Abos - Hip & Femur - Total Hip Arthroplasty - Common Complication Questions

Front 1

Are THA dislocation rates higher in males or females?

Back 1

Females

Front 2

What two populations are at especially high risk of nerve palsy with THA?

Back 2

Females with DDH
CMT (Charcot-Marie-Tooth)

Front 3

What THA complication is especially common in patients with prior acetabular fracture?

Back 3

Loosening

Front 4

If planning a THA after acetabular fracture, what is the advantage of performing ORIF?

Back 4

Decreased need for bone graft

Front 5

What complication is particularly common in THA patients with contralateral hip fusion?

Back 5

Loosening

Front 6

Ankylosing spondylitis is associated with what HA two complications? Why is acetabular component positioning often difficult in this patient population?

Back 6

Decreased functional outcomes
Increased heterotopic bone
Flexion contractures of hip may lead to excess anteversion

Front 7

Why is femoral component positioning often difficult in patients with Paget's disease?

Back 7

Femoral bow may lead to varus malalignment

Front 8

What THA is particularly likely in patients with severe coxa vara? Why?

Back 8

Dislocation
Inadequately restored offset

Front 9

What effect does hip protrusion have on hip center of rotation? What is the implication for THA?

Back 9

Moves hip center medially and posteriorly
Must restore normal center of rotation at time of THA

Front 10

What is the likely cause of late failure and sudden pain with modular acetabular components?

Back 10

Liner dissociation secondary to failure of locking ring

Front 11

What is the benefit of foot/ankle exercises in the prevention of deep venous thrombosis (DTV)

Back 11

20% increase in venous outflow

Front 12

What three factors are associated with increased mortality for THA after femoral neck fracture?

Back 12

Female
Elderly
Cemented stem

Front 13

What is the principal THA complication in patients with pathologic fracture?

Back 13

Deep infection

Front 14

What is the principal THA complication in elderly patients with failed femoral neck ORIF?

Back 14

Highest dislocation rates

Front 15

What is the principal cause of intraoperative acetabular fracture? What is the treatment if stable? If unstable?

Back 15

Under reaming
Stable: ignore
Unstable: ORIF

Front 16

What are the three treatment options for intraoperative femoral fracture?

Back 16

Longer stem
Cerclage
Locking plate

Front 17

AT what intraoperative stage do DVTs start to form?

Back 17

At time of femoral canal preparation

Front 18

What three intraoperative events are associated with fat embolization?

Back 18

Insertion of cemented stem
Relocation of the hip
Use of intramedullary guides

Front 19

Most orthopaedic surgical cases present what level of cardiac risk? What does this mean?

Back 19

Intermediate cardiac risk
<5% chance of cardiac event

Front 20

Increased cardiac risk is present if patient can't perform __ metabolic equivalent tasks (METs)? Cite three example activities.

Back 20

4 METs
Do light house work
Climb one flight of stairs
Walk on level ground at 4 mph

Front 21

What are the two demonstrated benefits of perioperative beta-blockers?

Back 21

Increased survival
Decreased perioperative events

Front 22

What is the best clinical indicator of preoperative nutritional status?

Back 22

Arm circumference

Front 23

What is the preferred treatment for a malnourished patient at risk of multiorgan failure?

Back 23

Enteral protein

Front 24

What is Ogilvie"s syndrome? What is its relevance? What is its associated electrolyte abnormality? What is its treatment?

Back 24

Cecal distention> 10 cm
Can occur after arthroplasty
Associated with hypokalemia
Treat with colonoscopic decompression