1. Exposures for the Complex Primary Total Hip Arthroplasty..................................1
Henry Budd, Vikas Khanduja
• Approaches used for the Complex Primary Hip Arthroplasty 1
• Trochanteric and Proximal Femoral Osteotomies 4
• Complex Primary Hip Conditions 6
2. Total Hip Replacement in Avascular Necrosis Hip................................................. 11
Rajesh Bawari, Shivan Marya
• Staging of Avn Femoral Head 11
• Treatment of Avn Femoral Head 12
• Total Hip Arthroplasty 15
3. Total Hip Arthroplasty Following Acetabular Fractures.......................................21
P Suryanarayan
• Total Hip Arthroplasty in Acute Fractures of the Acetabulum 22
• Important Issues in Surgery 22
• Thr in Old Acetabular Fractures 22
• Acetabular Reconstruction 23
• Considerations in Specific Situation 24
• Principles in the use of Block Allografts for Reconstruction 25
• Complex Situations 26
• Complications 26
• Future 26
4. Total Hip Replacement for Failed Trochanteric Fractures....................................28
C Thakkar
• Preoperative Planning 28
• Surgical Technique 29
• Results in Literature 30
5. Total Hip Replacement in Protrusio Acetabuli.......................................................32
Anil Mehtani
• Protrusio Acetabuli 32
• Types/Etiology 32
• Clinical Features 34
• Radiological Assessment 34
• Measurement and Grading of Protrusio 36
• Total Hip Arthroplasty in Protrusio 37
• Postoperative 42
Contents
6. Total Hip Replacement After Girdlestone Arthroplasty........................................44
Chandeep Singh, Albert D’ Souza, SKS Marya
• Preoperative Evaluation 45
• Original Records 45
• Physical Examination 45
• Labs 46
• Aspiration 46
• Radiography 46
• Timing of Revision Surgery 46
• Surgical Approach 47
• Presence of Cement Beads or Spacers 47
• Intraoperative Specimens 48
• Factors in Achieving Limb Length 48
• Cementless vs Cemented Implants 49
• Acetabular Cups 50
• Femoral Stem 50
• Postoperative Management 51
• Review of Literature 51
7. Osteoporotic Femoral Neck Fractures.....................................................................54
Rastogi S, Shitij Kacker, SKS Marya
• Etiology 55
• Sex 55
• Protein Energy Malnutrition 56
• Surgical Fixation does Timing Matter? 56
• Treatment 56
• Internal Fixation 57
• Arthroplasty 58
• Total Hip Arthroplasty vs Bipolar Hemiarthroplasty 59
• Hemiarthroplasty-Unipolar or Bipolar? 61
• The Severely Cognitively Impared Patient Internal Fixation vs Hemoarthroplasty 62
• Cemented vs Cementless Arthroplasty 63
• The Future of Patient Safety: Geriatric Fracture Centers 65
8. An Overview of Total Hip Arthroplasty in Rheumatoid Arthritis........................69
SV Vaidya, Sachin G Gujarathi, Arvind Arora
• Surgical Steps 73
• Complications 77
9. Total Hip Arthroplasty for Old Tuberculous Hip Arthritis....................................84
Y Kharbanda
• Recrudescence of Infection 84
• Surgical Difficulties 87
• THA in Ankylosed Hips 90
xvi Complex Primary Total Hip Replacement
10. Total Hip Replacement in Ankylosing Spondylitis..................................................95
JA Pachore, HR Jhunjhunwala, Vikram I Shah, Sachin G Gujarathi
• History 95
• Surgical Technique 97
• Postoperative Protocol 100
• Authors’ Recommendation 104
11. Total Hip Arthroplasty in Patients with Neuromuscular Abnormalities............107
Rajiv Thukral, SKS Marya 107
• Conditions with Increased Muscle Tone 107
• Conditions with Decreased Muscle Tone 109
12. Total Hip Replacement in Dysplastic Hips............................................................ 113
Vijay C Bose
• Anatomy 113
• Surgical Indications 115
• Preoperative Preparation 115
• Surgical Considerations 115
• Complications 119
13. Hip Arthroplasty in Tumors Around the Hip Joint..............................................120
Shishir Rastogi, Shah Alam Khan, Ashok Kumar
• Indications of Hip Arthroplasty in Bone Tumors 122
• Contraindications of Hip Arthroplasty in Bone Tumors 122
• How is Hip Arthroplasty in Bone Tumors different from a Primary Replacement? 123
• Preoperative Evaluation 123
• Staging of Malignant Tumors around the Hip 125
• The Implant 125
• Surgical Technique 126
• Postoperative Protocol 129
• Complications of the Endoprosthesis 129
14. Total Hip Arthroplasty in Proximal Femoral Deformity.....................................129
Rajesh Malhotra
• Etiology 131
• Pathoanatomy 131
• Preoperative Planning 132
• Challenges 133
• Surgical Technique 133
• Results 140
Contents xvii
15. Computer-assisted Navigation in Complex Primary Total Hip Arthroplasty....140
Kamal Deep
• Registration 146
• Tracker-related problems 148
• Time 148
• Outcome Measures 148
• Future of Computer-assisted Surgery 148
16. Evaluation of Patients with Pain after Total Hip Arthroplasty...........................148
Mandeep S Dhillon, Sarvdeep S Dhatt
• Evaluation of the Patient 150
• Physical Examination 151
• Laboratory Investigations 154
• Role of Radiology 155
• Arthrocentesis 156
• Algorithm 157
Index...........................................................................................................................161