Bone Joint Surg AmVolume 87(12):2800-2811

December 1, 2005

Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811

Intraoperative photograph showing use of a high-speed carbide disk-cutting wheel to cut across a well-fixed cobalt-chromium femoral stem.

Trephining over the distal portion of a transected fully porous-coated stem to remove the stem.

The Explant Acetabular Cup Removal System (Zimmer, Warsaw, Indiana) for removing a well-fixed cementless acetabular implant.

Pre-revision radiograph showing a cementless stem with a modular distal bullet tip, the removal of which requires specific instruments.

Extraction of the stem leaves the distal bullet tip remaining within the canal.

Radiograph showing the distal bullet tip after the stem has been removed.

Preoperative radiograph showing a right total hip replacement with aseptic loosening of a cemented stem.

There is varus remodeling of the femur, with an associated fracture, and templating shows that a long cementless stem inserted without an osteotomy will result in perforation.

Radiograph made after revision of the femoral component, which required an extended trochanteric osteotomy.

Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J....

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