Main options for management in such cases: Impaction bone grafting (IBG) Metal augments Cup/ cage constructs The survivorship of the grafted acetabulum and acetabular component was 94% (95% CI: 99-78) at 7 years Hydroxyapatite (HA) granules can also be used instead of IBG Metal augments are made of tantalum, a bio-inert and corrosion-resistant metal that can be shaped into a…
Combination of fractured bone with an existing prosthesis makes these fractures challenging Mortality rate within one year following surgical treatment of periprosthetic femoral fractures is high If the Stem/component loose then revision of the component, with adjunctive stabilization of the fracture with a plate or allograft/plate composite is required. If the Stem/component well fixed then the component should be retained…
Limb discrepancy causes patient dissatisfaction, pain, gait disturbance etc Postoperative goal is a final LLD of <1 cm Evaluate and document any structural and apparent limb-length discrepancy before total hip arthroplasty for later comparison Measurement of LLD on a preoperative anteroposterior pelvic radiograph is best performed using the inter-teardrop line and the femoral head center as the landmarks Hip position…
Dislocation is the cause of 15% of THA revision surgeries Surgeon factors : Component Positioning, Implant Choice, Surgical Approach Low-volume surgeons and patients with elevated BMI increase the risk of malpositioning No convincing evidence that fluoroscopic or robotic assistance helps Increasing the size of the femoral head (up to 38 mm) provides greater resistance to dislocation Dual-mobility designs also raise…
Most common disorder affecting adolescent hips Associated conditions : Hypothyroidism, Renal osteodystrophy, Growth hormone deficiency Southwick Slip Angle Classification: 0-30, 30-50 and >500 X rays- AP & frog-leg lateral of right and left hip MRI-may help diagnose a preslip condition when radiographs are negative To avoid delayed diagnosis, physicians should consider SCFE in any patient 10 to 15 years of age with…
Total cemented fixation reached a peak of 92-93% during 1998-2000. Increasing use of uncemented fixation in THA is a worldwide phenomenon McLaughlin JR et al reported revision for aseptic loosening as the endpoint was 99% at 26 yrs Streit MR et al : Survivorship for femoral revision for aseptic loosening as the end point was 93% at 22 years 25Year…
