ESR

Management

Incidence

 

Knee > Hip

- superficial position

- limited cover of well vascularised muscle 

- watershed area of skin blood supply anterior to the skin incision 

- much increased in fully constrained prosthesis 

 

Ideal < 1%

 

Risk Factors

 

Increased with

- revision

- prior infection

- RA / Psoriatic arthropathy

- DM

Painful THA

Aetiology

 

Intrinsic

 

Infection

 

Loosening

 

Thigh pain in uncemented

- micro motion at distal end of stem

- modulus mismatch

 

Stress fracture / insufficiency fracture

- pubic rami, sacral

 

Intra-operative fracture

 

Prosthesis failure

 

Subtle instability

 

Extrinsic