arthrodesis of hip

Indications

· young adult

· monoarticular disease

· active lifestyle

· most common for

· post-infectious

· post-traumatic

Advantages

· permanent solution

· freedom from pain

· stability

· no restrictions on activities

Disadvantages

· increased stress on

· lumbar spine

· contralateral hip

· ipsilateral knee

· difficulties with certain activities

· squatting

· procreation

technique

Position

· 30^o flexion

· 0^o adduction

· 15^o external rotation

Intra-articular approach

· Watson-Jones approach

· leave abductors intact

· dislocate hip anteriorly

· remove cartilage from femoral head and acetabulum

· cup arthoplasty instruments useful

· approximate raw surfaces

· pack with cancellous autograft

· position hip and hold with guide-wires temporarily

· check position with x-ray

· fix with 150^o sliding screw-plate device

· through joint into thick bone of ischium

· supplement with additional screws as necessary

· partial weight-bearing until radiographic union