November 21, 2009

quotes from Hip Health 2009

oftentimes, a "healed" patient is considered when the patient has no more problems. We need to start thinking about getting the patient above their pre-treatment status and improving the overall quality of life.

DO NOT BE FOOLED: although rates are decreasing in overall hip fractures and osteoarthritis, the numbers are exponential (sometimes rates aren't the best tool to use when budgeting/planning service use)

Hip Developmental Dysplasia: abnormal development of the hip - 1/2000 kids where 89% are female and 66% are the firstborn kids --> you can dislocate the hip if you rotate it
- this needs to be treated ASAP orelse operation might be needed later on

60% of pediatric hip fractures lead to complications (avascular necrosis, osteonecrosis, nonunions, coxa vera, malunions)

it's amazing how arthroscopies can be done and leave such a small scar - the cameras are amazingly clear!

arthroplasty decreases revision surgeries by 70% but there's a 7% dislocation rate which usually requires another surgery or treatment. 35% of fixations require revision but there's a decreased mortality risk and OR time while 65% of people never need a reop. 56% of people prefer internal fixation. so why are there more people getting arthroplasties when they prefer internal fixation?

FAI is a hip impingement type that can lead to arthritis but can be fixed with arthroscopy
1. Pincer Type --> socket is too deep
2. Cam Type --> excess bone on the femoral head which can lead to labral tears and cartilage injuries


avascular necrosis is a vascular insult to the bone (stuff from the circulatory system affects the bone). This can be caused by steroids, trauma, or alcohol. 85% of the patients with AVN get a collapsed femoral head and increases their chances of clinical failure.

80-90% of 60-74 year olds who are hospitalized have severe osteoporosis
90-95% of people over 75 who are hospitalized have severe osteoporosis

5% of people with hip fractures will get a second one within 1 year

90% of hip fractures are from falls

eat your vitamin D! or go outside and get some sun!

an operating table can take 450 lbs of weight. operating on obese people is uber hard.
it takes 40% more effort for your heart to pump blood to the other parts of the body than a normal person

groin pain usually indicates something wrong with the hip

ontario guidelines say that fractures of the hip need to be fixed in less than 48 hours. CT Scans usually take forever to order. Ethical issue: should you confirm things with a CT scan or just operate to make a deadline?

operating / hip REPLACEMENTS usually lead to faster recovery and weightbearing which is also a decreased hospital cost HOWEVER after 1 year, there is a 30% mortality rate of these patients and only 5% of 90+ year olds can walk independently.

huge causes of hip fractures in seniors: cats and throw rugs

there is a huge need for primary prevetion and postoperative prevention so that we keep our seniors OUT of nursing homes and living independently

60% of bone health is due to genetics

FRAX is an online risk assessment tool for osteoporosis with customizable stats for each country (Canada's is coming out within the next year) What does it assess?
1. Age
2. bone density
3. fragility (fractures from before) --> if this is yes, you have double the chance
4. gender
5. nationality
6. medications you're on
7. cardiovascular disease (increases your chance of hip fracures up to 30%)
8. admitted in the hospital 3 times for anything (increases your chance of hip fracture by 4x)


hip fractures have a 35% failure rate of being healed. This is the dogma of the medical field. We can't let it be a standard - it's way too high!

tons of random facts that i may or may not need but tons of lessons to learn. I thought medicine was an exact science. It's not. I hate that.

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