Orthopaedic hip conditions Flashcards
What does the head of the femur articulate at the hip?
Acetabulum
Where do the abductors and rotators attach to the neck of the femur?
Greater trochanter
Where does the psoas attach to the neck of the femur?
Lesser trochanter
What is the labrum?
Fibrocartilaginous lining of acetabulum
What is the function of the labrum?
Deepen socket
Add stability
Why is an intracapsular fracture at the neck of the femur more dangerous than extracapsular?
Primary blood supply enters via capsule so intracapsular fracture would disrupt blood supply
What are the main blood suppliers for the head of the femur?
MFCA
LFCA
Where is the throchanteric bursa?
Sandwiched between hip abductors and ITB
What are some possible causes of trochanteric bursitis?
Trauma
Over-use
Abnormal movements
What might cause abnormal movements leading to trochanteric bursitis?
Distant problem like scoliosis
Muscle wasting
Total hip replacement
Osteoarthritis
How would trochanteric bursitis present?
Point pain in lateral hip
May have surgery scars or muscle wasting
Tenderness at greater tuberosity
Active abduction sore af
How do we treat trocahnteric bursitis?
NSAIDs Rest Physiotherapy Corticosteroid injection Bursectomy
How might trauma cause avascular necrosis?
Irradiation
Fracture
Dislocation
Iatrogenic
What are some systemic causes of avascular necrosis?
Idiopathic Hypercoagulable states Steroids Sickle cell disease Lymphoma Leukaemia Alcoholism
How does avascular necrosis present?
Insidious onset groin pain
Worse pain with stairs
Examination usually normal
How is avascular necrosis treated?
Reduce weight bearing NSAIDs Bisphosphonates Anticoagulants Physiotherapy
What is a femoroacetabular impingement?
Impingement of femoral neck against anterior edge of acetabulum
What are some injuries associated with FAI?
Labral degeneration and tears
Cartilage damage and flap tears
Secondary hip osteoarthritis
How does FAI present?
Groin pain exacerbated with flexion
How is FAI treated?
NSAIDs Physio to correct posture and strengthen muscles around the joint Arthroscopy Resection Osteotomy
What are some possible causes of a labral tear?
FAI Trauma OA Dysplasia Ehlers-Danlos
How does labral tear present?
Groin or Hip Pain
Snapping sensation
Jamming or locking
How can labral tears be treated?
Activity modification
NSAIDs
Steroid injection
Arthroscopy
