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Hip preserving surgery

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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
#1
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/27868077/platelet-rich-plasma-injections-with-needle-tenotomy-for-gluteus-medius-tendinopathy-a-registry-study-with-prospective-follow-up
#2
James J Lee, Julian R Harrison, Kwadwo Boachie-Adjei, Elizabeth Vargas, Peter J Moley
BACKGROUND: Gluteal tendinopathy is a prevalent condition that can be associated with significant pain and disability. To date, no studies have prospectively assessed the efficacy of intratendinous platelet-rich plasma (PRP) injections as a minimally invasive treatment for gluteus medius tendinopathy. PURPOSE: To prospectively assess the efficacy of intratendinous PRP injections as treatment for chronic recalcitrant gluteus medius tendinopathy. STUDY DESIGN: Case series; Level of evidence, 4...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27857822/revision-of-metal-on-metal-hip-arthroplasty-with-well-fixed-and-positioned-acetabular-component-using-a-dual-mobility-head-and-review-of-literature
#3
Guillem Figueras, Ramón Vives Planell, Ramón Serra Fernàndez, Joan Camí Biayna
BACKGROUND: As a consequence of use of metal-on-metal hip arthroplasties some patients have precised revision for pain or metal hipersensivity reactions among other causes. We propose to salvage monoblock acetabular component and femoral component using a dual-mobility head and perform a lower morbidity operation in young patients preserving host bone stock in cases with well fixed and positioned components. OBJECTIVE: (1) What clinical problems have been reported in patients with Metal-on-metal hip arthroplasties? (2) Could the tribocorrosion potentially cause a fracture of neck femoral component? (3) Can be the dual-mobility head a recourse in metal-on-metal hip revision? METHODS: Ten patients were revised for pain or/and raised Cobalt/Chromium levels between August 2012 and December 2015...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27830486/three-patterns-of-acetabular-deficiency-are-common-in-young-adult-patients-with-acetabular-dysplasia
#4
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/27830361/long-term-results-of-valgus-osteotomy-for-terminal-stage-osteoarthritis-of-the-hip
#5
Suguru Ohsawa
INTRODUCTION: Pauwels' femoral osteotomy is a classical and joint-preserving method for osteoarthritis of the hip caused by acetabular dysplasia and/or subluxation. However, its application for terminal-stage osteoarthritis of the hip, and the long-term results, have not yet been reported. We herein aim to investigate the long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip. METHODS: Eighty-two hips of 75 patients (74 women and 1 man, mean age: 48...
November 9, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27816389/biomechanical-optimization-of-the-angle-and-position-for-surgical-implantation-of-a-straight-short-stem-hip-implant
#6
Gillian E Cook, Saeid Samiezadeh, Zachary Morison, Mina S R Aziz, Habiba Bougherara, Radovan Zdero, Emil H Schemitsch
Conservative hip implants preserve healthy bone for revision surgeries and improve physiological loading; however, they have little supporting biomechanical data with respect to their 3D orientation during implantation. This study endeavored to determine the optimal 3D orientation of a straight short stem hip implant within the proximal femur that would yield a stress distribution most similar to an intact femur. Synthetic femurs were implanted with a stem in one of seven maximum angles or positions and axially loaded, with resultant strain values used to validate a finite element model...
November 2, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27803218/the-exeter-universal-cemented-femoral-stem-at-20-to-25-years-a-report-of-382-hips
#7
T G Petheram, S L Whitehouse, H A Kazi, M J W Hubble, A J Timperley, M J Wilson, J R Howell
AIMS: We present a minimum 20-year follow-up study of 382 cemented Exeter Universal total hip arthroplasties (350 patients) operated on at a mean age of 66.3 years (17 to 94). PATIENTS AND METHODS: All patients received the same design of femoral component, regardless of the original diagnosis. Previous surgery had been undertaken for 33 hips (8.6%). During the study period 218 patients with 236 hips (62%) died, 42 hips (11%) were revised and 110 hips (29%) in 96 patients were available for review...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27771040/fate-of-subchondral-fatigue-fractures-of-femoral-head-in-young-adults-differs-from-general-outcome-of-fracture-healing
#8
Sang-Min Kim, Seung-Min Oh, Chang-Ho Cho, Seung-Jae Lim, Young-Wan Moon, Sang-Hee Choi, Youn-Soo Park
PURPOSE: The purpose of this study is to report the clinical course of fatigue-type subchondral fractures of the femoral head in young healthy adults. MATERIALS/METHODS: We retrospectively reviewed 28 consecutive patients (34 hips) who had a clear history of a sudden increase in physical activity without trauma on the hip and pelvis, and were diagnosed as having a fatigue-type subchondral fracture of the femoral head. The diagnosis was made primarily on the basis of sequential plain radiographs and magnetic resonance images...
December 2016: Injury
https://www.readbyqxmd.com/read/27765733/preoperative-outcome-scores-are-predictive-of-achieving-the-minimal-clinically-important-difference-after-arthroscopic-treatment-of-femoroacetabular-impingement
#9
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
https://www.readbyqxmd.com/read/27756723/outcomes-of-hip-arthroscopy-in-the-older-adult-a-systematic-review-of-the-literature
#10
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
https://www.readbyqxmd.com/read/27755642/incidence-and-complications-of-open-hip-preservation-surgery-an-abos-database-review
#11
Jon Hedgecock, P Christopher Cook, John Harrast, Judith F Baumhauer, Brian D Giordano
Hip preservation surgery encompasses various surgical procedures that have the goal of decreasing the progression of osteoarthritis, preserving normal hip function, and delaying the need for arthroplasty. These procedures can encompass arthroscopic, open, and combined techniques. This study investigated the trends and complications associated with open hip preservation surgery performed by candidates undergoing Part II of the American Board of Orthopaedic Surgery examination. The American Board of Orthopaedic Surgery Part II surgeon case database was queried from the years 2003 to 2013 for Current Procedural Terminology (CPT) codes related to open hip preservation surgery in patients 10 years and older...
October 18, 2016: Orthopedics
https://www.readbyqxmd.com/read/27752989/femoral-morphology-in-the-dysplastic-hip-three-dimensional-characterizations-with-ct
#12
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/27744594/labral-reattachment-in-femoroacetabular-impingement-surgery-results-in-increased-10-year-survivorship-compared-with-resection
#13
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
https://www.readbyqxmd.com/read/27726746/postoperative-imaging-in-the-setting-of-hip-preservation-surgery
#14
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/27716459/study-of-the-bone-behavior-around-a-neck-preserving-short-stem-implant-bone-densitometric-analysis-over-a-span-of-two-years
#15
Tarek Abdel Shafy, Adel Sayed, Ahmed H Abdelazeem
PURPOSE: Study the bone mineral density (BMD) changes and the remodelling process after implantation of a neck preserving short stem implant over a period of two years. METHODS: Using specific patients' selection criterion, a prospective study was done including 26 patients. All were operated upon by a single surgeon using the MiniHipTM, (Corin, Cirencester, UK). Mean age was 42.5 years. Clinical and radiological evaluation was done. Periprosthetic bone density was measured by DEXA...
2016: SICOT-J
https://www.readbyqxmd.com/read/27709422/how-does-the-dgemric-index-change-after-surgical-treatment-for-fai-a-prospective-controlled-study-preliminary-results
#16
Florian Schmaranzer, Pascal C Haefeli, Markus S Hanke, Emanuel F Liechti, Stefan F Werlen, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI). QUESTIONS/PURPOSES: (1) How does the mean acetabular and femoral dGEMRIC index change after surgery for FAI at 1-year followup compared with a similar group of patients with FAI treated without surgery? (2) Does the regional distribution of the acetabular and femoral dGEMRIC index change for the two groups over time? (3) Is there a correlation between the baseline dGEMRIC index and the change of patient-reported outcome measures (PROMs) at 1-year followup? (4) Among those treated surgically, can dGEMRIC indices distinguish between intact and degenerated cartilage? METHODS: We performed a prospective, comparative, nonrandomized, longitudinal study...
October 5, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27709055/pendulum-exercises-after-hip-arthroscopy-a-video-technique
#17
Ryan Sauber, George Saborio, Beth M Nickel, Benjamin R Kivlan, John J Christoforetti
Advanced hip joint-preserving arthroscopic techniques have been shown to improve patient-reported functional outcomes with low rates of postoperative complications. Prior work has shown that formation of adhesive scar is a potential source of persistent pain and cause for revision surgery. As resources for postoperative in-studio physical therapy become scarce, a home-based strategy to avoid scar formation without adding formal therapy cost may be beneficial. The purpose of this technical note is to introduce a patient-centered educational video technique for home-caregiver delivery of manual hip pendulum exercises in the postoperative setting...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27590174/clinical-outcomes-of-hip-arthroscopic-surgery-a-prospective-survival-analysis-of-primary-and-revision-surgeries-in-a-large-mixed-cohort
#18
Benjamin G Domb, Chengcheng Gui, Mark R Hutchinson, Shane J Nho, Michael A Terry, Parth Lodhia
BACKGROUND: With the rapid increase in hip preservation procedures, revision hip arthroscopic surgery and conversion to total hip arthroplasty (THA) or hip resurfacing (HR) after primary hip arthroscopic surgery have become a large focus in the recent literature. PURPOSE: The primary purpose was to perform a survival analysis in a large mixed cohort of patients undergoing hip arthroscopic surgery at a high-volume tertiary referral center for hip preservation with a minimum 2-year follow-up...
October 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27587516/total-hip-arthroplasty-following-failure-of-core-decompression-and-tantalum-rod-implantation
#19
M Olsen, P M Lewis, Z Morrison, M D McKee, J P Waddell, E H Schemitsch
AIMS: One method of femoral head preservation following avascular necrosis (AVN) is core decompression and insertion of a tantalum rod. However, there may be a high failure rate associated with this procedure. The purpose of this study was to document the clinical and radiological outcomes following total hip arthroplasty (THA) subsequent to failed tantalum rod insertion. PATIENTS AND METHODS: A total of 37 failed tantalum rods requiring total hip arthroplasty were identified from a prospective database...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27583161/sartorius-muscle-pedicle-iliac-bone-graft-for-the-treatment-of-avascular-necrosis-of-femur-head
#20
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks...
August 2016: Journal of Hip Preservation Surgery
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