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https://www.readbyqxmd.com/read/29628686/treatment-options-for-chronic-pelvic-discontinuity
#1
REVIEW
Mark D Hasenauer, Wayne G Paprosky, Neil P Sheth
Chronic pelvic discontinuity is a distinct and unique challenge seen during revision total hip arthroplasty (THA) in which the superior ilium is separated from the inferior ischiopubic segment through the acetabulum, rendering the anterior and posterior columns discontinuous. The operative management of acetabular bone loss in revision THA is one of the most difficult challenges today. Common treatment options include cage reconstruction with bulk acetabular allograft, custom triflange acetabular component, a cup-cage construct, jumbo acetabular cup with porous metal augments, or acetabular distraction with a porous tantalum shell with or without modular porous augments...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29615377/correct-assessment-of-acetabular-component-orientation-in-total-hip-arthroplasty-from-plane-radiographs
#2
Diana Widmer, Kilian Reising, Elmar Kotter, Peter Helwig
BACKGROUND: Correct positioning of the cup is an important factor in total hip arthroplasty. Assessing its position from a plain anteroposterior pelvic radiograph is known to be hampered by systemic errors. This study focuses on developing a correction method to adjust for these potential sources of error and to eliminate them based on a 3D geometric analysis. METHODS: Computed tomography scans of 113 (66 male, 47 female) pelvices were reconstructed and virtually projected onto a plain radiograph with varying rotational and translational positions...
March 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29615012/how-does-iliosacral-bone-tumor-resection-without-reconstruction-affect-the-ipsilateral-hip-joint
#3
Tao Jin, Weifeng Liu, Hairong Xu, Yuan Li, Lin Hao, Xiaohui Niu
BACKGROUND: Whether reconstruction is more beneficial after iliosacral bone tumor resection remains controversial. Because of high rates of complications and recurrence, few patients benefit from reconstruction. The aim of this study is to assess functional outcomes and to reveal changes in the ipsilateral hip joint after partial iliosacral resection. METHODS: From 1998 to 2016, 21 patients aged 20-66 years underwent iliosacral resection, 18 without reconstruction (group 1) and 3 with reconstruction (group 2)...
April 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29560393/the-direct-anterior-approach-for-acetabular-augmentation-in-primary-total-hip-arthroplasty
#4
Erin Honcharuk, Stephen Kayiaros, Lee E Rubin
Addressing acetabular bone defects can be difficult and depends on the amount of bone loss. Augments, either with bone or highly porous metals, are options that still allow the use of a hemispherical cup. Almost all previous research and publication on acetabular augments have focused on revision hip arthroplasty utilizing either a modified lateral or a posterolateral surgical approach. We describe 3 cases of augmenting acetabular bone defects through a direct anterior approach for primary total hip arthroplasty...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29556506/a-rare-case-of-severe-third-degree-friction-burns-and-large-morel-lavallee-lesion-of-the-abdominal-wall
#5
Darnell J Brown, Kuo Jung G Lu, Kristina Chang, Jennifer Levin, John T Schulz, Jeremy Goverman
Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL...
2018: Burns and Trauma
https://www.readbyqxmd.com/read/29553552/individualized-stem-positioning-in-calcar-guided-short-stem-total-hip-arthroplasty
#6
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/29536682/-application-of-tri-lock-bone-preservation-stem-in-acetabular-protrusion-combined-with-shorten-defect-of-femoral-head-and-neck
#7
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29529665/tantalum-components-in-difficult-acetabular-revisions-have-good-survival-at-5-to-10-years-longer-term-followup-of-a-previous-report
#8
Paul F Lachiewicz, Jane Anne O'Dell
BACKGROUND: The best method for acetabular revisions in patients with severe bone loss remains controversial; typical approaches include jumbo cups, cages, cup-cages, and custom components. Tantalum (TM) components have good results at midterm followup, but the longer term survival and complications are not available. We previously reported on a series of such reconstructions; here we provide additional followup on that group along with a larger study cohort. QUESTIONS/PURPOSES: (1) What is the survival at a minimum followup of 5 years of these components implanted in difficult revisions and what is the mechanism of failure? (2) What is the most common complication of these reconstructions, and what hip scores did these patients achieve? METHODS: Between 2001 and 2010, one surgeon performed 150 acetabular revisions, of which 74 (49%) were done using TM components...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529662/novel-acetabular-cup-for-revision-tha-improves-hip-center-of-rotation-a-radiographic-evaluation
#9
Anton Khlopas, Morad Chughtai, Randa K Elmallah, David Hip-Flores, Arthur L Malkani, Steven F Harwin, Michael A Mont, Michael D Ries
BACKGROUND: Bone loss in patients undergoing revision THA poses a considerable challenge for orthopaedic surgeons. Often, to achieve better fixation in remaining bone, larger diameter acetabular components and reaming superiorly may be necessary. However, this is likely to raise the hip center of rotation, which may lead to altered biomechanics, specifically, insufficiency of the abductor muscles, altered gait, and increased risk of dislocation from impingement. More recently, a newer acetabular shell has been designed to more closely replicate the native hip center of rotation in these circumstances while maintaining adequate fixation...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529660/can-dislocation-of-a-constrained-liner-be-salvaged-with-dual-mobility-constructs-in-revision-tha
#10
Brian P Chalmers, Graham D Pallante, Michael J Taunton, Rafael J Sierra, Robert T Trousdale
BACKGROUND: Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobility (DM) construct, but there are few data on this approach. QUESTIONS/PURPOSES: (1) What were the Harris hip scores in a small group of patients whose constrained liners were converted to DM constructs to treat recurrent dislocation? (2) What were the redislocation, rerevision, and DM construct retention rates in these patients? METHODS: We conducted a retrospective analysis of a longitudinally maintained institutional database maintained by individuals other than the treating surgeons to identify patients undergoing conversion of constrained liners to DM constructs in revision THA from 2011 to 2014...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29526153/surgical-reconstruction-of-hip-subluxation-and-dislocation-in-children-with-cerebral-palsy
#11
Murat Oto, İlker Abdullah Sarıkaya, Ozan Ali Erdal, Ali Şeker
OBJECTIVES: This study aims to review the efficacy of femoral varus derotation osteotomy (VDRO) and Dega transiliac osteotomy in the treatment of hip subluxation and dislocation of cerebral palsy (CP) patients. PATIENTS AND METHODS: This retrospective study included 25 hips of 22 CP patients (9 males, 13 females; mean age 8.7 years; range 4 to 18 years) who were operated due to hip subluxation and dislocation between July 2010 and December 2015. The mean follow-up period was 36...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29511673/structural-and-morselized-allografting-combined-with-a-cementless-cup-for-acetabular-defects-in-revision-total-hip-arthroplasty-a-4-to-14-year-follow-up
#12
Hou-Tsung Chen, Cheng-Ta Wu, Tsan-Wen Huang, Hsin-Nung Shih, Jun-Wen Wang, Mel S Lee
Using morselized and structural allograft to restore bone stock for massive acetabular bone defect in revision total hip arthroplasty (THA) is an appealing procedure. However, concerns about inability to achieve long-term stability following allograft resorption remained. From 2003 to 2012, 59 hips in 58 patients undergoing revision THA for Paprosky type II or III acetabular defects were retrospectively reviewed. The acetabular defects were managed with deep-frozen morselized and structural allografts, and a press-fit cementless cup along with supplementary screws...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29500087/the-use-of-fluoroscopy-during-direct-anterior-hip-arthroplasty-powerful-or-misleading
#13
Christopher R James, Blake E Peterson, Julia R Crim, James L Cook, Brett D Crist
BACKGROUND: Direct anterior approach total hip arthroplasty (THA) with fluoroscopic assistance is growing in popularity. Variables such as pelvic tilt, c-arm technique, and patient positioning can affect the perceived fluoroscopic view. This study evaluates the effect of these variables on the position of the acetabular component. METHODS: Forty-one hips in 40 patients undergoing direct anterior arthroplasty THA with fluoroscopic assistance underwent routine postoperative radiographs and postoperative pelvic computed tomography scan...
February 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29464580/outcome-after-early-mobilization-following-hip-reconstruction-in-children-with-developmental-hip-dysplasia-and-luxation
#14
Katharina Susanne Gather, Eva von Stillfried, Sebastien Hagmann, Sebastian Müller, Thomas Dreher
BACKGROUND: Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia. This challenging treatment may be associated with complications. Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction. METHODS: Twenty-seven children (3.4±2.0 years), including 33 hips with developmental hip dysplasia (DDH) and dislocation of the hip (Tönnis grade 1 to 4), who underwent hip reconstruction (Dega acetabuloplasty, varisation-derotation osteotomy and facultative open reduction) were retrospectively included in this study...
February 20, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29460155/pelvic-reconstructions-following-peri-acetabular-bone-tumour-resections-using-a-cementless-ice-cream-cone-prosthesis-with-dual-mobility-cup
#15
Samir-Pierre Issa, David Biau, Antoine Babinet, Valérie Dumaine, Malo Le Hanneur, Philippe Anract
PURPOSE: Despite numerous reconstructive techniques and prosthetic devices, pelvic reconstructions following peri-acetabular malignant tumours resections are highly challenging. In the present study, we describe our experience with the Integra® (Lépine, Genay, France) ice-cream cone prosthesis in such indications. The objective was to assess the mid-term outcomes of this device. METHODS: Twenty-four patients' chart with peri-acetabular malignant tumours, who underwent types II or II + III peri-acetabular resections according to Enneking and Dunham with subsequent reconstruction using the Integra® prosthesis between February 2009 and February 2015, were reviewed...
January 27, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29428321/cement-augmentation-in-the-proximal-femur-to-prevent-stem-subsidence-in-revision-hip-arthroplasty-with-paprosky-type-ii-iiia-defects
#16
Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Chao-Ming Chen, Wei-Ming Chen
BACKGROUND: Subsidence remains a common complication after revision hip arthroplasty which may lead to prolonged weight-bearing restrictions, leg-length discrepancies or considerable loss of function. We evaluated the effectiveness of cement augmentation in the proximal femoral metaphysis during a revision of femoral components to prevent post-operative stem subsidence. METHODS: Forty patients were enrolled. Follow-up averaged 67.7 months (range: 24-149). Twenty-seven patients had a Paprosky type II defect and 13 had a type IIIa defect...
February 7, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29423250/labral-augmentation-with-ligamentum-capitis-femoris-presentation-of-a-new-technique-and-preliminary-results
#17
Jan Weidner, Michael Wyatt, Martin Beck
Preservation of an intact labrum and reconstruction of a deficient or worn acetabular labrum are accepted techniques in modern hip surgery. If the remaining labrum is very thin, its intact tip can be preserved and its volume restored with a ligamentum teres graft. Technique and preliminary results of this augmentation technique are presented. Labral augmentation was performed in 16 hips (11 rights) in 16 patients (7 males, mean age 29 years) during surgical dislocation for treatment of femoroacetabular impingement...
January 2018: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/29413190/editorial-commentary-wanted-dead-or-alive-primary-allograft-labral-reconstruction-of-the-hip-is-as-successful-if-not-more-successful-than-primary-labral-repair
#18
EDITORIAL
Thomas Youm
Primary repair of acetabular labral tears has been the gold standard treatment with excellent short to mid-term results. Autograft and allograft labral reconstruction has been described mostly in the revision labral surgery setting with good short-term results. A recent study has compared primary labral reconstruction to labral repair head-to-head in the same patient. Primary labral reconstruction may be a suitable alternative to labral repair in patients with symptomatic labral pathology. Concerns remain, however, about sacrificing living labral tissue for dead allograft tissue for the long term...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29396805/standardized-three-dimensional-computerised-tomography-scanner-reconstructions-increase-the-accuracy-of-acetabular-fracture-classification
#19
Amer Sebaaly, Guillaume Riouallon, Mourad Zaraa, Peter Upex, Véronique Marteau, Pomme Jouffroy
PURPOSE: Evaluate the role of four standardized 3D reconstruction views in the accurate diagnosis of acetabular fractures. MATERIALS AND METHODS: Thirty-five acetabular fracture cases were selected from a tertiary centre database. Fourteen reviewers with different experience level evaluated this set of images which were provided in axial 2D views and multiplanar reconstruction (MPR) without 3D views in the first two readings then the standardized 3D views were added for the subsequent two readings...
February 2, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29390479/biaxial-reduction-technique-for-the-medially-displaced-quadrilateral-surface-in-acetabular-fracture-through-the-modified-iliofemoral-approach-an-observational-study
#20
Byung Hoon Lee
Treatment of acetabular fractures is technically demanding injuries. The complex surgical approaches and special equipment have been introduced for achieving accurate anatomical reduction.The aim of the study was to present our experiences of using a newly operative technique to achieve accurate reduction of articular dome impaction and of the quadrilateral surface without special equipment or traction device in reference to fracture reduction and fixation, technical aspects, and the incidence of complications...
December 2017: Medicine (Baltimore)
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