Hip Pathologies Flashcards
Hip pathology most commonyl presents with pain where?
Groin
In which three locations can hip pain present?
- Groin
- Knee
- Buttocks
Why can hip pain be felt in the knee?
The obturator nerve innervates both areas
In which condition can hip pain characteristically present only with knee pain in some instances?
SUFE
In clinical examination what is generally the firstsign of hip pathology?
Loff of internal rotation
Which type of total hip replacement is the gold standard?
Cemented metal/polyethylene
What is loosening of a hip replacement due to?
- Wear particles on the articualr surface form
- Macrophages detect such particles as foreign and release inflammatory mediators
- Osteoclasts become activated at the implant/bone barrier causing loosening over time
What are possible early local complications of total hip replacement?
- Infection
- Dislocation
- Nerve injury
- Leg length discrepancy
What are the possible early general complications of total hip replacement?
- MI
- Chest infection
- UTI
- Blood loss
- Hypovolaemia
- DVT and PE
What are the possible late local complications of total hip replacement?
- Early loosening
- Late infection
- Late dislocation
Where is pain generally felt for AVN in the femoral head?
Groin
Later cases of AVN show changes on X-ray, what are these changes (before collapse)?
- Patchy sclerosis of the weight bearing area
- Lytic zone underneath patchy sclerosis (formed from granulation tissue) which causes the classical sagging rope sign (also seen in Perthes)
If AVN of the femoral head is caught early enough, what is the treatment?
Drill holes can be made up the femoral neck into the diseased region to decompress, promote healing and prevent collapse
When AVN of the femoral head collapses, what is the treatment?
Total hip replacement
