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

May 03, 2023 179 likes •320 views

3/9/2018 Hip Case Presentations Travis G. Maak, MD Department of Orthopaedics Hip & Knee Preservation Service Disclosure I (and/or my coauthors) have something to disclose. Detailed disclosure information is available via: The

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3/9/2018 1 Travis G. Maak, MD

Department of Orthopaedics Hip & Knee Preservation Service

Hip Case Presentations

I (and/or my co‐authors) have something to disclose.

Detailed disclosure information is available via:

  • The course syllabus, or
  • n the AAOS website at

http://www.aaos.org/disclosure

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
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3/9/2018 2

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3/9/2018 3 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
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3/9/2018 4

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3/9/2018 5 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
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3/9/2018 6

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3/9/2018 7

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3/9/2018 8 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
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3/9/2018 9

  • 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

Case #3

Right Hip LCEA: 18 Tonnis: 4 False Profile ACEA: 28 45 Degree Dunn Lateral

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3/9/2018 10

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3/9/2018 11

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3/9/2018 12

Thank You