outcomes

Hip arthroscopy

Indications

Labral tear

Cam / pincer impingement

Loose bodies / trauma / synovial proliferation

Issues

Operative v Nonoperative

Levy et al Arthroscopy 2009

- systematic Review

- improved outcomes with operative management

https://pubmed.ncbi.nlm.nih.gov/19341932/

Vicenti et al. Injury 2019

- systematic review

- two studies compare operative v nonoperative

Distal Tibial Fractures

Definition

Metaphyseal

Extra-articular

Intra-articular Extension

Patella Baja

Aetiology

Congenital

Acquired

- trauma

- post ACL reconstruction / TKR

- chronic quadriceps rupture

Issues

Decreases ROM

Associated with early OA of the PFJ

Diagnosis

Blackburne-Peel ratio at 30 degrees flexion

Definition

Facet joint dislocations secondary flexion distraction injury

Epidemiology

10%

Stages

1. Unifacet subluxation - interspinous process widening

2. Unifacet dislocation - 25% anterolisthesis

3. Bifacet dislocation - 50% anterolisthesis

4. Complete vertebral translation - 100% anterolisthesis

Unilateral Facet Joint Dislocation

Mechanism

1. Direct lateral blow to patella

- usually with knee partly flexed and quadriceps relaxed

2.  Indirect low energy injury

Concept

Femur

- removal of femoral head cartilage

- resurfacing with metal

- cemented / uncemented

Acetabulum

- standard technique

Bearing surface

- metal on metal

Indications

Relatively young man (40 - 50)

OA

Types

Age 0 - 5

- Salter Harris I

Age 5 - 11

- Salter Harris II

III / IV rare

Issues

Great remodelling potential

- 80% growth of humerus from proximal physis

Shoulder ROM compensatory

Age

- even older adolescents do well