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Anatomy of the hip

Karl Philipp Kutzner, Joachim Pfeil
Bone- and soft-tissue sparing short stems are increasingly used in total hip arthroplasty (THA). However, there are a large variety of models of short stems, differing in design and function. Calcar-guided short stems provide an anatomical curvature in the medial calcar region, thus, positioning is done individually alongside the calcar in the "round-the-corner" technique. Depending on the level of the neck's osteotomy, stems can be aligned individually in a large bandwidth of varus- and valgus anatomies...
February 27, 2018: Journal of Visualized Experiments: JoVE
Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
R Michael Meneghini
The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity...
March 6, 2018: Journal of Arthroplasty
Sung-Jae Park, Sung-Jae Lee, Wen-Ming Chen, Jung-Hong Park, Yong-Soo Cho, Taejin Shin, Soon-Yong Kwon
Periacetabular osteotomy (PAO) is a complex surgical procedure to restore acetabular coverage in the dysplastic hip, and the amount of acetabular rotation during PAO plays a key role. Using computational simulations, this study assessed the optimal direction and amount of the acetabular rotation in three dimensions for a patient undergoing PAO. Anatomy-specific finite element (FE) models of the hip were constructed based on clinical CT images. The calculated acetabular rotation during PAO were 9.7°, 18°, and 4...
2018: Applied Bionics and Biomechanics
John M Dundon, Dvorah Leah Felberbaum, William J Long
Background: Total hip arthroplasty (THA) is a highly successful surgery with a high prevalence in women. Women have been noted to have smaller proximal femoral anatomy and decreased bone strength compared to males. The goal of our study was to define the size discrepancy in femoral stem implants between men and women using a metaphyseal fitting single taper stem. Methods: We retrospectively reviewed the THA's performed by a single surgeon over the previous two years...
June 2018: Journal of Orthopaedics
Craig J Della Valle, Tyler E Calkins, Joshua J Jacobs
There has been an increasing use of modularity at the head-neck junction in total hip arthroplasty to more closely mimic the native anatomy, allowing for optimal leg length and stability. Corrosion at this junction in metal-on-polyethylene bearings can lead to an adverse local tissue reaction (ALTR). This increasingly prevalent condition should be considered in the differential diagnosis of hip pain and difficulty ambulating. A recent symposium by the American Academy of Hip and Knee Surgeons described the diagnosis, etiology, management, and prevention of taper corrosion...
March 1, 2018: Journal of Arthroplasty
G C Brombini, S C Rahal, B C Schimming, I F C Santos, M H Tsunemi, M J Mamprim, L S Alves, A L Filadelpho, C R Teixeira
This study aimed to describe the radiographic anatomy and osteology and to evaluate angular radiographic measurements-Norberg angle, inclination angle and anteversion angle-of the pelvic limbs in free-ranging capybaras. Twenty cadavers of free-ranging capybaras (Hydrochoerus hydrochaeris), including five adults and 15 subadults, were studied. Ventrodorsal, craniocaudal, dorsoplantar and mediolateral radiographic views of the pelvic limbs were obtained. The radiographic features were described together with bone samples...
March 1, 2018: Anatomia, Histologia, Embryologia
Amir Sternheim, Ornit Giladi, Yair Gortzak, Michael Drexler, Moshe Salai, Nir Trabelsi, Charles Milgrom, Zohar Yosibash
Physician recommendation for prophylactic surgical fixation of a femur with metastatic bone disease (MBD) is usually based on Mirels' criteria and clinical experience, both of which suffer from poor specificity. This may result in a significant number of these health compromised patients undergoing unnecessary surgery. CT-based finite element analyses (CTFEA) have been shown to accurately predict strength in femurs with metastatic tumors in an ex-vivo study. In order to assess the utility of CTFEA as a clinical tool to determine the need for fixation of patients with MBD of the femur, an ad hoc CTFEA was performed on a retrospective cohort of fifty patients...
February 20, 2018: Bone
Julien Wegrzyn, Jean-Paul Roux, Charlotte Loriau, Nicolas Bonin, Vincent Pibarot
PURPOSE: Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study...
February 22, 2018: International Orthopaedics
Ran Tao, Fan Liu, Ya-Ke Liu, Yue Lu, Hua Xu, Yi Cao, Zhen-Yu Zhou, Wei Wang
INTRODUCTION: Both hip resurfacing arthroplasty (HRA) and large-diameter head metal-on-metal total hip arthroplasty (LDH MoM THA) are generally used for young and active patients. A number of comparative studies of HRA and total hip arthroplasty have been published in the literature. However, studies that have compared HRA with LDH MoM THA are rare. The purpose of this study is to compare the mid-term results of HRA with those of LDH MoM THA in young patients. PATIENTS AND METHODS: Between 2007 and 2011, 68 patients were enrolled in the study and randomized into two groups: HRA group (28 hips) and LDH MoM THA group (40 hips)...
February 18, 2018: International Orthopaedics
Giovanni Trisolino, Stefano Stilli, Giovanni Gallone, Pedro Santos Leite, Giovanni Pignatti
Background and purpose - The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. Patients and methods - We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed...
February 16, 2018: Acta Orthopaedica
Bin-Fei Zhang, Yu-Xuan Cong, Peng-Fei Wang, Hai Huang, Hu Wang, Yan Zhuang
INTRODUCTION: Complications involving vascular injuries after hip fracture are rare, and the diagnosis and management of deep femoral artery (DFA) injuries are challenging. We reported 4 cases of DFA injuries after hip fracture surgery and aimed to discuss their early detection, treatment, and prevention. METHODS: We reviewed 4 cases of deep femoral injury after hip fracture. Case 1: a 71-year-old woman suffered a fracture around a prosthesis. Cases 2-4: 2 men and 1 woman suffered subtrochanteric or intertrochanteric fracture...
February 2018: Medicine (Baltimore)
Carol V Ward, Scott D Maddux, Emily R Middleton
OBJECTIVES: Pelvic form is hypothesized to reflect locomotor adaptation in anthropoids. Most observed variation is found in the ilium, which traditionally is thought to reflect thoracic and shoulder morphology. This article examines the articulated bony pelvis of anthropoids in three dimensions (3D) to test hypothesized variation in pelvic anatomy related to overall torso form. MATERIALS AND METHODS: Sixty landmarks were collected on articulated pelves from 240 anthropoid individuals...
February 8, 2018: American Journal of Physical Anthropology
Nathan W Skelley, William K Conaway, Scott D Martin
The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This important anatomic relationship has been demonstrated in several biomechanical studies. Performing the acetabular recession and evaluating the congruity of labral repairs during surgery is difficult with the application of traction distracting the femoral head from the chondrolabral junction...
October 2017: Arthroscopy Techniques
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
Andrew G Geeslin, Matthew G Geeslin, Jorge Chahla, Sandeep Mannava, Salvatore Frangiamore, Marc J Philippon
Radiologic imaging is an essential supplement to the physical examination in the evaluation of a patient with femoroacetabular impingement. Plain radiographs are the initial modality of choice for the evaluation of bony anatomy and pathology. Magnetic resonance imaging supplements the physical examination and standard radiographs by enabling qualitative and quantitative evaluation of both articular cartilage and soft tissues about the hip. Magnetic resonance imaging also provides improved 3-dimensional characterization of the bony anatomy owing to the multiplanar nature of this technique...
October 2017: Arthroscopy Techniques
Austin J Ramme, Nina D Fisher, Jonathan Egol, Gregory Chang, Jonathan M Vigdorchik
Background: Digital templating systems foster patient-specific measurements for preoperative planning. Questions/Purposes: We aim (1) to verify the accuracy of a templating system, (2) to describe the effects of scaling marker position on the accuracy of digital templating of the hip, and (3) to provide a practical guide for scaling marker position using patient body mass index (BMI). Methods: A scaling sphere was placed in five positions along the anterior-posterior axis of an acetabular implant and pelvis phantom, and x-rays were obtained...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Nobuhiro Kaku, Tatsuo Shimada, Tomonori Tabata, Hiroaki Tagomori, Tetsutaro Abe, Juan Juan Zhang, Hiroshi Tsumura
Background: We aimed to investigate the three-dimensional structure of the collagenous fibers of the ligamentum teres (LT) of the human hip and clarify the LT micro-anatomy at the attachment of the femoral head. Methods: Femoral heads and LT were collected during hip arthroplasty. Specimens were cut into 5-10-mm squares, prepared, developed, and observed under a light microscope. Next, specimens were prepared and examined under a scanning electron microscope (SEM)...
July 2017: Muscles, Ligaments and Tendons Journal
Emma Vartanian, Daniel J Gould, Ziyad S Hammoudeh, Beina Azadgoli, W Grant Stevens, Luis H Macias
Background: As the popularity of aesthetic gluteoplasty continues to grow, there is renewed focus on defining the ideal buttocks. However, the literature lacks studies characterizing an ideal thigh, despite the impact of thigh contour on overall gluteal aesthetic. Objectives: The authors performed the first population analysis of the characteristics of perception of attractive thighs, to identify a role for fat grafting of the thigh in gluteoplasty. Methods: Survey images were digitally modified to create thighs of varying widths and angles relative to fixed buttocks...
January 20, 2018: Aesthetic Surgery Journal
Xavier Flecher, Matthieu Ollivier, Pascal Maman, Sébastien Pesenti, Sébastien Parratte, Jean-Noël Argenson
INTRODUCTION: Due to complex anatomical considerations, results of cementless-stem total hip arthroplasty (THA) in hip fusion remain controversial compared with conventional THA. We therefore aimed to analyse 3D anatomy of the fused hip based on pre-operative computed tomography (CT) scans, functional outcomes based on the Harris Hip Score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS), modifications of hip anatomy based on post-operative standardised radiography, and determine complication rate and long-term survival based on Kaplan-Meier analysis...
January 19, 2018: International Orthopaedics
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