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Hip Replacement (Contraindications (Chronic osteomyelitis, Significant…
Hip Replacement
Contraindications
Chronic osteomyelitis
Significant loss of bone after resection of malignant tumor
Systemic/septic infection
Inadequate bone stock
Active jt. infection
Neuropathic hip joint
Severe paralysis of muscles surrounding hip joints
Indications
Hip Instability
Bone tumors
Non-union fx
Failure of conservative mgmt. or previous surgeries
Severe hip pain
Methods of fixation
Cementless
Hybrid
Cemented
Press-fit
Anterior/Anterolateral Approach Precautions
External rotation >45 deg
Excessive Hyperextension
Adduction beyond midline
Hip flexion >80-90 deg
Pathophysiology
II. Late stage Deteriorations
Osteotomy
Arthroplasty
III. Salvage Procedure
Arthrodesis
I. Small-to-medium Deterioration
Resection
Osteoplasty
Capsulorraphy
Arthroplasty
Total
Hip resurfacing
Parial
Universal Precautions
Adduction beyond midline
Internal and External rotation >45 deg
Hip flexion >80-90 deg
Posterior/Posterolateral Approach Precautions
Internal rotation >45 deg
Hip flexion >80-90 deg
Adduction beyond midline
Rehabilitation Program Stages
II. Bedside walker or Parallel bar activities
III. Ambulation outside parallel bars with AD
I. Early Post-op bed level activities
Surgical Approaches
Traditional
Anterior/Anterolateral
Direct lateral
Posterolateral
Minimally Invasive
Single incision
Two incision