SCFE
Indications for THA
Osteoarthritis
- abnormal morphology
- loss of head neck offset
- bony impingement on acetabulum
AVN
Osteoarthritis
- abnormal morphology
- loss of head neck offset
- bony impingement on acetabulum
AVN
- 85 intra-articular ganglions
- 49 ACL, 16 PCL
- 12 from anterior horn meniscus, 3 posterior horn meniscus
- 3 from fat pad
Technique
Surgical technique PDF using trans-septal portal
Deformity correction
Poor soft tissues
- prohibit ORIF
Non union
Infected non uniion
Malunion / deformity
Bone loss / bone transport / LLD
https://www.vumedi.com/video/arthroscopic-double-row-subscapularis-repa…
Technique
- extra-articular
Portals
- posterior portal very lateral so can see anterior aspect subacromial space
- port of Wilminton at anterolateral acromion to access SSC
- anterior portal in normal position, slightly more lateral so becomes working portal
Engaging Hill Sachs
Platelet rich plasma
2 main components
1. Platelets
- contain PDGF, TGF, VEGF
2. Growth factors
- ILGF
- FGF
Formed from the separation of whole blood into plasma and RBC
- separation usually achieved with centrifugation
Platelet concentration
Types
1. Supracondylar
2. Unicondylar
3. Intracondylar
Supracondylar / Extra-condylar
1. Provide representative sample
- to determine whether benign or malignant
- to determine cell line
- to grade lesion
2. Not compromise definitive treatment
Last step in evaluation / after staging
Don't perform definitive procedure immediately after biopsy unless
- pre-operative & Xray information characteristic
Option 1
- lateral and medial aspect femoral trochlea
Option 2
- intercondylar notch
Option 3
- allograft
- can take larger grafts without donor site risk