The Hip book

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

Accessory Navicular

Discussion accessory navicular is an accessory ossicle of the foot which is located on the medial side of foot, proximal to the navicular and in continuity with the tibialis posterior tendon; approximately 2-12% of people may have this ossicle; accessory navicular generally does not ossify until 9 years of age, and in about one half … 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

Hemophilia

Discussion classic disease results from deficiency of factor VIII clotting activity; hemophilia A is not caused by an absolute deficiency of factor VIII, but from an abnormal molecule making up part of the VIII clotting factor; hemophilic arthropathy: pathologic changes (coag pathway / coag labs); inheritance pattern: sex-linked recessive; affected male will have normal sons … Read more

Septic Arthritis

Discussion » orthopaedic infection menu general orders and treatment differential diagnosis » (also consider Brucella melitensis, Borrelia burgdorferi and Treponema pallidum) Painful knee–an unusual cause secondary to pseudomonas septic arthritis of the hip. Septic until proven otherwise: approach to and treatment of the septic joint in adult patients. Indicators for detection of septic arthritis in … Read more

Rheumatoid Arthritis

Discussion ARA criteria for RA pathogenesis differential diagnosis: spondyloarthropathies & related chronic seroneg arthritides; systemic lupus erythematosus; scleroderma; dermatomyositis; juvenile rheumatoid arthritis Clinical Aspects » Laboratory Aspects » Radiographic Aspects » Treatment of RA Medical Management of RA » Surgical Treatment cervical spine hand wrist elbow and shoulder: frequently there is concomitant shoulder and elbow … Read more

Ankle Arthroscopy

Discussion indicated for symptomatic soft tissue impingement, synovitis: specific lesions amenable to arthroscopic debridement include: osteochondral lesions; meniscoid lesion in anterolateral gutter; mass of fibrocartilagenous tissue arising from the tibio-fibular joint will protrude into the joint; patients will note anterolateral ankle pain, popping, and giving way; anterior impingement snydrome of the ankle thickening of antero-inferior … 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

Juvenile Rheumatoid Arthritis

Discussion JRA is a persistent non infectious arthritis lasting more than 6 wks to 3 months after other possible etiologies have bee ruled out; most common chronic childhood rheumatoid dz; affects girls more than boys; synovial proliferation leads to joint destruction (chondrolysis) & soft tissue destruction; severe joint destruction is seen in only 5% of … Read more