SECTION 1
Perioperative Management of Revision Total Hip Arthroplasty and Total Knee Arthroplasty Patients 1

1 Anesthesia and Pain Management 3
Terese T. Horlocker

2 Venous Thromboembolism Prevention 17
Yi-Meng Yen and Jay R. Lieberman

3 Medical Morbidity and Mortality Following Revision Total Hip and Knee Arthroplasty 33
Jeanne M. Huddleston and Kulsum D. Casey

SECTION 2
Evaluation of the Failed Total Hip Arthroplasty 45

4 Mechanisms of Total Hip Arthroplasty Failure 47
Piya Pinsornsak and Thomas P. Schmalzried

5 Evaluation of the Painful and Problematic Total Hip Arthroplasty 57
Paul F. Lachiewicz

6 Indications for Revision Total Hip Arthroplasty 65
Tony Danesh-Clough and Steven J. MacDonald

SECTION 3
Planning, Decisions, and Approaches in Revision THA 75

7 Critical Decisions in Revision Total Hip Arthroplasty 77
Daniel J. Berry

8 Operative Approaches 89
Daniel J. Berry

SECTION 4
Revision Techniques 111

9 Acetabular Component Removal 113
Douglas A. Dennis and Lee McFadden

10 Acetabular Revision with Metal Shell Retention 125
William A. Jiranek

11 Acetabular Bone Loss Classification 133
Scott M. Sporer, Wayne G. Paprosky, Karl Dermingian, and Brett Levine

12 Acetabular Reconstruction Options Based on Bone Loss 139
Daniel J. Berry

13 Cementless Acetabular Reconstruction in Revision Total Hip Arthroplasty 155
Craig J. Della Valle and Aaron G. Rosenberg

14 Uncemented Hemispherical Cups in Extreme Bone Loss 163
R. Michael Meneghini, Arlen D. Hanssen, and David G. Lewallen

15 The Use of Cages in Revision Arthroplasty of the Acetabulum 179
Allan E. Gross and Stuart M. Goodman

16 Triflange Cup 193
David K. DeBoer and Michael J. Christie

17 Pelvic Discontinuity 203
Daniel J. Berry and Wayne G. Paprosky

18 Use of Structural Allografts in Acetabular Revision Surgery 215
Scott M. Sporer, Wayne G. Paprosky, and Michael O’Rourke

19 Femoral Component and Cement Removal 221
Andrew H. Glassman

20 Femoral Bone Loss Classification 243
Neil P. Sheth, and Wayne G. Paprosky

21 Femoral Reconstruction Options Based on Bone Loss 259
Daniel J. Berry

22 Cemented Femoral Component Revision 271
Adam A. Sassoon and Daniel J. Berry

23 Proximally Porous-Coated Modular Stems 279
Thomas Parker Vail

24 Calcar Replacement Stems 287
Keith R. Berend and Adolph V. Lombardi Jr.

25 Extensively Porous-Coated Stems 293
Scott M. Sporer, Wayne G. Paprosky, Karl Dermingian, and Brett Levine

26 Fluted Tapered Uncemented Femoral Stems 303
Daniel J. Berry

27 Impaction Grafting of the Femur 313
James A. Browne and Miguel E. Cabanela

28 Allograft Prosthetic Composite 321
Daniel J. Berry

29 Proximal Femoral Replacement with Megaprostheses 331
David J. Jacofsky

SECTION 5
Revision/Reoperation for Specific Diagnoses 337

30 Surgical Management of the Infected Total Hip Arthroplasty 339
Brian J. Keyes, R. Michael Meneghini, and Arlen D. Hanssen

31 Revision for Hip Instability After Total Hip Arthroplasty 347
Matthew P. Abdel and Daniel J. Berry

32 Postoperative Periprosthetic Femur Fracture Around Total Hip Arthroplasty 361
Daniel J. Berry

33 Periprosthetic Osteolysis 385
William Maloney

34 Heterotopic Ossification 395
Vincent D. Pellegrini, Jr.

SECTION 6
Complications and Postoperative Management 407

35 Prevention and Management of Complications Following Total Hip Arthroplasty 409
Daniel J. Berry

36 Postoperative Care Following Revision Total Hip Arthroplasty 419
Daniel J. Berry

SECTION 7
Evaluation of the Failed TKA 423

37 Mechanisms of Failure in Total Knee Arthroplasty 425
William L. Griffin

38 Evaluation of the Painful Total Knee Arthroplasty 431
Douglas A. Dennis

39 The Aseptic, Failed Total Knee Arthroplasty: Indications for Revision 437
Tad M. Mabry and Mark W. Pagnano

SECTION 8
Preoperative Strategy 447

40 Preoperative Planning and Prosthetic Choices 449
Michael E. Berend and Douglas A. Dennis

41 Operative Exposures For Revision Total Knee Arthroplasty 461
Robert T. Trousdale

SECTION 9
Surgical Techniques 467

42 Removal of Implants in Revision Total Knee Arthroplasty 469
Daniel J. Berry

43 Balancing the Flexion and Extension Gaps in Revision Total Knee Arthroplasty 479
Bryan D. Springer and Thomas S. Thornhill

44 Classification of Bone Defects in Total Knee Revision 491
Joseph P. Turk and James P. McAuley

45 Minor Bone Defect Management in Revision Knee Arthroplasty 497
J. Bohannon Mason and Richard D. Scott

46 Major Bone Defect Management 505
Gerard A. Engh and Deborah J. Ammeen

47 Ligament Deficiency in Revision Total Knee Arthroplasty 517
Christopher M. Farrell and Giles R. Scuderi

48 Managing the Patella in Revision Total Knee Arthroplasty 531
R. Stephen J. Burnett and Robert L. Barrack

49 Fixation Techniques in Revision Total Knee Arthroplasty 541
Robert T. Trousdale

SECTION 10
Knee: Revision/Reoperation for Specific Diagnoses 545

50 Wound Complications 547
Henry D. Clarke, Susan Craig Scott, and W. Norman Scott

51 Extensor Mechanism Complications 559
Douglas A. Dennis and Michael E. Berend

52 The Infected Total Knee Arthroplasty: Prevention and Management 571
R. Michael Meneghini and Arlen D. Hanssen

53 Evaluation and Management of Periprosthetic Fractures after Total Knee Arthroplasty 589
Douglas A. Dennis and Christopher B. Lynch

54 Stiffness after Total Knee Replacement 601
Jess H. Lonner and Paul A. Lotke

55 Instability in Total Knee Arthroplasty 607
Kelly G Vince

SECTION 11
Salvage Procedures 613
56 Condylar Replacement Procedures 615
Mary I. O’Connor

57 Arthrodesis and Resection Arthroplasty of the Knee 621
Hari P. Bezwada, Jess H. Lonner, and Robert Booth Jr

SECTION 12
Complications and Postoperative Management 633

58 Avoidance and Management of Intraoperative Complications in Revision Total Knee Arthroplasty 635
Raymond H. Kim, Douglas A. Dennis, and Robert T. Trousdale

59 Postoperative Rehabilitation After Total Knee Replacement 651
Robert T. Trousdale