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acetabular reconstruction

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https://www.readbyqxmd.com/read/27909669/reconstruction-of-massive-posterior-nonrepairable-acetabular-labral-tears-with-peroneus-brevis-tendon-allograft-arthroscopy-assisted-mini-open-approach
#1
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
https://www.readbyqxmd.com/read/27837399/reconstruction-of-the-shallow-acetabulum-with-a-combination-of-autologous-bulk-and-impaction-bone-grafting-fixed-by-cement
#2
Masaaki Maruyama, Shinji Wakabayashi, Hiroshi Ota, Keiji Tensho
BACKGROUND: Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). QUESTIONS/PURPOSES: In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications)...
November 11, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27800202/leg-lengthening-as-a-means-of-improving-ambulation-following-an-internal-hemipelvectomy
#3
Wakyo Sato, Hiroshi Okazaki, Takahiro Goto
Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27783835/percutaneous-acetabuloplasty-for-metastatic-lesions-to-the-pelvis
#4
Ryan A Durfee, Scott A Sabo, G Douglas Letson, Odion Binitie, David Cheong
Metastatic lesions of the acetabulum can be painful and debilitating. First-line treatment is multimodal and consists of disease-specific chemotherapy, osteoclastic inhibitors, analgesics, and radiation therapy. When these therapies fail, surgical intervention usually is indicated and varies from regional defect stabilization to large periacetabular reconstructions that are demanding procedures with high rates of complications. Percutaneous cement augmentation (acetabuloplasty) of lesions in selected patients has been explored as a less invasive method of lesional control...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27779271/inter-and-intra-observer-variability-of-radiography-and-computed-tomography-for-evaluation-of-zurich-cementless-acetabular-cup-placement-ex-vivo
#5
Jessica O Leasure, Jeffrey N Peck, Armando Villamil, Kara L Fiore, Cheryl A Tano
OBJECTIVE: To evaluate the inter- and intra-observer variability in measurement of the angle of lateral opening (ALO) and version angle measurement using digital radiography and computed tomography (CT). METHODS: Each hemipelvis was implanted with a cementless acetabular cup. Ventrodorsal and mediolateral radiographs were made of each pelvis, followed by CT imaging. After removal of the first cup, the pelves were implanted with an acetabular cup in the contralateral acetabulum and imaging was repeated...
October 25, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/27776903/delayed-total-hip-arthroplasty-for-failed-acetabular-fractures-the-influence-of-initial-fracture-management-on-outcome-after-arthroplasty
#6
Ashok S Gavaskar, Hitesh Gopalan, Bhupesh Karthik, Parthasarathy Srinivasan, Naveen C Tummala
BACKGROUND: Total hip arthroplasty (THA) provides a successful salvage option for failed acetabular fractures. The complexity of arthroplasty for a failed acetabular fracture will depend on the fracture pattern and the initial management of the fracture. Our objective was to compare the midterm outcome of THA between patients who presented with failed acetabular fractures following initial surgical or nonsurgical treatment. METHODS: Forty-seven patients underwent cementless THA ± acetabular reconstruction following failed treatment of acetabular fractures...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27766385/use-of-porous-tantalum-components-in-paprosky-two-and-three-acetabular-revision-a-minimum-five-year-follow-up-of-fifty-one-hips
#7
Xavier Flecher, Benjamin Appy, Sébastien Parratte, Matthieu Ollivier, Jean-Noel Argenson
INTRODUCTION: Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. OBJECTIVES: The objective of this study was to analyse the outcome and survivorship of acetabular revision hip arthroplasty using tantalum components for loosening associated with bone loss at a minimum of five-year follow-up...
October 21, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27757494/can-the-crossover-sign-be-a-reliable-marker-of-global-retroversion-of-the-acetabulum
#8
Seyed Ali Hashemi, Javad Dehghani, Amir Reza Vosoughi
OBJECTIVE: Diagnosis of acetabular retroversion based on crossover sign in the anteroposterior radiograph of the hip joint is well described. Accuracy of the crossover sign to identify global retroversion of the acetabulum in comparison to version of the acetabulum in reconstructed three-dimensional computed tomography (3D CT) scan of the hip was the aim of this study. MATERIALS AND METHODS: X-rays of 500 hips were assessed regarding presence of crossover sign and its location in the upper, middle, or lower third of the acetabulum...
January 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27739568/impact-of-individual-anatomy-on-the-benefit-of-cup-medialisation-in-total-hip-arthroplasty
#9
Alexandre Terrier, Valérie Parvex, Hannes A Rüdiger
INTRODUCTION: In total hip arthroplasty, cup medialisation with compensatory increase of femoral offset has been proposed to increase the moment arms of abductor muscles. However, this technique is associated with a loss of acetabular bone stock. Previous data indicates that the potential benefit is not constant among patients and is likely related to patient anatomy. METHOD: Therefore, to be able to select patients who would benefit most from this technique, we measured several anatomical parameters of the pelvis and femur in 15 patients; and evaluated correlations between them and the changes of moment arms associated with cup medialisation...
October 8, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27720304/revision-arthroscopic-acetabular-labral-treatment-repair-or-reconstruct
#10
Brian J White, Julie Patterson, Mackenzie M Herzog
PURPOSE: To compare the outcome of labral repair versus labral reconstruction in patients presenting to a single surgeon for revision hip arthroscopy following previous labral treatment. METHODS: Patients who underwent revision labral repair or labral reconstruction using iliotibial band allograft, after previous labral debridement or repair, between 2009 and 2013 were identified. Hips that underwent revision labral reconstruction were further stratified into 2 graft groups (freeze-dried v frozen allograft)...
October 5, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27687810/bone-remodeling-in-acetabular-reconstruction-using-a-kerboull-type-reinforcement-device-and-structural-bone-grafting-in-total-hip-arthroplasty
#11
Kenichi Oe, Hirokazu Iida, Kohei Tsuda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts. METHODS: This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years)...
August 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27656395/arthroscopic-technique-for-acetabular-labral-reconstruction-using-iliotibial-band-autograft
#12
Jorge Chahla, Eduardo Soares, Sanjeev Bhatia, Justin J Mitchell, Marc J Philippon
The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft...
June 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27656393/anatomic-hip-capsular-reconstruction-with-separate-suture-anchors
#13
Ricardo Cuéllar, Asier Cuéllar, Alberto Sánchez, Adrián Cuéllar
The number of reports on the use of capsule suturing techniques during hip arthroscopy has increased in the last few years because of the important function played by the iliofemoral ligament (IFL). This study describes an arthroscopic technique whereby the hip capsule is opened by a limited vertical dissection of both the capsule itself and the IFL from their footprint on the acetabular rim, and the capsulolabral junction and the IFL's deep fibers are released. After the intra-articular procedure, the capsule is closed through 2 to 4 side-to-side sutures in the vertical arm of the capsulotomy and 1 to 2 suture anchors with sutures are passed through either side of the capsular confluence...
June 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27650276/retention-of-the-well-fixed-implant-in-the-single-stage-exchange-for-chronic-infected-total-hip-arthroplasty-an-average-of-five%C3%A2-years-of-follow-up
#14
Baochao Ji, Boyong Xu, Wentao Guo, Aili Rehei, Wenbo Mu, Desheng Yang, Li Cao
PURPOSE: Removal of an infected prosthesis was considered the gold standard for eradication of infection. However, removal of well-fixed components can result in structural bone damage and compromised reconstruction. In these situations we questioned whether the infection after the total hip arthroplasty could be treated effectively and retain the well-fixed implant in a single-stage exchange. METHODS: A retrospective analysis which included 31 patients with chronic infected THA who underwent major partial single-stage revision, including routinely exchanged femoral head and liner components, aggressive soft tissue debridement, removal of the femoral stem or acetabular cup and retention of the well-fixed component, thorough exposed component brushing, and adequate surgical soaking...
September 20, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27639306/the-extended-direct-anterior-approach-for-column-augmentation-in-the-deficient-pelvis-a-novel-surgical-technique-and-case-series-report
#15
Jonathon M Spanyer, Christopher M Beaumont, Jonathan G Yerasimides
BACKGROUND: Anterior column deficiency of the pelvis may pose a serious threat to the stability of the acetabular component after total hip arthroplasty and, thus, jeopardize the overall success of the procedure. METHODS: After Institutional Review Board approval, a retrospective review was undertaken to identify all patients undergoing revision total hip arthroplasty with anterior column augmentation through an extended direct anterior approach. Demographics and surgical details were collected, and subjects were followed for a 2-year minimum period to measure patient outcomes and to evaluate for the stability of construct fixation...
August 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27610701/a-custom-made-acetabular-implant-for-paprosky-type-3-defects
#16
Marieke Baauw, Gijs Gerard van Hellemondt, Maarten Spruit
Acetabular revision is a challenging operation, especially when dealing with major bone loss and poor bone quality. This article describes a detailed approach to defect analysis, including measurement of bone deficiency and bone quality. A custom-made titanium implant, with precisely outlined flanges to the host bones of the ilium, ischium, and pubis, taking into account the bone quality for optimal screw purchase, was used to reconstruct the acetabular defect. Preliminary results for 12 patients who were retrospectively reviewed after a minimum follow-up of 18 months were promising...
September 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27596973/-the-acetabulum-nonunion-reconstruction-and-reosteosynthesis-a-long-term-outcome
#17
J Pluemer, C Kruppa, E Yilmaz, T A Schildhauer, M Dudda
Acetabular nonunions are rare, especially after operative treatment of an acetabular fracture. There are only single reports of the reconstruction and therapy of acetabular nonunion. Furthermore, there are fewer reports for treatment of acetabular nonunion with a long follow-up. We report a successful revision of an acetabular nonunion after transversal fracture and previous operative intervention, as well as the long-term follow-up after revision surgery.
September 5, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27589968/digital-tomosynthesis-with-metal-artifact-reduction-for-assessing-cementless-hip-arthroplasty-a-diagnostic-cohort-study-of-48-patients
#18
Hao Tang, Dejin Yang, Shengjie Guo, Jing Tang, Jian Liu, Dacheng Wang, Yixin Zhou
OBJECTIVES: For postoperative imaging assessment of cementless hip arthroplasty, radiography and computed tomography (CT) were restricted by overlapping structures and metal artifacts, respectively. A new tomosynthesis with metal artifact reduction (TMAR) is introduced by using metal extraction and ordered subset-expectation maximization (OS-EM) reconstruction. This study investigated the effectiveness of TMAR in assessing fixation stability of cementless hip arthroplasty components. MATERIALS AND METHODS: We prospectively included 48 consecutive patients scheduled for revision hip arthroplasty in our hospital, with 41 femoral and 35 acetabular cementless components available for evaluation...
November 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27581790/hip-labral-repair-options-and-outcomes
#19
REVIEW
Joshua D Harris
The importance of the acetabular labrum has been increasingly recognized, playing a critical role in both normal anatomy and abnormal pathology of the hip joint. The labrum increases acetabular surface area and volume, providing a stable and durable articulation. The fibrocartilaginous composition affords a tissue capable of a lifetime of normal function in the absence of significant osseous pathology. In the setting of femoroacetabular impingement (FAI) or dysplasia, bony biomechanics may cause labral injury, which may translate to patient symptoms...
December 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27536638/acetabular-reconstruction-in-total-hip-arthroplasty
#20
Won Yong Shon, Siva Swaminathan Santhanam, Jung Woo Choi
The difficulties encountered in dealing with the bone deficient acetabulum are amongst the greatest challenges in hip surgery. Acetabular reconstruction in revision total hip arthroplasty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws for minor acetabular defect. Acetabular component selection is mostly based on the amount of bone loss present. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been one of preferred surgical options...
March 2016: Hip & Pelvis
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