Surgical Diagnosis
1. Prosthetic loosening and failure
2. Infection
3. Patellofemoral tracking problems
4. Instability
5. Recurrent intra-articular soft-tissue impingement / Component overhang
Nonsurgical Diagnoses
1. Referred pain - Hip / Back
Intrinsic
Infection
Loosening
Thigh pain in uncemented
- micro motion at distal end of stem
- modulus mismatch
Stress fracture / insufficiency fracture
- pubic rami, sacral
Intra-operative fracture
Prosthesis failure
Subtle instability
Extrinsic
Patient
Advanced age
Immunosuppression - steroids / Rheumatoid / DM
Malnutrition - Lymphocyte count / Transferrin / Albumin
Vascular disease
Obesity
Poor skin i.e. psoriasis
Previous infection in joint
Infection elsewhere - i.e. UTi
Prolonged hospital admission
Revision surgery
Operative Factors
Preoperative
Cystic structure lined by a mature capsule of dense fibrous tissue
- contains thick viscous fluid with a high mucopolysaccharide content
- fluid is a myxoid degeneration of synovial fluid
Most common in young females
- peak age 15-30
- F:M = 3:1
Most common tumour in hand (2/3)
Unclear
Simple Bone Cyst
A simple bone cyst is a solitary cavity containing clear fluid
- originating in the metaphysis of growing children
- adjacent to the metaphyseal aspect of the growth plate.
Unknown pathological origin
Joint inflammation secondary pyogenic organism
All age groups
Usually children
- 50% < age 3
M= F
Any joint
- Infants = Hip
- Children = Knee
- Adults = Large Joints
IVDU - SCJ & SIJ
Two Routes