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periacetabular osteotomy

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https://www.readbyqxmd.com/read/28098707/descriptive-epidemiology-of-acetabular-dysplasia-the-academic-network-of-conservational-hip-outcomes-research-anchor-periacetabular-osteotomy
#1
Wudbhav N Sankar, Stephen T Duncan, Geneva R Baca, Paul E Beaulé, Michael B Millis, Young-Jo Kim, Christopher L Peters, David A Podeszwa, Perry L Schoenecker, Rafael J Sierra, Ernest L Sink, Daniel J Sucato, Robert T Trousdale, Ira Zaltz, John C Clohisy
BACKGROUND: Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia, which is a well-recognized cause of hip pain, functional limitations, and secondary osteoarthritis. The purpose of this study was to describe the demographics of patients undergoing PAO, the baseline patient-reported outcome measures for this population, and the types of adjunctive procedures performed at the time of PAO surgery. METHODS: Demographics, disease characteristics, and patient-reported functional measures were prospectively collected from all patients who underwent PAO performed by 12 surgeons from 2008 to 2013...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28078360/multimodal-nerve-monitoring-during-periacetabular-osteotomy-identifies-surgical-steps-associated-with-risk-of-injury
#2
Eduardo N Novais, Travis Heare, Lauryn Kestel, Patricia Oliver, Willy Boucharel, Jason Koerner, Kim Strupp
PURPOSE: Sciatic nerve palsy after periacetabular osteotomy (PAO) is a serious complication. The purpose of this study was to determine whether a multimodal sciatic monitoring technique allows for identification of surgical steps that place the sciatic nerve at risk. METHODS: Transcranial electrical motor evoked potentials (TcMEPs), somatosensory evoked potentials (SSEPs), and spontaneous electromyography (EMG) were monitored in a consecutive series of 34 patients (40 hips) who underwent PAO for the treatment of symptomatic hip dysplasia between January 2012 and November 2014...
January 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28060231/patient-reported-outcomes-of-periacetabular-osteotomy-from-the-prospective-anchor-cohort-study
#3
John C Clohisy, Jeffrey Ackerman, Geneva Baca, Jack Baty, Paul E Beaulé, Young-Jo Kim, Michael B Millis, David A Podeszwa, Perry L Schoenecker, Rafael J Sierra, Ernest L Sink, Daniel J Sucato, Robert T Trousdale, Ira Zaltz
BACKGROUND: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28053253/minimally-invasive-periacetabular-osteotomy-using-a-modified-smith-petersen-approach-technique-and-early-outcomes
#4
O H Khan, A Malviya, P Subramanian, D Agolley, J D Witt
AIMS: Periacetabular osteotomy is an effective way of treating symptomatic hip dysplasia. We describe a new minimally invasive technique using a modification of the Smith-Peterson approach. We performed a prospective, longitudinal cohort study to assess for any compromise in acetabular correction when using this approach, and to see if the procedure would have a higher complication rate than that quoted in the literature for other approaches. We also assessed for any improvement in functional outcome...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28017958/theoretical-implications-of-periacetabular-osteotomy-in-various-dysplastic-acetabular-cartilage-defects-as-determined-by-finite-element-analysis
#5
Meng Xu, Wenrui Qu, Yanbing Wang, Lei Zhong, Zhe Zhu, Wei Li, Xin Zhao, Jincheng Wang, Yu Sun
BACKGROUND Different extents and locations of acetabular cartilage defect have been supposed to be a major cause of undesirable outcomes of periacetabular osteotomy (PAO) in patients with developmental dysplasia of the hip (DDH). This study aimed to verify whether different locations of cartilage deficiency affect the biomechanical environment in a three-dimensional model utilizing finite element analysis (FEA). MATERIAL AND METHODS We developed 3 DDH models - DDH-1 (normal shape), DDH-2 (superior defect), and DDH-3 (anterosuperior defect) - by deforming from a normal hip model...
December 26, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27995561/corr-insights-%C3%A2-periacetabular-osteotomy-provides-higher-survivorship-than-rim-trimming-for-acetabular-retroversion
#6
Rafael J Sierra
No abstract text is available yet for this article.
December 19, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27977586/application-of-a-3-dimensional-printed-navigation-template-in-bernese-periacetabular-osteotomies-a-cadaveric-study
#7
You Zhou, Xiaopeng Kang, Chuan Li, Xiaoshan Xu, Rong Li, Jun Wang, Wei Li, Haotian Luo, Sheng Lu
The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model.Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. Using Mimics v10.1 software (Materialise, Leuven, Belgium), 3D computed tomographic reconstructions were created and the 4 standard PAO bone cuts-ischial, pubic, anterior, and posterior aspects of the ilium-as well as rotation of the dislocated acetabular bone blocks were simulated for each specimen...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27921206/periacetabular-osteotomy-provides-higher-survivorship-than-rim-trimming-for-acetabular-retroversion
#8
Corinne A Zurmühle, Helen Anwander, Christoph E Albers, Markus S Hanke, Simon D Steppacher, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d'Aubigné scores in a midterm followup compared with rim trimming...
December 5, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27905061/one-third-of-hips-after-periacetabular-osteotomy-survive-30-years-with-good-clinical-results-no-progression-of-arthritis-or-conversion-to-tha
#9
Till Dominic Lerch, Simon Damian Steppacher, Emanuel Francis Liechti, Moritz Tannast, Klaus Arno Siebenrock
BACKGROUND: Since its first description in 1984, periacetabular osteotomy (PAO) has become an accepted treatment for hip dysplasia. The 30-year survivorship with this procedure has not been reported. Because these patients are often very young at the time of surgery, long-term followup and identification of factors associated with poor outcome could help to improve patient selection. QUESTIONS/PURPOSES: Looking at the initial group of patients with hip dysplasia undergoing PAO at the originator's institution, we asked: (1) What is the cumulative 30-year survival rate free from conversion to THA, radiographic progression of osteoarthritis, and/or a Merle d'Aubigné-Postel score < 15? (2) Did hip function improve and pain decrease? (3) Did radiographic osteoarthritis progress? (4) What are the factors associated with one or more of the three endpoints: THA, radiographic progression of osteoarthritis, and/or Merle d'Aubigné-Postel score < 15? METHODS: We retrospectively evaluated the first 63 patients (75 hips) who underwent PAO for hip dysplasia between 1984 and 1987...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27830486/three-patterns-of-acetabular-deficiency-are-common-in-young-adult-patients-with-acetabular-dysplasia
#10
Jeffrey J Nepple, Joel Wells, James R Ross, Asheesh Bedi, Perry L Schoenecker, John C Clohisy
BACKGROUND: Detailed recognition of the three-dimensional (3-D) deformity in acetabular dysplasia is important to help guide correction at the time of reorientation during periacetabular osteotomy (PAO). Common plain radiographic parameters of acetabular dysplasia are limited in their ability to characterize acetabular deficiency precisely. The 3-D characterization of such deficiencies with low-dose CT may allow for more precise characterization. QUESTIONS/PURPOSES: The purposes of this study were (1) to determine the variability in 3-D acetabular deficiency in acetabular dysplasia; (2) to define subtypes of acetabular dysplasia based on 3-D morphology; (3) to determine the correlation of plain radiographic parameters with 3-D morphology; and (4) to determine the association of acetabular dysplasia subtype with patient clinical characteristics including sex, range of motion, and femoral version...
November 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27796801/the-femoro-epiphyseal-acetabular-roof-fear-index-a-new-measurement-associated-with-instability-in-borderline-hip-dysplasia
#11
Michael Wyatt, Jan Weidner, Dominik Pfluger, Martin Beck
BACKGROUND: The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making-specifically, a tool that might be associated with instability-therefore would be very helpful for this group of patients. QUESTIONS/PURPOSES: (1) To compare a new radiographic measurement, which we call the Femoro-Epiphyseal Acetabular Roof (FEAR) index, with the lateral center-edge angle (LCEA) and acetabular index (AI), with respect to intra- and interobserver reliability; (2) to correlate AI, neck-shaft angle, LCEA, iliocapsularis volume, femoral antetorsion, and FEAR index with the surgical treatment received in stable and unstable borderline dysplastic hips; and (3) to assess whether the FEAR index is associated clinical instability in borderline dysplastic hips...
October 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27791243/transpositional-periacetabular-osteotomy-with-allografting-in-patients-with-severe-dysplasia-mid-term-results
#12
Motoki Sonohata, Yutaka Yonekura, Masaru Kitajima, Syunsuke Kawano, Masaaki Mawatari
AIM: The purpose of this study was to analyse the extent of surgical correction and the early clinical results obtained using periacetabular osteotomy with allogenic bone grafting in patients with severe acetabular dysplasia. METHODS: 44 hips in 38 patients were confirmed to have severe acetabular dysplasia and underwent this procedure. The mean follow-up period was 4.2 (range 1.5-8.2) years. Severe acetabular dysplasia was defined as a centre-edge angle less than 0°, an acetabular-head index less than 50% and an acetabular roof obliquity greater than 30°...
October 26, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27791238/complications-and-short-term-patient-outcomes-of-periacetabular-osteotomy-for-symptomatic-mild-hip-dysplasia
#13
Benjamin F Ricciardi, Kara G Fields, Catherine Wentzel, Danyal H Nawabi, Bryan T Kelly, Ernest L Sink
INTRODUCTION: The purpose of our study is to identify complications and early functional outcome scores in patients treated with periacetabular osteotomy (PAO) for mild acetabular dysplasia. METHODS: The study population consisted of patients from a single centre prospective hip registry undergoing PAO with mild acetabular dysplasia (LCEA ≥18° and ≤25°; n = 27 patients; Mild Dysplasia group). A comparison group of patients undergoing PAO with more severe acetabular dysplasia (lateral centre-edge angle [LCEA] ≤17°; n = 50 patients; Severe Dysplasia group) were included as a comparison cohort...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27757728/reduced-rates-of-non-union-with-modified-periacetabular-osteotomy-using-peracetic-acid-sterilized-cancellous-allografts
#14
Georgi I Wassilew, Viktor Janz, Lisa Renner, Carsten Perka, Axel Pruss
The objective of the present study was to analyze the clinical and radiological results of periacetabular osteotomies (PAO) using Kirschner wire fixation and an allogeneic cancellous bone graft. This retrospective cohort study included 73 patients (85 PAOs). The allografts were processed from distal femur of cadaveric donors, defatted, sterilized with a peracetic-acid ethanol solution and freeze-dried. The clinical outcome, as measured by the Harris Hip Scores (HHS), the complication rate and the acetabular correction, as measured by radiological parameters, were compared...
December 2016: Cell and Tissue Banking
https://www.readbyqxmd.com/read/27752989/femoral-morphology-in-the-dysplastic-hip-three-dimensional-characterizations-with-ct
#15
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27751174/acetabular-labrum-blood-flow-in-developmental-dysplasia-of-the-hip-an-intraoperative-in-vivo-study-using-laser-doppler-flowmetry
#16
So Minokawa, Masatoshi Naito, Koichi Kinoshita, Takuaki Yamamoto
BACKGROUND: The vascular supply to the acetabular labrum is important in the treatment of labral lesions. However, in vivo blood flow measurements in the acetabular labrum have not been described in the literature. The purpose of this study was to examine this blood flow in vivo using laser Doppler flowmetry (LDF) in patients with acetabular dysplasia. METHODS: Periacetabular osteotomy combined with arthroscopy was performed in 47 consecutive patients (three males, 44 females; mean age at surgery, 35...
October 17, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27744000/microinstability-of-the-hip-a-review
#17
A Dangin, N Tardy, M Wettstein, O May, N Bonin
With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors concern hip joint bone architecture or peri-articular soft tissues. Bone abnormalities are identified on hip assessment parameters. Soft tissues also play a key role in the static and dynamic stability of the hip: the joint capsule, labrum, ligamentum teres and adjacent myotendinous structures affect joint coaptation; any abnormality or iatrogenic lesion concerning these structures may constitute a risk factor for microinstability...
October 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27726746/postoperative-imaging-in-the-setting-of-hip-preservation-surgery
#18
Megan K Mills, Colin D Strickland, Mary K Jesse, Peter A Lowry, Omer Mei-Dan, Jonathan A Flug
Osteoarthritis of the hip remains a prevalent disease condition that influences ever-changing treatment options. Procedures performed to correct anatomic variations, and, in turn, prevent or slow the progression of osteoarthritis, are aptly referred to as types of hip preservation surgery (HPS). Conditions that predispose individuals to femoroacetabular impingement (FAI), including pincer- and cam-type morphology, and hip dysplasia are specifically targeted in HPS. Common surgical interventions include acetabuloplasty, osteochondroplasty, periacetabular osteotomy (PAO), and derotational femoral osteotomy (DFO)...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27716351/does-the-optimal-position-of-the-acetabular-fragment-should-be-within-the-radiological-normal-range-for-all-developmental-dysplasia-of-the-hip-a-patient-specific-finite-element-analysis
#19
Xuyi Wang, Jianping Peng, De Li, Linlin Zhang, Hui Wang, Leisheng Jiang, Xiaodong Chen
BACKGROUND: The success of Bernese periacetabular osteotomy depends significantly on how extent the acetabular fragment can be corrected to its optimal position. This study was undertaken to investigate whether correcting the acetabular fragment into the so-called radiological "normal" range is the best choice for all developmental dysplasia of the hip with different severities of dysplasia from the biomechanical view? If not, is there any correlation between the biomechanically optimal position of the acetabular fragment and the severity of dysplasia? METHODS: Four finite element models with different severities of dysplasia were developed...
October 4, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27714624/corr-insights-%C3%A2-operative-fluoroscopic-correction-is-reliable-and-correlates-with-postoperative-radiographic-correction-in-periacetabular-osteotomy
#20
Rocco P Pitto
No abstract text is available yet for this article.
October 6, 2016: Clinical Orthopaedics and related Research
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