Trevor Younger

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An osteotomy technique for removal of distally fixed cemented and cementless femoral components is described. The anterolateral proximal femur is cut for one third of its circumference, extended distally, and levered open on an anterolateral hinge of periosteum and muscle. This creates an intact muscle-osseous sleeve composed of the gluteus medius, greater(More)
The authors report a classification system in grades, based on preoperative x-rays of the bone loss surrounding a loosened implant that may be cemented or cementless. Moreover, this classification system allows for the prior choice of which prosthesis to use at the time of reimplantation, and which type of graft depending on whether or not the residual bone(More)
Classification of loss of bone substance in cases of prosthetic loosening allow for planning of the most suitable type of reconstructive surgery. The use of cemented prostheses has revealed negative long-term results. For this reason a cementless implant which is entirely coated is preferred in order to allow for distal anchoring (particularly in type 2B(More)
The authors report how the choice of a prosthesis for implantation (cemented or cementless), must be made only after a careful evaluation of the type of osteolysis present. This preoperative evaluation, based on a classification that was previously described, will also guide the choice of any grafts that may be of small size to massive depending on the loss(More)
The authors standardize the method to use for a correct approach to acetabular reconstruction in relation to the loss of bone tissue. In type 1 or 2A and C loss, cancellous bone and porous hemispheric acetabula may be used. In type 2B loss there are 3 options: a small acetabulum with a high rotation center, a larger component leaving 30% of the(More)
Removal of a stable, well-fixed cementless femoral arthroplasty component occasionally is necessary because of infection, component malposition, persistent pain, or incompatibility with a femoral revision component. Restricted access to ingrowth surfaces may make implant removal exceedingly difficult and increases the risk of iatrogenic damage to the(More)
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