Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Images
  • Summary
  • Epidemiology
  • Etiology
  • Classification of Bone Loss
  • Presentation
  • Imaging
  • Studies
  • Treatment
    • Nonoperative
      • indications
        • differing etiology of pain (i.e. back pain, greater trochanteric bursitis, etc.)
        • no identifiable etiology of pain
    • Operative
      • Femoral revision
        • primary total hip arthroplasty components
          • indications
            • minimal metaphyseal bone loss, Paprosky I
        • uncemented extensively porous-coated long-stem prosthesis (or porous-coated/grit blasted combination) or modular tapered stems
          • indications
            • most Paprosky II and IIIa defects; Paprosky IIIb (modular fluted tapered stem)
          • outcomes
            • 95% survival rate at 10-years
        • femoral impaction bone grafting
          • indications
            • large ectactic canal and thin cortices
            • Paprosky IIIb and IV defects
          • outcomes
            • most common complication is stem subsidence
        • allograft prosthetic composite (APC)
          • indications
            • Paprosky IIIb and IV defects
        • endoprosthetic replacement (EPR)
          • indications
            • massive bone loss with a non-supportive diaphysis
            • Paprosky IIIB and IV defects
        • cemented stems
          • indications
            • irradiated bone
            • elderly with severe osteopenia
            • Dorr C femur
          • outcomes
            • high failure rate
      • Acetabular revision
        • porous-coated hemisphere cup or jumbo secured with screws
          • indications
            • at least 50% of bone stock present to support cup
          • disadvantage
            • jumbo cup may disrupt posterior column with additional bone reamed
            • dislocation
        • porous-coated hemispherical cup with acetabular augments
          • indications
            • bone loss (Paprosky defects Type IIB-C and IIIA-B)
          • outcomes
            • 2 year survivorship 94%-100%
            • 5 year survivorship 92%-100%
            • 10 year survivorship 92%
        • reconstruction cage with structural bone allograft
          • indications
            • rim is incompetent (<2/3 of rim remaining), <50% of bone stock present
          • outcomes
            • allograft failure is the most common complication
            • high failure rate (40-60%) without reconstruction cage due to component migration after graft resorption
        • custom triflange cup
          • indications
            • pelvic discontinuity
        • cemented acetabular components
          • can cement a liner by itself or into a well fixed cup
        • liner options
          • e.g. face changing, oblique, lipped, offset, contrained, dual mobility, etc.
      • Combined revision
        • femoral head and polyethylene exchange
          • indications
            • eccentric wear of the polyethylene with stable acetabular and femoral components
            • acute infection
            • trunnionosis
          • outcomes
            • hip instability is the most common complication of isolated liner exchange
        • conversion from a hip arthrodesis
          • indications
            • low back and knee pain as a result of arthrodesis
          • outcomes
            • implant survival greater than 95% at 10 years
            • competence of abductor and gluteal musculature is predictive of ambulatory success
            • improved ipsilateral knee and back pain
      • Revision without changed modular or nonmodular components
        • ORIF periprosthetic fracture
          • indications
            • fracture with stable components
        • psoas release
          • indications
            • painful psoas with clinical signs of impingement and improvement with lidocaine injection
            • can be completed arthroscopically
        • heterotopic bone excisions
          • indications
            • mature heterotopic bone formation causing pain and restricted range of motion
  • Surgical Techniques
  • Prognosis
flashcard locked
Create a free account or log in to see the cards.
Question
1 of 50
Recon | THA Revision
  • Recon
  • - THA Revision
23:31 min
10/15/2019
1455 plays
3.6
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
(5)
Private Note

Add Colleague
Lab Values
Calculator
Content analytics