Surgical Considerations: Soft-Tissue Tension

Surgeons discovered that the soft tissue ‘tension' (i.e., tendinous attachments of the psoas and the abductors) is critical for post-operative stability.^{3, 6} 

• Myodeses are performed and intraoperative testing consisting of range of motion, saddle stability and ease of dislocation is routine.
• Dysfunctional systems must be corrected at the operative time.
• The modular intermediate component allows for patient variability to maintain the soft tissue tension.

Intraoperative placement of PAR prosthesis⁴

Specific technique for PAR prosthesis by Menendez et al.⁴

•  Space posterior to prosthesis packed with gelfoam
•  Spaces between prosthesis and ilium packed with polymethylmethacrylate  
•  Femoral component implanted as in total hip replacement
•  Components assembled and trialed, modular components may be needed to maintain optimal length and stability

Modular intermediate component.

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