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Selected Instructional Course Lecture   |    
Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty
Keith R. Berend, MD1; Scott M. Sporer, MD2; Rafael J. Sierra, MD3; Andrew H. Glassman, MD, MS4; Michael J. Morris, MD1
1 Joint Implant Surgeons, Inc., 7277 Smith's Mill Road, Suite 200, New Albany, OH 43054. E-mail address for K.R. Berend: berendkr@joint-surgeons.com
2 Department of Orthopedics, Rush University Medical Center, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612
3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905
4 Department of Orthopedics, Ohio State University, 1491 East Broad Street, Columbus, OH 43205
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity in excess of $10,000 (Biomet and Zimmer) and less than $10,000 (Innomed).

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2011 in Instructional Course Lectures, Volume 60. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Copyright © 2010 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Nov 17;92(16):2737-2752
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Extract

Total hip arthroplasty is an exceptionally cost-effective and successful surgical intervention1,2. Dislocation, infection, osteolysis, and limb length inequality are among the most common complications affecting the long-term success of total hip arthroplasty2-8. Instability with dislocation is a complication that is costly to the patient, surgeon, and hospital9. The surgeon is frequently faced with the challenge of obtaining a stable hip at the cost of increasing the length of the lower extremity10. This Instructional Course Lecture addresses the common issues that surround the achievement of both stability and limb length equality with total hip arthroplasty. We review the preoperative patient education and factors associated with stability and limb length, the effect and role of various surgical approaches, the surgical techniques, and the management of instability with and without limb length inequality.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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