Non Insertional Achilles Tendinopathy
Definition
Inflammation and degeneration of the achilles tendon in the midsubstance 2 - 6 cm from insertion
Inflammation and degeneration of the achilles tendon in the midsubstance 2 - 6 cm from insertion
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Acute dislocation of the atlanto-axial facet joint
Present with acute torticollis
Children
Athletes with increase activity / distance
Women with eating disorders / amenorrhea
Compression / inferior neck
- < 50% protective weight bear
- > 50% emergent ORIF
Tension side / superior neck
- emergent ORIF
Ranges
- up to 4%
Focal pain
- typically anterolateral thigh
- often tender
- corresponds to tip of stem
1. Instability
Types
- early
- late / failed bony ingrowth
Cause
- micromotion at distal stem
Disseminated Intravascular Coagulation
Results from excessive activation of either extrinsic or intrinsic coagulation pathway
- multiple small clots
- consumptive coagulopathy
1. Excessive Extrinsic Activation
Secondary to extensive cellular destruction
- thromboplastins +++ released into circulation
Chronic Regional Pain Syndrome
CRPS 1
Sympathetically mediated pain syndrome
- excessive or exaggerated response of extremity to injury, surgery or disease
Manifested by
- intense or unduly prolonged pain
- vasomotor disturbances
- trophic changes
- delayed functional recovery
CRPS 2
Most common of the bleeding disorders
- 1:100
vWF
- needed for platelet adhesion and platelet-platelet interactions
- also carrier for factor VIII / protects it from rapid breakdown
Gene on chromosome 12
1. Reduced production VWF
1. Loosening
2. Infection
3. Instability
4. Periprosthetic fracture