outcomes
Hip Arthroscopy
Hip arthroscopy
Indications
Labral tear
Cam / pincer impingement
Loose bodies / trauma / synovial proliferation
Surgical management
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
Distal Tibial Fractures
Definition
Metaphyseal
Extra-articular
Intra-articular Extension
Patella Baja
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
Facet Joint Dislocation
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
Acute Patella Dislocation
Mechanism
1. Direct lateral blow to patella
- usually with knee partly flexed and quadriceps relaxed
2. Indirect low energy injury
Resurfacing
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
Proximal Humeral Fractures
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
Schwannoma
Definition
Schwannoma
- benign tumour of nerve sheath
Epidemiology
Less common than neurofibroma
- occurs in adults
- can occur along any peripheral nerve
- also can occur along a nerve root
Usually a large nerve
More common in forearm
Seen in NF 2
- acoustic Schwannoma