Hip injection with patient with post traumatic oa after a Acetabular ORIF

[schmee90]

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I have a patient with an acetabular fx about 6 months ago s/p ORIF, with some post traumatic arthritis whom I will see in a few days. Surgeron sent to us saying they have post traumatic oa with residual pain and may eventually need a hip replacment but could also consider a hip intraarticular injection for pain.

I dont have the xrays to actually view (just impression saying harware in tact with OA) but this is typically something I dont see everyday. Wouldn't there be a higher risk of infection with an acetabular fx with ORIF since hardware there, and does this seem like a low yield thing to do? Anybody have any experience with this? My main concerns I guess would be doing an injection with the hardware in place. Thank you in advance

 

[SSdoc33]

I have a patient with an acetabular fx about 6 months ago s/p ORIF, with some post traumatic arthritis whom I will see in a few days. Surgeron sent to us saying they have post traumatic oa with residual pain and may eventually need a hip replacment but could also consider a hip intraarticular injection for pain.

I dont have the xrays to actually view (just impression saying harware in tact with OA) but this is typically something I dont see everyday. Wouldn't there be a higher risk of infection with an acetabular fx with ORIF since hardware there, and does this seem like a low yield thing to do? Anybody have any experience with this? My main concerns I guess would be doing an injection with the hardware in place. Thank you in advance

the hardware is rarely intra-articular. this isnt a hip replacement you are injecting. you should be fine. id do the shot and not think twice about it

 

[knoxdoc]

Just like doing injections around lumbar hardware - there are no issues. Like SS said, the hardware is not intra-articular, so zero concerns.

 

[schmee90]

Sorry..dumb question but for me the confusion is how is the acetablum not part of the hip joint itself. Again I only have the impression of the acetabluar fracture with ORIF for this particular pt (I plan to get my own films however). I have been doing some reading on acetabuar fx with ORIF and there are different approaches but just from my less experienced view some of these look intraarticular

 

[cowboydoc]

Sorry..dumb question but for me the confusion is how is the acetablum not part of the hip joint itself. Again I only have the impression of the acetabluar fracture with ORIF for this particular pt (I plan to get my own films however). I have been doing some reading on acetabuar fx with ORIF and there are different approaches but just from my less experienced view some of these look intraarticular

Fixation is intramedullary. Dynamic hip screw is an example. It doesn’t communicate with the intraarticular space.

 

[schmee90]

Thanks all fo the input

 

[Doctodd]

when you have him on the table you will see the hardware on fluoroscopy and inject away from hardware if you are concerned