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Benedict U Nwachukwu, Kara Fields, Brenda Chang, Danyal H Nawabi, Bryan T Kelly, Anil S Ranawat
BACKGROUND: There is increasing interest in defining meaningful improvement in patient-reported outcomes. Knowledge of the thresholds and determinants for successful femoroacetabular impingement (FAI) outcomes is evolving. PURPOSE: To define preoperative outcome score thresholds and determine clinical/demographic patient factors predictive for achieving the minimal clinically important difference (MCID) after arthroscopic FAI surgery. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2...
October 20, 2016: American Journal of Sports Medicine
Mohammed A Zwawi, Faissal A Moslehy, Christopher Rose, Victor Huayamave, Alain J Kassab, Eduardo Divo, Brendan J Jones, Charles T Price
: This study utilized a computational biomechanical model and applied the least energy path principle to investigate two pathways for closed reduction of high grade infantile hip dislocation. The principle of least energy when applied to moving the femoral head from an initial to a final position considers all possible paths that connect them and identifies the path of least resistance. Clinical reports of severe hip dysplasia have concluded that reduction of the femoral head into the acetabulum may occur by a direct pathway over the posterior rim of the acetabulum when using the Pavlik harness, or by an indirect pathway with reduction through the acetabular notch when using the modified Hoffman-Daimler method...
October 20, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Andrea J Dolenc, William Z Morris, John J Como, Karl G Wagner, Heather A Vallier
OBJECTIVES: Controversy exists over association of blood transfusions with complications. The purpose was to assess effects of limited transfusions on complication rates and hospital course. SETTING: level 1 trauma center PATIENTS AND METHODS:: 371 consecutive patients with ISS≥16 underwent fixation of fractures of spine (n = 111), pelvis (n = 72), acetabulum (n = 57), and/or femur (n = 179). Those receiving >3 units PRBC were excluded. MAIN OUTCOME MEASUREMENTS: Fracture type, associated injuries, treatment details, ventilation time, complications, and hospital stay were prospectively recorded...
October 1, 2016: Journal of Orthopaedic Trauma
X M Lü, C Feng, Y F Dong, G Fu, Y Guo
Objective: To explore the influence of the labro-chondral complex (LLC) on the development of the acetabulum after close reduction in developmental dysplasia of the hip (DDH). Methods: Sixty-one cases (72 hips) with DDH presented in Beijing Jishuitan Hospital were reviewed, all the patients were treated by closed reduction, arthrogram and Spica casting from March 2010 to December 2013. The anterior-posterior pelvic radiography was performed to evaluate the morphology of the labro-chondral complex and reduction of the hip...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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...
October 18, 2016: Skeletal Radiology
Ryan Urchek, Eric Miller
The typical injury pattern of a posterior hip dislocation includes posterior wall fracture, capsular injury, and muscular strain. This report presents an example of a posterior wall acetabulum fracture-dislocation associated with complete hip abductor tendon and capsular avulsion from the femur. The patient was found to have an unstable hip despite a small posterior wall fragment due to the extensive soft tissue injury. This was repaired. The patient had improvement in function initially, but ultimately required repair of the hip abductor tendons...
October 13, 2016: Orthopedics
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
Tomohiro Mimura, Kanji Mori, Shin Itakura, Yuki Furuya, Taku Kawasaki, Shinji Imai
BACKGROUND: Femoroacetabular impingement (FAI) is thought to be associated with hip osteoarthritis. We investigated the prevalences of radiologic deformities of the pincer, cam, and their combinations in Japanese hip joints using computed tomography (CT) according to the Japanese Hip Society diagnostic guideline for FAI. METHODS: Multi-slice CT images were evaluated. Pincer deformities were defined as: type 1: center-edge angle (CE) ≥40°; type 2: CE ≥ 30° and acetabular roof obliquity ≤0°; type 3: CE ≥ 25° and retroverted acetabulum...
October 6, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
A J Schreiner, F Stuby, P M de Zwart, B G Ochs
In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular...
October 6, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Monan Wang, Lei Wang, Pengcheng Li, Yili Fu
Understanding the hip joint surface contact stress distribution characteristics is helpful to determine hip joint biomechanical features and abnormal pathological behavior. Firstly, a 3-dimensional static hip joint biomechanical model is built using analytical method of model in order to study biomechanical properties including bearing area, stress distribution and the peak value of the contact stress of the femoral head, which reveals the relationship between the biomechanical properties and its geometric parameters...
October 3, 2016: Bioengineered
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
PURPOSE: The purpose of this study was to determine whether or not there is a distinct pattern of injury to the acetabular labrum and/or cartilage in the hip with instability without bony dysplasia. METHODS: Surgical records and intra-operative images of consecutive patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and/or hip instability by the senior author from April 2007 to December 2014 were retrospectively reviewed. Pathological changes were documented and charted on a novel diagram of the acetabulum, and classified into eight patterns corresponding to the lesion's location and size...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alban Fouasson-Chailloux, Benoit Metayer, Pierre Menu, Lydie Khatchatourian, Joelle Glemarec, Marc Dauty
OBJECTIVE: The loosening of total joint replacement is a frequent complication after total hip arthroplasty (THA). Septic osteolysis should always be feared. We report here a rare case of hip arthroplasty infection due to Mycobacterium bovis after Bacillus Calmette-Guerin (BCG) therapy in a context of bladder cancer. OBSERVATIONS: A 70-year-old man was referred to the department of rheumatology in September 2015, because of a total functional disability of the left lower limb...
September 2016: Annals of Physical and Rehabilitation Medicine
Daniel Howard Wiznia, Mike Wang, Chang Yeon-Kim, Paul Tomaszewski, Michael P Leslie
We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum...
2016: Case Reports in Orthopedics
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Jacob D Gire, Michael J Gardner, Alex H S Harris, Julius A Bishop
PURPOSE: There has recently been an increase in the number of fellowship trained orthopaedic trauma surgeons, raising concerns that the surgical experience of early career surgeons may be diluted. We sought to evaluate the change in complex trauma case volume of orthopaedic trauma surgeons sitting for Part II of the American Board of Orthopaedic Surgeons certification examination. METHODS: The case log data from all surgeons taking Part II of the American Board of Orthopaedic Surgeons examination over a 13-year period (2003-2015) was evaluated...
October 2016: Journal of Orthopaedic Trauma
Jae Hoon Lee, Jisun Yun, Jung-Won Seo, Go-Eun Bae, Jeong-Won Lee, Sang Wun Kim
Primary malignant melanoma (MM) accounts for 1% of all cancers, and only 3% to 7% of these tumors occur in the female genital tract. Data are limited with respect to the basis for treatment recommendations because of the rarity of MM. The overall prognosis of melanomas of the female genital tract is very poor. Two cases of MM of the female genital tract are presented. The first case is of a 70-year-old female patient who complained of left thigh pain and underwent magnetic resonance imaging that showed cervical cancer with involvement of the vagina, bladder, and parametrium, in addition to multiple bony metastases of the proximal femur, acetabulum, and both iliac bones...
September 2016: Obstetrics & Gynecology Science
Eduardo N Novais, Stephen Duncan, Jeffrey Nepple, Gail Pashos, Perry L Schoenecker, John C Clohisy
BACKGROUND: The goal of periacetabular osteotomy (PAO) is to improve the insufficient coverage of the femoral head and achieve joint stability without creating secondary femoroacetabular impingement. However, the complex tridimensional morphology of the dysplastic acetabulum presents a challenge to restoration of normal radiographic parameters. Accurate acetabular correction is important to achieve long-term function and pain improvement. There are limited data about the proportion of patients who have normal radiographic parameters restored after PAO and the factors associated with under- and overcorrection...
September 19, 2016: Clinical Orthopaedics and related Research
Aniss Chagou, Abdelatif Benbouha, Abdelkarim Rhanim, Abdou Lahlou, Mohammed Saleh Berrada, Moradh El Yaacoubi
Coxalgia causes osteocartilaginous destructions of the hip joint; these lesions are responsible for severe pain leading to functional discomfort and limitations in everyday life. Their surgical treatment is still not well established. The aim of our study was to demonstrate the interest of total hip arthroplasty associated with anti-tuberculous chemotherapy to improve patients' quality of life. We report a retrospective study of 10 cases of total hip replacement following coxalgia at the Department of Orthopaedics and Trauma of Rabat University Hospital from 2002 to 2011...
2016: Pan African Medical Journal
Stephanie Y Pun, Andreas Hingsammer, Michael B Millis, Young-Jo Kim
BACKGROUND: Surgical treatment for pincer femoroacetabular impingement (FAI) of the hip remains controversial, between trimming the prominent acetabular rim and reverse periacetabular osteotomy (PAO) that reorients the acetabulum. However, rim trimming may decrease articular surface size to a critical threshold where increased joint contact forces lead to joint degeneration. Therefore, knowledge of how much acetabular articular cartilage is available for resection is important when evaluating between the two surgical options...
September 8, 2016: Clinical Orthopaedics and related Research
YiQiang Li, YuanZhong Liu, QingHe Zhou, WeiDong Chen, JingChun Li, LingJia Yu, HongWen Xu, DengHui Xie
There are no data regarding the acetabular orientation on magnetic resonance imaging (MRI); this study investigates the changes of acetabular orientation with age in normal Chinese children.We retrospectively analyzed the medical records of children who underwent hip MRI examination at our hospital from January 2009 to December 2015. A total of 180 patients with normal MRI reading of the hip joints were included and were divided into 14 groups according to age: from 6 months of age and then for each year from 1 to 16 years...
September 2016: Medicine (Baltimore)
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