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Jung-Mo Hwang, Deuk-Soo Hwang, Woo-Yong Lee, Chang-Kyun Noh, Long Zheng
Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation...
September 2016: Hip Pelvis
Marcelo Novelino Simão, Emily N Vinson, Charles E Spritzer
OBJECTIVE: The objective of this study was to determine the incidence of a "meniscoid" superior labrum. MATERIALS AND METHODS: This was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra...
July 2016: Radiologia Brasileira
Seung Jae Paek, Ji Yong Yoo, Jang Won Lee, Won-Jong Park, Young Deok Chee, Moon Gi Choi, Eun Joo Choi, Kyung-Hwan Kwon
BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
William Rossy, George Sanchez, Anthony Sanchez, Matthew T Provencher
CONTEXT: Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment. EVIDENCE ACQUISITION: Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016. STUDY DESIGN: Database review. LEVEL OF EVIDENCE: Level 5...
October 7, 2016: Sports Health
Daniel W Griffin, Matthew J Kinnard, Peter M Formby, Michael P McCabe, Terrence D Anderson
BACKGROUND: The indications for hip preservation surgery have expanded to include treatment of hip pathology in older adults. While several studies have examined the efficacy of hip arthroscopy in the setting of osteoarthritis, there has been no review of outcomes in older adults. PURPOSE: To review the outcomes of hip arthroscopy in older adults and identify factors associated with treatment failures. STUDY DESIGN: Systematic review. METHODS: PubMed, EMBASE, and the Cochrane Library were searched through March 2016 for studies reporting outcomes of primary hip arthroscopy in patients older than 40 years...
October 18, 2016: American Journal of Sports Medicine
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
Helen Anwander, Klaus A Siebenrock, Moritz Tannast, Simon D Steppacher
BACKGROUND: Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years...
October 15, 2016: Clinical Orthopaedics and related Research
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
Zeid Al-Ani, Syed Ali, Simon Beardmore, Vinay Parmar, Teik Chooi Oh
BACKGROUND: Although subspecialist orthopaedic surgeons usually request Magnetic Resonance Arthrogram (MRA) examinations, some orthopaedic surgeons may request this examination for a body part that is different from their subspecialty. The purpose of the study is to compare the MRA and the clinical findings in the subspecialist and non-subspecialist groups. METHOD: Retrospective analysis of MRA examinations over a 6-month period. Findings were compared with the clinical information...
2016: Open Orthopaedics Journal
Caroline Witney-Lagen, Abdul Hassan, Anouska Doodson, Balachandran Venkateswaran
BACKGROUND: Treatment of patients who have not improved after physiotherapy for multidirectional instability (MDI) remains challenging, with no agreed best practice. The purpose of this study was to ascertain whether arthroscopic plication is safe and effective for these patients. METHODS: Fifty consecutive patients who had not improved after at least 6 months of specialized shoulder physiotherapy for symptomatic MDI and no labral lesion at arthroscopy underwent arthroscopic plication between 2006 and 2013...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tineke De Coninck, Steven S Ngai, Monica Tafur, Christine B Chung
The shoulder joint is the most unstable articulation in the entire human body. While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion. There are many elements that work in combination to offset the inherent instability of the glenohumeral joint, but the glenoid labrum is perhaps related most often. Broadly, clinical unidirectional instability can be subdivided into anterior and posterior instability, which usually raise concern for anteroinferior and posteroinferior labral lesions, respectively...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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
Pascal Cyrill Haefeli, Christoph Emanuel Albers, Simon Damian Steppacher, Moritz Tannast, Lorenz Büchler
BACKGROUND: In recent years, surgical treatment of symptomatic femoroacetabular impingement (FAI) has been increasingly performed using arthroscopy. Bony pathomorphologies and damage to the labrum as well as cartilage defects can be addressed with comparable results to open surgery with overall less surgery-related complications. Despite the increasing importance of hip arthroscopy, however, reports on midterm clinical and radiographic outcomes and comparison to open surgical hip dislocation are scarce...
October 7, 2016: Clinical Orthopaedics and related Research
Nata Parnes, Maryellen Blevins, Brian Carr, Paul Carey
Inferior labrum anterior to posterior lesions as an isolated injury or as part of an extensive traumatic labral tear are uncommon and may present as multidirectional instability of the shoulder. These lesions are hard to visualize radiographically and many times are diagnosed only during surgery. Arthroscopic repair of these lesions requires advanced arthroscopic skills and is required for restoration of glenohumeral stability. We report a combined double-pulley simple knot technique that anatomically reconstructs the inferior labrum while overcoming the typical technical challenges, providing a large footprint for healing along the inferior glenoid rim and minimizing the amount of suture material in direct contact with the articular cartilage and the risk of knot migration...
August 2016: Arthroscopy Techniques
Ivan J Antosh, John M Tokish, Brett D Owens
CONTEXT: Posterior shoulder instability has become more frequently recognized and treated as a unique subset of shoulder instability, especially in the military. Posterior shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. "Posterior instability" may encompass both dislocation and subluxation, and the most common presentation is recurrent posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of posterior shoulder instability has evolved...
October 3, 2016: Sports Health
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
Joel Narveson, Matthew D Haberl, Patrick J Grabowski
Study Design Case report. Background Intra-articular hip pathologies can be difficult to diagnose, and evidence to guide physical therapy interventions is lacking. The purpose of this report is to describe a clinical pathway for conservative management of a patient with an acute acetabular labral tear (ALT) and femoroacetabular impingement (FAI). Case Description The patient was an 18-year-old woman with recent onset of right groin pain who underwent intra-articular corticosteroid injection and therapeutic exercise for the management of an acute ALT identified on radiographic imaging...
September 29, 2016: Journal of Orthopaedic and Sports Physical Therapy
L Willemot, R Elfadalli, K C Jaspars, M H Ahw, J Peeters, N Jansen, G Declerq, O Verborgt
Purpose : The aim of this study was to assess radiological and clinical outcome after arthroscopic all--suture anchor labral repair. Method: 20 patients treated for anterior and superior labral instability (mean age 29, range 14-51 years) were assessed at a minimum follow-up time of 1 year (mean 19 months ; range, 12-28 months). Postoperative MRI scans were assessed by 3 independent radiologists. The radiological appearance of bone at the anchor-site was judged by the presence of cyst formation, tunnel widening (> 2 mm) or bone edema...
August 2016: Acta Orthopaedica Belgica
Ludovic Humetz
OBJECTIVE: The isokinetic exploration of the shoulder seems little standardized, particularly at the time of the choice of the studied muscular groups, of the installation of the subject as well as positioning of the articulation itself. OBSERVATIONS: Rehabilitation treatment of a 17 year old patient, hyperlaxe, swimmer, in the context of a painful chronic former instability of the shoulder without osseous, muscular lesion or labrale. An isokinetic work of reinforcement of the internal rotators is carried out, into concentric of 60°/s to 240°/s, position known as of Davies modified then in decubitus dorsal of 45° to 90° of abduction...
September 2016: Annals of Physical and Rehabilitation Medicine
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