Mike Millis, M.D., Boston Children's Hospital

More documents

Recommendations

Info

Middle-Term Results of PAO: Bern and Boston • Hip still preserved in 84% at 10+ yrs • Pain relief excellent in most • Mild loss of flexion in most • CE angles improved from ~5 to~30 degrees * Best results if OA 0 or grade 1 preop and no labral tear • ~50% reoperation rate at 5 y if OA gr. 2-3 • Conversion to THR straightforward
5-15 yr Boston PAO Followup: Matheney, Kim, and Millis (JBJS, 9/09) • 161/189 of 1991-1998 PAO’s (MBM) located. • All had pain preop. Preop CE angle in most 83% * Important prognostic factors for outcome after PAO
Page 1 and 2:
Hipology 2010 COA Meeting April 17,
Page 3 and 4:
Disclosures • None relevant to th
Page 5 and 6:
Major Points * In North America, mo
Page 7 and 8:
“It seems clear that either osteo
Page 9:
Joint Function Activity level Insta
Page 12 and 13:
“We see what we know.” Frank Ph
Page 14 and 15:
The Contemporary Mechanical Theory
Page 16 and 17:
Etiology of OA of the Hip-1986 •
Page 18 and 19:
MAJOR POINTS * A labral tear is usu
Page 20 and 21:
Acetabular Rim Syndrome(s) • Groi
Page 22 and 23:
Step-Wise Analysis of the Symptomat
Page 24 and 25:
Good News About OA in the Hip • R
Page 26 and 27:
The Normal Hip: Anatomic Characteri
Page 28 and 29:
The Normal Hip: Mechanical Characte
Page 30 and 31:
Important Definitions • Instabili
Page 32 and 33:
Hip Mechanics (INSTABILITY) (IMPIN
Page 34 and 35:
How can joints go wrong mechanicall
Page 36 and 37:
Hip Mechanics • IMPINGEMENTINSTAB
Page 38 and 39:
Femoro-Acetabular Impingement as a
Page 40 and 41:
Femoro-Acetabular Impingement • F
Page 42 and 43:
Femoro-Acetabular Impingement as a
Page 44 and 45:
Herniation pit; usually means cam-
Page 46 and 47:
Femur-based FAI: Cam Impingement
Page 48:
CAM Impingement-Mechanism CAM Type
Page 61 and 62:
Delamination of Cartilage
Page 63 and 64:
Ortho Uni Berne
Page 65 and 66:
Ortho Uni Berne
Page 67 and 68:
(pincer) M:F = 4:12 pistol grip/ ca
Page 69 and 70:
Etiologies of Hip OA in North Ameri
Page 71 and 72:
Acetabulum-Based Femoro- Acetabular
Page 73 and 74:
“We see what we know.” Frank Ph
Page 75:
Pincer Impingement-Mechanism PINCER
Page 80 and 81:
Impingement of Acetabular Rim Contr
Page 84 and 85:
Protusio Ortho Uni Berne
Page 86 and 87:
Campincer Impingement • Commonest
Page 88 and 89:
Clinical Evaluation for Femoro- Ace
Page 90 and 91:
Contour of the Head-Neck Junction a
Page 92 and 93:
Imaging for F-A Impingement • Pla
Page 94 and 95:
Analysis for F-A Impingement • Pl
Page 96 and 97:
Treatment of pincer impingement (pr
Page 98 and 99:
Treatment of combined femoral and a
Page 100 and 101:
Prerequisite for “Safe” Surgica
Page 102 and 103:
Surgical Dislocation Technique •
Page 104 and 105:
Lateral Position
Page 106 and 107:
Greater Trochanter Piriformis Tendo
Page 108 and 109:
Femoral Head Acetabulum
Page 110:
Improved Access
Page 114 and 115:
Early Harvard Experience with Surgi
Page 119 and 120:
Pre-op, postop offset creation by n
Page 122: • Acknowledgement to Professor R.
Page 126 and 127: Cartilage Delamination due to Impin
Page 128 and 129: Outcome depends on pre-existing dam
Page 130 and 131: Hip Joint-Preserving Techniques Ext
Page 133 and 134: Hip Arthroscopy • What it IS: A s
Page 135: Slipped Capital Femoral Epiphysis
Page 141 and 142: Etiologies of Hip OA in North Ameri
Page 143 and 144: DDH: Primary Anatomic Characteristi
Page 145 and 146: Clinical Evaluation of the Patient
Page 147: Plain Radiography: The Gold Standar
Page 150 and 151: Acetabular depth and version • An
Page 152 and 153: Indications for Joint-Preserving Th
Page 154 and 155: Site(s) of Correction • Willy Sut
Page 156 and 157: Acetabular Redirectional Osteotomy
Page 158 and 159: Bernese Periacetabular • Single i
Page 160: Arthrotomy • Useful if labral sx,
Page 164 and 165: Positioning of the osteotomized fra
Page 166 and 167: 14 yo F 1 yr hx limp
Page 169 and 170: Now 49 yo; 11.5 y after PAO; no sym
Page 171: CH PAO Numbers • >1100 hips (1991
Page 175 and 176: “Salvage” Joint-Preserving Proc
Page 178 and 179: Diarthrodial Joint Function Activit
Page 180: Summary Thoughts on Osteotomy and R
show all

Mike Millis, M.D., Boston Children's Hospital

Create successful ePaper yourself

Delete template?

Save as template?