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Article
Open AccessDiagnostic and prognostic relevance of plain radiographs for periprosthetic joint infections of the hip: a literature review
Conventional radiography is regularly used to evaluate complications after total hip arthroplasty. In various recent consensus meetings, however, plain radiographs of a potentially infected hip joint have been...
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Chapter
Surgical Technique, Bone Loss, and Muscle Insufficiency
In recent years, it has been shown that the outcomes of one-stage septic prosthesis revisions of the knee joint are comparable in terms of freedom from infection and even slightly better in terms of clinical o...
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Article
Open AccessClinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties
In septic two-stage revision surgery, success depends on numerous factors. Key steps are the procedure of ex- and reimplantation and the choice of spacer in the interim phase. The latter is still a matter of d...
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Living Reference Work Entry In depth
Revisionsendoprothetik des Hüftgelenkes: Pfannenimplantate für die Revisionsendoprothetik
Aufgrund der geringeren Interdigitation des Zementes in die spongiöse Knochenstruktur bei der Pfannenrevision im Vergleich zur Primärimplantation sind die Standzeiten zementierter Pfannen bei Revisionsoperatio...
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Article
Open AccessThe significance of synovial biopsy in the diagnostic workup of the low-grade periprosthetic joint infection of shoulder arthroplasty
A common reason for painful shoulder arthroplasties and revision surgery is a low-grade periprosthetic joint infection (PJI). Diagnosing a low-grade infection is, however, a major diagnostic challenge. This ap...
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Article
Open AccessReconstruction of the anatomy of the hip in total hip arthroplasty with two different kinds of stems
The reconstruction of the individual anatomy is important in total hip replacement. The aim of the study was to compare two different kinds of stems with respect to the reconstruction of the individual anatomy...
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Chapter
Principles of Femoral Revision
There are several concepts for the fixation of the new stem in femoral revision arthroplasty. The fixation can be cemented or cementless. The cemented fixation can be performed with normal stems, with longer r...
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Chapter
Removal of the Old Stem
The removal of firmly fixed prosthesis stems is a special challenge for the surgeon. It may be indicated in cases of a periprosthetic late infection, broken stems, old monoblock prostheses with a tendency to d...
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Chapter
Necessary Length of the Revision Stems
The required length of the revision stem depends on the extent of the bone defect, the type of fixation used, and, in the case of distally fixed stems, the thickness and quality of the remaining cortical bone ...
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Chapter
Reasons for Femoral Revision
The most frequent reasons for carrying out hip prosthesis revision surgery are aseptic loosening of the prosthesis, followed by dislocations, periprosthetic infections, and periprosthetic fractures. These indi...
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Chapter
Differences in Distal Fixated Revision Stems
The different stem systems have individual characteristics that the surgeon should be familiar with in order to achieve reproducible outcomes while avoiding complications such as unintentional fractures. The t...
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Chapter
Choice of the Implant Depending on the Type of Defect
The aim in femoral revision procedures is to achieve a defect-oriented implant selection. Revision stems do not have to be implanted for every revision. The advantages and disadvantages of the various implant ...
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Chapter
Choice of the Surgical Approach
There is a variety of standard and extended approaches available for revision arthroplasty of the femur. The chosen approach should allow effective visualization and avoid unintentional damage to the bone (esp...
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Chapter
Removal of the Cement
There are a number of different instruments required for the removal of cement. These include a variety of chisels and long drills. The cement can be softened by ultrasound and then scraped off. Long cement pl...
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Chapter
Postoperative Rehabilitation
The nature of the follow-up treatment after surgery depends mainly on the type of fixation of the new prosthesis and the condition of the soft tissue. Cement-anchored prostheses can usually bear full body weig...
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Chapter
Introduction
Increasing numbers of hip endoprosthesis implantations and longer life expectancy of the recipients have meant that the number of prosthesis revision surgeries is also steadily increasing. Revision surgery of ...
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Chapter
Explanation of Terms
Barnejtt–Nordin Index: It is defined as a score for quantifying a reduction in cortical thickness of the femur caused by osteoporosis. Also, it is used to quantify proximal bone regeneration or stress shielding o...
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Chapter
Classification of Femoral Bone Defects
Of the numerous existing classifications of femoral defects, the Paprosky, AAOS, and Endoklinik classifications are the most widely used. These are described in more detail in this chapter. The Paprosky classi...
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Chapter
Principles of Cementless Distal Fixation
There are three different principles associated with distal fixation of revision stems. Scratch fit is a cylinder-in-cylinder fixation in which a cylindrical, coarsely textured stem is placed in a cylindrical ...
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Chapter
Allograft Prosthesis Composite (APC) and Megaprostheses
In cases of pronounced defects of the proximal femur, it can be replaced by an allograft, as a so-called allograft prosthesis composite (APC), or by a prosthetic component acting as a proximal femoral replacem...
