Femoral Component Revision in Total Hip Arthroplasty

Abstract

Revision total hip arthroplasty is associated with increased morbidity, mortality, and cost of health care. The number of total hip revisions has been projected to increase 137% by 2030. Determining the best approach to use for femoral revision may be challenging, and requires the surgeon to be comfortable with performing extensile surgical procedures and utilizing modular components. A femoral revision procedure includes identification of the mode of failure of the primary arthroplasty, and selection of the appropriate surgical approach to maximize visualization and facilitate component exchange. Proper visualization is paramount, and the surgeon should be comfortable with performing an extended trochanteric osteotomy. With the projected rise of the number of revision total hip arthroplasties over the next several years, there will be increased need for surgeons to be well-versed in more advanced adult reconstruction techniques and be familiar with newer implant designs. We review the recently published literature and report on modes of failure, surgical techniques, implant choices, and outcomes following difficult femoral revision.

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