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    Exposure and the Posterior Approach for Revision THA


    Dr. Neil Sheth shares his systematic approach to enhancing exposure when performing a revision total hip arthroplasty using the posterior approach, including a video of his technique.

    The posterior approach is the most commonly used approach for revision total hip arthroplasty (THA).

    At ICJR’s recent Revision Hip & Knee Course, Neil P. Sheth, MD, from the University of Pennsylvania in Philadelphia, enumerated the reasons:
    It’s the most extensile approach.
    It allows access to the posterior acetabulum.
    It allows access to the posterior ilium.

    Dr. Sheth noted that every hip has its own “personality,” meaning differing degrees of:
    Flexion and extension
    Internal and external rotation
    Abduction and adduction

    It’s important for the surgeon to get to know the personality of the hip to ensure the patient is properly positioned for optimum exposure.

    In his presentation, Dr. Sheth shared his systematic approach to enhancing exposure when performing a revision procedure using the posterior approach, which includes:
    Making the incision through the fascia
    Positioning the leg for maximal visualization
    Identifying key anatomic landmarks
    Taking down and tagging the posterior capsule
    Removing scar tissue within the joint
    Dislocating the hip
    Increasing anterior femoral excursion
    Exposing the components

    Click on the image below for Dr. Sheth’s full presentation, including a video demonstration of his technique.