Being prepared to change the management plan
No two patients are the same and determining the management plan will depend on a number of factors. Dr. Christopher Peters shared some insight on how he develops his management plan. He identified three key areas to consider for each patient that visits his office:
1. Pre-existing medical conditions
We aren’t going to worry as much about a 45-year-old healthy male or female that has absolutely no medication use from an overall health standpoint. In contrast, someone who smokes, has a BMI of 45, and is on several different medications for blood pressure and diabetes is a totally different situation. We take this into consideration and let it drive our management plan for each patient.
We consider whether a patient has osteoarthritis, inflammatory arthritis, avascular necrosis, or sequali of pediatric hip disease. For example, if they’ve had four operations as a kid or have screws left in the acetabulum or femur, we may need to adjust the management plan.
3. Anatomical factors
A patient with osteoarthritis could present with protrusio acetabulae, or a coxa vara that is three standard deviations outside of the norm, or a dysplastic patient presents challenges on both the femoral side and the acetabular side. Any anatomical factors such as these will impact the management plan.