Video Gallery

Video Gallery

Welcome to the AAOS Video Gallery, providing an enhanced viewing experience of AAOS video content.

Minimally Invasive Direct Anterior Approach for Revision of the Acetabular Component

February 19, 2016

Contributors: Cesare Faldini, MD; Francesco Traina, MD; Daniele Fabbri, MD; Domenico Fenga, MD; Raffaele Borghi, MD; Fabrizio Perna; Eugenio Leo, MD; Carlotta Calamelli; Mohammadreza Chehrassan, MD

The prevalence of revision total hip arthroplasty (THA) has significantly increased over the past few years, in direct proportion to the increasing number of primary THA cases. A review of the National Inpatient Sample Database found that isolated acetabular revision accounted for approximately two-thirds of revision THA cases. Performing revisions through surgical approaches such as the posterior, modified Hardinge, and modified Watson-Jones are described. The direct anterior (DA) approach through the Smith-Petersen interval has been gaining popularity, otherwise few articles have described revisions through this approach. The aim of this video is to describe surgical tricks and pitfalls for performing acetabular cup revisions through a modified minimally invasive anterior approach. This approach offers the only path to performing minimally invasive THA cup revision in an inter muscular plane without muscle detachment from bone. An incision 2 cm distal and 2 cm lateral of the anterior superior iliac spine in the direction of the lateral epicondyle of the distal femur extended for 6 cm to 8 cm is suggested to reach the anterior-medial part of the tensor fasciae lata. The fascia is incised and detached superiorly and medially to achieve the intermuscular space without damaging the LFN. Dedicated instrumentation and an orthopaedic table are mandatory for correct exposure of the acetabulum. The anterior approach provides good access to the acetabulum and it is effective to manage all possible acetabular bone defect. Furthermore it allows cup revision with low blood loss and a quick recovery.

Results for "Revision Hip Arthroplasty"