hip Flashcards
RF OA of the hip
age, female, obese, DDH
symptoms OA hip
groin ache releved by rest
invx OA hip
clinical diagnosis, if not sure Xray
mx oa hip
steroid injection –> hip replacement
what is the leading indication for hip arthroplasty (replacement or remodelling)
pain
how long do hip replacements usually last
10-15 years
what components are involved in a cemented hip replacement
cemented metal femoral component + cemented acetabular polyethlene cup
what components are involved in a hybrid/ resurfacing hip replacement
metal cone over femoral head into cemented cup
when are uncemented hips now favoured
young patients - they are better but more expensive
how long are crutches needed after THA (or TKR)
6 weeks
prophylaxis for VTE vollowing THA
LMWH for 4 weeks
advise to minimise risk of dislocation post THA
sleep on back // dont sit cross legged // dont sit too low // dont flex hip over 90
what dislocation is most common following hip replacement + symptoms
posterior // clunk, pain, cant weight bear, short leg
what is the most common cause for early hip revision
aseptic loosening
risks of revision THA
more blood loss and complications and dont work as well
what is AVN of the hip
ischaemia of femoral head secondary to lost blood supply
causes hip AVN
steroids, chemo, alcohol, chondral fracture, trauma
symptoms hip AVN
unilateral joint pain worse on impact
invx hip AVN
plain Xray // MRI- sclerosis and granulation rissue
mx hip AVN
if not collapsed drill holes into femur // if collapsed THA
what can cause transient idiopathic osteoporosis of the hip
pregnancy!! hyperaemia, increased venous return
invx transient idiopathic osteoporosis of the hip
raised PV or ESR // MRI // Xray
what causes trochanteric bursitis // trochanter pain syndrome
repeated trauma by IT band over bursa
who gets trochanteric bursitis / trochanter pain
females, runners, 50-70
symptoms trochanteric bursitis // trochanter pain
pain on lateral thigh, tenderness on palpation greater trochanter
mx trochanteric bursitis // trochanter pain
physio, NSAIDs, steroid injection // surgery not indicated
what is hip imingement (FAI)
femoral head changes shape and part of bone begins to pinch the labrum (cartilage between acetabulum and femoral head)
who usually gets FAI
young people, females, atheletes, previous SUFE
symptoms FAI
groin pain esp on flexion + rotation // worse sitting // C sign + FADIR positive
mx FAI
surgery to remove extra bone (osteotomy) // THR in older patients
symptoms of acetabular tear
hip/ groin pain // snapping sensation // potential locking
what is leriche syndrome
atherosclerosis of iliac vessels
symptoms leriche
butt claudication + impotence
