Extract
One of the primary steps in revision hip arthroplasty is the extraction of
retained components and cement before surgical reconstruction. In revision hip
arthroplasty, the removal of well-fixed cement can be extremely demanding,
time-consuming, and damaging to the remaining host
bone1. A number of
studies have shown the usefulness of endoscopy of the medullary canal to
facilitate cement removal without performing a trochanteric osteotomy. Various
endoscopy systems have been designed to visualize the endosteal surface of the
bone2-5.
Here we report on a multicenter prospective study on cement removal with
standard available endoscopy equipment in both infected and uninfected hips
undergoing revision arthroplasty (Fig.
1). The aims of our study were (1) to define the usefulness of and
the quality of the view provided by standard available laparoscopic equipment,
(2) to report on intraoperative complications during medulloscopy-assisted
cement removal, (3) to define the risk factors for femoral perforation and
intraoperative fracture, (4) to define the indications for and limitations of
medulloscopy for cement removal, and (5) to perform a critical analysis of the
completeness of cement removal, especially in revisions done in infected
hips.