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Surgical Approaches for Revision Total Hip Arthroplasty
Total hip arthroplasty (THA) is a highly successful strategy for the management of numerous hip disorders, and increasing numbers of THAs are being performed. However, failure of THA and the need for revision can result from osteolysis and polyethylene wear, implant dissociation, implant fracture, instability, infection, and periprosthetic fracture. In most revision hip surgery, one of the standard hip approaches is used with the addition of soft-tissue extensile maneuvers or an osteotomy. The goals of revision THA are to address the reason for revision and achieve a comfortable, stable THA that will allow mobilization with optimal hip mechanics and functional outcomes. One major cause of failure to achieve these desired results is the inability to access the hip sufficiently to perform the revision and avoid intraoperative complications. Therefore, any surgeon performing revision THA must understand and have experience performing the standard soft-tissue exposures and adjunct extensile exposures of the hip.