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Hip, femur

X Q Wang, C S Wu, S Sun, J Wang, W Li, W Zhang
Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Amanda T Whitaker, James Kasser, Young-Jo Kim
RATIONALE: The sciatic nerve runs a predictable course combining L4-S3 nerve roots through the true pelvis and under the greater sciatic notch. There are reports of bony protuberances from the sacrum and ilium in cases of spinal dysraphism; however advanced imaging, treatment, or outcomes are not described. There are no cases with associated fibular hemimelia in the current literature. PATIENT CONCERNS: This is a 4-year-old girl with tethered cord, acetabular dysplasia with hip subluxation, congenital short femur, anterior cruciate ligament (ACL) deficiency, and fibular hemimelia with her sciatic nerve coursing through the ilium...
March 2018: Medicine (Baltimore)
Pierre H M Pechon, Rhys Pullin, Mark J Eaton, Stephan A Jones, Sam Evans
During uncemented hip arthroplasty the femoral prosthesis can be fitted too tightly into the femoral canal, causing a hoop-stress fracture of the proximal femur. The research undertaken evaluated Acoustic Emission (AE) technology as a potential method of detecting a fracture forming in this manner, in an attempt to assess whether this technology may be used as a means of early warning of impending fracture during surgery. Deer femora were prepared in a manner similar to surgery and uncemented hip arthroplasty broaches were inserted until fracture occurred...
March 21, 2018: Journal of Medical Engineering & Technology
Colin D Canham, Christopher P Walsh, Stephen J Incavo
Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers...
March 2018: Arthroplasty Today
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
Junghyun Baek, Nohkyoung Park, Bongju Lee, Sungju Jee, Shinseung Yang, Sangkuk Kang
Objective: To investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the vastus lateralis (VL) in the early stage after hip replacement surgery. Methods: Twenty-two patients who underwent hip replacement after proximal femur fracture were included in this study. After hip surgery, the experimental group was applied with 15 sessions of 10 Hz rPMS over the VL 5 times per week for 3 weeks, while the control group took sham stimulation. All patients were also given conventional physical therapy...
February 2018: Annals of Rehabilitation Medicine
Andrew S Moon, Walter Smith, Sawyer Mullen, Brent A Ponce, Gerald McGwin, Ashish Shah, Sameer M Naranje
BACKGROUND: The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries. METHODS: The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing five common orthopedic procedures: hip (THA), knee (TKA), and shoulder arthroplasty (TSA), spinal fusion, and traumatic femur fracture fixation...
March 20, 2018: Substance Abuse
William McCartney, Bryan MacDonald, Ciprian Andrei Ober, Rubén Lostado-Lorza, Fátima Somovilla Gómez
BACKGROUND: Finite element analysis was used to compare fixation methods for double pelvic osteotomy (DPO). Using 3D scanning a stereolithography (stl) image was produced of a canine pelvis and this was subsequently refined in computer aided design (CAD). Using the CAD files, the images were imported in MSC Marc software to produce a working finite element (FE) model with 3 dimensional tetrahedral elements with linear shaped functions. The dimensions of a precontoured pelvic osteotomy plate with eight screws and a twisted seven screw straight plate were used to build the 2 fixations implants for the FE models...
March 20, 2018: BMC Veterinary Research
Robert J Cooper, Sophie Williams, Marlène Mengoni, Alison C Jones
BACKGROUND: Impingement resulting in soft tissue damage has been observed in hips with abnormal morphologies. Geometric parameterisation can be used to automatically generate a range of bone geometries for use in computational models, including femurs with cam deformity on the femoral neck. METHODS: This study verified patient-specific parametric finite element models of 20 patients with cam deformity (10 female, 10 male) through comparison to their patient-specific segmentation-based equivalents...
March 14, 2018: Clinical Biomechanics
Tom J Crijns, Stein J Janssen, Jacob T Davis, David Ring, Hugo B Sanchez
BACKGROUND: Radiographic fracture classification helps with research on prognosis and treatment. AO/OTA classification into fracture type has shown to be reliable, but further classification of fractures into subgroups reduces the interobserver agreement and takes a considerable amount of practice and experience in order to master. QUESTIONS/PURPOSES: We assessed: (1) differences between more and less experienced trauma surgeons based on hip fractures treated per year, years of experience, and the percentage of their time dedicated to trauma, (2) differences in the interobserver agreement between classification into fracture type, group, and subgroup, and (3) differences in the interobserver agreement when assessing fracture stability compared to classifying fractures into type, group and subgroup...
March 14, 2018: Injury
Galateia J Kazakia, Julio Carballido-Gamio, Andrew Lai, Lorenzo Nardo, Luca Facchetti, Courtney Pasco, Chiyuan A Zhang, Misung Han, Amanda Hutton Parrott, Phyllis Tien, Roland Krug
Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...
February 2018: Quantitative Imaging in Medicine and Surgery
Mamoudou Sawadogo, Hamado Kafando, Salam Ouedraogo, Alexandre Stanislas Korsaga, Souleymane Ouedraogo, Sayouba Tinto, Anatole Jean Innocent Ouedraogo, Mohamed Tall, Songahir Christophe DA
Introduction: Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of "Girdlestone's operation" or "Girdlestone's procedure" has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone's procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit...
2018: Open Orthopaedics Journal
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Adolph V Lombardi, Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams
INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...
March 12, 2018: Surgical Technology International
Mohammad Kia, Timothy M Wright, Michael B Cross, David J Mayman, Andrew D Pearle, Peter K Sculco, Geoffrey H Westrich, Carl W Imhauser
BACKGROUND: The correct amount of external rotation of the femoral component during TKA is controversial because the resulting changes in biomechanical knee function associated with varying degrees of femoral component rotation are not well understood. We addressed this question using a computational model, which allowed us to isolate the biomechanical impact of geometric factors including bony shapes, location of ligament insertions, and implant size across three different knees after posterior-stabilized (PS) TKA...
January 2018: Clinical Orthopaedics and related Research
Joseph J Kavolus, David Sia, Hollis G Potter, David E Attarian, Paul F Lachiewicz
BACKGROUND: Surgeon-performed periarticular injections and anesthesiologist-performed femoral nerve or adductor canal blocks with local anesthetic are in common use as part of multimodal pain management regimens for patients undergoing TKA. However, femoral nerve blocks risk causing quadriceps weakness and falls, and anesthesiologist-performed adductor canal blocks are costly in time and resources and may be unreliable. We investigated the feasibility of a surgeon-performed saphenous nerve ("adductor canal") block from within the knee at the time of TKA...
January 2018: Clinical Orthopaedics and related Research
Shuman Yang, Yunhua Luo, Lang Yang, Enrico Dall'Ara, Richard Eastell, Andrew L Goertzen, Eugene V McCloskey, William D Leslie, Lisa M Lix
BACKGROUND: Dual-energy X-ray absorptiometry (DXA)-based finite element analysis (FEA) has been studied for assessment of hip fracture risk. Femoral strength (FS) is the maximum force that the femur can sustain before its weakest region reaches the yielding limit. Fracture risk index (FRI), which also considers subject-specific impact force, is defined as the ratio of von Mises stress induced by a sideways fall to the bone yield stress over the proximal femur. We compared risk stratification for prior hip fracture using FS and FRI derived from DXA-based FEA...
March 8, 2018: Bone
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
INTRODUCTION: In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate...
March 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Zhendong Zhang, Dianzhong Luo, Hui Cheng, Kai Xiao, Hong Zhang
BACKGROUND: Several methods are commonly used to predict lower-limb-length discrepancy (LLD) on pelvic radiographs. It is not clear how the lower-limb length of patients with unilateral developmental dislocation of the hip (DDH) changes and whether a pelvic radiograph is reliable to predict LLD. In this study, we analyzed the characteristics of LLD in patients with unilateral DDH by measuring full-length standing anteroposterior radiographs. METHODS: The radiographic data of all patients with unilateral DDH who met the inclusion criteria from March 2011 to May 2016 were retrospectively reviewed...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Y Luo
Femur expansion occurs during normal aging in both men and women. Average bone mineral density (BMD) over a region of interest (ROI) on the femur may considerably decrease with age even in healthy people, and therefore, it is inaccurate if used to monitor treatment-induced bone change. INTRODUCTION: Areal bone mineral density (BMD), averaged over a region of interest (ROI) on the femur, is widely used in the diagnosis of osteoporosis, assessment of fracture risk, and monitoring of treatment effectiveness...
March 5, 2018: Osteoporosis International
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