The most common type is osteoarthritis (OA), a non-inflammatory arthritis. There is a complete deficiency of the acetabulum and excessive anteversion of the true acetabulum.There are many kinds of arthritis that can affect the hip joint and make it difficult to do everyday activities. Inadequate depth of the true acetabulum.įemoral head is completely uncovered by the true acetabulum and has migrated superiorly and posteriorly. There is complete absence of the superior wall. Inadequate true acetabulum depth.įemoral head creates a false acetabulum superior to the true acetabulum. Segmental deficiency of the superior wall. hip arthrodesis if very young patient in a labor intensive occupationįemoral head within acetabulum despite some subluxation.contraindicated in underlying disease process or chronic steroid use causing AVN (poor bone quality) and renal disease (metal ions from metal-on-metal implant).requires adequate bone to support resurfacing component.in advanced DJD with small, isolated focus of AVN.rotational osteotomy if small lesions (40 with large lesions.early AVN, before subchondral collapse occurs.core decompression with or without bone grafting if.nonoperative treatment acceptable if precollapse AVN (Ficat stages 0-II).Steinberg Classification (modification of Ficat classification) grade 3 = large cysts in femoral head/acetabulum, joint space obliteration/severe narrowing, severe femoral head deformity vs.grade 2 = small cysts in femoral head/acetabulum, moderate joint space narrowing, moderate loss of head sphericity.grade 1 = sclerosis of femoral head + acetabulum, slight joint space narrowing, slight lipping at joint margins.OA posterior increased = anterior convexityĭistance between line parallel to femoral neck through anterior femoral neck + anterior femoral head divided by diameter of femoral headĭisplacement of femoral head from reference circleĪnterior center-edge angle/angle of lequesneĪngle between vertical line through femoral head + line along femoral head/anterior acetabulumĪssesses anterior coverage can have crossover sign but no posterior wall deficiency Minimum distance between femoral head + acetabulum Hip instability > 10° pincer-type FAI 10 mm femoral headĬoxa profunda = acetabular floor touches/medial to ilioischial line protrusion acetabuli = femoral head touches/medial to ilioischial lineĪcetabular inclination/acetabular roof angle of tonnisĪngle between line through inferior sourcil parallel to inter-teardrop line + line from inferior to lateral sourcil Relationship of ilioischial line with acetabular floor vs. % of femoral head not covered by acetabulum Lateral center-edge angle/angle of wibergĪngle between vertical line through femoral head + line along lateral acetabulumĪssesses superolateral coverage: dysplasia 40 ° Line along inferior ischial tuberosity + line along superior aspect of lesser trochanterĪngle between femoral neck + femoral shaft demonstration of bullet sign = superimposition of ischial tuberosity.too much ER leads to nonvisualization of lesser trochanter.visualization of greater trochanters in profile.symmetrical obturator foramen + iliac wing concavity.no overhang of greater trochanter over posterior margin.
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