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Hip Osteoarthritis
Posted: Aug 13 2024 #(C102551)
A

Left Hip Pain in Muscular 74M

;
Left Hip Pain in Muscular 74M

HPI

This is a 74-year-old male who presents with left hip pain for over two years. He has pertinent history of right THA via posterior approach in 2016 with which he is pleased with the results.

PMH

Past medical history includes atrial fibrillation. A recent cardiac stress test was normal, with an EF of 50%. Past surgical history includes right THA (2016) via posterior approach as above.

PE

On exam, he has a BMI of 34 and a muscular build. His skin is intact. He has a positive Stinchfield. His range of motion is 0-100 flexion, internal rotation of 5 degrees, external rotation of 40 degrees, abduction of 30 degrees, and adduction of 10 degrees. All directions of motion are painful.

Poll
1 of 1
1. If you choose Total hip arthroplasty (THA), what approach would you use?
I would not choose THA
0%
3/655
    • Anterior (Smith-Petersen)
    25%
    165/655
    • Anterolateral (Watson-Jones)
    10%
    67/655
    • Lateral (Hardinge)
    16%
    106/655
    • Posterior (Southern-Moore)
    45%
    298/655
    • Outside my area of expertise - best if I don't vote
    2%
    16/655
    • PROCEDURE #1 DOP: 7/8/2024

    Primary THA with Anterior Approach

    Intra-procedure P1
    icon
    OUTCOMES
    Post-procedure P1
    4 weeks after
    Post-procedure P1
    POLL#
    Surgeon's Choices
    1
    If you choose Total hip arthroplasty (THA), what approach would you use?
    Anterior (Smith-Petersen)
    3
    If you choose THA with an Anterior Approach, what would the surgical setting and post-operative disposition be?
    Hospital - Outpatient
    4
    If you choose THA and were considering outpatient surgery at the ASC, who would evaluate and qualify the patient for outpatient surgery?
    Medical Doctor (Primary Care, Internist) (PC)
    6
    If you choose THA via an Anterior Approach at an ASC, what technology would you use to optimize the position of the components?
    Robot-Assisted Navigation (Robot)
    7
    If you choose THA with an Anterior Approach at an ASC with Robot-Assisted Navigation (Robot), which portions of the procedure do your find the robot to be MOST valuable
    Acetabular reaming
    8
    If you choose THA with an Anterior Approach, which table would you use?
    Specialized Anterior Hip Table (eg., Hana)
    9
    If you choose THA with an Anterior Approach, what would be your implant fixation technique?
    Press-fit Acetabulum + Press-fit Femur
    11
    If you choose Total hip arthroplasty (THA) with an Anterior Approach, would you use a collared stem?
    Yes - I would use a collared stem
    12
    If you choose THA with an Anterior Approach, what bearing surface would you use?
    Ceramic on poly
    13
    If you performed the operation shown at the ASC and sent the patient home, would you give the patient your personal cell phone number?
    No - I would not give my cell phone, just office on-call line
    14
    If you choose the operation shown at the ASC and sent the patient home, what would be your postoperative antibiotic protocol?
    Single Postoperative Dose of IV antibiotics Alone
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