Principles of Primary Total Hip Arthroplasty

Preface
Contents
Contributors
Part I: Basic Knowledge of Total Hip Arthroplasty
1: Total Hip Arthroplasty: Indications and Contraindications
1.1 Indications for Hip Arthroplasty
1.2 Contraindications of Artificial Hip Arthroplasty
References
2: Cemented Hip Arthroplasty and Cementing Technique
2.1 Introduction
2.2 Importance of Optimal Cementing Technique
2.2.1 Cement Restrictors
2.2.2 Choice of Mixing System
2.2.3 Bone Preparation
2.2.4 Cement Mantle Thickness
2.3 Cemented Femoral Stems
2.4 The Role of Cemented Cups
2.5 Cementing Hip Could Have Good Results Using Modern Cementing Techniques
2.6 Treatment of Infected Total Hip Arthroplasty with Antibiotic-Loaded Cement
References
3: Cementless Component Design
3.1 Cementless Stem Design
3.1.1 Coating
3.1.2 Stem Shapes
3.2 Cementless Cup Design
References
4: Bearing Surfaces for Total Hip Arthroplasty
4.1 Polyethylene
4.2 Ceramics
4.3 Metal-on-Metal
4.4 Summary
References
Part II: Preoperative Preparation and Surgical Techniques of Total Hip Arthroplasty
5: Preoperative Medical Evaluation for Total Joint Arthroplasty
5.1 Cardiovascular Disease
5.2 Hypertension
5.3 Cerebrovascular Disease
5.4 Pulmonary Disease
5.5 Diabetes Mellitus
References
6: How to Avoid Periprosthetic Joint Infection
6.1 Preoperative Measures
6.2 Perioperative Measures
6.3 Postoperative Measures
References
7: Preoperative Assessment and Templating in Total Hip Arthroplasty
7.1 Clinical History
7.2 Physical Examination
7.2.1 Thomas Test
7.2.2 Trendelenburg Test
7.3 Radiographic Evaluation
7.4 Preoperative Templating
References
8: Postoperative Radiological Assessment After Total Hip Arthroplasty
8.1 Sequence of Radiographic Evaluation of the Hip
8.2 Patient’s Condition
8.3 Characteristics of the Prosthesis
8.4 Component Position
8.5 Complications
8.5.1 Component Loosening
8.5.1.1 Loosening of Cemented Stems
8.5.1.2 Loosening of Cementless Stems
8.5.1.3 Loosening of Cemented Cups
8.5.1.4 Loosening of Cementless Cups
8.5.1.5 Digital Tomosynthesis for Assessment of Component Loosening
8.5.1.6 Single-Photon Emission Computed Tomography for Assessment of Component Loosening
8.5.2 Heterotopic Ossification
8.5.3 Osteolysis and Bone Defects
8.5.4 Periprosthetic Fractures
References
9: Critical Techniques for Total Hip Arthroplasty
9.1 Preoperative Planning
9.2 Exposure
9.3 Acetabular Side Operation
9.3.1 Depth of Acetabular Reaming
9.3.2 Acetabular Reaming
9.3.3 Management of Periace
9.3.4 Choice of the Size of the Metal Acetabular Cup
9.3.5 Acetabular Cup Orientation
9.4 Femoral Side Operation
9.4.1 Stability of Femoral Prosthesis
9.4.2 Stem Anteversion
9.4.3 Offset
9.4.4 Leg Length
References
10: Minimally Invasive Posterolateral Approach to Total Hip Arthroplasty
10.1 Surgical Technique
10.2 Postoperative Rehabilitation
References
11: Minimally Invasive Direct Anterior Approach for Total Hip Arthroplasty
11.1 Surgical Technique
11.2 Postoperative Rehabilitation
11.3 Complications
References
12: The Surgical Approach and Outcomes of Total Hip Arthroplasty
References
Part III: Complex Primary Total Hip Arthroplasty
13: Total Hip Arthroplasty for Developmental Dysplasia of the Hip. Part 1: Crowe I–II
13.1 Introduction
13.2 Typical Deformities
13.3 Classification
13.4 Surgical Planning
13.5 Surgical Technique
References
14: Total Hip Arthroplasty for CROWE Type III Developmental Dysplasia of the Hip
14.1 Surgical Technique
14.1.1 Acetabular Reconstruction
14.1.2 Femur
14.2 Postoperative Rehabilitation
References
15: Total Hip Arthroplasty in Crowe IV Developmental Dysplasia of the Hip
15.1 Anatomy
15.2 Clinical Outcomes
15.3 Surgical Technique
15.3.1 Acetabular Reconstruction
15.3.2 Femoral Reconstruction
15.4 Challenges During THA in Crowe IV DDH
15.5 Summary
References
16: Total Hip Arthroplasty After Previous Periacetabular Osteotomy
16.1 Preoperative Evaluation and Preparation
16.2 Exposure and Approach
16.3 Prosthesis Selection and Implantation
16.4 Intraoperative Damage Control and Perioperative Complications
16.5 Main Postoperative Complaints
References
17: Total Hip Arthroplasty in Hip Ankylosis
17.1 Introduction
17.2 Perioperative Management
17.3 Intraoperative Patient Positioning and Surgical Technique
17.4 Postoperative Management
References
18: Total Hip Arthroplasty After Hip Fracture
18.1 Preoperative Evaluation
18.1.1 Exclusion of Joint Infection
18.1.2 Physical Examination
18.1.3 Radiographic Analysis
18.2 Implant Selection and Instrument Preparation
18.3 Surgical Techniques
18.3.1 Soft Tissue Exposure
18.3.2 Hardware Removal
18.3.3 Reconstruction of the Acetabular Side
18.3.4 Reconstruction of Femoral Side
18.4 Postoperative Rehabilitation
18.5 Complications
18.6 Outcomes
References
19: Total Hip Arthroplasty in Adult Patients with Sequelae After Childhood Hip Infection
19.1 Introduction
19.2 Anatomical Abnormalities
19.3 Radiographic Assessment
19.4 Bacteriological Evaluations
19.5 Implant Selection and Technical Details
19.6 Infection Reactivation
19.7 Summary
References
20: Total Hip Arthroplasty in the Treatment of Inflammatory Arthritis
20.1 Introduction
20.2 Psychiatric Status Assessment
20.3 Comorbidity Evaluation
20.4 Disease Activity Assessment
20.5 Medication Management
20.6 Considerations for Anesthesia
20.7 Implant Selection
20.8 Surgical Techniques
20.9 Surgical Complications
20.9.1 Disease Flares
20.9.2 Allogeneic Blood Transfusion
20.9.3 Heterotopic Ossification
20.9.4 Limited Range of Motion
20.9.5 Dislocation
20.9.6 Venous Thromboembolism
20.9.7 Surgical Site Infections
20.10 Summary
References
21: Total Hip Arthroplasty for Avascular Necrosis (AVN) of the Femoral Head
21.1 Epidemiology of AVN and THA for AVN
21.2 Indication for THA
21.3 Implant Selection
21.4 Survivorship
21.5 THA After Hip-Preserving Strategy
21.5.1 THA After Core Decompression (CD)
21.5.2 THA After Failed Femoral Osteotomy
21.6 Summary
References
Part IV: How to Avoid the Pitfalls in the Primary Total Hip Arthroplasty
22: How to Achieve a Stable Hip Arthroplasty
22.1 Background
22.2 Underlying Mechanisms of Dislocation
22.3 Time to Dislocation
22.4 Risk Factors for Unstable Hip Arthroplasty
22.5 Patient Characteristics
22.6 Disease Features
22.7 Psychological Factors
22.8 Prior Surgery
22.9 Surgeon’s Experience
22.10 Surgical Approach
22.11 Component Size
22.12 Impingement
22.13 Skirted Neck Design
22.14 Acetabular Liner Lips
22.15 Offset
22.16 Limb Length Inequality
22.17 Component Orientation
22.18 Postoperative Variables
22.19 Range of Motion
22.20 Treatment
22.21 Nonoperative Treatment
22.22 Revision Surgery for Dislocation After THA
22.23 Soft Tissue Repair/Reinforcement
22.24 Component Revision
22.25 Tripolar Arthroplasty
22.26 Constrained Acetabular Liners
References
23: How to Control Leg Length during Total Hip Arthroplasty
23.1 Preoperative Evaluation
23.2 Evaluation of Intraoperative Leg Length
23.3 Postoperative Assessment and Treatment
References
24: Periprosthetic Fractures After Total Hip Arthroplasty
24.1 Epidemiology
24.2 Risk Factors and Protective Factors
24.3 Diagnosis and Classification
24.4 Treatment Strategies
24.4.1 Type A1
24.4.2 Type A2
24.4.3 Type B
24.4.3.1 Type B1
24.4.3.2 Types B2 and B3
24.4.4 Type C
24.4.5 Type D
24.5 Periprosthetic Acetabular Fractures
References
Part V: AI Assisted Primary Total Hip Arthroplasty
25: Determining the Goals of Component Orientation in Total Hip Arthroplasty
25.1 Rationale
25.1.1 Death of the Lewinnek Safe Zone
25.1.2 Shortcomings of the Transverse Acetabular Ligament Method
25.1.3 Influence of Sagittal Imbalance and Stiffness on Cup Orientation and Joint Stability
25.2 Qualitative Solution: Pelvic Posture Analysis
25.3 Quantitative Solution: Patients’ Individual Safe Zones
References
26: Robotic-Assisted Total Hip Arthroplasty
26.1 Technologic Types of Robotics
26.2 Surgical Technique with Mako® Assistance
26.2.1 Preoperative Planning
26.2.2 Intraoperative Surgical Techniques
26.3 Advantages and Disadvantages of Robotic-Assisted THA
References