By Daniel J. Berry MD, Scott P. Steinmann MD, Paul Tornetta III MD, Thomas A. Einhorn MD

Written via prime specialists from the Mayo health center, this quantity of our Orthopaedic surgical procedure necessities Series provides the entire info citizens want on hip, knee, shoulder, and elbow reconstruction in adults. it will possibly simply be learn conceal to hide in the course of a rotation or used for fast reference ahead of a sufferer workup or operation. The uncomplicated, visually stimulating structure beneficial properties considerable illustrations, algorithms, bulleted lists, charts, and tables.

Coverage of every sector contains actual overview and imaging, review and remedy of problems, and operative remedy tools. The wide insurance of operative therapy contains basic and revision arthroplasty and possible choices to arthroplasty.

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Cls March 19, 2007 Chapter 2 / Imaging of the Hip A 15 B Figure 2-19 Radiographs (A) and T1-weighted magnetic resonance imaging (B) of a 50-year-old man with bilateral avascular necrosis of the hips. The evaluation of acetabular or femoral component anteversion in relationship to fixed bony landmarks may provide useful information prior to revision surgery. MAGNETIC RESONANCE IMAGING Magnetic resonance imaging (MRI) has gained wide acceptance in the evaluation of the painful total hip. Pathologic conditions in which MRI may be useful include: avascular necrosis, labral pathology, occult fractures, infection, and tumors.

Pathophysiology The exact mechanisms underlying the pathophysiology of atraumatic ON of the femoral head are not clearly defined; however, several theories have implicated both intravascular and extravascular factors that may contribute to this pathologic process. Each of these phenomena shares the final outcome of ischemia, cellular necrosis, and failure of remodeling of the subchondral bone. Osteocyte death has been attributed to alterations in blood flow that may be the result of local or systemic factors.

Arthritis Rheum. 2000;43:2410–2416. Radin EL. Who gets osteoarthritis and why? J Rheumatol. 2004;31(suppl 70):10–15. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg. 1999;81B:281–288. Siebenrock KA, Wahab KHA, Werlen S, et al. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop. 2004;418:54–60. cls March 19, 2007 OSTEONECROSIS OF THE FEMORAL HEAD FRANK A. PETRIGLIANO J AY R . L I E B E R M A N Osteonecrosis (ON) of the femoral head is a progressive disease that if left untreated often results in subchondral fracture, collapse of the femoral head, and debilitating arthrosis.

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