This book is intended to be a comprehensive guide for surgeons performing primary and revision total hip arthroplasty. The authors encompass a group of renowned experts from around the world. Section I of this book deals with diagnostic evaluation of hip pain and imaging of the hip. Section II of the book reviews in detail the reconstruction and replacement options for the diseased hip joint, and also alternative non-arthroplasty options. The latest developments such as incorporation of computers and navigation into the procedure, the use of minimally invasive techniques and specific instrumentations are described in detail. Section III of the book deals with perioperative management of the patient after hip surgery. Section IV is dedicated to revision arthroplasty of the hip. Section V highlights a series of controversial issues associated with hip arthroplasty.
Total hip arthroplasty is one of the most successful surgical procedures as it relieves pain, restores mobility, and improves quality of life for patients with previous incapacitating arthritis. In the United States almost one quarter million total hip replacements are performed annually, and this number is expected to rise to 572,000 (plus another 97,000 revisions) by 2030. There are numerous causes of hip arthritis including childhood disorders (such as DDH, Perthes disease, and SCPE), inflammatory arthritis, osteonecrosis, trauma, and infection. For the majority of patients, however, a growing body of evidence suggests that subtle morphological changes in the hip, such as acetabular retroversion, mild acetabular dysplasia, and subtle forms of epiphyseal slippage are the underlying causes of hip arthritis.
Non-replacement options for hip arthritis will be covered in detail. Hip arthroscopy has evolved as a method to treat a variety of hip conditions, including intra-articular and extra-articular pathology. Osteochondroplasty of the hip involves resection of osteophytes, resection of a portion of the anterior femoral cortex to improve the femoral head and neck ratio, debridement of damaged cartilage, and repair of the labrum. The indication for this procedure is usually femoroacetabular impingement. Osteotomy of the adult hip is indicated for the treatment of dysplasia, residual deformity from SCFE, cerebral palsy with hip instability and osteonecrosis. The choice of femoral or acetabular osteotomy is dictated by the type of deformity present.
Implant material, design, and surgical techniques for total hip arthroplasty are critically important for good functional results and longevity. The average age of a primary total hip arthroplasty patient is decreasing,* and younger, more active patients require hip implants that will last for decades. Hence, alternative bearing surfaces such as highly cross-linked polyethylene, ceramic-on-ceramic, and metal-on-metal are evaluated in detail. For example, with progressive improvement in mechanical properties of ceramics, fracture has become a rarity. A new problem is has now been encountered with the modern ceramic surfaces—squeaking. The availability of the alternative bearing surface has allowed orthopedic surgeons to perform total hip arthroplasty in younger patients who would have been deemed inappropriate candidates for hip arthroplasty during the early era of joint replacement. Various complications related and unrelated to the procedure can occur—infection, loosening, instability, wear—and methods to minimize complications are discussed in detail.[†]
Hip resurfacing has enjoyed a renaissance in recent years. There are several hip resurfacing devices available today, but the most critical factors in resurfacing are the surgeon and proper patient selection. The main concern following hip resurfacing arthroplasty continues to be postoperative femoral neck fracture. Excessive varus or notching of the femoral neck can result in early failure due to femoral neck fracture. In addition female gender, poor bone quality, and femoral head cysts greater than 1cm in diameter are all associated with a higher likelihood of postoperative femoral neck fracture.
Minimally invasive surgical techniques continue to be an area of controversy in total hip replacement. Patient selection and surgeon experience are clearly factors that influence the degree of soft tissue trauma created during the hip replacement procedure. A variety of different techniques have been offered as being minimally invasive, and this book will evaluate them in detail.
Total hip arthroplasty inevitably necessitates revision surgery. Multiple causes including aseptic loosening, infection, recurrent dislocation, implant failure, periprosthetic fracture, and leg length discrepancy necessitate hip revision. There may be considerable acetabular bone deficiency. Pre-operative evaluation is critically important. Consensus has developed regarding management of bone loss encountered during total hip revision, but it still remains a challenging problem.
The goal of this book is ambitious, but we feel that the challenge has been successfully met.
-- Authors
Key Features
- Presents state-of-the-art surgical management strategies for hip arthritis---from reconstruction to replacement to revision---by experts worldwide, for comprehensive guidance in one convenient resource.
- Offers current information on computer-assisted navigation techniques and minimally invasive techniques, to equip you with the latest surgical options.
- Provides extensive discussions of the management of a full range of complications to help you overcome the challenges you’ll face.
- Addresses the rationale for and management of revision surgery, given specific patient problems and intraoperative issues, enabling you to make the best informed surgical decisions.
- Presents more than 600 illustrations, including original line art, radiologic images, and full-color intraoperative photos, that show you exactly what to look for and how to proceed.
- Includes a DVD containing step-by-step narrated videos of surgeries covered in the text, depicting these procedures in action.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
- Videos: View video clips illustrating a variety of conditions.
Contents
SECTION 1 - Diagnosis and Evaluation
- Chapter 1 - Evaluation of Hip Pain in Adults
- Chapter 2 - Radiologic Evaluation of Hip Arthroplasty
- Chapter 3 - Cross-sectional Imaging of the Hip
- Chapter 4 - Assessing Clinical Results and Outcome Measures
SECTION 2 - Reconstruction
- Chapter 5 - Arthroscopy of the Hip
- Chapter 6 - Femoroacetabular Osteoplasty
- Chapter 7 - Femoral Osteotomy
- Chapter 8 - Periacetabular Osteotomy
SECTION 3 - Replacement
- Chapter 9 - Indications for Primary Total Hip Arthroplasty
- Chapter 10 - Preoperative Planning for Primary Total Hip Arthroplasty
- Chapter 11 - The Direct Anterior Approach
- Chapter 12 - The Anterolateral Minimal/Limited Incision Intermuscular Approach
- Chapter 13 - The Direct Lateral Approach
- Chapter 14 - Posterior and Posteroinferior Approaches
- Chapter 15 - The Dual-Incision Approach
- Chapter 16 - The Cemented All-Polyethylene Acetabular Component
- Chapter 17 - The Cemented Stem
- Chapter 18 - Cementless Acetabular Fixation
- Chapter 19 - The Cementless Tapered Stem
- Chapter 20 - The Cementless Tapered Stem
- Chapter 21 - The Fully Coated Cementless Femoral Stem
- Chapter 22 - The Cementless Modular Stem
- Chapter 23 - Metal-on-Metal Hip Resurfacing Arthroplasty
- Chapter 24 - Deformity
- Chapter 25 - Total Hip Arthroplasty in Patients with Metabolic Diseases
- Chapter 26 - Preoperative Rehabilitation
- Chapter 27 - Anesthesia for Hip Surgery
- Chapter 28 - Pain Control
- Chapter 29 - The Rapid Recovery Program for Total Hip Arthroplasty
SECTION 4 - Revision
- Chapter 30 - Evaluation of the Painful Total Hip Arthroplasty
- Chapter 31 - Indications for Revision Total Hip Arthroplasty
- Chapter 32 - Preoperative Radiographic Evaluation and Classification of Defects
- Chapter 33 - Revision Total Hip Arthroplasty
- Chapter 34 - Revision Total Hip Replacement
- Chapter 35 - Surgical Approach
- Chapter 36 - Surgical Approach to the Hip
- Chapter 37 - Extended Trochanteric Osteotomy
- Chapter 38 - Extended Trochanteric Osteotomy
- Chapter 39 - Component Removal
- Chapter 40 - Femoral Component Removal
- Chapter 41 - Cement Extraction Techniques
- Chapter 42 - Monolithic Extensively Porous-Coated Femoral Revision
- Chapter 43 - Surgical Options for Femoral Reconstruction
- Chapter 44 - Surgical Options for Femoral Reconstruction Impaction Grafting
- Chapter 45 - Revision Total Hip Arthroplasty
- Chapter 46 - Surgical Options for Femoral Reconstruction
- Chapter 47 - Jumbo Cups
- Chapter 48 - Use of a Modular Acetabular Reconstruction System
- Chapter 49 - Impaction Bone Grafting of the Acetabulum
- Chapter 50 - Reconstruction of Acetabular Bone Deficiencies Using the Antiprotrusio Cage
- Chapter 51 - Surgical Options for Acetabular Reconstruction
- Chapter 52 - Lesional Treatment of Osteolysis
- Chapter 53 - Venous Thromboembolic Disease after Total Hip Arthroplasty
- Chapter 54 - Periprosthetic Infection
- Chapter 55 - Neurovascular Injury
- Chapter 56 - Management of Postoperative Hematomas
- Chapter 57 - Periprosthetic Hip Fractures
- Chapter 58 - Dislocation
- Chapter 59 - Treatment of Leg Length Discrepancy after Total Hip Arthroplasty
SECTION 5 - Current Controversies
- Chapter 60 - Computerized Hip Navigation
- Theory
- Evidence
- Indications And Limitations
- Operating Room Setup
- Technique
- Acetabular Preparation And Cup Insertion With Navigation
- Stem Insertion
- The Future
- Chapter 61 - Cross-Linked Polyethylene
- Basic Science
- Clinical Studies Comparing Cross-Linked And Conventional Polyethylene
- Current Controversies
- Chapter 62 - Bearing Surface
- Tribology: Lubrication And Geometry, Alloy Microstructure, Concluding Remarks On The Tribology
- Clinical Performance
- Biological Response
- Chapter 63 - Ceramic-on-Ceramic Bearings in Total Hip Arthroplasty
- Chapter 64 - New Developments in Alternative Hip Bearing Surfaces
- Carbon Fiber Polymeric Composites
- Compliant Bearings
- Chapter 65 - Minimally Invasive Total Hip Arthroplasty
- Approaches: Mini-Posterior (Mini-Posterolateral), Mini-Anterolateral, Mini–watson-Jones, Mini–direct Lateral, Mini-Anterior, Two-Incision
- Summary
- Chapter 66 - Current Controversies
- Rationale And Indications
- Limitations Of The Current Techniques In Total Hip Arthroplasty
- Clinical Applications Of Robotic Techniques
- Preoperative Planning
- Robotic Techniques
- Complications
- Future Directions
About the Authors
- William J. Hozack, MD, Professor of Orthopaedic Surgery, Rothman Institute of Orthopaedics, Thomas Jefferson University Medical School, Philadelphia, PA.
- Javad Parvizi, MD, FRCS, Professor of Orthopaedic Surgery, Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA.
- Benjamin Bender, MD, Orthopaedic Surgeon Holon, Israel.
Product Details
- Hardcover: 544 pages
- Publisher: Saunders; 1 Har/DVD/ edition (September 9, 2009)
- Language: English
- ISBN-10: 1416058982
- ISBN-13: 978-1416058984
- Product Dimensions: 11.1 x 8.7 x 1 inches
List Price: $268.00