Diagnosis: Right hip pain;osteoarthritis to the hip
Treatment: Total Hip Arthroplasty

This is a male with right hip pain. The duration was several years (approximately 15). He had undergone hip arthroscopy seven years ago with no improvement. He had several injections to the right hip. He had chronic low back pain and had undergone a spinal fusion. He had received courses of PT (physical therapy). He had a hernia repair, which decreased his pain 50%. The pain limited his life.

The physical examination was significant for "SLR intact, normal gait pattern". His physician opined osteoarthritis to the right hip. A total hip replacement was recommended.

He was evaluated by a second physician. He was reported to have pain with activities of daily living and had received several courses of treatment. His physical examination was remarkable for antalgic gait, mild pain with internal rotation and + Stinchfield test. His recent imaging reported narrowing of joint space, near bone on bone arthritis. A total hip replacement was recommended.

The medical record was consistent for the diagnosis of osteoarthritis to the hip. The patient had ongoing high hip pain for several years. He was found to have progression. There was loss of internal rotation and gradual development of abnormal gait. His recent imaging demonstrated progressive osteoarthritis. There was reported joint space narrowing and near "bone on bone". He underwent arthroscopic surgery and was found to have grade 3 loss of articular cartilage. This has progressed.

The patient had received a full course of conservative treatments. These included multiple courses of medications, injections and arthroscopic surgery. A search for pain generator was made by several physicians (i.e. source of pain being back, SI, or hernia) with treatments provided. No resolution to his condition has resulted.

He has limitation to function and activities to daily living.

His physician's opinion has credence and is in agreement with guidelines and Criteria.

The total hip replacement would thus be necessary and appropriate at this time.