Mike Millis, M.D., Boston Children's Hospital
Mike Millis, M.D., Boston Children's Hospital Mike Millis, M.D., Boston Children's Hospital
Major Points * In North America, most OA in the hip is secondary • Developmental hip deformity is the commonest etiology of this secondary OA • A mechanical perspective is very helpful in understanding the nature of secondary hip OA (i.e., most OA in the hip is caused by abnormal mechanics) * Accurate analysis of the mechanical hip abnormality can often allow its surgical correction (and prevent OA!!) • Instability and impingement are the common bad actors • The acetabular rim is the usual locus of early damage – The labrum is often damaged but labral tears rarely can be repaired successfully in isolation – (>90% of labral tears have important associated bony abnormalities) * Joint-preserving hip surgery can be highly effective IF performed before there is major articular cartilage damage
Major Points * In North America, most OA in the hip is secondary (Most OA in the hip is caused by abnormal mechanics) * Accurate analysis of the mechanical hip abnormality can often allow its surgical correction (and prevent OA!!) * Joint-preserving hip surgery can be highly effective IF performed before there is major articular cartilage damage
- Page 1 and 2: Hipology 2010 COA Meeting April 17,
- Page 3: Disclosures • None relevant to th
- 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
Major Points<br />
* In North America, most OA in the hip is secondary<br />
• Developmental hip deformity is the commonest etiology of this secondary OA<br />
• A mechanical perspective is very helpful in understanding the nature of<br />
secondary hip OA<br />
(i.e., most OA in the hip is caused by abnormal mechanics)<br />
* Accurate analysis of the mechanical hip abnormality can often allow its surgical<br />
correction (and prevent OA!!)<br />
• Instability and impingement are the common bad actors<br />
• The acetabular rim is the usual locus of early damage<br />
– The labrum is often damaged but labral tears rarely can be repaired successfully in<br />
isolation<br />
– (>90% of labral tears have important associated bony abnormalities)<br />
* Joint-preserving hip surgery can be highly effective IF performed before there is<br />
major articular cartilage damage
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