-
Select a Community
- MB 1 Preclinical Medical Students
- MB 2/3 Clinical Medical Students
- ORTHO Orthopaedic Surgery
-
About Bullet Health
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Painful Blinded Cup Arthroplasty in 61M with DDH
HPI
A 61-year-old male, married office worker presents with LEFT hip pain and leg length discrepancy. He has a history of left hip DDH treated as a child with hip spica casting. He underwent left femoral derotational osteotomy in 1969, which was complicated by S. aureus infection treated with I&D. He then had cup arthroplasty of the left hip in 1974, and left femoral lengthening in 2000. He did quite well with his left hip until ~ 2-3 years of progressively worsening pain and now wears a 1.5-inch (3.8 cm) shoe lift on his left. A comprehensive workup for infection was performed. Labs include an ESR of 2 and CRP of 3.2. Left hip aspiration revealed 260 WBC with 60% PMN, Negative Alpha defensin, and Cultures with NGTD at 21 days.
PMH
Past Medical History: Non-smoker, DDH-left, Hyperthyroidism, IBS, GERD, L distal femur chondrosarcoma Past Surgical History 1. s/p DFR, 2018 for L distal femur chondrosarcoma 2. L rev TKA for tibial component loosening 07/2020 3. Left hip resurfacing, derotational osteotomy, lengthening, RTHA, RTKA Allergies: Hydrocodone, Seasonal
PE
Positive Stinchfield’s test. Pain with log rolling of the left hip. Limited ROM. NVI. Left lower extremity is 5cm shorter than right.
Conversion to hybrid total hip arthroplasty. Lower center of rotation closer to native acetabulum and use highly porous hemispherical cup, bone graft vs. superior augments if needed. Cemented stem for Dorr C bone and to control version, length, and offset
Please Login to Vote and See All Expert Comments