Protrusio acetabuli

AIMS: Dislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction...

This study compared patients who underwent femoral head microfracture with a control group of patients who did not require microfracture. Patients had more than 2 years of follow-up. The patient groups had similar demographic and radiographic features, including sex, age within 5 years, body mass index within 5 points, equal Tönnis grade, lateral center edge angle within 5°, labral treatment, and capsular closure vs release. Inclusion criteria were a minimum of 2 years of follow-up, Outerbridge grade IV cartilage damage, and femoral head marrow stimulation technique performed at the time of arthroscopy...

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...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

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...

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])...

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...

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...

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...

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...

A new CT-based diagnostic method of protrusio acetabuli (PA) was introduced. However, prevalence of PA by this method and correlation between PA and other manifestations of Marfan syndrome (MFS) is unknown in Korean MFS patients. This study aimed to investigate the prevalence of PA diagnosed by a CT-based method in Korean patients with MFS, the association of PA with other manifestations of MFS, and the contribution of PA to MFS diagnosis. We retrospectively reviewed the records of 146 MFS patients with the presence of a causative FBN1 mutation and 146 age- and sex-matched controls from a single tertiary care center...

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.

Rheumatoid arthritis affects around 1% of the global population with a predilection for Western societies. The treatment of the rheumatoid hip has gone through significant changes in recent years. Although osteotomies and synovectomies were previously commonplace, advances in arthroplasty technique and technology has seen these former procedures being performed less commonly. This article tackles some of the key issues with regard to the rheumatoid hip, namely the increased risk and methods of dealing with protrusio acetabuli, the risk of dislocation, infection and rates of aseptic loosening...

OBJECTIVE: The goals of a tissue-preserving minimally invasive approach to the hip are to allow early short-term recovery, achieve hip joint stability, minimize muscle strength loss from surgery, spare the peri-articular soft tissues, and allow unrestricted motion in the long term. INDICATIONS: Hip arthroplasty in patients with no pre-existing hardware, with a sufficient space between the acetabular rim and greater trochanter; management of subcapital femoral fractures in older patients...

Femoroacetabular impingement (F.A.I.) is a pathologic process caused by an abnormal shape of the acetabulum, of the femoral head, or both. F.A.I., often referred to as idiopathic, may be secondary to slipped capital femoral epiphysis, congenital hypoplasia of the femur, Legg-Calvé Perthes disease, post-traumatic mal-union and protrusio acetabuli. From 2009 to 2012 we studied 21 patients (14 males), with a mean age of 52 (33 y - 75 y), affected by idiopathic F.A.I. Every patient underwent pelvic and hip joint X-rays and CT scan with 3D reconstructions, in order to evaluate the morphology of the pelvis and the hip joint and the torsion of the lower limbs (Femoroacetabular ante-retroversion)...

PURPOSE: Protrusio acetabuli is an uncommon finding that can be seen in patients undergoing primary total hip arthroplasty for arthritis. Uncemented fixation of the acetabular component and bone grafting of the protrusio defect is commonly used as a reconstruction method and has shown good mid-term results. The long-term outcome of these reconstructions warrants further study. The objective of this study was to determine the results of primary total hip arthroplasty (THA) with use of an uncemented acetabular component for protrusio acetabuli in patients followed for a minimum of ten years...

INTRODUCTION: To analyze the spectrum of pelvic and hip joint injuries by computed tomography in patients attending to emergency. METHODS: CT evaluation with multiplanar and 3-D reformations of 62 patients done with pelvic and hip fractures during 18 months. The mode of injury and treatment were recorded. RESULTS: Forty four (70.9%) of the injuries were sustained in high speed vehicle accidents (automobile, motorcycle, autopedestrian), 14 patients (22...

BACKGROUND: We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. MATERIALS AND METHODS: We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010...

Severe pincer impingement (acetabular protrusio) is an established cause of hip pain and osteoarthritis. The proposed underlying pathomechanism is a dynamic pathological contact of the prominent acetabular rim with the femoral head-neck junction. However, this cannot explain the classically described medial osteoarthritis in these hips. We therefore asked: (1) Does an overload exist in the medial aspect of the protrusio joint? and (2) What is the influence of three contemporary joint-preserving procedures on load distribution in protrusio hips? In vivo force and motion data for walking and standing to sitting were applied to six 3D finite element models (normal, dysplasia, protrusio, acetabular rim trimming, acetabular reorientation, and combined reorientation/rim trimming)...