Adult Recon Flashcards
Proximal Dissection of GLutues Medius in Modified Hardinge apporach ( direct lateral)?
Superior gluteal artery is 5cm proxmal in gluteus medius
Where is the center of gravity of body commonly referred to?
What is normal JRF?
Anterior to S2
3X body weight
The most common artery supplies the femoral head?
Medial femoral circumflex arter
Kerboul Angle Measurement?
Mid Saggital MRI
Mid Coronal MRI
Summation of angles <190 190-240, >240 high pprobabilty of collapse
Alpha Angle on CAM view and angle?
MOdified DUNN
angle should be LESS thatn 55d
Hip Arthroplasty performed through anterior approach uses the plan between that nerves?
Superior gluteal and femoral
What artery do you have to watch out for ( near piriformis tendon) when dooing surgical dislocation of hip to avoid femoral head AVN?
Inferior gluteal artery
Fusion Position of the Hip ?
0-30 of ER
20-25 FF
NEUTRAL ABDUCTION- AVOID ABD and IR
When templating- What mistakes are made if femur is flexed and externally roated ?
- Canal diameter looks samller
- Neck looks more valgus
- Offset looks less
Flexion contracturers can lead to OVER estimation of leg length descrepancy
Excursion Distance in Femoral Head Neck Ratios?
The ED is 1/2 the diameter of the femoral head
How much poly do you needt ohave at least in Hip replacement?
5.0 mm
What could be a consequence of increasing plus sizes of femoral head to get offset at H/N JXN?
As you go up on plus sizes, you may need to have a SKIRTED Turnion to engage head. That will compromise you h/n ration in decrease your excusrion distance
What can you use contrainsed liner for ?
Needs to be abductor insufficiency
HAS no be stable cup
Cementless Metaphyseal Fit Implants
FLAT WEDGE TAPER
Stryker- Accolade
Tri-Lock- Depuy
Fit and fill stems; Depuy- Summit
Proximal Modular: Depuy- SROM
What does cementless metaphyseal engaging stems help with compared to cementless diaphyseal engaging for cemented?
LESS proximal stres sheilding
Also higher rates of intra-operative fracture
Types of Diaphyseal fitting non cemented stems?
Non-modular tapered
Modular tapered ( Arcos, Res Mod,
Extensively porous coated stems ( AML,
TENDENCY TO FAIL DUE TO SUBSIDENCE. People are afraid to break femur so they undersize
Non Cemented Femoral Stems fixation by ?
Bone INGROWTH- Depends on Pore depth
Bone ON GROWTH- Depends on Surface Roughness
Ankylosing Spondylitis THA considerations?
Loss of Lumbar lordosis
- Increased Acetabular anteversion
- Increased anteiror instability
- INcreased Post OP Heterotopic Ossification
What is the most common portion of Sciatic nerve that is affected with too much lengthening?
Peroneal division ( closer to the acetabulum)
Only Indication for primary cemented cup?
Radiation necrosis
Metal on Metal ions?
Cr 3+
Lymphocyte based reaction
Possible cancer risk
Crosses the placenta
Contra indications for femoral resurfacing?
Cysts in the Head
LLD
Osteoporosis, Osteonecrosis >50% of head
Neck Shaft <120
Linear Wear rate should be?
<0.1mm/year
Increased Head size DECREASES Linear wear
Increased Head size INCREASE volumetric wear
What is best technique for PE molding?
Direction compression molding
Decreases backside wear
