PSOAS TENDONITIS IN DAA ANTHONY S UNGER MD
- Slides: 30
PSOAS TENDONITIS IN DAA ANTHONY S UNGER, MD WASHINGTON, DC
ANTHONY S UNGER, MD • DISCLOSURES – INNOMED—ROYALTIES – SIGNATURE ORTHOPAEDICS-ROYALTIES – J OF ARTHROPLASTY-EDITORIAL BOARD – ARTHROPLASTY TODAY-EDITOR BOARD
IS ANTERIOR GROIN PAIN A PROBLEM AFTER DAA? ? ? • YES---BUT PREVENTABLE
PSOAS TENDONITIS=GROIN PAIN
IDENTIFY TO CAUSE OF GROIN PAIN
ANTERIOR OVERHANG>8 MM • Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes • • Chalmers, Brian P. ; Sculco, Peter K. ; Sierra, Rafael J. ; Trousdale, Robert T. ; Berry, Daniel J. Copyright © 2017 The Journal of Bone and Joint Surgery, Inc. All rights reserved • JBJS. 99(7): 557 -564, April 5, 2017. • doi: 10. 2106/JBJS. 16. 00244 8
HISTORY • ANTERIOR GROIN PAIN UPON RISE FROM CHAIR OR STAIR CLIMB • USUALLY AFTER 6 -12 WEEKS POST OP
PHYSICAL EXAM • PAINLESS PASSIVE ROM • PAIN ON SLR OR ACTIVE FLEXION • PAIN ON PALPATION OVER PSOAS TENDON
IMAGING • XRAY-AP AND X-TABLE LATERAL • MRI-MARS • ULTRASOUND GUIDED INJECTION
PREVENTION • HOLD PT UNTIL 6 WEEKS • NO OPEN CHAIN HIP FLEXION IN FIRST 6 WEEKS • WORK WITH KNOWLEDGABLE PT
PREVENTION • NO ANTERIOR OVERHANG • BURY CUP • SAVE MEDIAL CAPSULE? ?
PT for DAA is DIFFERENT !!
NON-OP RX • NSAI • PT • GUIDED INJECTION – STEROID – BOTOX – PRP? ?
Tenotomy successful!!
ANTERIOR OVERHANG>8 MM • Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes • • Chalmers, Brian P. ; Sculco, Peter K. ; Sierra, Rafael J. ; Trousdale, Robert T. ; Berry, Daniel J. Copyright © 2017 The Journal of Bone and Joint Surgery, Inc. All rights reserved • JBJS. 99(7): 557 -564, April 5, 2017. • doi: 10. 2106/JBJS. 16. 00244 23
REVISE CUP Copyright © 2017 The Journal of Bone and Joint Surgery, Inc. All rights reserved • Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes • • Chalmers, Brian P. ; Sculco, Peter K. ; Sierra, Rafael J. ; Trousdale, Robert T. ; Berry, Daniel J. • JBJS. 99(7): 557 -564, April 5, 2017. • doi: 10. 2106/JBJS. 16. 00244 25
HIP SCOPE
93% successful!!
CONCLUSION • IN OR-- WATCH OUT FOR ANTERIOR IMPINGEMENT • HOLD THE PT • FOLLOW THE ALGORITHIM : RELEASE PSOAS for <8 mm AND/OR REVISE CUP FOR >8 mm in CHRONIC CASES
- Dr anthony unger
- Dr anthony unger sibley hospital
- Anthony unger md
- Cacific
- Achilles tendon rupture moi
- Stress strain curve physiotherapy
- Bursitis fibromyalgia
- Muscles for knee flexion
- Anterior knee pain ddx
- Brachioradialis muscle
- Tendon injuries clinton
- Daa instruction in 8051 example
- Imul assembly
- Randomized algorithm in daa
- Define amortized analysis
- Casa daa
- Daa gnc
- Transitive closure in daa
- Disjoint set operations in daa
- Semitendinosus origin and insertion
- Gluteus medius origo
- Enrico unger
- Soleal line tibia
- Unger sabine
- Rovsing bulgusu
- Michael unger md
- Psoas sign
- Aed kinderreanimation
- Ron unger lcsw
- Psoas and obturator signs
- Segno rovsing