Most common
- fascia lata on greater trochanter
- iliopsoas on lesser trochanter
1. Intra-articular structures
- labrum
- ligamentum Teres
- loose bodies
- synovial chondromatosis
- osteochondoma
2. Extra-articular structures
- fascia lata on greater trochanter (common)
Dorsal
- most common
Volar
1. Acute traumatic peripheral tear TFCC with DRUJ dislocation
- usually major trauma
- dorsal or volar
2A. Distal radial fracture
Volar Intercalated Segmental Instability
- secondary to injury to the lunate-triquetral ligament
Less common
Caused by fall on outstretched extended wrist
- hypothenar eminence strikes ground first
- isolated LT ligament injury
Can be part of perilunate dislocation
- SL heals
- residual LT laxity
Chronic massive rotator cuff defect
- uncovered humeral articular cartilage
- high riding humeral head
- abrasion by undersurface of coracoacromial arch
Neer
- introduced term "cuff tear arthropathy"
- included significant rotator cuff diagnosis & arthritis in older patients
- especially women
- synovial fluid contained calcium phosphate crystals + proteases
Mid-substance calcification of the rotator cuff
- part of a metaplasia secondary to hypoxia
2 groups of patients
Failure of fusion of adjacent ossification centers
Incidence 3%
Bilateral in 60%
4 ossification centers present in acromion
- pre-acromion
- mesoacromion
- metaacromion
- basiacromion
Increased pressure within a closed fibro-osseous space
Seen in athletes, associated with repetitive exertion
Leg
1. Anterior compartment
- anterior tibial artery
- deep peroneal nerve
Patient
Advanced age
Immunosuppression - steroids / Rheumatoid / DM
Malnutrition - Lymphocyte count / Transferrin / Albumin
Vascular disease
Obesity
Poor skin i.e. psoriasis
Previous infection in joint
Infection elsewhere - i.e. UTi
Prolonged hospital admission
Revision surgery
Operative Factors
Preoperative
Progressive and chronic disorder associated with cord cavitation & gliosis
Muscle wasting
Dissociate anaesthesia
Scoliosis
Neuropathic arthropathy
M > F
No familial tendency
1. Idiopathic
Abnormality of type 1 collagen
- amino acid substitution of glycine with another amino acid
- prevents triple helix formation
Many many deformities described
- some 286 mutations of Type 1 collagen described
There are actually now 7
Type I
- mild
- AD
- blue sclera