Hip Problems Flashcards
Where might pain from hip pathology be felt?
Groin
May radiate to knee or present with only knee pain
Buttock (although more likely from lumbar spine/SI joint)
Why is does hip pathology often cause knee pain?
Referred pain via obturator nerve (supplies both joints)
Which hip pathology commonly presents with only pain in the knee?
SUFE
Which movement is usually affected first in hip pathology?
Loss of internal rotation
What does a positive Trendellenburg indicate?
Abductor weakness (gluteus minimus and medius)
Which hip pathologies may cause shortening of the limb?
OA Perthes SUFE AVN Fracture
How long will a total hip arthroplasty last in a low demand, older patient?
Cup - 15 years
Stem - 20 years
When is a THR indicated for hip OA?
Unacceptable level of pain + disability
Failed conservative methods
How is level of pain assessed for hip OA?
Analgesia use
Rest pain
Sleep disturbance
How is level of disability assessed for hip OA?
Walking distance
ADLs
Impact on hobbies
What are the early local complications of THR?
Infection
Dislocation
Sciatic nerve injury
Leg length discrepancy
What are the early general complications of THR?
MI Pneumonia UTI Blood loss/hypovolaemia DVT/PE
What are the late complications go THR?
Early loosening
Late infection (haematological spread from other site)
Late dislocation
Why should THR be delayed as long as possible in younger patients?
Will very likely require revision hip replacement at some point:
- bigger, more complex surgery
- increased complications and poorer outcomes
What are some causes of avascular necrosis of the hip?
Idiopathic Alcohol abuse Steroids Hyperlipidaemia Thrombophilia Injury
