Key Points While the etiology of heterotopic ossification (HO) is diverse, it most commonly occurs through a process of endochondral ossification after operative procedures about the hip. While HO is typically only a radiographic finding without clinical consequences, clinically meaningful…
Key Points Choice of anticoagulation, body mass index, and high drain output are significant risk factors for persistent wound drainage and subsequent infection. Irrigation and debridement of hip wounds with persistent drainage within 14 days of the index total hip…
Key Points Neurologic Injuries Know inherent risks and special considerations for each patient in order to predict and avoid complications. Once inherent risks are known, take intraoperative steps to avoid injury to the nervous or vascular structures at risk. Early…
Key Points Preoperative assessment of leg length inequality should include a history, physical examination, and radiographic evaluation, including templating. Preoperative education of the patient should include discussion of the patient's perception of leg length discrepancy and a discussion of the…
Key Points Early detection of intraoperative and postoperative trochanteric problems is important to optimize chances of successful treatment. Trochanteric claw plates with locking screws and cables have shown promising results in the fixation of trochanteric fractures and nonunions. Trochanteric bursitis…
Key Points The diagnosis of periprosthetic fractures is based on the history, physical examination, and radiographic evaluation. Attempts should be made to identify underlying causes of the fracture, if any. Use of a classification system helps the surgeon better understand…
Key Points Instability is one of the most common indications for revision total hip arthroplasty in the United States. The cost burden for treating dislocation is substantial. Multiple risk factors for instability are known, including patient-specific (female gender, increasing age,…
Key Points Periprosthetic infection with a total hip arthroplasty occurs at a rate of approximately 0.5% to 1%; the prevalence will increase substantially as the volume for this procedure grows to meet the projected demand. Prevention relies on optimizing patient…
Key Points Awareness of metal-on-metal (MOM) failure and taper corrosion has increased and requires special consideration. Regular surveillance of MOM articulations is recommended. Thorough assessment is required to evaluate all common causes of postarthroplasty hip pain. A systematic diagnostic approach…
Key Points Revision of the femoral component in patients with failed total hip replacement with significant proximal femoral bone loss of more than 5 cm distal to the lesser trochanter may be accomplished by the use of allograft prosthetic composite (APC)…