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Epiphysitis of the femoral head

Tobias Hesper, Sarah D Bixby, Daniel A Maranho, Patricia Miller, Young-Jo Kim, Eduardo N Novais
BACKGROUND: Hip osteoarthritis has been reported in the contralateral hip in patients who had been treated for unilateral slipped capital femoral epiphysis (SCFE) during adolescence. Although this might be related to the presence of a mild deformity, the morphologic features of the contralateral hip in unilateral SCFE remains poorly characterized. QUESTIONS/PURPOSES: Do measurements of (1) femoral head-neck concavity (α angle and femoral head-neck offset), (2) epiphyseal extension into the metaphysis (epiphyseal extension ratio and epiphyseal angle), and (3) posterior tilt of the epiphysis (epiphyseal tilt angle) differ between the contralateral asymptomatic hips of patients treated for unilateral SCFE and hips of an age- and sex-matched control population without a history of hip disease? METHODS: From January 2005 to May 2015, 442 patients underwent surgical treatment for SCFE at our institution...
February 23, 2018: Clinical Orthopaedics and related Research
M Pinheiro, C A Dobson, D Perry, M J Fagan
OBJECTIVES: Legg-Calvé-Perthes' disease (LCP) is an idiopathic osteonecrosis of the femoral head that is most common in children between four and eight years old. The factors that lead to the onset of LCP are still unclear; however, it is believed that interruption of the blood supply to the developing epiphysis is an important factor in the development of the condition. METHODS: Finite element analysis modelling of the blood supply to the juvenile epiphysis was investigated to understand under which circumstances the blood vessels supplying the femoral epiphysis could become obstructed...
February 2018: Bone & Joint Research
Xing Qiu, Liang-Liang Cheng, Ben-Jie Wang, Bao-Yi Liu, Lei Yang, Mingyang Yu, Guishan Gu, De-Wei Zhao
The present study investigates the feasibility of micro perfusion of femoral head specimens from femoral neck fracture patients by the inferior retinacular arteries and performing intraosseous artery quantitative analysis of the femoral head. Twelve femoral neck fracture patients who had undergone conventional hip replacement surgery were included in this study. Femoral head specimen arteries were first dissected and exposed and then perfused by the inferior retinacular arteries and all the femoral heads underwent micro-CT scanning...
February 9, 2018: Orthopaedic Surgery
Fabio Santanelli di Pompeo, Gennaro Selvaggi, Benedetto Longo, Rosaria Laporta, Vittoria Amorosi, Michail Sorotos
We present a case report of a 10-year-old girl diagnosed with Ewing sarcoma treated with intra-articular wide resection of the right femur and reconstruction with a series-connected double-barrel bilateral vascularized fibula graft (db-BVFG), including fibular head for articulation with the acetabulum of the pelvic bone and preservation of the epiphyseal growth plates for eventual limb growth. No postoperative complications were observed and bone union was achieved with fibular graft hypertrophy, allowing for full weight bearing...
February 8, 2018: Microsurgery
Helen Anwander, Martin Beck, Lorenz Büchler
Anatomy and biomechanics of the human hip joint are a consequence of the evolution of permanent bipedal gait. Habitat and behaviour have an impact on hip morphology and significant differences are present even within the same biological family. The forces acting upon the hip joint are mainly a function of gravitation and strength of the muscles. Acetabular and femoral anatomy ensure an inherently stable hip with a wide range of motion. The femoral head in first human ancestors with upright gait was spherical (coxa rotunda)...
February 5, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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
Donghai Li, Zhouyuan Yang, Zhun Wei, Pengde Kang
This study aimed to determine whether bisphosphonates exert an effect on preventing femoral head collapse after osteonecrosis of the femoral head (ONFH) in an animal model and in clinical trials. A systematic literature search was performed for studies published up to January 2017. Twenty-three articles (16 animal studies, seven clinical trials) were included in the meta-analysis. We found that the bisphosphonate group obtained significant improvement in epiphyseal quotients (MD = 15.32; 95% CI, 9.25-21...
January 23, 2018: Scientific Reports
Sophie Merckaert, Pierre-Yves Zambelli
Perthes's disease corresponds to an interruption of the vascularization of the epiphyseal nucleus of the femoral head followed by avascular necrosis. This necrosis weakens the bone and subchondral fractures associated with a deformation of the femoral head is seen. It is important not to miss an extrusion of the femoral head, which makes surgical treatment unavoidable. The loss of joint congruence causes functional limitations and represents an increased risk for early hip osteoarthritis. Non weight bearing limits the subchondral fractures, but requires an important adaptation from the patient and his entourage...
January 10, 2018: Revue Médicale Suisse
Eduardo N Novais, Sandra J Shefelbine, Karl-Philipp Kienle, Patricia E Miller, Garrett Bowen, Young-Jo Kim, Sarah D Bixby
BACKGROUND: Increased mechanical load secondary to a large body mass index (BMI) may influence bone remodeling. The purpose of this study was to investigate whether BMI is associated with the morphology of the proximal part of the femur and the acetabulum in a cohort of adolescents without a history of hip disorders. METHODS: We evaluated pelvic computed tomographic (CT) images in 128 adolescents with abdominal pain without a history of hip pathology. There were 44 male patients (34%) and the mean patient age (and standard deviation) was 15 ± 1...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
Xiang Hong Meng, Xue Ning Zhang, Zhi Wang, Jian Ping Yang, Zhong Li Zhang, Shuang Xia
Background Patients with developmental dysplasia of the hip (DDH) may have decreased blood supply to the femoral heads. Finding a non-invasive method to evaluate whether the femoral heads in patients with DDH are ischemic is paramount for orthopedic surgeons. Purpose To identify whether parameters reflecting perfusion and diffusion in intravoxel incoherent motion (IVIM) sequences can be used to assess ischemia in femoral heads in patients with DDH after closed reduction. Material and Methods Twenty-eight patients with DDH who had undergone closed reduction were enrolled...
January 1, 2017: Acta Radiologica
David E Lazarus, Christine L Farnsworth, Megan E Jeffords, Nikolas Marino, Jericho Hallare, Eric W Edmonds
BACKGROUND: There is evidence that oblique tension band plating can affect torsional growth in long bones. This study sought to determine if the torsional growth could be modulated based on the angles of the tension band plating and whether or not oblique plating affected overall longitudinal growth. METHODS: New Zealand White rabbits (10.5 wk old) had one screw placed on the metaphyseal side and one on the epiphyseal side of both medial and lateral sides of the right knee distal femoral physis...
February 2018: Journal of Pediatric Orthopedics
Ashishkumar K Parikh, Eleby R Washington, Adam J Bobbey, Stephanie E Spottswood
BACKGROUND: Evaluating postoperative patients with hardware is challenging following surgical intervention for hip maladies such as femoral neck fractures and slipped capital femoral epiphysis (SCFE). These children are at increased risk of developing avascular necrosis, and imaging may be requested to confirm or exclude this diagnosis. Children with Legg-Calvé-Perthes disease can be monitored for restoration of blood flow to the capital femoral epiphysis to guide management and help with prognosis...
March 2018: Pediatric Radiology
Chang Ho Shin, Wan Kee Hong, Doo Jae Lee, Won Joon Yoo, In Ho Choi, Tae-Joon Cho
BACKGROUND: The purpose of this study was to evaluate the radiologic outcome of percutaneous medial hemi-epiphysiodesis using a transphyseal screw for the management of caput valgum associated with developmental dysplasia of the hip (DDH). METHODS: Eighteen hips (18 patients) having caput valgum treated with screw hemi-epiphysiodesis were followed for more than 2 years, and were included in this study. The mean age at the time of the index operation was 8.3 years (range, 4...
November 14, 2017: BMC Musculoskeletal Disorders
Kelsey E McHugh, Cynthia L Emory, Graham E Parks, Scott E Kilpatrick
Clear cell chondrosarcoma is a rare chondrosarcoma variant often involving the long bone epiphyses of young to middle aged adults. We report herein a case involving the left femoral head in a 25-year-old female with a 3-month history of worsening left hip pain. Radiographs revealed a complex, multifocal and lytic lesion centered in the left proximal femoral epiphysis with involvement of the femoral neck. Computed tomography-guided fine needle aspiration biopsy with concomitant core needle biopsy was performed, and a diagnosis of clear cell chondrosarcoma was rendered...
September 19, 2017: Diagnostic Cytopathology
Antony Palmer, Scott Fernquest, Mo Gimpel, Richard Birchall, Andrew Judge, John Broomfield, Julia Newton, Mark Wotherspoon, Andrew Carr, Sion Glyn-Jones
INTRODUCTION: Cam morphology is a strong risk factor for the development of hip pain and osteoarthritis. It is increasingly thought to develop in association with intense physical activity during youth; however, the aetiology remains uncertain. The study aim was to characterise the effect of physical activity on morphological hip development during adolescence. METHODS: Cross-sectional study of individuals aged 9-18 years recruited from Southampton Football Club Academy (103 male) with an age-matched control population (52 males and 55 females)...
August 10, 2017: British Journal of Sports Medicine
Esmee Oussoren, Johannes H J M Bessems, Virginie Pollet, Jan C van der Meijden, Lianne J van der Giessen, Iris Plug, Annick S Devos, George J G Ruijter, Ans T van der Ploeg, Mirjam Langeveld
Hip problems in Mucopolysaccharidosis type VI (MPS VI) lead to severe disability. Lack of data on the course of hip disease in MPS VI make decisions regarding necessity, timing and type of surgical intervention difficult. We therefore studied the development of hip pathology in MPS VI patients over time. Data were collected as part of a prospective follow-up study. Standardized supine AP pelvis and frog leg lateral radiographs of both hips were performed yearly or every 2years. Image assessment was performed quantitatively (angle measurements) and qualitatively (hip morphology)...
May 19, 2017: Molecular Genetics and Metabolism
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
Hasime Qorraj Bytyqi, Cen Bytyqi
BACKGROUND Coxa vara and pseudoarthrosis of the femoral neck after septic hip arthritis is a very rare disease. The aim of this study was to present a case with pseudoarthrosis of the femoral neck, with coxa vara after neonatal septic arthritis of the right hip, and treatment of the pseudarthrosis with proximal femoral valgus osteotomy. CASE REPORT A 12-month-old female, who had suffered neonatal septic arthritis with a five-day history of fever and painful right hip now demonstrated painless limping to the right hip, pelvic obliquity, Trendelenburg-Duchenne gait, limitation of hip abduction, lower-extremity length discrepancy with 3...
April 23, 2017: American Journal of Case Reports
William Z Morris, Ryan T Li, Raymond W Liu, Michael J Salata, James E Voos
Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity...
February 2018: American Journal of Sports Medicine
Geetha Wickrematilake
Progressive pseudorheumatoid dysplasia (PPD) or spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare arthropathy of childhood involving the axial skeleton as well as small peripheral joints. A 10-year-old boy was referred by a general practitioner with pain and deformity in the fingers of hands and limping gait. There was no joint synovitis although the finger joints were bulky on examination with mild flexion deformity. Patient had exaggerated kyphosis and lumbar lordosis with pigeon chest and restricted hip joint movements...
2017: Case Reports in Rheumatology
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