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Greater trochanteric

Colin G Murphy, Michel P Bonnin, Antoine H Desbiolles, Yannick Carrillon, Tarik Aїt Si Selmi
BACKGROUND: Varus inclination of the uncemented stem is not necessarily a technical error. The proximal femoral anatomy of hips with a coxa vara deformity frequently predisposes varus inclination. METHODS: We reviewed a series of 200 patients undergoing primary uncemented THA with the Corail® hip system. Preoperative data were based on patient demographics, diagnosis, and radiographic information (preoperative templating-CT measurements), and compared postoperative alignment for each stem and type of stem used...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jay R Ebert, Theertha Retheesh, Rinky Mutreja, Gregory C Janes
BACKGROUND: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome (GTPS), though limited information exists on the disability associated with this condition and specific presentation of these patients. PURPOSE: To describe the clinical, functional and biomechanical presentation of patients with symptomatic HAT tears. Secondary purposes were to investigate the association between these clinical and functional measures, and to compare the pain and disability reported by HAT tear patients to those with end-stage hip osteoarthritis (OA)...
October 2016: International Journal of Sports Physical Therapy
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
Mark Lenz, Karl Stoffel, Heike Kielstein, Keith Mayo, Gunther O Hofmann, Boyko Gueorguiev
INTRODUCTION: Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). METHODS: After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses...
September 30, 2016: Injury
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
Jon A Jacobson, Corrie M Yablon, P Troy Henning, Irene S Kazmers, Andrew Urquhart, Brian Hallstrom, Asheesh Bedi, Aishwarya Parameswaran
OBJECTIVES: The purpose of this study was to compare ultrasound-guided percutaneous tendon fenestration to platelet-rich plasma (PRP) injection for treatment of greater trochanteric pain syndrome. METHODS: After Institutional Review Board approval was obtained, patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (<50% depth) were blinded and treated with ultrasound-guided fenestration or autologous PRP injection of the abnormal tendon...
September 23, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Michael M Nogler, Martin R Thaler
BACKGROUND: The direct anterior approach (DAA) to the hip has been criticized as an approach that is limited to primary arthroplasty only. Our study objective was to demonstrate, in a cadaveric setting, that an alternate extension of the DAA can be used to reach the femur at the posterior border of the lateral vastus muscle without endangering the nerve supply. METHODS: The iliotibial tract is split anteriorly and pulled laterally, thereby opening the interval to the lateral-posterior aspect of the vastus muscle...
August 10, 2016: Journal of Arthroplasty
Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Yoshihiko Okudera, Ken Sasaki, Tetsuya Kawano, Naohisa Miyakoshi, Yoichi Shimada
PURPOSE: In femoral trochanteric fractures, fractures whose fracture lines extend to the basal neck or to the subtrochanteric part have high instability. Area classification can identify such instable fractures. The best choices of internal fixators for femoral trochanteric fractures were investigated according to area classification. METHODS: Femoral trochanteric fractures were investigated with respect to area classification. In area classification, the proximal femur is divided into 4 areas with 3 boundary lines: Line-1 is the center of the neck; Line-2 is the border between the neck and the trochanteric zone; and Line-3 links the inferior borders of the greater and lesser trochanters...
2016: SpringerPlus
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
PURPOSE: Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. MATERIALS AND METHODS: This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013...
June 2016: Hip Pelvis
James Drummond, Camdon Fary, Phong Tran
INTRODUCTION: Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here...
July 12, 2016: Archives of Orthopaedic and Trauma Surgery
U Dorn, F Landauer, T Hofstaedter
Gluteal tendinopathy as well as partial and full-thickness tears of gluteal tendons (gluteus minimus and/or medius tendon) were underestimated as a cause of chronic pain in the past, and treatment was most commonly based on the diagnosis of trochanteric bursitis. Tendinous pathologies can either stay asymptomatic or cause pain and muscular dysfunction, not necessarily being associated with osteoarthritis of the hip 1. As the terminus "rotator cuff tear of the hip" was published in 1997 2, its aetiopathogenesis was reconsidered, resulting in improvements in diagnosis and treatment...
June 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Charlotte Ganderton, Adam Semciw, Jill Cook, Tania Pizzari
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is pathology in the gluteus medius and minimus tendons and trochanteric bursa that causes debilitating tendon pain and dysfunction, particularly in post-menopausal women. Limited evidence in clinical studies suggests hormone changes after menopause may have a negative effect on tendon. This protocol describes a randomised controlled trial comparing the effectiveness of menopausal hormone therapy (MHT) and exercise therapy in reducing pain and dysfunction associated with GTPS in post-menopausal women...
2016: BMC Women's Health
Devendra Pathrot, Rehan Ul Haq, Aditya N Aggarwal, Mahindra Nagar, Shuchi Bhatt
BACKGROUND: Intramedullary devices have increasingly become popular and are widely used for fixation of unstable intertrochanteric and subtrochanteric fractures. These implants have been designed taking into consideration of the anthropometry of the western population which varies from those of other ethnic groups. This study was carried out to assess the geometry of proximal femur for the placement of short cephalomedullary nails in our subset of patients and suggest suitable design modifications based on these parameters...
May 2016: Indian Journal of Orthopaedics
Seung-Chan Kim, Young-Wook Lim, Soon-Yong Kwon, Jun-Ku Lee, Il-Kyu Park, Yong-Sik Kim
BACKGROUND: A contralateral normal hip joint has been often used as a reference standard in preoperative planning and intraoperative assessment of hip arthroplasty, with the assumption that bilateral hip joint geometries have no significant differences. However, one previous study using analog measurements on hardcopy films reported significant bilateral variation in hip joint geometry. We therefore investigated the level of agreement between the right and left hips for each measurement and determined index values and the range of normal bilateral variations...
May 11, 2016: Journal of Arthroplasty
Belma Füsun Köseoğlu, Sinem Akselim, Bilge Kesikburun, Özge Ortabozkoyun
BACKGROUND: The presence of lower extremity pain may be associated with poorer motor recovery, impaired activities of daily living (ADL), reduced quality of life, and disability in patients with stroke. OBJECTIVE: The aims of the study were to describe the characteristics of lower extremity pain conditions and to evaluate the impact of lower extremity pain on clinical variables, and health-related quality of life in patients with stroke. METHODS: One hundred and eighty-five patients with stroke who have self-reported pain in the lower extremity were included in the study...
May 30, 2016: Topics in Stroke Rehabilitation
Ki Deok Park, Woo Yong Lee, Jihae Lee, Min-Ho Park, Jae Ki Ahn, Yongbum Park
BACKGROUND: Trochanteric bursa injections of corticosteroids and local anesthetics have been shown to provide pain relief for the treatment of greater trochanteric pain syndrome (GTPS). However, symptom recurrence and incomplete symptom relief are common. The reason for the variation in response is unclear but may be related to disease-, treatment-, or patient-related factors. OBJECTIVE: To determine whether there are factors related to patient, treatment, or disease that can predict either the magnitude or duration of response to ultrasound-guided trochanteric bursa injections for GTPS...
May 2016: Pain Physician
George N Guild, Robert P Runner, Tracy D Rickels, Ryan Oldja, Ahmad Faizan
BACKGROUND: The incidence of revision hip arthroplasty is increasing with nearly 100,000 annual procedures expected in the near future. Many surgeons use straight modular tapered stems in revisions; however, complications of periprosthetic fracture and cortical perforation occur, resulting in poor outcomes. Our objective was to identify patient demographics and femoral characteristics that predispose patients to cortical perforation when using the straight modular stems. METHODS: We used a computed tomography database and modeling software to identify patient demographics and morphologic femoral characteristics that predispose patients to cortical perforation during revision hip arthroplasty...
April 13, 2016: Journal of Arthroplasty
Kerim Sarıyılmaz, Murat Korkmaz, Okan Özkunt, Halil Can Gemalmaz, Mustafa Sungur, Murat Baydoğan, İbrahim Kaya, Fatih Dikici
OBJECTIVE: The purpose of this study was to biomechanically compare cable, trochanteric grip plate, and locking plate techniques in Vancouver type AG fracture model in an in vitro test environment. METHODS: Fifteen pieces of fourth-generation synthetic femora were separated into 3 groups of 5 models each. A greater trochanteric fracture model was created after femoral stem implantation. Group 1 was fixated with only cable, Group 2 with trochanteric grip plate, and Group 3 with locking plate...
2016: Acta Orthopaedica et Traumatologica Turcica
Scott W Cheatham
There is growing subgroup of patients with poor outcomes after hip arthroscopy for intra-articular pathology suggesting unrecognized cause(s) of impingement may exist. Extra-articular hip impingement (EHI) is an emerging group of conditions that have been associated with intra-articular causes of impingement and may be an unrecognized source of pain. EHI is caused by abnormal contact between the extra-articular regions of the proximal femur and pelvis. This review discusses the most common forms for EHI including: central iliopsoas impingement, subspine impingement, ischiofemoral impingement, and greater trochanteric-pelvic impingement...
March 2016: Journal of the Canadian Chiropractic Association
Long Qin, Zexing Zhu, Diyu Song, Jianqiang Xu, Hao Yu, Shuming Zhang
OBJECTIVE: To investigate the effectiveness of the modified Urbaniak operation to treat avascularnecrosis of the femoral head (ANFH). METHODS: A retrospective analysis was made on the clinical data of 38 patients (41hips) with ANFH treated between February 2010 and October 2012 with the modified Urbaniak operation (to add lateralfemoral incision based on femoral greater trochanter incision, to preserve the original fibula flap drilling, decompressionand filling through trochanteric outer cortex, and to select the descending branch of lateral circumflex femoral artery asthe supply vessel)...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
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