Patient Positioning and Exposure

Abstract

Surgical exposure of the hip is a little more difficult for hip resurfacing than for standard total hip replacement (THR), as the femoral head and neck are obviously not resected in resur facing. The other difficulty is that one is often operating on young, muscular men with stiff hips, and this adds much more difficulty than newcomers to the resurfacing operation expect. Obese patients also add a degree of difficulty with the surgical exposure but are not as much of a problem as muscular men. Previous surgery adds problems, particularly when metalwork is still in situ from childhood developmental dysplasia of the hip (DDH) surgery or when there is retained metalwork from previous pelvic fractures. The scarring from previous surgery often stiffens the hip making exposure more difficult. Previ ous scars must be considered in order to avoid tram lines and skin necrosis. All this has to be taken into account in position ing and surgical approach.