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Specialized techniques for evaluation and treatment of failed total hip arthroplasties were developed in the management of 171 patients from 1972 through 1978, using an integrated, interdisciplinary approach. Various surgical techniques were tailored to the individual and directed at the specific etiology of failure. Intraoperative biplanar fluoroscopic monitoring of a high-speed, low-torque pneumatic drill facilitated removal of femoral acrylic and reaming of the distal shaft. Coordinated use of instrumentation for autotransfusion, cement fragmentation, bone debridement and acetabuloplasty, together with new advances in the diagnosis and management of various intraoperative complications are described. An average follow-up of 36 months was obtained in 91 cases. Good to excellent hip ratings were seen in 83%.

Total knee arthoplasty has been accepted as a valuable adjunct in the treatment of knees severely compromised by disease or trauma. One hundred nine geometric total knee replacements were reviewed to determine the efficacy of the device in the relief of pain, the correction of deformity and instability, and the restoration of functional motion in the diseased knee.1