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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
M Cody O'Dell, Diego Jaramillo, Laura Bancroft, Laura Varich, Gregory Logsdon, Sabah Servaes
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jennifer L Pierce, Nicholas C Nacey, Stephen Jones, Davis Rierson, Brian Etier, Stephen Brockmeier, Mark W Anderson
Imaging interpretation of the postoperative shoulder is a challenging and difficult task for both the radiologist and the orthopedic surgeon. The increasing number of shoulder rotator cuff, labrum, and biceps tendon repairs performed in the United States also makes this task a frequent occurrence. Whether treatment is surgical or conservative, imaging plays a crucial role in patient care. Many imaging findings can be used to predict prognosis and functional outcomes, ultimately affecting treatment. In addition, evolving surgical techniques alter the normal anatomy and imaging appearance of the shoulder such that accepted findings proved to be pathologic in the preoperative setting cannot be as readily described as pathologic after surgery...
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
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
Robert A Duerr, John J Christoforetti
Posterior glenohumeral capsular rupture is a rare cause of posterior glenohumeral instability. With advances in imaging and arthroscopic techniques, diagnosis and treatment of posterior glenohumeral instability are becoming more common in practice. We present a technique for arthroscopic repair of a posterior glenohumeral capsular rupture with concomitant anterior and posterior labrum detachment. Arthroscopic fixation was facilitated by use of a 70° arthroscope through an anterior viewing portal to allow accurate placement of the posterior portal in preparation for knot tying...
August 2016: Arthroscopy Techniques
Justin A Ly, Erin M Coleman, Eric J Kropf
The treatment of anterior shoulder instability is well described with various techniques, including arthroscopic double-row repair, an alternative to open stabilization procedures in high-risk groups. The surgical management of posterior instability in high-risk and athletic populations is a less-explored entity. We describe our technique for an all arthroscopic double-row suture anchor repair of a large posterior bony Bankart lesion. We prefer this technique over percutaneous cannulated screw fixation because the double-row suture technique allows for incorporation of capsular plication with bony fixation in an effort to better restore normal anatomy for capsulolabral complex...
August 2016: Arthroscopy Techniques
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
Mukesh Kumar, Jai Thilak
INTRODUCTION: The glenoid labrum is frequently torn in traumatic glenohumeral dislocation; arthroscopic repair is the standard method of treatment. The complications associated with this repair are pulling out of metal suture anchors, chondrolysis and joint infection. The infection of joint after arthroscopy is less than 1%. Staphylococcus is most common organism and rarely followed by Pseudomonas aeruginosa. We report a case of infected shoulder with chondrolysis of the joint and pulled out metal suture anchor lying inside the joint after Bankart's repair...
April 2016: Journal of Orthopaedic Case Reports
Andrzej Kownacki, Olga Woznicka, Ewa Szarek-Gwiazda, Paraskeva Michailova
Larvae belonging to the family Chironomidae are difficult to identify. The aim of the present study was to describe the larval morphology of G. (G.) glaucus with the aid of a Scanning Electron Microscope (SEM), the karyotype and biology based on materials obtained from laboratory culture. Describing the morphology of larvae, special attention was paid to rarely or never described structures like the maxilla (lacinia and maxillary palp), the long plate situated below the ventromental plate, and plate X situated between lacinia and mentum...
September 21, 2016: Zootaxa
Matthew T Provencher
Although superior labrum anterior posterior (SLAP) repairs have a relatively high success rate, emerging evidence suggests that this is not always the case. The authors of "Subsequent Shoulder Surgery Following Isolated Arthroscopic SLAP Repair" reveal that 1 in 10 people needed additional surgery within 3 years after SLAP repair-mainly for disorders of the rotator cuff, biceps, and distal clavicle. This underscores the fact that SLAP tears rarely occur in isolation and that the initial diagnosis and management may require more than just SLAP work...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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
Sandra R Breyer, Nicole Muschol, Mona Schmidt, Martin Rupprecht, Kornelia Babin, Jochen Herrmann, Ralf Stücker
BACKGROUND: Hip dysplasia is common in mucopolysaccharidosis type-1H (MPS-1H) patients, but its morphology is not completely understood. No magnetic resonance imaging (MRI)-based studies have been reported in the literature. The purpose of this study was to improve knowledge of hip dysplasia pathology by describing the hip morphology of these patients in MRI scans, plain radiographs, and arthrograms. METHODS: We performed a retrospective chart review of 18 MPS-1H patients...
September 15, 2016: Journal of Pediatric Orthopedics
Yan-Kun Cao, Min Huang
There are direct relationships between the behavioral mechanisms and sensilla. To obtain a better understanding of the behavioral mechanisms in Omosita colon (Linnaeus) (Coleoptera: Nitidulidae), we investigated the types, quantities, and distribution of sensilla on the antenna and mouthparts of O. colon by scanning electron microscopy. The clavate antenna comprised the scape, pedicel, and nine segment flagellomeres and had six types of sensilla, including two subtypes of sensilla chaetica (SC), three subtypes of sensilla basiconica (SB) and sensilla trichodea (ST), and one type of sensilla cavity, sensilla styloconica, and Böhm bristles (BB)...
September 15, 2016: Microscopy Research and Technique
Ryuzo Arai, Hideto Harada, Hiroyuki Tsukiyama, Yoshimitsu Takahashi, Masahiko Kobayashi, Takahiko Saji, Shuichi Matsuda
BACKGROUND: For shoulder arthroscopy, few anatomical landmarks are available and inexperienced surgeons tend to be adrift due to the limited visual field of the scope. The purpose of this study was to demonstrate the useful landmarks around the glenoid for accurate orientation, and also the safe distance to avoid suprascapular nerve injury during surgical procedures around the glenoid. METHODS: In 15 human solution-fixed cadavers, a cross-section of the shoulder joint on the labrum surface was created...
August 30, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Brian D Petersen, Bryan Wolf, Jeffrey R Lambert, Carolyn W Clayton, Deborah H Glueck, Mary Kristen Jesse, Omer Mei-Dan
Patients with developmental dysplasia of the hip often have compensatory labral hypertrophy, which presumably lends stability to an unstable joint. Conversely, patients with acetabular overcoverage may have small or ossified labra. The purpose of this study is to explore the interaction of labral length with the degree of acetabular hip coverage. A retrospective cohort of patients with hip pain presenting to a hip preservation center, who had undergone hip magnetic resonance imaging and AP pelvis radiographs were studied...
August 2016: Journal of Hip Preservation Surgery
Joshua D Harris
The importance of the acetabular labrum has been increasingly recognized, playing a critical role in both normal anatomy and abnormal pathology of the hip joint. The labrum increases acetabular surface area and volume, providing a stable and durable articulation. The fibrocartilaginous composition affords a tissue capable of a lifetime of normal function in the absence of significant osseous pathology. In the setting of femoroacetabular impingement (FAI) or dysplasia, bony biomechanics may cause labral injury, which may translate to patient symptoms...
August 31, 2016: Current Reviews in Musculoskeletal Medicine
K C Geoffrey Ng, Giulia Mantovani, Mario Lamontagne, Michel R Labrosse, Paul E Beaulé
BACKGROUND: It is still unclear why many individuals with a cam morphology of the hip do not experience pain. It was recently reported that a decreased femoral neck-shaft angle may also be associated with hip symptoms. However, the effects that different femoral neck-shaft angles have on hip stresses in symptomatic and asymptomatic individuals with cam morphology remain unclear. QUESTIONS/PURPOSES: We examined the effects of the cam morphology and femoral neck-shaft angle on hip stresses during walking by asking: (1) Are there differences in hip stress characteristics among symptomatic patients with cam morphology, asymptomatic individuals with cam morphology, and individuals without cam morphology? (2) What are the effects of high and low femoral neck-shaft angles on hip stresses? METHODS: Six participants were selected, from a larger cohort, and their cam morphology and femoral neck-shaft angle parameters were measured from CT data...
August 31, 2016: Clinical Orthopaedics and related Research
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