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acetabular and femur neck

Luis Moraleda, Christian Bravo, Francisco Forriol, Javier Albiñana
BACKGROUND: Derotational osteotomy of the proximal femur has proved to be effective in the treatment of residual acetabular dysplasia. However, the reason why this osteotomy is effective remains debatable. The purpose of this study is to investigate if an alteration of femoral head orientation affects acetabular growth. METHODS: A proximal femoral osteotomy was performed in 21 lambs aged 3 months: 5 varus osteotomies (110 degrees), 4 valgus osteotomies (150 degrees), and 12 derotation osteotomies...
March 21, 2017: Journal of Pediatric Orthopedics
Matthieu Ollivier, Thomas Le Corroller, Sebastien Parratte, Patrick Chabrand, Jean-Noël Argenson, Olivier Gagey
PURPOSE: The function of the hip labrum during hip motion remains poorly known. Our hypothesis was that acetabular labrum will deform and change its shape during adduction to abduction movement consecutively to variation of strains passing from the acetabulum to the femoral head. An ex vivo anatomical study was conducted to analyse the morphological parameters variation of the mid-portion of the labrum (length, thickness, shape, deformation) as well as femoro-labral strains during hip adduction to abduction movement...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jason Bt Lim, Chia Liang Ang, Hee Nee Pang
INTRODUCTION: Bipolar hemi-arthroplasty of the hip is a commonly performed procedure in elderly patients with intra-capsular fracture of the neck of the femur with good short-term results for pain relief, return to activity and morbidity. The incidence of intra-pelvic prosthesis migration or protrusion is rare and one of the inciting factors is chronic low-grade sepsis. Acetabular prosthesis protrusion poses a difficult and challenging surgical problem due to surrounding neurovascular structures...
July 2016: Journal of Orthopaedic Case Reports
Samuel E McMahon, Laurence A Cusick
Acetabular fractures in the elderly are a challenging clinical problem due to both the complex nature of operative intervention, osteoporotic bone and the multiple comorbidities of the patients involved. They are associated with poor functional outcomes and high levels of morbidity and mortality. Treatment currently ranges from conservative treatment, open reduction internal fixation and variations of total hip arthroplasty. We present the surgical technique and early results of the use of a coned hemipelvic acetabular component in the primary treatment of these complex injuries...
January 23, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
José Batista Volpon
The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies...
November 2016: Revista Brasileira de Ortopedia
Jemin Yi, Kye Young Han, Young Jun Nam, Keun Woo Kim
PURPOSE: This study aimed to investigate the outcomes of modular neck-utilization in primary total hip arthroplasty (THA). MATERIALS AND METHODS: Thirty patients (34 hips) who had modular stem THA between April 2011 and January 2013 were evaluated. There were 19 men and 11 women with a mean age of 61.2 years at the time of surgery. There were 20 cases of osteonecrosis of femoral head, 7 cases of osteoarthritis, 6 cases of femur neck fracture, and 1 case of rheumatoid arthritis...
September 2016: Hip & Pelvis
Michael Worlicek, Markus Weber, Benjamin Craiovan, Michael Wörner, Florian Völlner, Hans R Springorum, Joachim Grifka, Tobias Renkawitz
BACKROUND: Improper femoral and acetabular component positioning can be associated with instability, impingement, component wear and finally patient dissatisfaction in total hip arthroplasty (THA). The concept of "femur first"/"combined anteversion", incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position of the stem relative to the cup intraoperatively. In the present study we asked two questions: (1) Do native femoral anteversion and anteversion of the implant correlate? (2) Do anteversion of the final broach and implant anteversion correlate? METHODS: In a secondary analysis of a prospective controlled trial, a subgroup of 55 patients, who underwent computer-assisted, cementless THA with a straight, tapered stem through an anterolateral, minimally invasive (MIS) approach in a lateral decubitus position were examined retrospectivly...
September 20, 2016: BMC Musculoskeletal Disorders
J Schmolders, S Koob, P Schepers, S Gravius, D C Wirtz, C Burger, P H Pennekamp, A C Strauss
Introduction/Background: With extended life expectancy, the number of primary joint arthroplasties has also increased. Revision surgery is also more often necessary, due to aseptic or septic loosening of the prosthesis or periprosthetic fracture. Large bone defects often occur in these patients and several non-modular, conventional implants are available to handle this difficult situation. Custom made implants offer an individually designed and defect-adapted shape with perfect covering of the lesion, but may delay the operation...
February 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Abir Massaad, Ayman Assi, Ziad Bakouny, Christophe Sauret, Nour Khalil, Wafa Skalli, Ismat Ghanem
Skeletal abnormalities, affecting posture and walking pattern, increase with motor impairment in children with cerebral palsy (CP). However, it is not known whether these skeletal malalignments occur in children with slight motor impairment. Our aim was to evaluate skeletal malalignment at the level of the pelvis and lower limbs in ambulant children with CP, with slight motor impairment, using a low dose biplanar X-ray technique. Twenty-seven children with spastic CP (mean age: 10.9±4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels I:17, II:10), with no previous treatments at the hips and knees, underwent EOS(®) biplanar X-rays...
September 2016: Gait & Posture
Aysha Rajeev, Paul Banaszkiewicz
INTRODUCTION: Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. PRESENTATION OF CASE: A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out...
2016: International Journal of Surgery Case Reports
Kazuaki Mineta, Tomohiro Goto, Keizo Wada, Yasuaki Tamaki, Daisuke Hamada, Kosaku Higashino, Koichi Sairyo
OBJECTIVE: To examine the prevalence of herniation pits (HPs) and to evaluate differences in radiographic features related to femoroacetabular impingement-a hip disorder with abnormal abutment between the acetabulum and femur-between hips with and without HPs in a convenience sample of Japanese patients. MATERIALS AND METHODS: We reviewed 1,178 hips on each side (695 men, 483 women; mean age, 58.2 years) using computed tomographic images. The radiological assessments of hip morphology were performed by measuring the lateral center edge angle, acetabular index, acetabular version, alpha angle, and femoral head-neck offset...
August 2016: Skeletal Radiology
Luigi Murena, Roberto Fattori, Veronica Scamacca, Paolo Cau, Chiara Ratti, Gianluca Canton
BACKGROUND AND AIM OF THE WORK: Hemiarthroplasty (HA) for femoral neck fractures in relatively young patients has been reported to have poor results. Moreover, cotyloiditis has been described for HA as a possible cause of revision. Nontheless, in the literature there is lack of studies specifically evaluating this topic, particularly in relatively young patients. Aim of the study was to evaluate bipolar HA clinical and radiographic results at long term follow up in patients treated under the age of 70...
2016: Acta Bio-medica: Atenei Parmensis
S Molière, J-C Dosch, G Bierry
Pelvic ring fractures when caused by trauma, either violent or in demineralized bone, generally consist of injuries in both the anterior (pubic symphysis and rami) and posterior (iliac wing, sacrum, sacroiliac joint) portions. Injury classifications are based on injury mechanism and pelvic stability, and are used to determine treatment. Acetabular fractures, associated or not to pelvic ring disruption, are classified on the basis of fracture line, into elementary fractures of the acetabular walls, columns and roof, and into complex fractures...
July 2016: Diagnostic and Interventional Imaging
Richard Prazeres Canella, Guilherme Pradi Adam, Roberto André Ulhôa de Castillo, Daniel Codonho, Gerson Gandhi Ganev, Luiz Fernando de Vicenzi
OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient...
March 2016: Revista Brasileira de Ortopedia
Thomas F McCarthy, Vincent Alipit, Jim Nevelos, Randa K Elmallah, Michael A Mont
BACKGROUND: It is advocated that to avoid complications associated with femoral stem impingement, acetabular positioning should be within a "safe zone." However, instability remains prevalent despite accurate cup positioning, with studies showing dislocations of cups despite positioning within safe zones. We assessed cup position angles associated with impingement in a group of subjects during (1) squatting; (2) object pick-up; and (3) low chair rise. METHODS: Ten subjects (mean age, 69 years; body mass index, 28...
September 2016: Journal of Arthroplasty
Jibanananda Satpathy, Arun Kannan, John R Owen, Jennifer S Wayne, Jason R Hull, William A Jiranek
The current literature on femoroacetabular impingement (FAI) is focused on acetabular orientation and femoral head asphericity, with little emphasis on the effect of version of the femoral neck. A biomechanical model was developed to determine the causative effect, if any, of femoral retroversion on hip contact stress and, if present, delineate the type of FAI with femoral neck retroversion. Five pairs of cadaveric hips (n = 10) were tested by loading the hip in 90° of flexion and measured the peak joint pressure and the location of the peak joint pressure...
October 2015: Journal of Hip Preservation Surgery
Chikahisa Higuchi, Nobuhiko Sugano, Kiyoshi Yoshida, Hideki Yoshikawa
BACKGROUND: Various deformities appear in hereditary multiple exostoses (HMEs). Deformities around the knee or ankle joints are easy to detect in this disease because such deformities are visible in appearance. However, deformities in the hip joints of skeletally mature patients are not well understood because their tumors are invisible. METHODS: To understand deformities around the hip joint in HMEs, we investigated 36 hip joints in 19 skeletally mature patients (12 males, 7 females)...
May 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Marko Mladenović, Ivan Micić, Zoran Andjelković, Desimir Mladenović, Predrag Stojiljković
INTRODUCTION: Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. CASE REPORT: We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected...
December 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Jean-Christophe Bel, Jean-Paul Carret
The purpose of this study was to investigate whether minimal invasive surgery (MIS) in elderly patients with neck of femur fractures would reduce the peri-operative complications and improve the post-operative ambulation and length of hospital stay in his cohort of patients. Forty elderly patients were treated with either total hip arthroplasty (THA) or bipolar prosthesis using MIS transgluteal approach. A matched reference group treated with a conventional surgical approach formed the control group. All procedures were performed by the same surgeon...
January 2015: Injury
Zhou Xiang, Daiqing Wei, Ming Liu, Xin Duan, Jun Ma, Yue Fang, Qingquan Kong, Fuguo Huang, Shiqiang Cen, Gang Zhong
OBJECTIVE: To investigate the application and technical essentials of computer-assisted navigation in the surgical management of periacetabular fractures and pelvic fractures. METHODS: Between May 2010 and May 2011, 39 patients with periacetabular or anterior and posterior pelvic ring fractures were treated by minimally invasive fixation under computer-assisted navigation and were followed up more than 2 years, and the clinical data were analyzed retrospectively...
January 2015: Chinese Journal of Reparative and Reconstructive Surgery
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