Postsurgical Hip

hip postop 1

For post traumatic fixation, learn the general hardware types (plate and screw fixation, closed reduction percutaneous pinning, intramedullary nail, dynamic hip screw). 
Report on the following during immediate post operative and follow-up radiographs: 

  • Hardware alignment
  • Changes in existing fracture alignment
  • Newly detectable fractures 
  • Signs of hardware loosening (adjacent lucency, displacement, backout) 
  • Hardware failure
  • Post traumatic complications such avascular necrosis, nonunion, and malunion. 

 

 

 

FINDINGS: Right proximal femur cephalomedullary screw fixation with new screw cut out now articulating with the superior acetabulum.  

hip postop 2
hip postop 3

Fig D. Increased lucency about the proximal and mid femoral stem component measuring >2 mm which may represent sequela of motion and/or infection. 
 

hip postop 4

Fig F. Progressive circumferential osteolysis about the acetabular component consistent with particle disease. 
 

Learn to differentiate the difference between total and hemi hip arthroplasty by assessing their respective components. 

  • Prosthesis alignment Symmetric limb length (standing full-length lower limb radiographs)
  • Normal angle of inclination measured between transverse reference line across ischial tuberosities (on AP) and rim of acetabular cup (30- 50 degrees) (Fig A)

 

  • Normal acetabular version angle measured between transverse reference line across ischial tuberosities (on lateral) and the rim of acetabular cup (5-25 degrees of anteversion) (Fig B)

 

 

  • Periprosthetic fractures (Fig C)

 

 

 

  • Signs of loosening (periprosthetic lucency, change in position, subsidence) (Fig D)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Prosthesis component fracture (Fig E)

 

 

 

 

  • Signs of polyethylene wear (Fig F)
hip postop 5

Example report negative for postoperative complication.

FINDINGS:

  • Postsurgical changes of ______ with unchanged alignment and intact appearing prosthesis components. No periprosthetic fracture or lucency. 

IMPRESSION:

  • Uncomplicated post surgical appearance of ___.