Hip LCP/AVN

Question 1

Avascular necrosis of the femoral epiphysis before closure of the growth plate due to disruption of blood supply

Answer 1

Legg Calvé Perthes Disease (ages 4-9)

Question 2

Blood supply to the femoral head comes from three sources

Answer 2

Ligamentum teres artery, Epiphyseal arteries and Metaphyseal arteries

Question 3

Lateral Epiphyseal Arteries are located on the

Answer 3

femoral neck

Question 4

pain, inflammation, bone turns to dead tissue; several months to 1 year

Answer 4

AVSCULAR Phase of Legg Calvé Perthes Disease

Question 5

dead bone cells are cleaned up, new cells are formed; still irritated and painful; 1 to 3 years

Answer 5

Revascularization Phase of Legg Calvé Perthes Disease

Question 6

deposition of new bone cells predominates; 1 to 2 years

Answer 6

Repair phase of Legg Calvé Perthes Disease

Question 7

enlarged head, flattened head, large greater trochanter

Answer 7

Deformity phase of Legg Calvé Perthes Disease

Question 8

most serious functional problems in hip AVN result not from

Answer 8

the body’s attempt to repair the damage done by the ischemic event.

Question 9

Arthrodesis, AKA

Answer 9

joint fusion

Question 10

Children with LCPD often have delayed

Answer 10

bone age.

Question 11

No radiologic changes are present and Scintigraphy may demonstrate decreased or increased uptake due to reparative processes

Answer 11

Stage I Hip AVN

Question 12

Radiologic changes are present, but the shape of the femoral head is preserved.
Radiologic changes include diffuse osteoporosis, subchondral lytic lesions, sclerotic changes, and mixed osteoporotic or sclerotic changes.

Answer 12

Stage II Hip AVN

Question 13

Classic radiologic features of osteonecrosis are present.
Findings include collapse of subchondral bone, crescent sign, and flattening of the femoral head.
Patients are symptomatic.

Answer 13

Stage III Hip AVN

Question 14

Findings include extensive collapse of subchondral bone and severe deformity of the femoral head.
Acetabulum maintains its shape.

Answer 14

Stage IV Hip AVN

Question 15

Findings include those in stage IV with acetabular involvement

Answer 15

Stage V Hip AVN

Question 16

The most common brace method for LCPD is using the

Answer 16

Petrie cast (A frame for 2-3 months)

Question 17

brace used for older children with LCPD

Answer 17

The Scottish - Rite (Atlanta)

Question 18

what percent of LCPD cases resolve without any major deformity regardless of treatment?

Answer 18

60-80%

Question 19

a procedure that involves drilling into the femoral neck (hip bone), through the necrotic (dead) area in order to relieve the pressure in the bone and to allow the bone to regrow in the area and heal on its own

Answer 19

Core decompression

Question 20

involves taking a graft (segment of healthy bone) from the fibula (bone below the knee), and placing it into the core after core decompression.

Answer 20

Bone grafting

Question 21

attempt to shift the diseased femoral head by relocating some viable (living) cartilage in the weight bearing area

Answer 21

Osteotomy

Question 22

entails replacing the hip joint with an artificial femoral head and part of the femur with an artificial stem.

Answer 22

Arthroplasty (total hip replacement)