complications

Indications for THA

Osteoarthritis

- abnormal morphology

- loss of head neck offset

- bony impingement on acetabulum

AVN

Acetabular trauma and PTOA

Definition

Unstable injuries

Complete disruption of both the anterior and posterior ring

Complications

Subscapularis failure

Rotator cuff failure

Instability

Infection

Periprosthetic fracture

Aseptic loosening

Neurological injury

Incidence

Parada et al. J Should Elbow Surg 2021

- 2224 aTSA complication rate 11%, revision rate 5.6%

Indications

Osteoarthritis

Rheumatoid arthritis

Avascular necrosis

Indications

Poor soft tissues

- prohibit ORIF

Non union

Infected non uniion

Malunion / deformity

Bone loss / bone transport / LLD

Concept

Distal Tibial Fractures

Definition

Metaphyseal

Extra-articular

Intra-articular Extension

Epidemiology

Adolescent boys

Ossification

Proximal tibia / primary ossification centre

Tibial tuberosity / secondary ossification centre

- eventually merges with primary ossification centre

Ogden Classification

Type I - Tibial tuberosity ossification only

Ossification

3 - 5 years old

Management

Undisplaced

- manage in plaster in extension

Displaced > 3 mm

- ORIF

Patella sleeve fracture

- usually small inferior fragment seen on xray

- patella high riding on xray / alta

- is actually large cartilaginous fragment avulsed with retinaculum

- can be osteochondral