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Anterior hip replacement

William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
Fouad A Chaudhry, Sanaa Z Ismail, Edward T Davis
Computer-assisted navigation techniques are used to optimise component placement and alignment in total hip replacement. It has developed in the last 10 years but despite its advantages only 0.3% of all total hip replacements in England and Wales are done using computer navigation. One of the reasons for this is that computer-assisted technology increases operative time. A new method of pelvic registration has been developed without the need to register the anterior pelvic plane (BrainLab hip 6.0) which has shown to improve the accuracy of THR...
January 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Morteza Kalhor, Kaveh Gharanizadeh, Paulo Rego, Michael Leunig, Reinhold Ganz
OBJECTIVES: The purpose of this study was to report (1) a different but specific pattern of impingement in hips involved with valgus slipped capital femoral epiphysis (valgus SCFE) and (2) the results of surgical treatment using intracapsular realignment techniques. DESIGN: Case series. SETTING: Multiple academic centers. PATIENTS: Six patients with 8 involved hips referred for valgus alignment of proximal femoral epiphysis (valgus SCFE)...
February 2018: Journal of Orthopaedic Trauma
Mitsunori Kaya
PURPOSE: For patients who have anterior hip pain evaluated by Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that extra-articular pathologies are responsible for the hip pain. The purpose of this study was to categorize the endoscopic extra-articular findings and to evaluate the clinical significance of periarticular pathologies in anterior hip pain. METHODS: Arthroscopic findings of 77 patients who underwent periarthritic debridement were evaluated...
2018: PloS One
Jim Pierrepont, Long Yang, Jevan Arulampalam, Catherine Stambouzou, Brad Miles, Qing Li
Edge-loading of a ceramic-on-ceramic total hip replacement can lead to reproducible squeaking and revision. A patient's functional acetabular cup orientation, driven by their pelvic tilt, has been shown to be a significant factor in squeaking during hip flexion. The aim of this study was to investigate the effect of seated pelvic tilt on the contact mechanics at the ceramic bearing surface. A finite element model of a ceramic-on-ceramic total hip replacement was created. The cup was orientated at 40° inclination and 15° anteversion relative to the anterior pelvic plane...
January 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Dirk Pieter Hogerzeil, Imraan Muradin, Eline W Zwitser, Joris A Jansen
Acute compartment syndrome (ACS) of the thigh following primary total hip arthroplasty (THA) is a highly uncommon complication and has not yet been reported before with regards to the anterior approach through the anterior supine interval. We present a case of a 69-year-old male patient with a history of stroke, who developed ACS of the thigh after elective THA while using therapeutic low molecular weight heparin as bridging for regular oral anticoagulation. ACS pathogenesis, diagnostic tools, treatment and relevant literature are discussed...
December 18, 2017: World Journal of Orthopedics
Adrian J Talia, Cassandra Coetzee, Oren Tirosh, Phong Tran
BACKGROUND: Total hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty. METHODS/DESIGN: This is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre...
January 8, 2018: Trials
P Martinot, A Blairon, S Putman, G Pasquier, J Girard, H Migaud
BACKGROUND: Dislocation rates in posterior total hip arthroplasty (THA) range between 2% and 5%, but long-term course (recurrence of dislocation or revision surgery) is not known, most series having short follow-up or small populations. We therefore conducted a retrospective study on a large series, to determine long-term rates of recurrence and surgical revision and recurrence risk factors. HYPOTHESIS: Long-term follow-up of a large cohort of THA dislocations enables recurrence rate and factors to be determined...
December 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sumit Kumar Jain, Parit Aggarwal, Arun Yadav
Introduction: Traumatic dislocation of the hip with ipsilateral fracture neck femur is a rare injury because of the different mechanism of both these injuries. The management of such injuries is a challenge as the chances of nonunion and avascular necrosis of femoral head are very high with fixation methods. We report a case of obturator dislocation of the hip with ipsilateral fracture neck of the femur which was treated with uncemented total hip replacement. Case Report: A 32-year-old male sustained obturator dislocation with ipsilateral fracture neck femur following road traffic accident...
September 2017: Journal of Orthopaedic Case Reports
David Clinton McNabb, Jason M Jennings, Daniel L Levy, Todd M Miner, Charlie C Yang, Raymond H Kim
BACKGROUND: The fluoroscopically assisted direct anterior approach for total hip arthroplasty has gained interest in recent years. One of the perceived advantages is the use of fluoroscopy to aid in the positioning of implants. The purpose of this study was to measure the radiation entrance surface dose to anatomically important areas of both patients and surgeons during direct anterior approach total hip arthroplasty. METHODS: Radiation dosimetry badges were placed at the sternal notch and pubic symphysis of 50 patients undergoing direct anterior approach total hip arthroplasty...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
Raphaël Guillin, Valérie Bertaud, Marc Garetier, Olivier Fantino, Jean-Louis Polard, Jean-Christophe Lambotte
OBJECTIVES: To assess visibility of the acetabular cup in total hip replacement and to determine the value of direct and indirect signs of iliopsoas impingement syndrome with ultrasound. METHODS: Ultrasound examinations were performed by a single operator in 17 patients with iliopsoas impingement syndrome and 48 control patients. Cup visibility, contact between the cup and psoas tendon, and the presence of indirect signs of iliopsoas impingement syndrome were investigated in all patients...
November 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
P Sautet, H Giorgi, P Chabrand, P Tropiano, J-N Argenson, S Parratte, B Blondel
BACKGROUND: Links between sagittal spinal alignment and acetabular orientation attract considerable research attention with the goal of optimising prosthetic cup position. However, whether pelvic incidence (PI) is related to anatomic acetabular orientation remains unknown. We therefore conducted a radiological study with the following objectives: to look for correlations between PI and anatomic acetabular parameters; to describe the sacro-pubic angle (SPA), defined by fixed bony pelvic landmarks, and its relations with acetabular anteversion; and to determine whether anatomical parameters (PI and SPA) correlate with demographic characteristics...
November 7, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yasuaki Tamaki, Tomohiro Goto, Takahiko Tsutsui, Tomoya Takasago, Keizo Wada, Koichi Sairyo
Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels...
2017: Case Reports in Orthopedics
Zhe Cao, Shaojie Su, Hao Tang, Yixin Zhou, Zhihua Wang, Hong Chen
With the aging of population, the number of Total Hip Replacement Surgeries (THR) increased year by year. In THR, inaccurate position of the implanted prosthesis may lead to the failure of the operation. In order to reduce the failure rate and acquire the real-time pose of Anterior Pelvic Plane (APP), we propose a measurement system in this paper. The measurement system includes two parts: Initial Pose Measurement Instrument (IPMI) and Real-time Pose Measurement Instrument (RPMI). IPMI is used to acquire the initial pose of the APP, and RPMI is used to estimate the real-time pose of the APP...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Ole-Christian L Brun, Lukas Månsson, Lars Nordsletten
INTRODUCTION: Introduction of new surgical techniques is normal, but seldom monitored in real time. The purpose of this study was to monitor the learning curve when introducing a new surgical technique to a department. We did a prospective evaluation of the learning curve when introducing the minimally invasive direct anterior approach in total hip arthroplasty. We wish to investigate whether there is a learning curve for the direct anterior minimal invasive approach in total hip replacement and what are the early complications to this approach...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Andrzej Kochman, Adrian Goral, Josef Kozak, Wojciech Marek, Monika Morawska-Kochman, Marek Synder
OBJECTIVES: Correct positioning of the acetabular component is a key factor in minimizing the risk of dislocation after total hip replacement (THR) surgery. A "safe" orientation of the cup is usually defined by 2 angles measured between its geometric axis and the anterior pelvic plane. However, in the current state-of-the-art approach to THR surgery, the intraoperative orientation of the anterior pelvic plane cannot be measured. Even less is known about the functional orientation of the pelvis, which determines the postoperative orientation of the cup during the patient's everyday activities...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
C Batailler, N Bonin, M Wettstein, A Nogier, S Martres, E Ollier, O May, S Lustig
BACKGROUND: Impingement of the ilio-psoas tendon on the acetabular component is a cause of pain after total hip arthroplasty (THA). Studies of cup revision for ilio-psoas impingement (IPI) are scarce and limited in size. We therefore conducted a large multicentre retrospective study with the following objectives: to assess the effectiveness of cup replacement in resolving the impingement syndrome, to determine the frequency and nature of complications after cup revision for IPI, and to identify pre-operative factors associated with good outcomes of cup revision for IPI...
December 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
W Guicherd, N Bonin, T Gicquel, J E Gedouin, X Flecher, M Wettstein, M Thaunat, N Prevost, E Ollier, O May
INTRODUCTION: Impingement between the acetabular component and the iliopsoas tendon is a cause of anterior pain after total hip replacement (THR). Treatment can be non-operative, endoscopic or arthroscopic, or by open revision of the acetabular component. Few studies have assessed these options. The present study hypothesis was that endo/arthroscopic treatment provides rapid pain relief with a low rate of complications. METHODS: A prospective multicenter study included 64 endoscopic or arthroscopic tenotomies for impingement between the acetabular component and the iliopsoas tendon, performed in 8 centers...
December 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ismail Hadisoebroto Dilogo, Jephtah Furano Lumban Tobing
INTRODUCTION: Operative treatment of acute acetabular fractures has shown better results than the non-operative approach. There is, however, limited data regarding the operative treatment of neglected acetabular fracture. METHODS: We present six subjects with neglected fracture of the acetabulum in Cipto Mangunkusumo National Hospital, Jakarta, Indonesia. One had only open reduction and internal fixation, three had open reduction and internal fixation first before we performed arthroplasty later, one had both open reduction and internal fixation with arthroplasty, and another had immediate arthroplasty...
August 2017: Journal of Clinical Orthopaedics and Trauma
Max P L van der Sijp, Inger B Schipper, Stefan B Keizer, Pieta Krijnen, Arthur H P Niggebrugge
BACKGROUND: The Direct Anterior Approach (DAA) is an alternative approach to the currently most used Lateral Approach (LA) for hip replacement in femoral neck fracture patients. Compared to the LA, the DAA minimizes soft tissue damage. Sparing muscle tissue may facilitate early and improved postoperative mobility. It may also be associated with fewer complications, increased quality of life and lower 1-year mortality. The aim of this study is to compare postoperative complications, hip function and patient mobility after hemiarthroplasty via the anterior or lateral approach following a displaced femoral neck fracture...
August 23, 2017: BMC Musculoskeletal Disorders
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