Surgical Technique for Anterior Approach for Total Hip Arthroplasty After Bilateral Below-Knee Amputation

Abstract

Case: We report a case of a 77-year-old man, with bilateral below-knee amputee, in whom the anterior approach (AA) for a left total hip arthroplasty was used successfully, with 3-year follow-up. This report also summarizes the key studies in the literature on this subject. Conclusions: The utility of AA surgery performed in the setting of bilateral below-knee amputation has not been previously described. We describe the surgical technique, including considerations and pearls in the amputee population, and particular technical tips related to the use of a fracture table and thin-wire femoral traction for optimum control of the residual limb.

Hip and knee replacement in lower limb amputees: a scoping review

“…Three studies described inserting a Steinman pin into the greater trochanter, to provide rotational control and facilitate dislocation/relocation [ 23 , 36 , 53 ]. Four studies involved inserting 5 mm or 6.5 mm Schanz pins into the distal femur, similarly for rotational control and to allow traction for dislocation/relocation [ 34 , 37 , 45 , 46 ]. Two studies described using bone clamps or hooks in the intertrochanteric region [ 16 , 34 ], while three studies used bone forceps or clamps on the proximal femoral shaft itself, up to 5 cm distal to the lesser trochanter [ 17 , 32 , 39 ].…”