Key Points Successful reconstruction of the acetabulum during revision total hip arthroplasty requires a thorough understanding of host bone defects. In an attempt to better define these defects, classification systems are used. The most commonly used systems are the American…
Key Points Osteolytic lesions of the pelvis that progress over a 3- to 6-month period in patients with osseointegrated cementless sockets are an indication for operative treatment. Severe polyethylene wear may justify a lower threshold for treatment because it is…
Key Points Ensuring maximum possible intact host bone following implant removal provides an optimum platform on which to build a successful hip reconstruction. Successful implant removal depends on careful preoperative planning, which cannot be separated from planning for subsequent hip…
Key Points Preoperative planning begins with a thorough history and physical examination to determine the cause and location of hip pain, the general medical condition of the patient, and the functional goals of the patient. Radiographic evaluation is helpful in…
Key Points A thorough history and physical must be performed when evaluating a patient with a symptomatic total hip arthroplasty (THA) to establish an accurate diagnosis. The clinician needs to differentiate between intraarticular and extraarticular causes of pain. Ruling out…
Key Points Bipolar/monopolar hemiarthroplasty treatment for displaced femoral neck fractures is best in the elderly population with comorbidities. Total hip arthroplasty for displaced femoral neck fractures is best in healthier, more active, and younger patients for management of displaced femoral…
Key Points Careful preoperative planning, along with pharmacologic consultation, is essential for optimal results in obese patients undergoing total hip arthroplasty (THA). Early postoperative mobilization, although possibly more difficult for obese patients, is critical to avoid decline in function as…
Key Points Sickle cell disease is a systemic disorder that requires a thorough preoperative evaluation in close coordination with multiple comanaging services. Preoperative blood transfusion according to a standardized protocol managed by an experienced hematologist may reduce the risk of…
Key Points The clinical signs of protrusio acetabuli are groin pain, limited hip abduction and, often, a hip flexion contracture. Deepening of the acetabulum leads to painful limitation of abduction as the femoral neck impinges on the superior acetabular margin.…
Key Points Conversion of a previously arthrodesed hip to total hip replacement is indicated for pain relief in surrounding joints (low back, ipsilateral knee, contralateral hip). However, patients may also seek conversion because of the disability related to an immobile…