Hip Pathology

Question 1

Presentation

Answer 1

Pain

• groin
• knee
• buttocks

Loss of internal rotation

Question 2

Reason for knee pain

Answer 2

Obturator nerve supplies the hip and knee

SUFE presents with only knee pain

Question 3

Hip replacements

Answer 3

Cemebted metal/ polyethylene

Question 4

Loosening of hip replacement

Answer 4

Wear particles on articular surface form

Macrophages detect such particles as foreign and release inflammatory markers

osteoclasts become activated at the implant. bone barrier causing loosening over time

Question 5

Early complications hip replacement

Answer 5

Dislocation
nerve injury
Leg length discrepancy Infection

Question 6

Early general complications hip replacement

Answer 6

MI
Chest infection 
UTI
Blood loss
Hypovolaemia 
DVT
PE

Question 7

Late local complications hip replacement

Answer 7

Early loosening
Late infection
late dislocation

Question 8

Avascular necrosis symptoms

Answer 8

Pain in groin

Question 9

Avascular necrosis x-ray appearance

Answer 9

before collapse

Patchy sclerosis of weight. bearing area

Lytic zone underneath patchy sclerosis which causes classical sagging rope sign

Question 10

Avascular necrosis treatment

Answer 10

pre-collapse
- drill holes in femoral neck into the diseased region to decompress, promote healing and prevent collapse

Collapsed
-total hip replacement