From the Department of Orthopaedic Surgery, Rush University, Chicago, IL (Paprosky), the Department of Orthopaedic Surgery, Pennsylvania HospitalPhiladelphia, PA (Tran, Yu, and Sheth).
J Am Acad Orthop Surg. 2023 Oct 1;31(19):e736-e745. doi: 10.5435/JAAOS-D-22-00724. Epub 2023 Jun 22.
As indications for total hip arthroplasty (THA) continue to expand, and patients continue to live longer with more active lifestyles, the incidence of revision THA is expected to rise. General orthopaedic surgeons are now beginning to consider doing revision THA surgery because of the increased revision burden being experienced nationwide. While classical approaches to the hip can be used for simple revisions, extensile exposure techniques in conjunction with selective soft-tissue releases are often required for adequate visualization for more complex revision cases. This review provides a systematic approach to surgical exposure for revision THA using the posterior approach. The surgeon should follow a stepwise progression to obtain safe, adequate, and reproducible visualization of both the acetabulum and the proximal femur.
随着全髋关节置换术(THA)适应证的不断扩大,以及患者的生活方式更加积极、寿命更长,翻修 THA 的发生率预计将会上升。由于全国范围内翻修负担的增加,普通骨科医生现在开始考虑进行翻修 THA 手术。虽然经典的髋关节入路可用于简单的翻修,但对于更复杂的翻修病例,通常需要广泛的显露技术并结合选择性软组织松解,以获得充分的显露。本文综述了采用后路进行翻修 THA 的手术显露的系统方法。术者应按照循序渐进的步骤,以安全、充分和可重复地显露髋臼和股骨近端。