Review Question - QID 838

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Hip Arthrodesis Techniques Hip arthrodesis QID: 838 (OBQ07.177)

QID 838 (Type "838" in App Search)

You are caring for an 18-year-old boy with severe hip arthritis and pain from a missed slipped capital femoral epiphysis. You decide that a hip arthrodesis is the best treatment option. What is the optimum position for a hip arthrodesis to maximize function and prevent complications?

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0° external rotation, 0° adduction, 0° hip flexion

20/3950

5° external rotation, 5° adduction, 20° hip flexion

47%

1865/3950

5° external rotation, 15° abduction, 5° hip flexion

28%

1114/3950

15° external rotation, 0° adduction, 20° hip flexion

14%

557/3950

15° external rotation, 15° abduction, 5° hip flexion

368/3950

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Hip arthrodesis is a salvage procedure for patients with hip arthritis without ipsilateral knee, contralateral hip, or lumbar spine pathology. The optimal position for hip arthrodesis is 5 degrees of adduction, 5-10 degrees of external rotation, and 20-35 degrees of hip flexion.

In their review, Beaule et al. discuss the current indications and techniques regarding hip arthrodesis including appropriate leg position, surgical techniques, methods to optimize function, and later conversion to hip arthroplasty.

Callaghan et al. evaluated the long term efficacy (20-25 yrs) of hip arthrodesis. They found the onset of ipsilateral knee, contralateral hip, or lumbar spine pathology usually began 20 years after the arthrodesis. Of their patients, they found a 15% rate of conversion to hip arthroplasty by 20 years.