Minimally invasive surgery in total hip arthroplasty by Joachim Pfeil (auth.), Prof. Dr. Joachim Pfeil, Prof. Dr. PDF
By Joachim Pfeil (auth.), Prof. Dr. Joachim Pfeil, Prof. Dr. W.E. Siebert (eds.)
ISBN-10: 3642008968
ISBN-13: 9783642008962
ISBN-10: 3642008976
ISBN-13: 9783642008979
Recent years have witnessed a pattern towards using minimally invasive suggestions in all components of orthopedic surgical procedure, together with hip alternative. this is often unsurprising because the advantages of the minimally invasive strategy are well-known to be major: smaller incisions, decreased tender tissue trauma, decreased blood loss, shorter in-patient remains, and speedier rehabilitation.
This ebook goals to supply a entire consultant to using minimally invasive surgical procedure in overall hip arthroplasty. The 4 ordinarily hired methods – anterior, anterolateral OCM, anterolateral supine, and posterior – are defined intimately using high quality illustrations. for every procedure, transparent information is accessible on sufferer choice, sufferer positioning, surgery, postsurgical care, and rehabilitation. capability issues and the benefits and downsides of every choice are conscientiously weighed up, and specialists additionally current their own reports, results, and good fortune premiums with the several ways. The ebook concludes through discussing destiny developments in hip arthroplasty.
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Sample text
Beginning at the femoral insertion side, the first incision in the fascia lata is made close to the greater trochanter. This exposes a small fat pad which acts as a guide to the intermuscular interval. A finger is inserted into this interval and a blunt dissection of muscles is made down to the joint capsule. The gluteal muscles are retracted with the first Hohmann retractor placed inferior to the femoral neck and overlying the joint capsule. Owing to anatomical variations, it is sometimes necessary to undermine the tendon of the gluteus minimus with an electrocautery knife.
The slight additional external rotation facilitates the preparation of the acetabulum. The surgeon stands in front of the patient and is attended by two assistants located behind the patient. One “scrubbed” assistant holds the retractors while the other assistant positions the operated leg. After insertion of the cup, the lower leg is placed in an extended, externally rotated adducted position. Handling the leg with care is of great importance to reduce and adapt muscle tension for better sight of the situs and facilitating surgery according to the progress of the operation.
Superficial wound infections or deeper joint infections are possible if patients are not treated with prophylactic antibiotics during the intra-operative period. Superficial wound infections may respond to treatment with antibiotics. Severe joint infections, however, may lead to removal of the prosthesis. Muscle rupture and hip dislocation can occur in those patients engaging in strenuous or sudden movements of the lower body during the rehabilitation period. The gluteus muscle can detach from the trochanter.
Minimally invasive surgery in total hip arthroplasty by Joachim Pfeil (auth.), Prof. Dr. Joachim Pfeil, Prof. Dr. W.E. Siebert (eds.)
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