a patient who is anticipating total hip replacement is considering autologous transfusion This is a topic that many people are looking for. amritsang.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, amritsang.org would like to introduce to you SuperCap® Total Hip Replacement Approach Animation. Following along are instructions in the video below:
Preserving total hip arthroplasty using a superior capsulotomy is a technique that allows for implantation implantation of the total hip components. Under direct vision through a single incision by preserving posterior hip. Joint capsule.
And short external rotators. The super calf technique assists. In avoiding the long hospital stays and short term joint instabilities that are associated with substantial soft tissue trauma.
The patient is placed in the lateral position with the hip flexed 45 degrees. And internally rotated 15 degrees. With the foot placed on a mayo.
Stand. The incision is placed starting at the tip of the greater trochanter and extending 8 centimeters. Proximal e.
Exactly in line with the femoral shaft. Axis. The incision is made to the level of the fashio.
The fascia is incised starting at the tip of the greater trochanter and extending again in line. With the incision to wing tipped. Elevators are then used to spread the gluteus maximus fibres to expose the bursa tissue overlying.
The gluteus medius muscle the very thin layer of bursa tissue is then carefully incised just along the posterior border of the gluteus medius. A. Blunt.
Pol. Retractor. Is then placed on the posterior border of the gluteus.
Medius. And the medius is retracted anteriorly to expose the piriformis tendon and gluteus minimus muscle. A cob elevator is placed underneath the anterior aspect of the piriformis tendon at its insertion in the piriformis fossa.
A wing tipped elevator is then placed on the piriformis tendon and pulled inferiorly to maximally expose the piriformis tendon as distally as possible a long handled knife. Is then used to transect the piriformis tendon distally. Take care not to extend the cut into the superior gemellus.
Or obturator internus tendon. A small spiked. Impacting homan.
Is then placed anterior to the transected piriformis tendon through the capsule and into the posterior portion of the femoral head to facilitate exposure of the gluteus minimus. Identify the posterior border of the gluteus minimus and mobilized. The muscle from the hip joint capsule from posterior to anterior using a cob elevator mobilized.
The gluteus minimus. Only enough to allow for a vertical incision to be made in the hip joint capsule place a large spike impacting homan. Just posterior to the mobilized edge of the minimus through the capsule into the anterior portion of the femoral head.
Make. An incision in the superior hip. Joint capsule.
From 6. 00. O.
clock. In the trochanteric fossa to a little. Posterior of 12.
Oclock at the superior acetabular rim use a long electrocautery to incise in the trochanteric fossa to prevent bleeding around the base of the femoral neck make. Another incision in the anterior superior capsule. For about 15 millimetres.
Just superior to the acetabular rim. Place. A tacking suture at the corner of the capsule.
Taking care not to tag the labrum with the capsule. Since the labrum will be excised. Once the capsule is open replace.
The two spiked. Homan retractors with the to blunt homan. Retractors.
With one placed inside the anterior capsule around the anterior femoral neck. And the other placed inside the posterior capsule around the posterior femoral neck. Complete the exposure by driving a straight spiked home and retractor into the superior part of the femoral head at the head socket junction.
Using an end cutting cylindrical starting reamer enter. The femoral canal through the trochanteric fossa use the conical metaphyseal reamer to ensure central placement of the starting hole and to ensure that the reimers and brooches are not placed in varus use cylindrical reimers sequentially. If the femoral component requires them use an osteotome to open.
The superior neck and the lateral portion of the femoral head to allow insertion of femoral broaches gauge the depth of the broaches by measuring the distance from the lateral shoulder of the broach to the tip of the greater trochanter this distance is typically 15 to 30 millimetres. But varies depending on the anatomy and preoperative leg length. Discrepancy.
Once the final brooch is fully seated remove the brooch and replace it with a brooch that is one size smaller to use as an internal neck. Cutting guide so that the neck osteotomy is slightly below the top of the final stem using an oscillating saw with a narrow blade transect the femoral neck using the top of the brooch as a template the blunt homan retractors serve to protect the surrounding tissues. The saw blade can be felt to penetrate the bone.
Much the same way that a cast saw is used when removing a cast to ensure that the neck has been transected place. A cob elevator in the path of the saw blade and lever to ensure that the femoral neck cut. Has been completed place a cob elevator at the head socket junction.
And rotate. The head into a slightly valgus position place. A longshan screw into a solid part of the head.
A fix a t. Handle chuck to the shant screw and a slap hammer to the t handle chuck use the slap hammer to extract the head. The socket exposure is established by placing a large sharp impacting holman retractor into the mid anterior socket region inside the capsule.
But outside of the labrum similarly place a small sharp impacting homan retractor into the mid posterior socket region. Again inside the capsule. But outside the labrum place.
A third impacting spike toman at the anterior superior acetabular region to complete the retraction for the acetabular exposure. Take care to ensure that the tips of the retractors. Do not penetrate.
The socket excise. Any non ossified labral tissue prior to reaming use. The 45 degree angled acetabular reamer.
Handle to ream the socket appropriately after reaming switched to the anterior side of the table. And run. A cob elevator along the superior edge of the acetabular rim to ensure that there is no remaining soft tissue at the edge of the acetabulum use the double angled cup impactor to insert the cup place.
A trial. Liner into the cup replace. The smaller brooch that was used for the neck osteotomy with the final brooch place.
The trial head into the socket while on the anterior side of the table. Carefully place a bone hook into the top of the bra trial control. The leg.
Using the bone hook for traction with one arm and control the position of the leg by cradling your other arm under the knee and lower leg deliver the femur into position to allow your assistant to place the trial net into the broach then reduce the trial neck into the trial head the hip should be fully stable and should not dislocate in any position. Have your assistant hold the trial head within the socket using a long snit and applying traction with the bone hook disassemble. The trial neck from the trial.
Head remove the trial neck and brooch insert the reel prosthesis and impact that prosthesis repeat. The trial reduction after the femoral prosthesis has been inserted to check for any changes that might have occurred. If the final implant seated at a level that is slightly different from the final brooch remove the trial.
Liner and impact the real liner using the double angled cup impactor place. The final head within the liner reduce the neck into the head using the tagging suture in the anterior capsule. Close the capsule using a running suture from proximal at the acetabular rim to distal toward the trochanteric fossa followed by fashion and superficial layer closure proper surgical procedures and techniques are the responsibilities of the medical professional.
The guidelines are furnished for informational purposes. Only each surgeon must evaluate the appropriateness of the procedures based on his or her personal medical training and experience prior to use of the system. The surgeon should refer to the instructions for use package insert and surgical technique for additional warnings precautions.
Indications contraindications and adverse effects instructions for use package inserts can be found under the link for prescribing information on micro port orthopedics website. At ortho micro port com. ass line.
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