Key Points Neuromuscular hip disorders can be classified as intrinsic or extrinsic. Both types may be spastic or flaccid. Patients with intrinsic neuromuscular disorders (e.g., cerebral palsy and myelomeningocele), or in whom a neuromuscular affliction occurs while the hip is…
Key Points Characteristics common among patients with avascular necrosis (AVN) of the hip: Present at a younger age than patients with osteoarthritis (OA) of the hip Systemic disease or condition associated with the osteonecrosis Abnormal bone quality of the hip…
Key Points Patients with metabolic bone disease have a heterogeneous variety of disorders with very different pathophysiologies and associated decision-making and technical challenges related to hip surgery. The most common metabolic bone problems leading to total hip arthroplasty (THA) are…
Key Points Proximal femoral deformity may be iatrogenic or develop as a consequence of a pathologic process. Treatment of proximal femoral deformity with total hip arthroplasty (THA) is challenging and requires careful preoperative planning. The surgeon considering THA for proximal…
Key Points The primary goals of total hip arthroplasty (THA) in the setting of proximal femoral deformity focus on control of femoral version, restoration of offset, fixation of the implant, achievement of functional and stable range of motion, and restoration…
Key Points Preoperative planning to template implant position and size: The acetabular component should be lateralized to its anatomic location if the inferior hemipelvis has been displaced medially as a result of prior fracture. Identify the sciatic nerve: If the…
Key Points Congenital dislocation of the hip (CDH) and developmental dysplasia of the hip (DDH) are diagnoses that often lead to secondary osteoarthritis at a relatively young age; total hip arthroplasty (THA) has become a safe, effective, and durable treatment…
Key Points The normal stand-to-sit postural change is 20 degrees of posterior pelvic tilt and 55 to 70 degrees of femur flexion—not 90 degrees of hip flexion. Stand-to-sit mobility involves two hinges: the posterior hinge is the lumbosacral junction (sacral…
Key Points Dual mobility combines a low-friction torque arthroplasty with an ultralarge effective femoral head. There are two articulations: small or inner bearing and large or outer bearing. Dual mobility increases jumping distance and ranges of motion. The stem neck…
Key Points Historically, 22.25-, 26-, 28-, or 32-mm metal femoral heads were used in primary total hip arthroplasty (THA), but innovations in materials now permit head sizes 36 mm or larger. Stability and wear of primary THA are related to the…