Posted: Jun 23 2020 #(C101507)

Acetabular Osteolysis in a 63M

}

HPI

63M 3 years s/p R dual mobility THA. Doing well up until 1 month ago. Began having atraumatic right groin pain and limp.

PMH

Hepatitis C Anxiety Chronic pain syndrome

MSK - previous incision well healed without erythema or fluctuance. Ambulates with an antalgic gait. Able to perform straight leg raise. No TTP about the hip or leg. NVID.

Poll

1 of 12

Would you order additional imaging on this patient?

1 I would not order advanced imaging

2 Judet x-rays

3 CT

4 MRI

5 Judet x-rays and CT

6 Judet x-rays and MRI

7 Judet x-rays, CT, and MRI

8 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116606

How would you classify this pathology?

1 I would not use a classification system

2 Paprosky 2B

3 Paprosky 2C

4 Paprosky 3A

5 Paprosky 3B

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116609

If the ESR and CRP are normal, would you aspirate the hip?

1 Yes

2 No

3 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116607

If the ESR and CRP are normal, would you order metal ion levels on this patient?

1 Yes

2 No

3 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116601

If the infection workup was negative, how would you manage this patient?

1 Nonoperative

2 Operative

3 Outside of my expertise - best I don't vote on this one

Other

Submit

P: 116602

If you choose Operative management, what procedure would you perform?

1 I would not choose Operative management

2 Open reduction internal fixation

3 Revision arthroplasty

4 Outside my area of expertise - best if I don't vote

Other

Submit

P: 120024

If you choose Revision arthroplasty, which components would you revise?

1 I would not choose Revision arthroplasty

2 Acetabular component only

3 Femoral component only

4 Femoral + Acetabular components

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116603

If you choose to include Revision arthroplasty of the Acetabular component , which approach would you utilize?

1 I would not choose to include Revision arthroplasty of the Acetabular component

2 Direct anterior

3 Anterolateral

4 Direct lateral

5 Posterior

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116611

If you choose to include Revision arthroplasty of the Acetabular component , how would you plan to address acetabular reconstruction?

1 I would not choose to include Revision arthroplasty of the Acetabular component

2 Press fit cup

3 Press fit cup with augmentation

4 Cup-cage construct

5 Custom 3D printed implant

6 Cemented cup

7 I would not choose operative management

8 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116604

If you choose to include Revision arthroplasty of the Acetabular component , would you use bone graft?

1 I would not choose to include Revision arthroplasty of the Acetabular component

2 No- I would not use bone graft

3 Yes - cancellous autograft only

4 Yes - structural autograft only

5 Yes - structural + cancellous autograft

6 Yes - allograft only

7 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116610

If you choose to include Revision arthroplasty of the Acetabular component , what type of articulation would you use?

1 I would not choose to include Revision arthroplasty of the Acetabular component

2 Modular dual mobility (ceramic, poly, metal)

3 Metal on poly

4 Ceramic on poly

5 Metal on metal

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116605

If you choose Operative management and attained the construct shown below, what weight bearing status would you assign the patient postoperatively?

1 I would not choose Operative management

2 Weight bearing as tolerated

3 Touch down weight bearing

4 Non weight bearing

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 116732

Post-procedure P1

Sort by

L1\L2 Evidence

Date