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acetabular reconstruction

Joong-Myung Lee, Tae-Ho Kim
The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e...
June 2018: Hip & Pelvis
Brian J White, Alexandra M Scoles, Mackenzie M Herzog
This study aims to present the surgical technique for reconstructing both the acetabular labrum and the ligamentum teres and to describe the early outcomes of this procedure in a 15-year-old male with recurrent hip instability. A 15-year-old patient with recurrent left hip dislocation, hip joint instability and failed non-operative intervention presented following two left hip dislocations. A labral reconstruction was performed utilizing an iliotibial band allograft tissue with a concomitant ligamentum teres reconstruction using a tibialis anterior allograft...
July 2018: Journal of Hip Preservation Surgery
Sun-Jung Yoon, Myung-Sik Park, Dean K Matsuda, Yun Ho Choi
BACKGROUND: Sciatic nerve injuries following total hip arthroplasty are disabling complications. Although degrees of injury are variable from neuropraxia to neurotmesis, mechanical irritation of sciatic nerve might be occurred by protruding hardware. This case shows endoscopic decompression for protruded acetabular screw irritating sciatic nerve, the techniques described herein may permit broader arthroscopic/endoscopic applications for management of complications after reconstructive hip surgery...
June 4, 2018: BMC Musculoskeletal Disorders
Chahine Assi, Jacques Caton, Thierry Aslanian, Camille Samaha, Kaissar Yammine
Acetabular reconstruction aims at filling bony defects and positioning the acetabular component in its anatomical place. To this, the use of Kerboull plate would give an automatic optimal positioning while reconstructing the acetabular cavity. We developed a technique, the cross technique, that approaches acetabular reconstruction in a systematic way. It consists of placing the KP following its cross design, in reference to a vertical plane (hook, center, palette) and a horizontal plane (horizontal flanges)...
2018: SICOT-J
Taylor J Reif, Patrick K Strotman, Stephanie A Kliethermes, Benjamin J Miller, Lukas M Nystrom
Objectives: Metastatic disease involving the femoral head and neck is often treated with a hemiarthroplasty or total hip arthroplasty (THA) to prevent pathologic fracture but there are no outcome studies demonstrating superiority of one option over the other. Methods: This investigation was designed as a survey of the current members of the Musculoskeletal Tumor Society (MSTS). The survey contained seven clinical vignettes with identical imaging of a pathologic lesion of the femoral head and neck...
September 2018: Journal of Bone Oncology
John P Scanaliato, Daniel L Christensen, Catherine Salfiti, Mackenzie M Herzog, Andrew B Wolff
BACKGROUND: Treatment of acetabular labral tears with moderate or severe intrasubstance damage or segmental defects remains a substantial challenge. Circumferential labral reconstruction with iliotibial band allograft is a relatively new technique that has been proposed to restore stability and eliminate high-stress junction points. PURPOSE: To compare outcomes between hips treated with primary allograft circumferential labral reconstruction and primary labral repair...
May 1, 2018: American Journal of Sports Medicine
Xi Zhou, Qiang Zhang, Wenhao Song, Dongsheng Zhou, Yu He
BACKGROUND: Delayed reconstruction of acetabular fractures remains a challenging task for orthopedists because of malunion, fracture line absorption, and scar formation. Accurate osteotomy, interfragmentary release, and proper adaptation of plates are keys to successful surgery. Prevention of superior gluteal artery (SGA) injury induced by cleaning of the osteotylus and reduction of the sciatic notch is also important. Therefore, sufficient preoperative planning is essential. However, traditional planning methods do not readily provide direct visual and tactile feedback to surgeons...
May 29, 2018: BMC Surgery
Owen J Diamond, Sujith Konan, Nelson V Greidanus, Donald S Garbuz, Clive P Duncan, Bassam S Masri
BACKGROUND: Instability remains one of the main problems after revision hip surgery. The aim of this study was to review the clinical, radiological, and patient-reported outcomes with the use of modular dual-mobility articulation for revision acetabular reconstruction and investigate the risk of fretting corrosion by measuring serum trace metal ion levels. METHODS: Sixty consecutive patients with a minimum of 24-month follow-up after the insertion of a modular dual-mobility (Stryker, Mahwah, NJ) cup at the time of revision hip surgery were identified...
May 9, 2018: Journal of Arthroplasty
Bowen Xu, Qingsong Zhang, Siqi An, Baorui Pei, Xiaobo Wu
Objective: To establish the model of compression fracture of acetabular dome, and to measure the contact characteristics of acetabular weight-bearing area of acetabulum after 3 kinds of internal fixation. Methods: Sixteen fresh adult half pelvis specimens were randomly divided into 4 groups, 4 specimens each group. Group D was the complete acetabulum (control group), and the remaining 3 groups were prepared acetabular dome compression fracture model. The fractures were fixed with reconstruction plate in group A, antegrade raft screws in group B, and retrograde raft screws in group C...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Shijiu Yin, Hang Zhong, Ruibo Li, Ping Mou, Jing Yang
Objective: To explore the surgical technique and effectiveness of autologous femoral head bone graft in total hip arthroplasty (THA) for Crowe type Ⅲ developmental dysplasia of the hip (DDH) with acetabular bone defect. Methods: Between July 2012 and September 2015, 12 cases (12 hips) of Crowe type Ⅲ DDH with acetabular bone defect were included. Of the 12 patients, 2 were male and 10 were female, with an average age of 54.3 years (range, 37-75 years). The Harris score before operation was 41...
January 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Vincent P Galea, Inari Laaksonen, Gabrielle S Donahue, Kiyokazu Fukui, Ayumi Kaneuji, Henrik Malchau, Charles Bragdon
BACKGROUND: The primary aim of this study was to determine the clinical outcomes at 13-year follow-up of patients diagnosed with developmental dysplasia of the hip and subsequently treated with total hip arthroplasty (THA). The secondary aim was to investigate the effect of hip center location on clinical outcomes and polyethylene wear. METHODS: We reviewed data from a consecutive series of 104 patients (123 hips) from a single center. Patients were treated with THA with the high hip center (HHC) technique using cementless acetabular shells and highly cross-linked liners...
April 30, 2018: Journal of Arthroplasty
Jewon Jeong, Hyun-Joo Kim, Eunsun Oh, Jang Gyu Cha, Jiyoung Hwang, Seong Sook Hong, Yun Woo Chang
INTRODUCTION: The development of dual-energy CT and metal artefact reduction software provides a further chance of reducing metal-related artefacts. However, there have been only a few studies regarding whether MARs practically affect visibility of structures around a metallic hip prosthesis on post-operative CT evaluation. METHODS: Twenty-seven patients with 42 metallic hip prostheses underwent DECT. The datasets were reconstructed with 70, 90 and 110 keV with and without MARs...
May 23, 2018: Journal of Medical Imaging and Radiation Oncology
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
Shanxi Wang, Bohua Li, Jun Li, Fuguo Huang, Zhou Xiang, Gang Zhong, Yue Fang, Min Yi, Xiaodan Zhao, Lei Liu
OBJECTIVE: To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice. METHODS: From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20-65 years). The causes of the fractures included traffic accidents (13 cases), falls from a height (four cases), heavy lifting injuries (three cases), and sport injury (one case)...
April 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Vahit E Ozden, Goksel Dikmen, Burak Beksac, Remzi Tozun
INTRODUCTION: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. METHODS: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Nadim Tarazi, Alastair Thomas, Majid Chowdhry, Andrew Carrothers
The incidence of acetabular fractures has increased markedly in patients over 60 in the last quarter of a century, with open reduction and internal fixation being regarded to be the treatment of choice in most patients with displaced acetabular fractures. Lower limb ischaemia following acetabular fixation or arthroplasty is rare. However, such complications can be limb or life threatening, and therefore, it is important to recognise them as early as possible. We present the case of a 70-year-old man with no significant medical history who underwent acetabular fixation with simultaneous arthroplasty complicated with bilateral lower limb ischaemia...
May 18, 2018: BMJ Case Reports
A Torres-Campos, J Albareda Albareda, B Seral García, N Blanco Rubio, J Gómez Vallejo, L Ezquerra Herrando
INTRODUCTION AND OBJECTIVES: Acetabular revision surgery is a challenge due to the appearance of bone defects that make primary fixation of implants difficult when extracting loosened components. Reinforcement rings, such as Burch-Schneider (BS), have been shown to be allies in moderate or severe bone defects. The objective of the study is to evaluate the results and survival of these types of implants in acetabular revision surgery in the medium follow-up. MATERIAL AND METHODS: Retrospective study on a cohort of 64 patients (67 replacements) with BS rings associated with morselized bone allografts in a 2 years minimum follow-up...
May 15, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Renato Locks, Ioanna Bolia, Hajime Utsunomiya, Karen Briggs, Marc J Philippon
Hip arthroscopy is an evolving procedure and its indications have expanded. The number of patients undergoing this procedure has increased significantly as well as the number of surgeons being trained. This has resulted in a notable increase in post-operative complication rates creating the need to develop advanced hip arthroscopic techniques. Revision hip arthroscopy is often complex and many factors should be considered to achieve a satisfactory clinical outcome. Careful pre-operative planning and agreement of expectations between the physician and patient regarding the procedure are important...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Ping Zhen, Xusheng Li, Shenghu Zhou, Hao Lu, Hui Chen, Jun Liu
BACKGROUND: The treatment of acetabular protrusions during total hip arthroplasty of patients with rheumatoid arthritis is difficult. A lack of bone stock, deficient medial cup support, and medialization of the joint center in those with protrusio acetabuli must be addressed during acetabular reconstruction. The purpose of this study was to assess the short-term clinical results of total hip arthroplasty in patients with severe acetabular protrusions secondary to rheumatoid arthritis...
April 19, 2018: Journal of Orthopaedic Surgery and Research
Dahui Wang, Yifeng Lin, Lian Chen, Yueqiang Mo, Peng Huang, Ruixue Ma
Developmental dysplasia of the hip (DDH) is one of the most common diseases encountered in pediatric orthopedic departments. Current treatment strategies seek to improve acetabular coverage, the principal defect of acetabular dysplasia, but are not very successful. We developed a guided bone regeneration (GBR) strategy to improve acetabular coverage via bone tissue engineering (BTE). Poly- dl -lactide (PDLLA) membranes were seeded with bone marrow mesenchymal stem cells (BMSCs) to form a BTE complex, which was then implanted into the superior margin of the acetabulum in a rabbit DDH model...
March 27, 2018: Oncotarget
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