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Vicky's 2nd Hip
Heterotopic Bone Growth PDF Print E-mail
What causes it?

Mainly traumatic surgery. No protection of soft tissues and too much pulling and stretching on the muscles. (BAD SURGERY) A NON posterior approach Lengthening of the leg.

Only in the minority patients are predicted to have it (bad luck).

Koen De Smet
 
Groin Pain PDF Print E-mail
Vicky,

Yes, psoas tendinitis is an important reason for groin pain in resurfacing surgery .

This is peculiar to resurfacing as the cup for resurfacing is a very large profile ie half a sphere. Nearly all THR cups are only portions ( arc) of a hemisphere.
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Gluteus Maximus Tendon PDF Print E-mail

Thanks to Vince DePalma for bringing up the subject of the gluteus maximus tendon.
Gluteus Maximus Tendon

Message #136595

Hello, I am new to this group. I am a 54 year old male with osteoarthiris in both hips, a former quarter miler at Bucknell University who can barely walk now. I have been very impressed by conversations I have had with Dr. James Pritchett in Seattle. Dr. Pritchett agrees with Dr. DeSmet in not reconnecting the gluteus maximum tendon (due to risk of impinging the sciatic nerve). By contrast, Dr. Vijay Bose strongly advocates that the gluteus maximus tendon be stitched back at the end of the surgery. In his email this morning he said the risk to the sciatic nerve is only during surgery. On the other hand, Dr. Tom Gross does not take down the gluteus maximus tendon all the way, only a small portion and says it will heal on its own, therefore there is no need for suture. I watched Dr. Bose perform the surgery on Youtube and was impressed with his extreme care taken to preserve the whole bursa and femoral capsule. Nevetheless, I remain confused on gluteus max tendon issue. Having said this, my decison on a doctor might ultimaley be more influenced by which one is in the CIGNA network. Any feedback or encouragement on the subject would be appreciated. Best regards, Vince This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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Neck Capsule Preserving Approach by Dr. Vijay Bose PDF Print E-mail

11/11/07

There are of course many views and opinions amongst surgeons regarding the best approach and what to preserve during the surgical approach. Failures in resurfacing which occurs due to faulty approaches and vascularity issue ,do so at the 3-6 yrs mark ( slow varus collapse with loosening of femoral component ie AVN of the entire head) . Hence, it is difficult to prove or disprove any concept regarding  this issue with statistical proof. One needs a large number of cases followed up carefully for a long time and have an opposite approach as a control group. This would be very difficult in a clinical setting.

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Head Neck Ratio in Hip Resurfacing by Dr. Vijay Bose PDF Print E-mail

Thanks for the mail. I read Dr. Kurtz thoughts on hip resurfacing in his website. His concerns are very valid but I cannot agree with his conclusions.

In short, his concerns only underline the fact that bad results of resurfacing are due to badly done resurfacings.  The head neck ratio is an important determinant of range of movement and prevention of  impingement.  In a patient with normal anatomy, if one is careful to restore anatomy the range will be like pre-0p range of movement before the onset of arthritis. This is a simple concept.

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