Data Trace Editor – positioning and prepping – posterolateral skin incision – incise thru iliotibial band – split gluteus maximus – peel back the trochanteric bursa: – divide trochanteric bursa and sweep it posteriorly to expose vastus lateralis, short external rotators and posterior border of gluteus medius; … Read more
– See: Total Hip Replacement Menu – Discussion: – most common complication in total hip arthroplasty and most common cause of component failure; – osteolysis is a time dependent process which arises from inflammatory reaction against polyethylene particulate debris; – patho-biology: – osteolysis is … Read more
– See: – radiographic templating of femoral neck cut – femoral component offset – Discussion: – femoral neck cut will influence leg length, caput collum diaphysis (CCD) angle, and offset; – base of the femoral neck (“the shoulder”) is used as a reference for appropriate level of osteotomy; – Exposure: … Read more
– See: Total Hip Replacement Menu: – IntraOperative Frx: – frx may occurr early while the attempt to dislocate hip is made; – most postoperative femoral fractures can be prevented by avoiding injury to the bone during the original THR procedure; – bone lysis from secondary aseptic loosening may significantly compromise strength of the femur … Read more
– See: Neurologic Injuries in THR: – Discussion: – sciatic nerve is palpated by rolling it under surgeon’s finger as it crosses ischial projection from posteroinferior aspect of the acetabulum; – palpate sciatic nerve as it passes superficial to obturator internus & gemelli; – sciatic … Read more
– Discussion:: – iliotibial band (and thin fascia covering maximus) are incised in line w/ the incision; – in most cases, the hip is kept in midflexion for both the skin incision and the IT band incision; – if the hip is repositioned in extension … Read more
– See: Total Hip Replacement Menu: – Discussion: – natural history of DDH: – acetabular rim syndrome: – results from dysplastic hip, which stresses the labrum, resulting in labral degeneration; – hip arthroscopy and debridement in these patients may provide the patient w/ a few … Read more
– Patient Position: – ensure that patient has not rotated anteriorly, for this may allow acetabular component to be placed in retroverted position; – ensure that patient’s torso is not tilted inferiorly (as can occur from a bean bag), as this can cause reaming in an excessive … Read more
– Discussion: – any change in stem positioning represents definite radiologic loosening; – changes include: – pistoning: – medial midstem pivot: – calcar pivot: – subsidence; … Read more
– Femoral Anteversion: – femoral version is defined as the angular difference between axis of femoral neck and transcondylar axis of the knee; – normal values: – on average, femoral anteversion ranges from 30-40 deg at birth and decreases progressively throughout growth to about 15 deg at skeletal maturation; – … Read more