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Femoral Retroversion

Christopher A Iobst, Ahmed Ansari
When persistent rotation of the femur remains into adolescence, it can cause functional limitations such as fatigue, anterior knee pain, and frequent tripping. In these cases, derotation of the femur via osteotomy is often performed. We report preliminary results of bilateral derotational osteotomy for excessive femoral anteversion or retroversion using the modified intramedullary nail technique. A retrospective review of 8 patients was performed. Patients were excluded if additional procedures were performed or if the femoral osteotomy included any deformity correction other than rotation...
December 2018: Techniques in Orthopaedics: TIO
Anna E Dunlap, Kyle G Mathews, Bethany L Walters, Kent A Bruner, Hongyu Ru, Denis J Marcellin-Little
OBJECTIVE To evaluate the 3-D geometry of canine pelves and to characterize the long-term effects of juvenile pubic symphysiodesis (JPS) on pelvic geometry by comparing the pelvic configuration between littermates that did and did not undergo the procedure. ANIMALS 24 Labrador Retriever, Golden Retriever, or Labrador Retriever-Golden Retriever crossbred service dogs from 13 litters. PROCEDURES At 16 weeks old, puppies with a hip joint distraction index ≥ 0.5 were randomly assigned to undergo thermal JPS (n = 9), mechanical JPS (7), or a sham (control) surgical procedure (8)...
November 2018: American Journal of Veterinary Research
Eduardo N Novais, Mariana G Ferrer, Kathryn A Williams, Sarah D Bixby
BACKGROUND: Leverage of the femoral head against the acetabular rim may lead to posterior hip dislocation during sports activities in hips with femoroacetabular impingement (FAI) deformity. Abnormal concavity of the femoral head and neck junction has been well described in association with posterior hip dislocation. However, acetabular morphology variations are not fully understood. QUESTIONS/PURPOSES: The purpose of this study was to compare the acetabular morphology in terms of acetabular version and coverage of the femoral head in adolescents who sustained a posterior hip dislocation during sports and recreational activities with a control group of patients without a history of hip disease matched by age and sex...
September 27, 2018: Clinical Orthopaedics and related Research
Morteza Kalhor, Diego Collado, Michael Leunig, Paulo Rego, Reinhold Ganz
The Bernese periacetabular osteotomy (PAO) is a widely used procedure to reorient a dysplastic acetabulum resulting from developmental dysplasia of the hip, retroversion, protrusio, or some deformities with a traumatic etiology. Throughout the execution, the lateral femoral cutaneous nerve (LFCN) as well as the obturator, femoral, and sciatic nerves can be injured. Injury to 1 of the 3 major nerves is a devastating event for the patient followed by an ill-defined period of hope for nerve recovery and fear of lifelong disability...
December 28, 2017: JBJS Essential Surgical Techniques
Robert L Buly, Branden R Sosa, Lazaros A Poultsides, Elaine Caldwell, S Robert Rozbruch
BACKGROUND: Version abnormalities of the femur can cause pain and hip joint damage due to impingement or instability. A retrospective clinical review was conducted on patients undergoing a subtrochanteric derotation osteotomy for either excessive anteversion or retroversion of the femur. METHODS: A total of 55 derotation osteotomies were performed in 43 patients: 36 females and 7 males. The average age was 29 years (range, 14 to 59 years). The osteotomies were performed closed with an intramedullary saw...
October 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Ziad Bakouny, Ayman Assi, Fares Yared, Nour Khalil, Elie Mansour, Jean Jacques Yaacoub, Wafa Skalli, Ismat Ghanem
BACKGROUND: Hip instability is frequent in patients with Down syndrome. Recent studies have suggested that skeletal hip alterations are responsible for this instability; however, there are currently no studies simultaneously assessing femoral and acetabular anatomy in subjects with Down syndrome in the standing position. The aim was to analyze the three-dimensional anatomy of the Down syndrome hip in standing position. METHODS: Down syndrome subjects were age and sex-matched to asymptomatic controls...
October 2018: Clinical Biomechanics
James R Ross, Moin Khan, Benjamin C Noonan, Christopher M Larson, Bryan T Kelly, Asheesh Bedi
Background: Femoroacetabular impingement (FAI) morphology can lead to range-of-motion deficits in football players. It is therefore important for physicians treating these players to be aware of the location and implications of FAI morphology. Purpose/Questions: We sought to characterize the radiographic deformity and dynamic impingement observed in a consecutive series of American football linemen with symptomatic, mechanical hip pain who underwent surgical treatment for FAI and to use software analysis to identify the location of impingement and terminal range of motion and the effects of simulated correction...
July 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
M M Ibrahim, S Poitras, A C Bunting, E Sandoval, P E Beaulé
Aims: What represents clinically significant acetabular undercoverage in patients with symptomatic cam-type femoroacetabular impingement (FAI) remains controversial. The aim of this study was to examine the influence of the degree of acetabular coverage on the functional outcome of patients treated arthroscopically for cam-type FAI. Patients and Methods: Between October 2005 and June 2016, 88 patients (97 hips) underwent arthroscopic cam resection and concomitant labral debridement and/or refixation...
July 2018: Bone & Joint Journal
William Z Morris, Cody A Fowers, Douglas S Weinberg, Michael B Millis, Leigh-Anne Tu, Raymond W Liu
INTRODUCTION: Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. METHODS: Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane)...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Susan Mayes, Peter Smith, Jill Cook
OBJECTIVES: Professional ballet dancers may have hip bony morphology that predisposes them to cartilage or labral injury. However, the relationship between bony morphology and pathology has not been investigated in ballet. This study investigates associations between bony morphology, chondrolabral defects and hip pain in ballet dancers. DESIGN: Cross-sectional study. METHODS: 33 male and female professional ballet dancers, (mean age 27 years (range 19-39)), completed questionnaires with hip pain measured on a visual analogue scale; and underwent 3...
September 2018: Journal of Science and Medicine in Sport
Casey A Myers, Peter J Laz, Kevin B Shelburne, Dana L Judd, Daniel N Huff, Joshua D Winters, Jennifer E Stevens-Lapsley, Paul J Rullkoetter
BACKGROUND: Component alignment is an important consideration in total hip arthroplasty. The impact of changes in alignment on muscle forces and joint contact forces during dynamic tasks are not well understood, and have the potential to influence surgical decision making. The objectives of this study were to assess the impact of femoral head/stem and cup component placement on hip muscle and joint contact forces during tasks of daily living and to identify which alignment parameters have the greatest impact on joint loading...
March 2018: Clinical Biomechanics
Lucas S Marchand, Dane C Todd, Patrick Kellam, Temitope F Adeyemi, David L Rothberg, Travis G Maak
BACKGROUND: Restoring normal femoral rotation is an important consideration when managing femur fractures. Femoral malrotation after fixation is common and several preventive techniques have been described. Use of the lesser trochanter profile is a simple method to prevent malrotation, because the profile changes with femoral rotation, but the accuracy of this method is unclear. QUESTIONS/PURPOSES: The purposes of this study were (1) to report the rotational profiles of uninjured femora in an adult population; and (2) to determine if the lesser trochanter profile was associated with variability in femoral rotation...
June 2018: Clinical Orthopaedics and related Research
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
Juan P Sardi, Jorge E Camacho, Roberto C Diaz, Miguel E Berbeo
STUDY: Design: Diagnostic studies-concordance between diagnostic tests. OBJECTIVES: The purpose of this study was to develop a novel spinopelvic parameter (Berbeo-Sardi angle [BSA], the angle formed at the intersection of a line that connects the inferior margin of the sacroiliac joint to the midpoint of a horizontal line joining both femoral heads) measurable in anteroposterior radiographs that indirectly estimates pelvic retroversion and correlates with traditional measurements like pelvic tilt (PT)...
March 2018: Spine Deformity
David E Hartigan, Itay Perets, John P Walsh, Edwin O Chaharbakhshi, Leslie C Yuen, Benjamin G Domb
Background: Femoral retroversion has been noted as a possible risk factor for poor clinical results after hip arthroscopic surgery. Purpose: To compare the outcomes of the arthroscopic treatment of hip abnormalities in patients with femoral retroversion to patients with femoral anteversion between 10° and 20°. Study Design: Cohort study; Level of evidence, 3. Methods: Between November 2011 and September 2013, 790 hip arthroscopic procedures were performed at a single institution...
October 2017: Orthopaedic Journal of Sports Medicine
Evgeny Bulat, Daniel A Maranho, Leslie A Kalish, Michael B Millis, Young-Jo Kim, Eduardo N Novais
BACKGROUND: The etiology of hip instability in Down syndrome is not completely understood. We investigated the morphology of the acetabulum and femur in patients with Down syndrome and compared measurements of the hips with those of matched controls. METHODS: Computed tomography (CT) images of the pelvis of 42 patients with Down syndrome and hip symptoms were compared with those of 42 age and sex-matched subjects without Down syndrome or history of hip disease who had undergone CT for abdominal pain...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
Caitlyn M Rerucha, Caleb Dickison, Drew C Baird
Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing is less common than intoeing and occurs more often in older children. Out-toeing is caused by external tibial torsion and femoral retroversion. Angular problems include genu varum (bowleg) and genu valgum (knock knee). With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid...
August 15, 2017: American Family Physician
William P Croom, Daniel J Lorenzana, Richard L Auran, Matthew J Cavallero, Nathanael Heckmann, Jackson Lee, Eric A White
OBJECTIVES: To determine native individual bilateral differences (IBDs) in femoral version in a diverse population. METHODS: Computed tomography scans with complete imaging of uninjured bilateral femora were used to determine femoral version and IBDs in version. Age, sex, and ethnicity of each subject were also collected. Femoral version and IBDs in version were correlated with demographic variables using univariate and multivariate regression models. RESULTS: One hundred sixty-four subjects were included in the study...
February 2018: Journal of Orthopaedic Trauma
Roger Jawish, Hassan Najdi, Ali Krayan
The periacetabular quadruple osteotomy of the pelvis (QOP), with the osteotomy of ischial spine to release the sacrospinal ligament, is reserved for older children with low potential of remodeling. Different parameters were studied with computed tomography (CT) scan before (pre-OH) and after surgery (post-OH) and for nonoperated hip (NOH). The study determined an optimal method to avoid retroversion and excessive anterior coverage. Fifteen QOP were performed in 13 patients, ranging in age from 10 to 15 years...
May 2018: Journal of Pediatric Orthopedics. Part B
Chaturong Pornrattanamaneewong, Rapeepat Narkbunnam, Keerati Chareancholvanich
OBJECTIVE: To prove the accuracy of a customized guide developed according to our method. METHODS: This customized guide was developed from a three-dimensional model of proximal femur reconstructed using computed tomography data. Based on the new technique, the position of the guide pin insertion was selected and adjusted using the reference of the anatomical femoral neck axis. The customized guide consists of a hemispheric covering designed to fit the posterior part of the femoral neck...
March 2017: Acta Ortopedica Brasileira
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