The “Inside-Out” Anterior Osteotomy of the Proximal Femur via the Direct Anterior Approach in Revision Hip Arthroplasty

• Type of Material: Article
• Authors: Sania Mahmood, Emory University; Brian Thomas Muffly, Emory University; Thomas Bradbury, Emory University
• Language: English
• Date: 2023-10-16
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.artd.2023.101219
• Title of Journal or Parent Work: Arthroplasty Today
• Volume: 24
• Start Page: 101219
• Keywords: femur osteotomy technique; revision hip osteotomy; direct anterior osteotomy
• Research Categories: Biology, Anatomy; Health Sciences, Medicine and Surgery

Abstract

Osteotomy techniques used for wide exposure during femoral component revision include the extended trochanteric osteotomy and its modifications. We describe an anterior proximal femur osteotomy technique starting from the inside of the femoral canal at the bone-implant interface and heading outward. The technique is used in conjunction with the extended direct anterior approach and allows direct access to and visualization of the anterior, medial, and lateral bone-implant interfaces. This technique is most useful for the removal of collared, fully hydroxyapatite-coated double-tapered femoral stems, in which bone-implant interfaces need to be accessed for removal of a well-osseointegrated hip arthroplasty implant.