The Orthobullets Podcast Coinflips⎪Recon⎪Severe Groin Pain s/p rTHA in 58F
Jul 11, 2025
Joseph Moskal, a doctor from the Crillian Clinic, and Stefan Kreuzer from Innovate Orthopedics share their insights on complex orthopedic decisions. They dive into a challenging case of a 58-year-old woman experiencing severe groin pain post-hip replacement. Topics include the intricacies of diagnosing post-surgical infections, navigating surgical approaches, and the importance of stem retention during revisions. The discussion also emphasizes innovative strategies for enhancing pelvic stability and optimizing patient outcomes in orthopedic surgeries.
AI Snips
Chapters
Transcript
Episode notes
Imaging and Infection Workup
- Get a CT scan with IV contrast to evaluate screw placement and vessel involvement in intrapelvic dislocations.
- Consider hip aspiration for infection ruling out, even if CRP and ESR are normal, to detect low-grade infection.
Choose Anterior Surgical Approach
- Use an anterior surgical approach for revision when previous posterior and Harding approaches were used.
- This allows better access, intraoperative fluoroscopy, and quick management of vascular structures if needed.
Use Birch-Snyder Style Cage
- Prefer Birch-Snyder style cages with iliac and ischial flanges for acute pelvic discontinuity.
- Use morselized allograft for bone defects and secure multiple iliac screws including percutaneous ones.