Hip surgery

Question 1

Primary THA components and what is replaceed?

Answer 1

components:
1. Acetabular cup
2. Head & neck of femur
Replacement of femoral stem AND acetabulum

Question 2

Hemiarthroplasty what is being replaced? why would it be used over primary THA technique?

Answer 2

*** replace femoral head
Typically used when ORIF is not possible or likely to be successful

Question 3

Hip resurfacing arthroplasty components, what is being replaced and for what population?

Answer 3

*** Replacement of acetabulum and articular surface of femoral head
used for young, active patients

Question 4

Hip resurfacing arthroplasty components, what is being replaced and for what population?

Answer 4

*** Replacement of acetabulum and articular surface of femoral head
used for young, active patients

Question 5

Hip Posterior Surgery what structures are involved?

Answer 5

TFL incised, glute max split, and ER detached

Question 6

Hip Posterior Surgery pros / cons

Answer 6

Pros: hip abductors are not disrupted
Cons: higher risk for dislocation and post op precautions

Question 7

Posterior precautions

Answer 7

No hip flexion past 90, no adduction or IR past neutral

Question 8

Direct Lateral approach surgery what is affected

Answer 8

anterior glut med & glut min

Question 9

Direct Lateral approach pros/cons

Answer 9

Pros: decreased risk for dislocation
Cons: hip abductor weakness
***Greater risk for HO ( heterotrophic ossification)

Question 10

Direct Lateral precautions

Answer 10

no AROM hip ABD

Question 11

Anteriolateral surgical approach what structures are involved

Answer 11

accessed between TFL & glut med

Question 12

Direct Anterior what structures are involved

Answer 12

accessed between TFL & rectus femoris/ sartorius tendons

Question 13

Pros / cons of anterior approach

Answer 13

Pros:
1. ADLs less affected by dislocation precautions
2. Decreased risk for dislocation
Cons:
1. Prolonged hip abduction weakness if anterior glut med cut

Question 14

precautions of anterior

Answer 14

1. No hyperextension
2. No ER past neutral

Question 15

Transtrochanteric surgical approach pros/ cons

Answer 15

Pros: Preserves attachment of hip abductors
Cons:
WB limitations until bony union
Risk for non-union ( bone isn’t ossified)
Prolonged hip abductor weakness

Question 16

Post-op precautions Transtrochanteric approach

Answer 16

No active hip abduction
*** WB restrictions (TDWB or PWB)

Question 17

cemented WB precautions

Answer 17

typically WBAT

Question 18

non cemented WB precautions

Answer 18

previously partial WB, newer prostheses allow WBAT

Question 19

Revision Arthroplasty indications, used for what population, and what are the downsides

Answer 19

indications: complications with initial procedure (dislocations, infection, fixation loss, etc.)
use: younger age of initial THA, obesity, and inflammatory arthritis
Downside: global hip precautions (anterior and posterior)
**More likely to have WB limitations post-operatively