Arthroplasty

Question 1

What complications are associated with THA in patients with Paget’s disease?

Answer 1

• Increased bleeding due to hypervascular bone
  
  • Give bisphosphonate (pamidronate) to decrease hypervascularity
• Rapid osteolytic bone resorption post op
  
  • Give bisphosphonate (pamidronate) to decrease bone resorption postop
• HO (50%)
  
  • Give indomethacin peri-op or radiation (optimal dose is single dose of 600-700 rad)
  • Would just say give endomethacin if no contraindication on exam