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Hip protrusio

Junho Ahn, Erin Carter, Cathleen L Raggio, Daniel W Green
BACKGROUND: Osteogenesis imperfecta (OI) is a genetic disorder commonly associated with osteopenia, osteoporosis, bone fractures, bone deformities, and other clinical features. A frequent radiologic finding with OI is acetabular protrusio (AP). We hypothesized that AP develops in patients with OI over time. In addition, we hypothesized that AP also develops in patients with OI without radiographic evidence of AP on initial examination. METHODS: Medical records and radiographs of 55 patients (109 hips) diagnosed with OI evaluated at our institution were retrospectively reviewed...
July 7, 2017: Journal of Pediatric Orthopedics
Scott M Eskildsen, Zenus J Wilson, David C McNabb, Christopher W Olcott, Daniel J Del Gaizo
BACKGROUND: In the setting of acetabular deficiency during total hip arthroplasty (THA), the medial protrusio technique (MPT) allows for increased component coverage while avoiding excessive component abduction or elevation of the hip center. The technique involves controlled reaming through the medial acetabular wall while maintaining the continuity of the anterior and posterior columns. The purpose of this study is to analyze the results of the largest reported series to date of primary and revision THAs using the MPT...
May 26, 2017: Journal of Arthroplasty
Jason Bt Lim, Chia Liang Ang, Hee Nee Pang
INTRODUCTION: Bipolar hemi-arthroplasty of the hip is a commonly performed procedure in elderly patients with intra-capsular fracture of the neck of the femur with good short-term results for pain relief, return to activity and morbidity. The incidence of intra-pelvic prosthesis migration or protrusion is rare and one of the inciting factors is chronic low-grade sepsis. Acetabular prosthesis protrusion poses a difficult and challenging surgical problem due to surrounding neurovascular structures...
July 2016: Journal of Orthopaedic Case Reports
Esther Moya, Luis Gerardo Natera, Carlomagno Cardenas, Emanuele Astarita, Vittorio Bellotti, Manel Ribas
Many of the described labral-reconstruction procedures are purely arthroscopic. This approach only allows segmentary reconstructions. For more extensive reconstructions, surgical dislocation of the hip still represents the more suitable approach. We present an arthroscopy-assisted procedure combined with an anterior mini-open approach, which could be considered for reconstruction of nonrepairable labral lesions located in the posterior aspect of the acetabulum and massive reconstructions in cases of global-pincer femoroacetabular impingement and protrusio acetabuli...
October 2016: Arthroscopy Techniques
Ira Zaltz
No abstract text is available yet for this article.
December 2016: Clinical Orthopaedics and related Research
Yavuz Saglam, Irfan Ozturk, Mehmet Fevzi Cakmak, Mustafa Ozdemir, Onder Yazicioglu
INTRODUCTION: The aim of this study was to evaluate the clinical and radiological outcomes of total hip arthroplasty (THA) in patients with Ankylosing Spondylitis (AS). PATIENTS AND METHODS: One hundred five hips of 61 AS patients (mean age: 41.3 ± 10.2 years) who underwent THA between 1997 and 2012 were included into the study. Dorr's classification of proximal femoral geometry, acetabular protrusio, bone ankylosis, acetabular protrusion, Brooker classification of heterotopic ossification (HO), Gruen and Charnley classifications of implant loosening were used in radiographic assessments...
August 2016: Acta Orthopaedica et Traumatologica Turcica
Markus S Hanke, Simon D Steppacher, Corinne A Zurmühle, Klaus A Siebenrock, Moritz Tannast
No abstract text is available yet for this article.
June 22, 2016: Clinical Orthopaedics and related Research
Suzanne S Long, Nicholas E Tawa, Douglas K Ayres, Ayesha Abdeen, Jim S Wu
Fistula formation between bowel and total hip arthroplasty or revision arthroplasty hardware is rare. We present a case of a 78-year-old woman with protrusio of left hip arthroplasty and acetabular reconstruction hardware that caused direct perforation of the sigmoid colon and fistula formation between the sigmoid colon and the left hip joint. The patient underwent several joint debridements, sigmoid colectomy, and removal of all orthopedic hardware; she ultimately died after two prolonged hospitalizations.
2011: Radiology case reports
Raumeen Gam, Savvas Andronikou, Rene Truter, Johan Deale
INTRODUCTION: Intrapelvic complications resulting from total hip arthroplasty are rare. Intrapelvic migration of the acetabular cup along with proximal migration of the femoral stem is one of these entities. Despite being a rare entity, there are serious complications. CASE REPORT: We report a case image of an elderly lady who presented 6 months after total hip arthroplasty to her general practitioner and gynaecologist complaining of a palpable hard pelvic mass as well as difficulty walking...
April 2012: Journal of Orthopaedic Case Reports
Markus S Hanke, Simon D Steppacher, Corinne A Zurmühle, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Protrusio acetabuli is a rare anatomic pattern of the hip in which the femoral head protrudes into the true pelvis. The increased depth of the hip and the excessive size of the lunate surface typically lead to severe pincer-type femoroacetabular impingement (FAI); however, to our knowledge, there are no published mid- or long-term studies on results of circumferential acetabular rim trimming through a surgical hip dislocation for patients with this condition. QUESTIONS/PURPOSES: (1) What is the 10-year survivorship of the hips treated with circumferential rim trimming through a surgical hip dislocation compared with a control group of hips that underwent surgery for pincer FAI but that did not have protrusio acetabuli? (2) What are the factors that were associated with a decreased likelihood of survivorship in those hips with the following endpoints: total hip arthroplasty, Merle d'Aubigné score of less than 15, and/or radiographic progression of osteoarthritis (OA)? (3) Does the radiographic pattern of degeneration differ between the two groups? METHODS: We performed a case-control study comparing two groups: a protrusio group (32 patients [39 hips]) and a control group (66 patients [86 hips])...
October 2016: Clinical Orthopaedics and related Research
Ali Al Kaissi, Vladimir Kenis, Eugeniy Melchenko, Maher Ben Ghachem, Robert Csepan, Franz Grill, Rudolf Ganger
BACKGROUND: Thoracolumbar kyphosis has been considered as the first presenting deformity and is often a key diagnostic clue noted in children with mucopolysaccharidosis (MPS) type IV (Morquio's syndrome). However, we observed that the progressive irregularities of the epiphyses of the long bones were the most prominent skeletal pathology, causing effectively the development of diverse forms of lower limbs deformities with extreme variation in age of onset. MATERIALS AND METHODS: Ten patients (seven children and three adults) with an average age of 15 years have been enrolled in this study...
April 2016: African Journal of Paediatric Surgery: AJPS
Guo-Chun Zha, Jun-Ying Sun, Kai-Jin Guo, Feng-Chao Zhao, Yong Pang, Xin Zheng
BACKGROUND: The medial protrusio technique may be used during total hip arthroplasty (THA) on patients with developmental dysplasia. However, studies have yet to determine whether a cementless cup can be sufficiently stable to withstand loading forces. This study aimed to assess the clinical and radiographic outcomes of this technique. Furthermore, we sought to determine the relationship between the rate of medial protrusion and the incidence of cup loosening. METHODS: Thirty-nine patients (43 hips) underwent cementless THA between April 2006 and March 2009 by using the medial protrusio technique...
August 2016: Journal of Arthroplasty
David M Levy, Michael D Hellman, Bryan Haughom, Michael D Stover, Shane J Nho
While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy...
2015: Frontiers in Surgery
M Drexler, Y Gortzak, A Sternheim, Y Kollender, E Amar, J Bickels
Excision of the proximal femur for tumour with prosthetic reconstruction using a bipolar femoral head places a considerable load on the unreplaced acetabulum. We retrospectively reviewed the changes which occur around the affected hip joint by evaluating the post-operative radiographs of 65 consecutive patients who underwent proximal prosthetic arthroplasty of the femur, and in whom an acetabular component had not been used. There were 37 men and 28 women with a mean age of 57.3 years (17 to 93). Radiological assessment included the extent of degenerative change in the acetabulum, heterotopic ossification, and protrusio acetabuli...
December 2015: Bone & Joint Journal
Muhammed Taha Demir, Yusuf Pirinççi, Muhammet Salih, Fahri Erdoğan, Nejat Güney
OBJECTIVE: The purpose of this study was to investigate the mid-term and long-term effects of the acetabular roof ring (ARR) and Burch-Schneider anti-protrusio cage (BSAPC) in acetabular revision for patients with acetabular bone deficiency and acetabular component loosening. METHODS: Between 1988 and 2007, ARR revisions were performed in 51 patients (25 women; average age: 46.9 years) and BSAPC in 18 patients (16 women; average age: 62.1 years). Grafts were used in all revisions...
2015: Acta Orthopaedica et Traumatologica Turcica
A E Nelson, J L Stiller, X A Shi, K M Leyland, J B Renner, T A Schwartz, N K Arden, J M Jordan
OBJECTIVES: We sought to describe the effect of alterations in hip morphology with respect to worsening hip OA in a community-based sample including African American (AA) and white men and women. METHODS: This nested case-control study defined case hips as Kellgren Lawrence grade (KLG) <3 on baseline supine pelvis radiographs and KLG ≥3 or THR for OA at the 1st or 2nd follow-up visit (mean 6 and 13 years, respectively); control hips had KLG <3 at both visits, with gender/race distribution similar to cases...
March 2016: Osteoarthritis and Cartilage
Ning Lu, Yang Yang, Hong Chen, Weiqiang Li, Bo Pu, Luping Liu
OBJECTIVE: To evaluate the effectiveness of total hip arthroplasty (THA) with impacted autologous bone grafting and a cementless cup in the treatment of rheumatoid arthritis (RA) with protrusio acetabuli. METHODS: Between January 2001 and April 2009, 18 cases (20 hips) of RA with protrusio acetabuli were treated, including 6 males and 12 females with an average age of 46 years (range, 36-62 years). The disease duration was 3-10 years (mean, 6 years). Preoperative Harris score was 40...
February 2015: Chinese Journal of Reparative and Reconstructive Surgery
Christopher T Martin, Anneliese D Heiner, Thomas E Baer, Andrew J Pugely, Nicolas O Noiseux
BACKGROUND: Medial protrusio is a recognized complication of total hip arthroplasty, but it is not known if a medial wall breach during cup implantation increases the risk. We thus investigated the effect of up to a 2 cm defect in the medial acetabular wall in a cadaveric model. Separately, we investigated the ability of acetabular screws to rescue the construct. METHODS: Nine human fresh-frozen hemipelves were reamed medially to create the defect, implanted with acetabular cups, and then loaded to failure...
2015: Iowa Orthopaedic Journal
Panagiotis Tsagozis, Rikard Wedin, Otte Brosjö, Henrik Bauer
BACKGROUND AND PURPOSE: Metastases engaging the acetabulum result in significant disability. We investigated the outcome after curettage and reconstruction of the defect with a protrusio cage, retrograde screws, and a cemented total hip arthroplasty. PATIENTS AND METHODS: We retrospectively identified 70 consecutive patients who were surgically treated for metastatic disease of the acetabulum between 1995 and 2012 using the above technique. The type of primary tumor, extent of the disease, degree of acetabular erosion, and type of implant used were identified...
2015: Acta Orthopaedica
Colm Murphy, Barry James O'Neill, John Francis Quinlan, Ronan Collins
Protrusio acetabuli is an uncommon complication of total hip arthroplasty, which results in intrapelvic implant migration after erosion of medial acetabular wall. We present a case of severe prosthetic migration with the formation of haematoma and impingement on iliac vessels leading to thrombosis and subsequent pulmonary embolus. This is the first reported case of protrusio acetabuli as a cause of pulmonary embolus.
July 7, 2015: BMJ Case Reports
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