Surgical process for anterior hip replacement

1. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post, comprising:

mounting a t-bar to the first vertical post,

mounting a proximal accessory arm to the t-bar,

mounting a middle accessory arm to the t-bar, and

mounting a distal accessory arm to the t-bar;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor; and

closing the surgical site.

2. The method of claim 1 , wherein the step of providing a retractor assembly comprises:

mounting the first vertical post to a rail on a non-operative side of a table.

3. The method of claim 2 , wherein the step of providing a retractor assembly further comprises:

mounting the second vertical post to the operative side of the table approximately 10 inches distal to the hip joint;

mounting an angled arm to the second vertical post; and

mounting a ratchet femur distractor to the arm.

4. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms, comprising:

making an incision from a spot approximately one fingerbreadth distal and lateral to the anterior superior iliac spine directed toward the lateral thigh, approximately 8-12 cm in length,

placing a first hohmann retractor underneath the rectus femoris muscle,

retracting the sartoris and rectus femoris muscles medially,

securing the first hohmann retractor in place by attaching the first hohmann retractor to a first accessory arm,

placing a second hohmann retractor around the medial femoral neck,

securing the second hohmann retractor to a second accessory arm,

placing a third right-angled hohmann retractor laterally around the lateral femoral neck, and

securing the third right-angled hohmann retractor to a third accessory arm;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor; and

closing the surgical site.

5. The method of claim 4 , wherein the step of exposing the surgical site further comprises:

making an L-shaped capsulotomy in the hip capsule forming a capsular flap;

tagging the capsular flap with two sutures; and

securing each of the two sutures to the retractor assembly.

6. The method of claim 5 , wherein the step of cutting the femoral neck comprises:

placing the second hohmann retractor directly on the bone around the medial femoral neck;

securing the second hohmann retractor using the second accessory arm;

placing the third hohmann retractor directly on the bone around the lateral femoral neck;

securing the third hohmann retractor using the third accessory arm; and

cutting the femoral neck with an oscillating saw.

7. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup comprising

placing a first hohmann retractor at the center of the posterior wall,

levering the femur posteriorly using the first hohmann retractor,

securing the first hohmann retractor to a first accessory arm,

placing a second hohmann retractor at the superior anterior wall,

securing the second hohmann retractor to a second accessory arm,

placing a third hohmann retractor at the inferior anterior wall,

securing the third hohmann retractor to a third accessory arm, and

reaming the acetabulum;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor; and

closing the surgical site.

8. The method of claim 1 , wherein the step of preparing the femur comprises:

placing a J-hook around the proximal femur at a point distal to the lesser trochanter;

securing the J-hook to the femur distractor; and

elevating the femur using the femur distractor.

9. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor, comprising:

placing a J-hook around the proximal femur at a point distal to the lesser trochanter,

securing the J-hook to the femur distractor,

elevating the femur using the femur distractor,

mounting a horizontal side bar to the second vertical side post such that the horizontal side bar is directed proximally,

mounting an accessory arm to the horizontal side bar,

placing a trochanteric retractor behind the greater trochanter, and

securing the trochanteric retractor to the accessory arm; and

closing the surgical site.

10. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor, comprising:

placing a J-hook around the proximal femur at a point distal to the lesser trochanter,

securing the J-hook to the femur distractor,

elevating the femur using the femur distractor,

dropping the distal end of a table such that the hip joint is extended approximately 30-60 degrees,

placing a two-pronged stout retractor medially over the lesser trochanter, and

securing the two-pronged stout retractor to one of the plurality of accessory arms; and

closing the surgical site.

11. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor, comprising:

placing a J-hook around the proximal femur at a point distal to the lesser trochanter,

securing the J-hook to the femur distractor,

elevating the femur using the femur distractor,

placing a femoral clamp directly on the proximal femoral shaft,

rotating the femur using the femoral clamp, and

securing the femoral clamp to the first vertical post; and

closing the surgical site.

12. A method of performing an anterior approach hip replacement using a retractor assembly, the method comprising:

providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first vertical post, a second vertical post, and a femur distractor mounted to the second vertical post;

exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the plurality of accessory arms;

cutting the femoral neck to remove the femoral head;

preparing the acetabulum for insertion of an acetabular cup;

preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor, comprising:

placing a J-hook around the proximal femur at a point distal to the lesser trochanter,

securing the J-hook to the femur distractor,

elevating the femur using the femur distractor,

placing a loop around the thigh,

adducting the hip using the loop, and

securing the loop to the first vertical post; and

closing the surgical site.