Derek Donegan, Michael Huo, Michael Leslie
Resection arthroplasty should be used for a joint that is not deemed as salvageable, most commonly due to infection or bone loss.
The surgeon should use the surgical approach that is the most familiar to him/her for any total hip arthroplasty, such as:
The patient is placed in a supine or a lateral position.
Utilize fracture planes to disengage femur from prosthesis.
Utilize available equipment (bone hook, pliers, vice grips, etc.) to engage the prosthesis and remove it.
Use bone tamp and mallet to disengage the femoral head from the Morse taper of the femoral prosthesis.
If the stem is uncemented, utilize available equipment (flexible osteotomes, pencil tip burr, microsagittal saw, etc.) to disrupt the stem/femur interface.
Once the stem/femur interface is fully disrupted, proceed with stem removal, utilizing extraction equipment (bone hook, pliers, vice grips, slap hammer, etc.)
If unable to fully disrupt stem/femur interface, or if a cemented stem is in place, proceed to an extended trochanteric osteotomy by extending the fracture line distally.
Stabilize with cerclage or remove loose bone fragments.
Follow-up radiographs should be per surgical protocol.