Solving Intraoperative Challenges During Primary Total Hip Arthroplasty: Prevention, Recognition, and Management.

Abstract

Intraoperative challenges during total hip arthroplasty (THA) can importantly impact surgical outcomes and patient satisfaction. Effective management of these complications is essential to avoid adverse events and optimize recovery. This symposium reviews four key areas where intraoperative difficulties commonly arise: surgical exposure, acetabular preparation, femoral management, and restoration of leg length, offset, and stability. Techniques for improving exposure, avoiding acetabular fixation errors and fractures, managing femoral complications such as perforation and poor bone quality, and restoring anatomical alignment are discussed. Emphasis is placed on prevention, recognition, and intraoperative problem-solving. A structured approach to intraoperative challenges in THA can enhance surgical efficiency, reduce complications, and improve patient outcomes. This symposium review provides actionable insights and algorithms to guide surgeons through complex scenarios safely and effectively.