Total Hip Arthroplasty After Proximal Femoral Nailing: Preoperative Preparation and Intraoperative Surgical Techniques

Simarjeet Puri; Peter K Sculco; Matthew P Abdel; David S Wellman; Elizabeth B Gausden

doi:10.1016/j.artd.2023.101243

Total Hip Arthroplasty After Proximal Femoral Nailing: Preoperative Preparation and Intraoperative Surgical Techniques

Arthroplast Today. 2023 Oct 27:24:101243. doi: 10.1016/j.artd.2023.101243. eCollection 2023 Dec.

Authors

Simarjeet Puri¹, Peter K Sculco², Matthew P Abdel³, David S Wellman⁴, Elizabeth B Gausden²

Affiliations

¹ Department of Orthopedic Surgery, Ascension Providence Hospital, Southfield, MI, USA.
² Department of Orthopedic Surgery, Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
³ Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
⁴ Department of Othopaedic Surgery, Westchester Medical Center, Valhalla, NY, USA.

Abstract

The combination of an aging population and increased utilization of total hip arthroplasty (THA) is leading to a higher incidence of conversion THA, defined as conversion from previous hip fracture surgery to THA. Conversion THA is a more technically challenging, time-consuming, and costly procedure compared to primary THA and frequently involve more medically complex patients. Thus, the aim of this review is to provide a rubric for surgeons to use when preparing for a conversion THA. We have assessed the compatibility of commonly available extraction devices with popular femoral nails. Furthermore, we review technical pearls for conversion THA including equipment planning, operative setup, intraoperative imaging, extraction sequencing, and troubleshooting commonly encountered obstacles.

Keywords: Complex total hip arthroplasty; Conversion total hip arthroplasty; Surgical technique.