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General Orthopaedics

HIERARCHY OF SOFT-TISSUE RELEASES FOR ADEQUATE FEMORAL EXPOSURE DURING ANTERIOR TOTAL HIP ARTHROPLASTY: SURGICAL TECHNIQUE AND REVIEW OF LITERATURE

International Society for Technology in Arthroplasty (ISTA) meeting, 32nd Annual Congress, Toronto, Canada, October 2019. Part 2 of 2.



Abstract

The anterior approach for total hip arthroplasty (THA) has been associated with a faster earlier functional recovery and has gained increasing utilization for primary THA exposure. However, some studies have suggested a higher risk of femoral complications, as well as difficulty with femoral exposure. Techniques of soft tissue releases have been described to offer better femoral exposure, and to help mitigate complications like femoral fracture or breach of the canal with broaching. However, appropriate titrated soft release remains important to decrease potential risk of dislocation. Here we present a suggested technique and hierarchy of soft tissue releases to adequately expose the femur. In addition, we discuss adjunctive table and patient position maneuvers for femoral exposure, as well as more extensile and revision techniques if necessary.

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