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Cemented Femoral Stem Technique Utilizing the Direct Anterior Approach to Total Hip Arthroplasty

March 01, 2017

Contributors: Joseph T Moskal, MD; John F Sloboda, MD; John F Sloboda, MD

Periprosthetic fractures are the third leading cause of revision total hip arthroplasty. Based on international registry data, one of the leading causes of periprosthetic fractures is the use of cementless stems, especially in elderly patients (older than 65 to 70 years). Cementless stems account for 93% of stems used for total hip arthroplasty in the United States and Canada. Given the increasing use of the direct anterior approach and to strengthen and broaden a surgeon's armamentarium for treatment via the best type of femoral fixation, we present the cemented technique via the direct anterior approach. Key methods to improve implant positioning via safe exposure, broaching, and excellent cementing are shown to demonstrate the utility of the approach in the treatment of all patient populations. Outcomes are discussed and support greater consideration of cemented femoral stems.

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