Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J....
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![Page 1: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/1.jpg)
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
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/2.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/3.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/4.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/5.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/6.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/7.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/8.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/9.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/10.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/11.jpg)
Intraoperative photograph showing use of a high-speed carbide disk-cutting wheel to cut across a well-fixed cobalt-chromium femoral stem.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/12.jpg)
Trephining over the distal portion of a transected fully porous-coated stem to remove the stem.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 13: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/13.jpg)
The Explant Acetabular Cup Removal System (Zimmer, Warsaw, Indiana) for removing a well-fixed cementless acetabular implant.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 14: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/14.jpg)
Pre-revision radiograph showing a cementless stem with a modular distal bullet tip, the removal of which requires specific instruments.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 15: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/15.jpg)
Extraction of the stem leaves the distal bullet tip remaining within the canal.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 16: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/16.jpg)
Radiograph showing the distal bullet tip after the stem has been removed.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 17: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/17.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 18: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/18.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 19: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/19.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 20: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/20.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 21: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/21.jpg)
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 22: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/22.jpg)
Preoperative radiograph showing a right total hip replacement with aseptic loosening of a cemented stem.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 23: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/23.jpg)
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.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.
![Page 24: Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):2800-2811.](https://reader035.fdocuments.in/reader035/viewer/2022062322/5697bfa81a28abf838c99715/html5/thumbnails/24.jpg)
Radiograph made after revision of the femoral component, which required an extended trochanteric osteotomy.
Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am 2005;87:2800-2811
©2005 by The Journal of Bone and Joint Surgery, Inc.