MSD&D Hip

MSD&D Hip

1. Bony Fractures

   • NoF
     • Avascular necrosis
     • ORIF, HA, THA
   • Acetabular
     • Treatment- Birmingham resurfacing
     • Cause-trauma, blunt forces transferred through to bone
   • Dislocation
     • Can lead to lots of soft tissue damage
   • Stress fracture
     • Cause- overuse, osteoporosis, tumour
       • Treatment- ORIF, POLICE and exercise
         • But eases with rest
   • Innominate
     • ORIF
     • Fuse the SIJ

2. Developmental Disorders

   • Dysplasia
     • Compromised growth plates, which lead to abnormalities
     • Likely to need surgery
   • Perths disease
     • Complex disorder
       • Normal growth to begin then the blood supply to the head of the femur is interupted
         • Necrosis
     • Cylindrical condition
       • WIll try to heal itself
     • Treatment= Casting/bracing, anti-inflam meds
   • Slipped upper femoral epiphysis
     • Weakening of the growth plate
     • Several contributory factors
     • Treatment is aimed at preventing further slipping
       • IF
       • Avoiding avascular necrosis

3. Tumors

   • Ewings Sarcoma
     • Found in the pelvis and long bones
     • Genetic tumor
     • Affects bones or tissue around the bones
     • Found through X-rays, blood tests
   • Treatment
     • Surgery to remove the tumor
       • Radiotherapy, or chemotherapy
   • Osteosarcoma
     • Malignant bone tumor
     • Develops during rapid growth
     • More prevalent in the young
     • Rare

4. Soft tissue

   • Vascular aneurysm
     • Femoral artery
   • Hernia
     • Weakness of posterior inguinal wall
       • Managed with a mesh insert
         • + Core work and adductor rehab
   • Labiral Tears
     • Causes- developmental disorders
       • Twisting, pivoting movements
     • MRI to confirm
     • Need to promote muscular control around hip
   • Trochanteric Bursitus
     • Rare, hip pain radiating from affected side
       • Inflammation of the bursa, under the ITB
         • Treatment- anti-inflam, injections or physical therapy
   • Ilio-psoas bursitis
     • Largest bursa in the body
       • Linked to overuse of hip flexion activities
         • Stretching and strengthening combined with anti-inflam med
   • Adductor strain
     • Common football injury
       • Overstretch of muscle
     • Grade of strain depends on prognosis

5. Joint replacement

   • Cemented or Uncemented
     • Cemented = older patients, less need for replacement
     • Cementless= micropores that new bone grow into.
   • THR- both the acetabulum and femoral head replaced
     • Thompson protheisis
   • Hemiarthroplasty
     • Just the femoral head replaced
       • Thompson prothesis
   • Birmingham hip resurfacing
     • New aceatabulum and femoral head
     • Metal-on-metal
     • better longevity
       • able to keep more of the bone
   • Hybrid
     • One component cemented, one component uncemented