Endocurricular Arthritis Case Study

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COMPONENT TYPE: Smith and nephew cemented Synergy, size 11, high-offset stem, a 54-mm reflection acetabular shell, a 28-mm cobalt-chrome head, a 20-degree acetabular liner, posterior-stabilized, a press-fit acetabular shell, minus 3 mm cobalt-chrome femoral head.

ANESTHESIA: General endotracheal.



INDICATIONS: [Name] is a 76-year-old female with a long history of right hip pain, unresponsive to conservative therapy. She was diagnosed with right hip degenerative arthritis and was admitted, after failing conservative treatment, for operative evaluation.

OPERATIVE PROCEDURE IN DETAIL: After informed consent was obtained, the patient was brought to the operating room and placed supine on the operating table. After adequate general anesthesia was attained, the patient was placed in the left lateral decubitus position, with all bony prominences well-padded, with the hip positioning system applied. With the patient in the lateral position, the right lower extremity was then prepped and draped in sterile fashion.
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The IT band and gluteus muscle were split in line with the wound. The trochanter bursa was excised, and the fat was retracted over the short external rotator musculature. The piriformis and obturator internus and short external rotators were then dissected free from the posterior greater trochanter and tagged for later reattachment, exposing the posterior hip capsule. The posterior hip capsule was then incised along the intertrochanteric ridge and tagged in a U-type shape for later repair. The hip was dislocated with findings of a severely degenerative femoral head and acetabular, with a complete loss of articular cartilage

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