Video Case Reports: How Would You Manage These Hip Patients?

    Dr. William Hamilton leads a panel of experts in discussing 7 real-life cases, eliciting comments on the procedures, bearing surfaces, and stems they would use.

    Each year, a popular session at ICJR’s annual Winter Hip & Knee Course is Let’s Do a Primary THA, a case-based presentation in which the moderator shows several cases and asks faculty from the meeting to discuss how they would treat the patients.

    At a recent meeting, William G. Hamilton, MD, from the Anderson Orthopaedic Clinic in Alexandria, Virginia, took the podium as the moderator and shared 7 total hip arthroplasty (THA) cases from his practice. Panel members included:

    • Ali Oliashirazi from Marshall University, Huntington, West Virginia
    • Christopher L. Peters, MD, from the University of Utah in Salt Lake City
    • Gwo-Chin Lee, MD, from the University of Pennsylvania in Philadelphia
    • Scott Sporer from Rush University Medical Center in Chicago
    • Bryan Springer from OrthoCarolina in Charlotte, North Carolina

    The cases Dr. Hamilton shared demonstrate the variety and complexity of THA patients. His patients include:

    • A 57-year-old male with left hip pain: Is he a candidate for hip resurfacing, or is a total hip arthroplasty more appropriate?
    • A 45-year-old female with bilateral hip pain: Should she have a simultaneous bilateral total hip arthroplasty, or is staging the procedure the better option?
    • A 32-year obese male with right hip pain and no medical co-morbidities, whose X-ray shows avascular necrosis: Is he a candidate for THA, or is there another choice?
    • A thin, fit 54-year-old female who complains of hip weakness 4 weeks post-THA, and whose X-ray shows a periprosthetic fracture: Is a second procedure the right choice for her? Or can she be managed non-surgically?
    • A 56-year-old male with right hip pain who underwent a direct anterior approach THA: Why, 3 days post-THA, does his hemoglobin level continue to drop despite transfusions? What needs to be done to diagnose the problem?
    • An 81-year-old female who had an intramedullary hip screw placed 2 year earlier: Is she a candidate for revision of the screw fixation?
    • A 48-year-old female with hip dysplasia and pain: Is hip preservation surgery an option? Or is she past the point where this procedure will help?

    Watch the presentation here to find out what the expert panel members said about these cases, as well as how Dr. Hamilton managed them. Do you agree with their treatment recommendations?