OA

Complications

Types

Chondrolysis

AVN

Indications for THA

Osteoarthritis

- abnormal morphology

- loss of head neck offset

- bony impingement on acetabulum

AVN

History

First generation (late 70s early 80s) 

Results

Deformity

Varus / extension / external rotation

Options

Intertrochanteric

Base of Neck

Subcapital

Osteotomy

Valgus / flexion / internal rotation

Intertrochanteric / Southwick 

Technique

- biplanar

- valgising / flexion / internal rotation 

Definition

Displacement of proximal femoral epiphysis in the immature hip

- due to imbalance of mechanical and endocrine factors 

Epidemiology

Age Peak Incidence : M 12-14; F 11-13; Slight downward trend due to earlier maturation of children

L hip > R

10 / 100 000

Bilateral SUFE

No endocrine abnormality

- 20% at time of of diagnosis

- another 20% during diagnosis

- up to 60% with long term follow up

Epidemiology

Male & Females > 60 years

- X-ray evidence of OA

Symptomatic 

- 25% females

- 15% males

Affected joints

Base thumb

PIPJ / Bouchard's nodes

DIPJ / Heberden's nodes

Epidemiology

Relatively rare

Average age 50

Men 4:1 Women

Usually dominant arm

Aetiology

Primary

- associated with strenuous manual labour

Secondary

- trauma

- OCD

- synovial chondromatosis

- valgus extension overload / MCL insufficiency

Definition

Body Fracture

- fracture line exits inferior surface behind lateral process

- into posterior facet

- intra-articular body fracture

Neck Fracture

- fracture line exits inferior surface anterior to lateral process

- in front of sinus tarsi

- extra-articular neck fracture

Types

1.  Shear

2.  Crush

3.  Posterior Process