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Hip Anatomy

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https://www.readbyqxmd.com/read/29928097/bridging-the-gap-a-technique-to-avoid-limb-length-discrepancy-in-arthroplasty-for-femoral-neck-fracture-a-case-report
#1
Aakash Mugalur
Equalizing limb length is of paramount importance for optimal outcome in patients undergoing hip arthroplasty(HA). Numerous techniques have been described for avoiding limb length discrepancy (LLD) in patients undergoing HA. However their applicability in patients undergoing HA for neck of femur(NOF) fractures remains questionable due to dissociation between the femur and the head. I hereby describe a novel yet simple technique for better utilization of already established techniques to avoid LLD in NOF fractures undergoing HA...
June 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29916934/modern-surgical-treatment-of-recurrent-posterior-dislocation-of-the-native-hip
#2
Bayard C Carlson, Nicholas M Desy, Joshua D Johnson, Robert T Trousdale, Michael Leunig, Reinhold Ganz, Rafael J Sierra
BACKGROUND: Redislocation of the native hip is rare. An anterior fulcrum between the proximal part of the femur and the pelvis must be present for a posterior dislocation to occur. The purpose of this study is to describe the cases of 9 patients with posterior redislocation or recurrent subluxation of the native hip that was treated with hip preservation surgery. METHODS: We retrospectively identified the cases of 9 patients, from 2 institutions, who had undergone hip preservation surgery for the management of posterior redislocation or recurrent subluxation of the native hip after a dislocation...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29877918/analysis-of-femoral-version-in-patients-undergoing-periacetabular-osteotomy-for-symptomatic-acetabular-dysplasia
#3
Wudbhav N Sankar, Eduardo Novais, Denise Koueiter, Christian Refakis, Ernest Sink, Michael B Millis, Young-Jo Kim, John Clohisy, Joel Wells, Jeffrey Nepple, Ira Zaltz
INTRODUCTION: A paucity of information exists on the range of femoral version, its effect on hip stability, clinical examination, and presentation in patients with symptomatic acetabular dysplasia. The purpose of this study was to describe the range of version in symptomatic acetabular dysplasia, the association between femoral version and proximal femoral morphology and degree of dysplasia, and the effect of version on clinically measured hip range of motion and on preoperatively measured hip outcome scores...
June 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29794857/revisiting-the-anteroinferior-iliac-spine-is-the-subspine-pathologic-a-clinical-and-radiographic-evaluation
#4
Michael R Karns, Temitope F Adeyemi, Andrew R Stephens, Stephen K Aoki, Mark E Beese, Michael J Salata, Travis G Maak
BACKGROUND: Subspine impingement is a recognized source of extraarticular hip impingement. Although CT-based classification systems have been described, to our knowledge, no study has evaluated the morphology of the anteroinferior iliac spine (AIIS) with plain radiographs nor to our knowledge has any study compared its appearance between plain radiographs and CT scan and correlated AIIS morphology with physical findings. Previous work has suggested a correlation of AIIS morphology and hip ROM but this has not been clinically validated...
May 22, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29783889/the-external-obturator-footprint-as-a-landmark-in-total-hip-arthroplasty-through-a-direct-anterior-approach-a-ct-based-analysis
#5
Hannes A Rüdiger, Benjamin Fritz, Franco M Impellizzeri, Michael Leunig, Christian W Pfirrmann, Reto Sutter
BACKGROUND: Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known. AIM: To determine the location and dimension of the EO footprint on pelvic radiographs by correlating the EO anatomy in CT scans with conventional radiographs...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29781820/management-of-pediatric-femoral-neck-fracture
#6
Joseph T Patterson, Jennifer Tangtiphaiboontana, Nirav K Pandya
In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29777918/sex-differences-in-the-spatial-distribution-of-bone-in-relation-to-incident-hip-fracture-findings-from-the-ages-reykjavik-study
#7
Elisa A Marques, Julio Carballido-Gamio, Vilmundur Gudnason, Gunnar Sigurdsson, Sigurdur Sigurdsson, Thor Aspelund, Kristin Siggeirsdottir, Lenore Launer, Gudny Eiriksdottir, Thomas Lang, Tamara B Harris
In this case-cohort study, we used data-driven computational anatomy approaches to assess within and between sex spatial differences in proximal femoral bone characteristics in relation to incident hip fracture. One hundred male and 234 female incident hip fracture cases, and 1047 randomly selected noncase subcohort participants (562 female) were chosen from the population-based AGES-Reykjavik study (mean age of 77 years). The baseline -i.e. before hip fracture- hip quantitative computed tomography scans of these subjects were analyzed using voxel-based morphometry, tensor-based morphometry, and surface-based statistical parametric mapping to assess the spatial distribution of volumetric bone mineral density (vBMD), internal structure, and cortical bone properties (thickness, vBMD and trabecular vBMD adjacent to the endosteal surface) of the proximal femur, respectively, in relation to incident hip fracture...
May 16, 2018: Bone
https://www.readbyqxmd.com/read/29757716/us-assessment-of-sports-related-hip-injuries
#8
Eugen Lungu, Johan Michaud, Nathalie J Bureau
Traumatic and overuse hip injuries occur frequently in amateur and professional athletes. After clinical assessment, imaging plays an important role in diagnosis and in defining care management of these injuries. Ultrasonography (US) is being increasingly used in assessment of hip injuries because of the wide availability of US machines, the lower cost, and the unique real-time imaging capability, which allows both static and dynamic evaluation as well as guidance of point-of-care interventions such as fluid aspiration and steroid injection...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29756497/relationship-between-muscular-and-bony-anatomy-in-native-hips-a-theoretical-background-for-approach-specific-implant-positioning
#9
Doruk Akgün, Philipp von Roth, Tobias Winkler, Carsten Perka, Adam Trepczynski, Bernd Preininger
INTRODUCTION: The aim of this study was to analyse the relationship between bony joint orientation and the distribution of hip musculature. METHODS: The bone anatomy of the hip (femoral antetorsion (AT), acetabular anteversion (AV), and combined anteversion (AV/AT)) and the muscle volume of the gluteal muscles and the tensor fasciae latae were analysed bilaterally using computed tomography data of 49 patients. Muscle force direction (MFD) was determined for each muscle...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29713768/is-it-painful-to-be-different-sciatic-nerve-anatomical-variants-on-mri-and-their-relationship-to-piriformis-syndrome
#10
Adam L Bartret, Christopher F Beaulieu, Amelie M Lutz
OBJECTIVES: To investigate the purported relationship between sciatic nerve variant anatomy and piriformis syndrome. METHODS: Over 49 months, 1039 consecutive noncontrast adult hip MRIs were completed for various clinical indications. Repeat and technically insufficient studies were excluded. Radiologists categorized sciatic nerve anatomy into Beaton and Anson anatomical types. Chart review using our institution's cohort search and navigation tool determined the prevalence of the explicit clinical diagnosis of piriformis syndrome (primary endpoint) and sciatica and buttock pain (secondary endpoints)...
April 30, 2018: European Radiology
https://www.readbyqxmd.com/read/29693206/3d-printed-model-improves-clinical-assessment-of-surgeons-on-anatomy
#11
Bin Zheng, Xiaolin Wang, Yixiong Zheng, Jiexiong Feng
Performing surgical procedures often requires a surgeon to develop a skill to create 3-dimensional (3D) mental model on patient's anatomy. Question remains whether the touching on the 3D printed model can facilitate learning of patient anatomy than viewing the rendered virtual on-screen model. The printed and the virtual 3D model were developed from CT films taken from a 4-year-old girl, who had dysplasia of the hip in the left hip. Eleven subjects were called to report measures on six key anatomical features on the hips...
April 24, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29657851/kinematic-alignment-technique-for-total-hip-and-knee-arthroplasty-the-personalized-implant-positioning-surgery
#12
Charles Rivière, Stefan Lazic, Loïc Villet, Yann Wiart, Sarah Muirhead Allwood, Justin Cobb
Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality.Technological improvements and a better understanding of joint kinematics have facilitated the progression to 'personalized' implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined.By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29651575/assessment-of-pelvic-tilt-in-anteroposterior-radiographs-by-means-of-tilt-ratios
#13
T Schwarz, A Benditz, H-R Springorum, J Matussek, G Heers, M Weber, T Renkawitz, J Grifka, B Craiovan
INTRODUCTION: In anteposterior (AP) radiographs, cup position in total hip arthroplasty and acetabular anatomy in hip-preserving surgery are highly influenced by pelvic tilt. The sagittal rotation of the anterior pelvic plane is an important measurement of pelvic tilt during hip surgery. Thus, correct evaluation of cup position and acetabular parameters requires the assessment of pelvic tilt in AP radiographs. METHODS: Changes in pelvic tilt inversely change the height of the lesser pelvis and the obturator foramen in AP radiographs...
April 12, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29627581/extracapsular-fracture-of-the-femur-in-an-elderly-male-from-the-church-of-nossa-senhora-da-anunciada-set%C3%A3%C2%BAbal-portugal
#14
Nathalie Antunes-Ferreira, Carlos Prates, Francisco Curate
In modern populations, hip fractures in older people are associated with high morbidity and mortality. Their incidence is rising; notwithstanding, fractures of the proximal femur are still relatively uncommon in archeological contexts. This case study represents a well-healed hip fracture in an aged male skeleton from Church of Nossa Senhora da Anunciada (16th-19th centuries AD) in Setúbal (Portugal). The individual was also diagnosed with diffuse idiopathic skeletal hyperostosis. Fractures of the proximal femur are usually associated with bone loss but in this case other causes are proposed, including the anatomy of the proximal femur, and the potential combined effect of diffuse idiopathic skeletal hyperostosis, cardiovascular disease, diabetes mellitus and falls...
April 5, 2018: International Journal of Paleopathology
https://www.readbyqxmd.com/read/29610309/hip-extensor-mechanics-and-the-evolution-of-walking-and-climbing-capabilities-in-humans-apes-and-fossil-hominins
#15
Elaine E Kozma, Nicole M Webb, William E H Harcourt-Smith, David A Raichlen, Kristiaan D'Août, Mary H Brown, Emma M Finestone, Stephen R Ross, Peter Aerts, Herman Pontzer
The evolutionary emergence of humans' remarkably economical walking gait remains a focus of research and debate, but experimentally validated approaches linking locomotor capability to postcranial anatomy are limited. In this study, we integrated 3D morphometrics of hominoid pelvic shape with experimental measurements of hip kinematics and kinetics during walking and climbing, hamstring activity, and passive range of hip extension in humans, apes, and other primates to assess arboreal-terrestrial trade-offs in ischium morphology among living taxa...
April 17, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29606539/anatomy-of-the-pudendal-nerve-and-other-neural-structures-around-the-proximal-hamstring-origin-in-males
#16
Gregory L Cvetanovich, Bryan M Saltzman, Gift Ukwuani, Rachel M Frank, Nikhil N Verma, Charles A Bush-Joseph, Shane J Nho
PURPOSE: To define the anatomy of the pudendal nerve in relationship to the proximal hamstring and other nearby neurological structures during proximal hamstring repair. METHODS: Six fresh-frozen human cadaveric hemi-pelvises from male patients ages 64.0 ± 4.1 years were dissected in prone position with hips in 10° flexion to identify the relationship of proximal hamstring origin to surrounding neurologic structures including the pudendal nerve, sciatic nerve, and posterior femoral cutaneous nerve...
March 29, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29587147/load-transfer-and-periprosthetic-fractures-after-total-hip-arthoplasty-comparison-of-periprosthetic-fractures-of-femora-implanted-with-cementless-distal-load-or-proximal-load-femoral-components-and-measurement-of-the-femoral-strain-at-the-time-of-implantation
#17
E Schwarz, G Reinisch, A Brandauer, S Aharinejad, W Scharf, K Trieb
BACKGROUND: Little is known about the causes and mechanisms underlying periprosthetic fractures around femoral components particularly in relation to the stem design. In an in vitro study 20 pairs of fresh cadaveric femora were loaded to fracture axially and transversally. FINDINGS: When proximal femoral strain was measured at the time of impaction of cementless stems the load transfer was determined by the underlying anatomy rather than by the shape of the stem, so that the so-called "load transfer" properties - proximal or distal - ascribed to stem designs are a myth...
May 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29578104/impact-of-operative-time-on-early-joint-infection-and-deep-vein-thrombosis-in-primary-total-hip-arthroplasty
#18
B W Wills, E D Sheppard, W R Smith, J R Staggers, P Li, A Shah, S R Lee, S M Naranje
PURPOSE: Infections and deep vein thrombosis (DVT) after total hip arthroplasty (THA) are challenging problems for both the patient and surgeon. Previous studies have identified numerous risk factors for infections and DVT after THA but have often been limited by sample size. We aimed to evaluate the effect of operative time on early postoperative infection as well as DVT rates following THA. We hypothesized that an increase in operative time would result in increased odds of acquiring an infection as well as a DVT...
March 22, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29575173/vascular-supply-of-the-femoral-head-in-sheep-implications-for-the-ovine-femoroacetabular-impingement-model
#19
Moritz Tannast, Nadja Wolfer, Michael K Ryan, Katja M Nuss, Brigitte von Rechenberg, Simon D Steppacher
Sheep hips have a natural non-spherical head similar to a cam-type deformity in human beings. By performing an intertrochanteric varus osteotomy, cam-type femoroacetabular impingement can be induced experimentally. In sheep, the aspherical portion is located superiorly-exactly matching the region where the superior retinacular vessels enter the femoral head-neck junction in human beings. In order to fully exploit the potential of this experimental FAI model, a safe osteochondroplasty of the superior asphericity would need to be done without the risk of avascular necrosis...
March 25, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29560394/intraoperative-bladder-perforation-during-primary-total-hip-arthroplasty
#20
Andrew Konopitski, Anthony Boniello, Patrick Wang, Mitesh Shah, Andrew Old, Kevin Gingrich
We present a unique case of bladder perforation occurring intraoperatively during primary total hip arthroplasty. It is suspected that the patient's aberrant bladder anatomy, with idiopathic erosion of the quadrilateral space, predisposed the patient to bladder injury. Several preoperative risk factors for bladder injury were identified in the literature. These factors include cemented acetabular components, previous history of hip arthroplasty, history of pelvic trauma or intrapelvic surgery, and poor bone quality...
March 2018: Arthroplasty Today
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