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Surgical approaches in revision hip replacement

Department of Orthopaedics, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada.

Revision hip arthroplasty will be performed with frequency in the future. A successful outcome depends on careful preoperative planning, and a key component of that plan is the surgical approach. The choice of the approach should be based on the indication for revision, the particular implant to be removed, the presence of acetabular or femoral bone loss, previous surgical approaches used, and the preferences and training of the surgeon. For simple revision procedures, one of the standard approaches used in primary hip arthroplasty may be adequate. More complex cases may necessitate an extended exposure or one of the techniques developed specifically for revision arthroplasty. No single approach is suitable for all revision procedures, and the surgeon must be familiar with a range of exposures if the clinical result is to be optimized.