hip

Question 1

RF OA of the hip

Answer 1

age, female, obese, DDH

Question 2

symptoms OA hip

Answer 2

groin ache releved by rest

Question 3

invx OA hip

Answer 3

clinical diagnosis, if not sure Xray

Question 4

mx oa hip

Answer 4

steroid injection –> hip replacement

Question 5

what is the leading indication for hip arthroplasty (replacement or remodelling)

Answer 5

pain

Question 6

how long do hip replacements usually last

Answer 6

10-15 years

Question 7

what components are involved in a cemented hip replacement

Answer 7

cemented metal femoral component + cemented acetabular polyethlene cup

Question 8

what components are involved in a hybrid/ resurfacing hip replacement

Answer 8

metal cone over femoral head into cemented cup

Question 9

when are uncemented hips now favoured

Answer 9

young patients - they are better but more expensive

Question 10

how long are crutches needed after THA (or TKR)

Answer 10

6 weeks

Question 11

prophylaxis for VTE vollowing THA

Answer 11

LMWH for 4 weeks

Question 12

advise to minimise risk of dislocation post THA

Answer 12

sleep on back // dont sit cross legged // dont sit too low // dont flex hip over 90

Question 13

what dislocation is most common following hip replacement + symptoms

Answer 13

posterior // clunk, pain, cant weight bear, short leg

Question 14

what is the most common cause for early hip revision

Answer 14

aseptic loosening

Question 15

risks of revision THA

Answer 15

more blood loss and complications and dont work as well

Question 16

what is AVN of the hip

Answer 16

ischaemia of femoral head secondary to lost blood supply

Question 17

causes hip AVN

Answer 17

steroids, chemo, alcohol, chondral fracture, trauma

Question 18

symptoms hip AVN

Answer 18

unilateral joint pain worse on impact

Question 19

invx hip AVN

Answer 19

plain Xray // MRI- sclerosis and granulation rissue

Question 20

mx hip AVN

Answer 20

if not collapsed drill holes into femur // if collapsed THA

Question 21

what can cause transient idiopathic osteoporosis of the hip

Answer 21

pregnancy!! hyperaemia, increased venous return

Question 22

invx transient idiopathic osteoporosis of the hip

Answer 22

raised PV or ESR // MRI // Xray

Question 23

what causes trochanteric bursitis // trochanter pain syndrome

Answer 23

repeated trauma by IT band over bursa

Question 24

who gets trochanteric bursitis / trochanter pain

Answer 24

females, runners, 50-70

Question 25

symptoms trochanteric bursitis // trochanter pain

Answer 25

pain on lateral thigh, tenderness on palpation greater trochanter

Question 26

mx trochanteric bursitis // trochanter pain

Answer 26

physio, NSAIDs, steroid injection // surgery not indicated

Question 27

what is hip imingement (FAI)

Answer 27

femoral head changes shape and part of bone begins to pinch the labrum (cartilage between acetabulum and femoral head)

Question 28

who usually gets FAI

Answer 28

young people, females, atheletes, previous SUFE

Question 29

symptoms FAI

Answer 29

groin pain esp on flexion + rotation // worse sitting // C sign + FADIR positive

Question 30

mx FAI

Answer 30

surgery to remove extra bone (osteotomy) // THR in older patients

Question 31

symptoms of acetabular tear

Answer 31

hip/ groin pain // snapping sensation // potential locking

Question 32

what is leriche syndrome

Answer 32

atherosclerosis of iliac vessels

Question 33

symptoms leriche

Answer 33

butt claudication + impotence