Operative Procedure:
The patient was anaesthetised, the left hip was prepped and draped in the usual manner to give a sterile field. An incision was made over the greater trochanter through the subcutaneous fat to ilia tibial band, this was split, the greater trochanter was found to have moderate bursitis here, this was excised.
A trochanteric osteotomy was undertaken, care was taken to avoid damaging the blood supply to the hip and the gluteus minus lifted off and the hip capsule exposed, a capsulotomy was undertaken, the hip was dislocated. The findings showed that there was an area of contusion to the anterior labrum with some associated chondral damage with this.
The previous arthroscopy where the labrum had been torn was visible and found that the labrum was adequately excised. I removed the anterior labrum and reattached it with X2 anchors after I'd removed the bone behind this, then went to the head/neck junction where there had been obviously impingement here and used the templates to check the serosity of the head and removed the excess bone, the head/neck junction offset was improved and the raw bone surface and placed some bone wax into the raw bones to prevent bleeding here.
I closed the wounds in layers just slightly tightened the anterior capsule as I felt it was somewhat lax, then a redivac drain was placed in the deep layer and the greater trochanter reattached with X2 screws. The skin was closed with subcuticular Monocryl.
Post Op Instructions: Pain relief as charted, no active abduction for 6 weeks but patient may mobilise full weight bearing, check xray and haemoglobin in 24 hours.
The patient was anaesthetised, the left hip was prepped and draped in the usual manner to give a sterile field. An incision was made over the greater trochanter through the subcutaneous fat to ilia tibial band, this was split, the greater trochanter was found to have moderate bursitis here, this was excised.
A trochanteric osteotomy was undertaken, care was taken to avoid damaging the blood supply to the hip and the gluteus minus lifted off and the hip capsule exposed, a capsulotomy was undertaken, the hip was dislocated. The findings showed that there was an area of contusion to the anterior labrum with some associated chondral damage with this.
The previous arthroscopy where the labrum had been torn was visible and found that the labrum was adequately excised. I removed the anterior labrum and reattached it with X2 anchors after I'd removed the bone behind this, then went to the head/neck junction where there had been obviously impingement here and used the templates to check the serosity of the head and removed the excess bone, the head/neck junction offset was improved and the raw bone surface and placed some bone wax into the raw bones to prevent bleeding here.
I closed the wounds in layers just slightly tightened the anterior capsule as I felt it was somewhat lax, then a redivac drain was placed in the deep layer and the greater trochanter reattached with X2 screws. The skin was closed with subcuticular Monocryl.
Post Op Instructions: Pain relief as charted, no active abduction for 6 weeks but patient may mobilise full weight bearing, check xray and haemoglobin in 24 hours.
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