The Hip book

Acetabular Protrusio

(see also: Bone Grafting for Acetabular Defects) Discussion it is probably the result of remodeling of weak, medial acetabular bone after multiple, recurring stress fractures. intrapelvic protrussion of the acetabulum may be primary or secondary; protrusio acetabuli is not found only in inflammatory arthritides; most cases are in patients with osteoarthritis. primary protrusio: Otto Pelvis … Read more

Acetabular Exposure and Preparation for Reaming

(see also: acetabular component) Discussion it is essential to have optimal acetabular exposure; once acetabular exposure is achieved, then note native acetabular anteversion; Exposure for hips w/ severe osteoarthritis (or w/ heavily scarred hips) it may be necessary to fully release the quadratus femoris, and a portion of the gluteal sling; because the majority of … Read more

Acetabular Component Revision w/ Gap Cup

Total Hip Replacement Menu » Acetabular Component Revision » Discussion indications: salvage device for use in cases of pelvic discontinuity where a stable socket cannot be wedged between the anterior and posterior columns; classification of bone defects and bone grafting options: in almost every case, bone graft is morcelized and placed behind the cup; in … Read more

Acetabular Component Revision

THR menu / Revision THR acetabular component Discussion note that some of the problems seen in dysplasia are frequently encountered in revision THR; indications for acetabular revision: sepsis, component malposition, impingement, polyethylene wear, pelvic osteolysis, recurrent dislocation, progressive protrusio, and component loosening; evaluation of the painful THR examination: examination for loosening previoius incisions; contracture of … Read more

Acetabular Component Loosening

(see also: acetabular component Loosening of Press Fit Acetabular Components (press fit acetabular components) normal bone ingrowth generally for bone ingrowth to occur, the component must lie with 50 micrometers of the acetabulum, inorder for host bone ingrowth to occur; as noted by Bloebaum RD, et al (1997), bone ingrowth into component averages only 12%, … Read more

Above the Knee Amputation

  (see also: AKA Prosthesis, Amputations in the Diabetic Patient Discussion average AK amputee walks 43% slower and expends 89% more kcal/min than the normal person; if proximal circulation is adequate, a longer anterior muscle flap may be left and the combination myodesis- myoplasty technique is used; ability to ambulate with a prosthesis depends heavily … Read more

Above Knee Amputation Prosthesis

Discussion it is important that knee joint is extended throughout stance phase; this means that the components are assembled so that a straight line extended fromthe "trochanter" will pass anterior to the knee and through the ankle; friction is adjusted to help control the amount of knee flexion and to help decelerate the shank; mechanical … Read more

Multiple Myeloma

(see also: Bone Tumor Menu) Discussion myeloma is malignant tumor of plasma cells arising from a single clone; multiple myeloma accounts for > 40% of primary malignant tumors of bone. it is most common malignant primary tumor of bone may arise as single intraosseous tumor but more often it develops as multiple painful lesions throughout … Read more

Osteoarthritis

Discussion OA is defined as a chronic irreversible degenerative disease of articular cartilage predisposing conditions pathology and histology clinical features laboratory aspects Osteoarthritis of the Knee » Hip Osteoarthritis clinical features pain on wt-bearing felt in the groin, buttock, or medial thigh; trendelenburg gait will decrease mechanical stress on joint and thereby lessen pain (see … Read more

Ankylosing Spondylitis (AS)

(see also: Spondyloarthropathies) Discussion affects young men (ages 15 to 25 years), but may also begin in middle-aged men; disease is often more severe when it occurs early in life; disease characterized by insidious onset of pain and stiffness in lower back associated w/ gradual loss of spinal mobility; illness may cause inflammation in uveal tract … Read more