I (and/or my coauthors) have something to disclose. Detailed - PDF document

3/9/2018 Hip Case Presentations Travis G. Maak, MD Department of Orthopaedics Hip & Knee Preservation Service Disclosure I (and/or my co‐authors) have something to disclose. Detailed disclosure information is available via:  The course syllabus, or on the AAOS website at http://www.aaos.org/disclosure Case #1 • 32 y/o male c/o R groin pain • Reports that he had anterior groin pain for > 2 years • Pain with stairs, deep squats, sitting for prolonged periods, difficulty playing basketball • He denies instability • Hip is painful, no Instability • Refractory to PT, NSAIDs 1

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3/9/2018 CT Calculations • CCEA: 29 degrees • SCEA: 57 degrees • Acetabular Version • @1: 6 degrees • @2: 18 degree • @3: 18 degrees • Max alpha angle: 72 degrees @ 1 o’clock • Femoral version: 22 degrees anteversion 3

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3/9/2018 Case #2 32 y/o male h/o left hip / groin pain for 10 years • • 4 yrs s/p open surgical dislocation with trochanteric flip, acetabuloplasty, femoral osteochondroplasty 3 yrs s/p ROH (screws) • Pain is worse since surgery and occurs with all activities including • ambulation and sitting for a prolonged period Currently uses a cane for ambulation (did not require pre‐op) • Case #2 • PE: • L hip • IR: 5 ER: 50 FF: 110 • + Stinchfield • + FADIR (groin and buttock pain) • +Subspine • Negative apprehension • Negative extrarticular impingements signs 5

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3/9/2018 CT Calculations • Cor CEA: 21 degrees • Sag CEA: 66 degrees • Acetabular Version • @1: ‐8 degrees • @2: 3 degree • @3: 8 degrees • Max alpha angle: 60 degrees @ 2 o’clock • Femoral version: 10 degrees anteversion 8

3/9/2018 Case #3  35 y/o female one year s/p right hip arthroscopy for CAM FAI – Femoral Osteochondroplasty – Labral Repair – No psoas lengthening – No capsular repair of interportal capsulotomy  c/o groin pain sitting and standing and hip ”slips around”  PT performed for 6 months post‐op with no relief  Pre‐op pain is slightly improved but current pain and instability is new and worse than pre‐op Right Hip LCEA: 18 Tonnis: 4 False Profile 45 Degree ACEA: 28 Dunn Lateral 9

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3/9/2018 Thank You 12