Podcast
Questions and Answers
Which of the following structures is NOT considered a primary stabilizer of the hip joint?
Which of the following structures is NOT considered a primary stabilizer of the hip joint?
- Acetabular labrum
- Strong capsule
- Ligamentum teres
- Iliopsoas muscle (correct)
The hip joint is classified as which type of joint based on its structure and movement?
The hip joint is classified as which type of joint based on its structure and movement?
- Condyloid joint
- Pivot joint
- Ball and socket joint (correct)
- Hinge joint
In osteoarthritis of the hip, pain is typically described as:
In osteoarthritis of the hip, pain is typically described as:
- Exacerbated by activity and relieved by rest (correct)
- Worse in the morning and improves with activity
- Constant and unremitting, even at rest
- Sharp, shooting pain radiating down the leg
Which of the following is typically considered the initial management strategy for osteoarthritis of the hip?
Which of the following is typically considered the initial management strategy for osteoarthritis of the hip?
A patient with advanced osteoarthritis of the hip is considering hip replacement surgery. What is a typical expected outcome regarding pain relief?
A patient with advanced osteoarthritis of the hip is considering hip replacement surgery. What is a typical expected outcome regarding pain relief?
Which surgical approach to the hip is most likely to be associated with a higher risk of posterior hip dislocation?
Which surgical approach to the hip is most likely to be associated with a higher risk of posterior hip dislocation?
Which of the following is an intraoperative complication specifically related to cemented hip arthroplasty?
Which of the following is an intraoperative complication specifically related to cemented hip arthroplasty?
Which of the following is a late postoperative complication following hip arthroplasty?
Which of the following is a late postoperative complication following hip arthroplasty?
What is the most common type of hip fracture in the elderly population?
What is the most common type of hip fracture in the elderly population?
An intracapsular neck of femur fracture is concerning due to the risk of avascular necrosis (AVN). Which of the following is a primary reason for this increased AVN risk?
An intracapsular neck of femur fracture is concerning due to the risk of avascular necrosis (AVN). Which of the following is a primary reason for this increased AVN risk?
According to the Garden classification for intracapsular neck of femur fractures, a Garden III or IV fracture is considered:
According to the Garden classification for intracapsular neck of femur fractures, a Garden III or IV fracture is considered:
In the management of a displaced intracapsular neck of femur fracture in an elderly patient with limited life expectancy, which surgical option is often preferred?
In the management of a displaced intracapsular neck of femur fracture in an elderly patient with limited life expectancy, which surgical option is often preferred?
What is the primary concern regarding the 'femoral calcar' in intertrochanteric fractures?
What is the primary concern regarding the 'femoral calcar' in intertrochanteric fractures?
According to the Evans classification of intertrochanteric fractures, which type is considered unstable due to loss of posterolateral support?
According to the Evans classification of intertrochanteric fractures, which type is considered unstable due to loss of posterolateral support?
Subtrochanteric fractures are defined as fractures occurring within what distance below the lesser trochanter?
Subtrochanteric fractures are defined as fractures occurring within what distance below the lesser trochanter?
In pre-hospital care for a suspected hip fracture, what is a key initial step in the integrated care pathway?
In pre-hospital care for a suspected hip fracture, what is a key initial step in the integrated care pathway?
According to BOA Blue Book Guidelines, patients with hip fractures should ideally be admitted to an acute orthopaedic ward within what timeframe of hospital presentation?
According to BOA Blue Book Guidelines, patients with hip fractures should ideally be admitted to an acute orthopaedic ward within what timeframe of hospital presentation?
What is a typical radiographic finding in osteoarthritis of the hip?
What is a typical radiographic finding in osteoarthritis of the hip?
In rheumatoid arthritis of the hip, which radiographic feature is most indicative of the inflammatory nature of the condition?
In rheumatoid arthritis of the hip, which radiographic feature is most indicative of the inflammatory nature of the condition?
For diagnosing Developmental Dysplasia of the Hip (DDH) in infants younger than 6 months, which imaging modality is preferred?
For diagnosing Developmental Dysplasia of the Hip (DDH) in infants younger than 6 months, which imaging modality is preferred?
A lateral center edge angle (Wiberg angle) of less than 15 degrees on hip radiograph is indicative of:
A lateral center edge angle (Wiberg angle) of less than 15 degrees on hip radiograph is indicative of:
What does the term 'femoral head extrusion index' in DDH refer to?
What does the term 'femoral head extrusion index' in DDH refer to?
Pelvic osteotomies, such as the Bernese periacetabular osteotomy, are primarily performed to treat:
Pelvic osteotomies, such as the Bernese periacetabular osteotomy, are primarily performed to treat:
Slipped Upper Femoral Epiphysis (SUFE) is characterized by slippage of the metaphysis relative to the epiphysis at which anatomical location?
Slipped Upper Femoral Epiphysis (SUFE) is characterized by slippage of the metaphysis relative to the epiphysis at which anatomical location?
What is the typical initial treatment for Slipped Upper Femoral Epiphysis (SUFE)?
What is the typical initial treatment for Slipped Upper Femoral Epiphysis (SUFE)?
Femoroacetabular Impingement (FAI) is best described as:
Femoroacetabular Impingement (FAI) is best described as:
Which imaging modality is considered most useful for assessing chondral and labral damage in Femoroacetabular Impingement (FAI)?
Which imaging modality is considered most useful for assessing chondral and labral damage in Femoroacetabular Impingement (FAI)?
In Femoroacetabular Impingement (FAI), 'Cam' impingement primarily involves:
In Femoroacetabular Impingement (FAI), 'Cam' impingement primarily involves:
Hip arthroscopy for Femoroacetabular Impingement (FAI) is most likely to provide a better outcome in patients:
Hip arthroscopy for Femoroacetabular Impingement (FAI) is most likely to provide a better outcome in patients:
According to the Irish Hip Fracture Database, approximately what percentage of patients with hip fractures are discharged directly home?
According to the Irish Hip Fracture Database, approximately what percentage of patients with hip fractures are discharged directly home?
Flashcards
Hip Joint
Hip Joint
A ball and socket joint between the head of the femur and the lunate surface of the acetabulum.
Acetabular Labrum
Acetabular Labrum
A fibrocartilaginous ring that attaches to the bony rim of the acetabulum, encircling the hip joint.
Ligamentum Teres
Ligamentum Teres
A ligament that originates from the non-articular acetabular fossa and inserts onto the head of the femur, providing stability to the hip joint.
Hip Ligaments
Hip Ligaments
Signup and view all the flashcards
Hip Joint Capsule Weakness
Hip Joint Capsule Weakness
Signup and view all the flashcards
Bony congruety
Bony congruety
Signup and view all the flashcards
Osteoarthritis of the Hip
Osteoarthritis of the Hip
Signup and view all the flashcards
Initial OA Management
Initial OA Management
Signup and view all the flashcards
Radiology of the hip
Radiology of the hip
Signup and view all the flashcards
Hip Arthroplasty
Hip Arthroplasty
Signup and view all the flashcards
Intracapsular Fracture
Intracapsular Fracture
Signup and view all the flashcards
Garden Classification
Garden Classification
Signup and view all the flashcards
Undisplaced femur fracture management
Undisplaced femur fracture management
Signup and view all the flashcards
Displaced Femur Fracture
Displaced Femur Fracture
Signup and view all the flashcards
Avascular Necrosis (AVN)
Avascular Necrosis (AVN)
Signup and view all the flashcards
Extracapsular Fracture
Extracapsular Fracture
Signup and view all the flashcards
Subtrochanteric Fracture
Subtrochanteric Fracture
Signup and view all the flashcards
Femoral calcar
Femoral calcar
Signup and view all the flashcards
Evans Classification
Evans Classification
Signup and view all the flashcards
Emergency Hip Fracture Pathway
Emergency Hip Fracture Pathway
Signup and view all the flashcards
Hip X-rays
Hip X-rays
Signup and view all the flashcards
Osteoarthritis Features
Osteoarthritis Features
Signup and view all the flashcards
Rheumatoid arthritis features
Rheumatoid arthritis features
Signup and view all the flashcards
Developmental Dysplasia of the Hip
Developmental Dysplasia of the Hip
Signup and view all the flashcards
DDH Diagnosing Dysplasia
DDH Diagnosing Dysplasia
Signup and view all the flashcards
Total Hip Arthroplasty
Total Hip Arthroplasty
Signup and view all the flashcards
Slipped Upper Femoral Epiphysis
Slipped Upper Femoral Epiphysis
Signup and view all the flashcards
Femoroacetabular Impingement
Femoroacetabular Impingement
Signup and view all the flashcards
FAI Hip Improvement
FAI Hip Improvement
Signup and view all the flashcards
FAI Aims
FAI Aims
Signup and view all the flashcards
Study Notes
- With this lecture, THEP 1 Anatomy & Clinical MSK lectures need to be revised
- Must understand hip pathologies
- Must understand the investigation and management of hip pathologies
Anatomy of the Hip
- Ball and socket joint is between the head of the femur and the lunate surface of the acetabulum
- The acetabular labrum encircles
- The ligamentum teres from the non-articular acetabular fossa to the head provides stability
- There is a strong capsule
- Iliofemoral, Ischiofemoral & Puboferoral Ligaments provide extra articular stability
- The capsule is strong and attached along the edge of the acetabulum and transverse acetabular ligament proximally
- Distally attached along intertrochanteric line anteriorly and 1.5cm proximal to intertrochanteric crest posteriorly
- The capsule is weaker posteriorly, so dislocation is prone to happen in that direction in high energy trauma
Stability of Hip Joint
- Bony congruety and acetabular labrum provide stability
- Strong ligaments assist stability
- Surrounding muscles provide dynamic stabilisation
Common Hip Joint Pathologies
- Arthritis, predominantly Osteoarthritis, and Rheumatoid Arthritis mainly managed by Rheumatology
- DMARDs demonstrate huge success in modern medicine
- Fractures of the hip are common
- Hip replacement surgery can provide some complications
- DDH: Developmental Dysplasia of the Hip
- SUFE: Slipped Upper Femoral Epiphysis
- FAI: Femoro Acetabular Impingement
Osteoarthritis of the Hip
- Commonly presents in patients over 40 years old
- Pain is the most common presenting symptom
- Pain is usually exacerbated by activity and relieved by rest
- As the disease process advances, pain may progress to night pain, and functional activity may become limited
- There is usually associated groin pain
Clinical Examination of the hip
- Gait assessment is required
- Involves FABER
- And FAIR tests
- Pain assessment at extremes of ROM
- History of paediatric hip
Radiology and investigations
- Plain film X Ray / Radiograph in the majority of cases
- MRI
- MR Arthrogram
Initial Management of OA
- Rest is key
- Modify activities to reduce strain
- Reduce impact sports
- Use NSAIDs to manage pain
- Physio for core stability and hip girdle exercises
- Weight loss
Definitive Management
- Hip replacement has a very high success rate
- Low complication rate
- Provides excellent pain relief
- Length of stay is 2-3 days
- 25 year survivorship is 78%: >80 years, 100%: <40 years, 67%
Outcomes
- Patient satisfaction is 90% at 4 years
- Implant survival is 95% at 20 years (>65 years) and risk of major complication <5%
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.