Chapter 40 - General Evaluation of the Hip Patient

Question 1

what does excessive internal rotation in flexion indicate on exam?

Answer 1

increased femoral anteversion

Question 2

patients with RA have an increased rate of what complication in THA?

Answer 2

Late periprosthetic fracture

Question 3

what evaluation should patients with RA undergo prior to elective surgery?

Answer 3

c-spine eval

lateral flex, ex XRs - a space availabe for the cord <14 or a difference >9-10 mm in ADI suggets atlantoaxial instability

Question 4

what implant considerations do you need to take into consideration in ankylosing spondylitis?

Answer 4

fixed pelvic hyperextension and loss of lumbar lordosis can lead to excessive femoral anteversion when they stand increasing the risk of anterior dislocation

Question 5

how should you orient your tha components in an ank spondy patient?

Answer 5

slightly less abduction (slightly more horizotal)
slightly less anteversion

Question 6

what percentage of hips with AVN are bilateral?

Answer 6

80%

Question 7

pathognomonic findings of osteonecrosis on hip MRI

Answer 7

low signal on T1
focal increases in signal on T2

Question 8

outcome of hip resurfacing for AVN

Answer 8

acetabular erosion, conversion to THA

Question 9

presentation of transient osteoporosis of the hip

Answer 9

groin pain out of proportion to XR findings

Question 10

who does transient osteoporosis of the hip affect?

Answer 10

women in their 40-50s
pregnant women

Question 11

MRI findings of transient osteoporosis of the hip

Answer 11

homogenous bright T2
homogenously low intensity on T1

Question 12

Treatment of compression sided femoral neck stress fractures

Answer 12

non-weightbearing and crutches

Question 13

treatment of a tension sided femoral stress fracture

Answer 13

fix it - three screws

Question 14

what HgbA1c levels correlate to increased infection rate?

Answer 14

7