What other XR can you do to determine amount of extrusion?
What classification do you know?
What is extrusion index?
What are the treatment options in a patient aged 30?
What osteotomy techniques are there?
What arthroplasty techniques are there?
What common problems can be anticipated at THR?
Answer
Describe XR
Dysplastic hip (Crowe type II) ,extrusion,2 OA, coxa valga
What other XR can you do to determine amount of extrusion?
60 deg standing oblique
What classification do you know?
Crowe (JBJS 1979)
I < 50%
II 50 to 75
III 75-100%
IV >100 (high dislocation) False acetabulum
What is extrusion index?
A/A+B x 100 (OA if >31% ie one third extruded)
What are the treatment options in a patient aged 30?
Conservative
Surgical
Osteotomy,arthrodesis,arthroplasty
What osteotomy techniques are there?
Periacetabular osteotomy (Ganz 1983, Muller 1995)
What arthroplasty techniques are there?
Total hip arthroplasty + autograft bone block(Harris 1977)
Impaction BG + mesh
What common problems can be anticipated at THR?
Acetabulum deficiency and small, femoral XS anteversion (80 deg) therefore need modular component or CDH stem(eg SROM dial in anteversion), narrow femoral canal may require extra small components
Limb shortened : can only lenghten 2.5 cm before osteotomy required to protect sciatic nerve in high dislocations
