Introduction This topic includes heterotopic ossification squeaking blood transfusion Other THA Complication topics periprosthetic infection THA dislocation Iliopsoas impingement periprosthetic fractures THA pseudotumor aseptic loosening limb length discrepancy sciatic nerve palsy THA trunnionosis Vascular injury and bleeding Heterotopic Ossification Introduction frequent complication that may limit functional outcome following hip replacement risk factors prolonged surgical time excessive soft tissue handling during procedure hypertrophic osteoarthritis male gender ankylosing spondylitis Treatment surgical excision indications severe loss of motion once heterotopic ossification is visible on radiographs, only surgical excision will eradicate technique must wait 6 months after initial procedure to allow for maturation and formation of capsule perioperative prophylaxis with perioperative radiation or NSAIDs Prophylaxis oral indomethacin radiation therapy 600-800 cGy administered ideally within 24-48 hours following procedure Squeaking Defined as a high pitched audible sound occurring during hip movement Incidence ceramic-on-ceramic 0.5-10% metal-on-metal 4-5% incidence of revision because of squeaking is 0.5% Risks impingement edge loading component malposition loss of fluid film lubrication third body particles thin, flexible (titanium) femoral stem Postoperative Anemia Low preoperative hemoglobin is the best predictor of the need for a blood transfusion postoperatively Prevention TXA Treatment postoperative transfusion indications most centers have dropped to a hemoglobin of 7-8
QUESTIONS 1 of 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Previous Next (OBQ13.121) A 55-year-old patient returns for followup 2 years after a left ceramic-on-ceramic total hip arthroplasty. He has no pain or symptoms of instability. The video in Figure V shows him ascending stairs. All of the following factors may contribute to this phenomenon EXCEPT QID: 4756 FIGURES: V Type & Select Correct Answer 1 Impingement 5% (220/4096) 2 Edge-loading 7% (306/4096) 3 Loss of fluid film lubrication. 9% (380/4096) 4 Third-body particles 4% (150/4096) 5 Subclinical infection 73% (3007/4096) L 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (SAE07HK.85) A 62-year-old patient is seen for routine follow-up after undergoing cementless total hip arthroplasty 2 years ago. The patient reports limited range of motion that severely affects daily activities. A radiograph is shown in Figure 51. Management should now consist of QID: 6045 FIGURES: A Type & Select Correct Answer 1 observation only. 0% (2/482) 2 nonsteroidal anti-inflammatory drugs and protected weight bearing. 2% (8/482) 3 irradiation to the affected area. 2% (10/482) 4 surgical excision. 14% (67/482) 5 surgical excision and postoperative irradiation. 81% (389/482) L 1 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (SAE07HK.80) Figure 49 shows a histologic section of the lung in a patient who died during total hip arthroplasty. What unexpected finding is seen in the pulmonary capillaries? QID: 6040 FIGURES: A Type & Select Correct Answer 1 Pulmonary embolism 21% (118/568) 2 Methylmethacrylate cement 68% (386/568) 3 Hemorrhagic infarct 8% (43/568) 4 Granuloma formation 1% (6/568) 5 Amyloid 2% (10/568) N/A Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (SAE07HK.47) A 58-year-old patient who underwent bilateral hip arthroplasty 12 years ago now reports pain in his hips and difficulty with ambulation to the point where he now uses crutches. A radiograph of the hip and pelvis is shown in Figure 26. What is the best treatment option for this patient? QID: 6007 FIGURES: A Type & Select Correct Answer 1 Revision hip arthroplasty with a bipolar implant 3% (13/475) 2 Revision hip arthroplasty with impaction grafting on the femoral and acetabular side 6% (29/475) 3 Revision hip arthroplasty with a cemented jumbo acetabular component 35% (165/475) 4 Revision hip arthroplasty with a cementless acetabular component 45% (213/475) 5 Acetabular component revision with a tri-flange protrusio ring 11% (54/475) L 4 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (SAE07HK.41) Figure 23 shows failure of the femoral stem in a patient. What is the most likely reason for the failure? QID: 6001 FIGURES: A Type & Select Correct Answer 1 Torsional loading 6% (32/504) 2 Cantilever bending 78% (395/504) 3 Pistoning 6% (28/504) 4 Subsidence 5% (25/504) 5 Torque 3% (14/504) L 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic
All Videos (11) Podcasts (1) Login to View Community Videos Login to View Community Videos ICJR 8th Annual Revision Hip & Knee Course Pelvic Discontinuity: Distraction with Augments, Plates, Cages, or Custom Implants - Wayne G. Paprosky, MD Wayne G. Paprosky Recon - THA Other Complications 5 days ago 5 views 0.0 (0) Login to View Community Videos Login to View Community Videos ICJR 8th Annual Revision Hip & Knee Course Evaluation of the Spine is Critical in Patients with Recurrent Instability after THA - Jonathan M. Vigdorchik, MD Jonathan M. Vigdorchik Recon - THA Other Complications 5 days ago 8 views 0.0 (0) Login to View Community Videos Login to View Community Videos ICJR 8th Annual Revision Hip & Knee Course Femoral Revisions and THA Complications Discussion Daniel Berry Recon - THA Other Complications 5 days ago 6 views 0.0 (0) Recon⎪THA Other Complications Team Orthobullets 4 Recon - THA Other Complications Listen Now 10:16 min 10/15/2019 199 plays 5.0 (1) See More See Less
Unrecognisable hip implant (C2490) Fares Uddin Recon - THA Other Complications E 1/23/2016 629 8 11 Infected Bipolar-hemiarthroplasty state, hip Lt (C2109) Recon - THA Other Complications E 1/13/2015 178 1 8 Failed cemented total hip replacement (C1878) Naji ullah khan Recon - THA Other Complications E 4/17/2014 334 1 12