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Hip Anatomy

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https://www.readbyqxmd.com/read/29651575/assessment-of-pelvic-tilt-in-anteroposterior-radiographs-by-means-of-tilt-ratios
#1
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
#2
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
#3
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 2, 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
#4
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
#5
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...
March 21, 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
#6
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/the-vascular-supply-of-the-femoral-head-in-sheep-implications-for-the-ovine-femoroacetabular-impingement-model
#7
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
#8
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
https://www.readbyqxmd.com/read/29553552/individualized-stem-positioning-in-calcar-guided-short-stem-total-hip-arthroplasty
#9
Karl Philipp Kutzner, Joachim Pfeil
Bone- and soft-tissue sparing short stems are increasingly used in total hip arthroplasty (THA). However, there are a large variety of models of short stems, differing in design and function. Calcar-guided short stems provide an anatomical curvature in the medial calcar region, thus, positioning is done individually alongside the calcar in the "round-the-corner" technique. Depending on the level of the neck's osteotomy, stems can be aligned individually in a large bandwidth of varus- and valgus anatomies...
February 27, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29547446/long-term-retention-of-musculoskeletal-ultrasound-training-during-residency
#10
Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29523442/investigation-of-the-unstable-total-hip-arthroplasty
#11
R Michael Meneghini
The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity...
March 6, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29515650/computer-assisted-optimization-of-the-acetabular-rotation-in-periacetabular-osteotomy-using-patient-s-anatomy-specific-finite-element-analysis
#12
Sung-Jae Park, Sung-Jae Lee, Wen-Ming Chen, Jung-Hong Park, Yong-Soo Cho, Taejin Shin, Soon-Yong Kwon
Periacetabular osteotomy (PAO) is a complex surgical procedure to restore acetabular coverage in the dysplastic hip, and the amount of acetabular rotation during PAO plays a key role. Using computational simulations, this study assessed the optimal direction and amount of the acetabular rotation in three dimensions for a patient undergoing PAO. Anatomy-specific finite element (FE) models of the hip were constructed based on clinical CT images. The calculated acetabular rotation during PAO were 9.7°, 18°, and 4...
2018: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/29515329/femoral-stem-size-mismatch-in-women-undergoing-total-hip-arthroplasty
#13
John M Dundon, Dvorah Leah Felberbaum, William J Long
Background: Total hip arthroplasty (THA) is a highly successful surgery with a high prevalence in women. Women have been noted to have smaller proximal femoral anatomy and decreased bone strength compared to males. The goal of our study was to define the size discrepancy in femoral stem implants between men and women using a metaphyseal fitting single taper stem. Methods: We retrospectively reviewed the THA's performed by a single surgeon over the previous two years...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29502964/diagnosis-taper-corrosion-when-is-it-the-taper-and-when-is-it-something-else
#14
Craig J Della Valle, Tyler E Calkins, Joshua J Jacobs
There has been an increasing use of modularity at the head-neck junction in total hip arthroplasty to more closely mimic the native anatomy, allowing for optimal leg length and stability. Corrosion at this junction in metal-on-polyethylene bearings can lead to an adverse local tissue reaction (ALTR). This increasingly prevalent condition should be considered in the differential diagnosis of hip pain and difficulty ambulating. A recent symposium by the American Academy of Hip and Knee Surgeons described the diagnosis, etiology, management, and prevention of taper corrosion...
March 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29492995/radiological-and-osteological-study-of-the-pelvic-limbs-in-free-ranging-capybaras-hydrochoerus-hydrochaeris
#15
G C Brombini, S C Rahal, B C Schimming, I F C Santos, M H Tsunemi, M J Mamprim, L S Alves, A L Filadelpho, C R Teixeira
This study aimed to describe the radiographic anatomy and osteology and to evaluate angular radiographic measurements-Norberg angle, inclination angle and anteversion angle-of the pelvic limbs in free-ranging capybaras. Twenty cadavers of free-ranging capybaras (Hydrochoerus hydrochaeris), including five adults and 15 subadults, were studied. Ventrodorsal, craniocaudal, dorsoplantar and mediolateral radiographic views of the pelvic limbs were obtained. The radiographic features were described together with bone samples...
March 1, 2018: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/29475110/pathological-fracture-risk-assessment-in-patients-with-femoral-metastases-using-ct-based-finite-element-methods-a-retrospective-clinical-study
#16
Amir Sternheim, Ornit Giladi, Yair Gortzak, Michael Drexler, Moshe Salai, Nir Trabelsi, Charles Milgrom, Zohar Yosibash
Physician recommendation for prophylactic surgical fixation of a femur with metastatic bone disease (MBD) is usually based on Mirels' criteria and clinical experience, both of which suffer from poor specificity. This may result in a significant number of these health compromised patients undergoing unnecessary surgery. CT-based finite element analyses (CTFEA) have been shown to accurately predict strength in femurs with metastatic tumors in an ex-vivo study. In order to assess the utility of CTFEA as a clinical tool to determine the need for fixation of patients with MBD of the femur, an ad hoc CTFEA was performed on a retrospective cohort of fifty patients...
February 20, 2018: Bone
https://www.readbyqxmd.com/read/29468265/the-tridimensional-geometry-of-the-proximal-femur-should-determine-the-design-of-cementless-femoral-stem-in-total-hip-arthroplasty
#17
Julien Wegrzyn, Jean-Paul Roux, Charlotte Loriau, Nicolas Bonin, Vincent Pibarot
PURPOSE: Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study...
February 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29455347/a-prospective-comparative-study-of-hip-resurfacing-arthroplasty-and-large-diameter-head-metal-on-metal-total-hip-arthroplasty-in-younger-patients-a-minimum-of-five-year-follow-up
#18
Ran Tao, Fan Liu, Ya-Ke Liu, Yue Lu, Hua Xu, Yi Cao, Zhen-Yu Zhou, Wei Wang
INTRODUCTION: Both hip resurfacing arthroplasty (HRA) and large-diameter head metal-on-metal total hip arthroplasty (LDH MoM THA) are generally used for young and active patients. A number of comparative studies of HRA and total hip arthroplasty have been published in the literature. However, studies that have compared HRA with LDH MoM THA are rare. The purpose of this study is to compare the mid-term results of HRA with those of LDH MoM THA in young patients. PATIENTS AND METHODS: Between 2007 and 2011, 68 patients were enrolled in the study and randomized into two groups: HRA group (28 hips) and LDH MoM THA group (40 hips)...
February 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29451057/comparison-between-modified-dunn-procedure-and-in-situ-fixation-for-severe-stable-slipped-capital-femoral-epiphysis
#19
Giovanni Trisolino, Stefano Stilli, Giovanni Gallone, Pedro Santos Leite, Giovanni Pignatti
Background and purpose - The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. Patients and methods - We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed...
February 16, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29419700/deep-femoral-artery-branch-pseudoaneurysm-formation-and-injury-after-hip-fracture-surgery-a-case-series-and-a-literature-review
#20
Bin-Fei Zhang, Yu-Xuan Cong, Peng-Fei Wang, Hai Huang, Hu Wang, Yan Zhuang
INTRODUCTION: Complications involving vascular injuries after hip fracture are rare, and the diagnosis and management of deep femoral artery (DFA) injuries are challenging. We reported 4 cases of DFA injuries after hip fracture surgery and aimed to discuss their early detection, treatment, and prevention. METHODS: We reviewed 4 cases of deep femoral injury after hip fracture. Case 1: a 71-year-old woman suffered a fracture around a prosthesis. Cases 2-4: 2 men and 1 woman suffered subtrochanteric or intertrochanteric fracture...
February 2018: Medicine (Baltimore)
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