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Anatomy of the hip

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https://www.readbyqxmd.com/read/28719561/arterial-topographic-anatomy-near-the-femoral-head-neck-perforation-with-surgical-relevance
#1
Paulo Rego, Vasco Mascarenhas, Diego Collado, Ana Coelho, Luis Barbosa, Reinhold Ganz
BACKGROUND: Knowledge of the vascular supply of the femoral head is crucial for hip-preserving surgical procedures. The critical area for reshaping cam deformity is at the retinacular vessel penetration, an area with ill-defined topographic anatomy. We performed a cadaver study of the extension of the lateral retinaculum near the head-neck junction, distribution of the arterial vascular foramina, and initial intracapital course of these vessels. METHODS: In 16 fresh proximal parts of the femur without head-neck deformities, the deep branch of the medial femoral circumflex artery was injected with gadolinium for magnetic resonance imaging (MRI) sequences to identify arterial structures...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28676359/office-evaluation-of-pelvic-pain
#2
REVIEW
Stacey Bennis, Sarah Hwang
The history and physical examination are important keys to diagnosis and treatment of patients with chronic pelvic pain. The comprehensive history should include questioning regarding patient's pain complaint and a thorough history and review of any body system that may be involved, including neuromusculoskeletal, obstetric, gynecologic, gastrointestinal, urologic, dermatologic, infectious, oncologic, and psychiatric. The physical examination should also follow a focused systems-based approach and includes examination of gastrointestinal, dermatologic, neurologic, and musculoskeletal (including lumbosacral spine, sacroiliac joints, pelvis, and hips) systems, and the pelvic floor (internal and external examination, including neuromuscular anatomy)...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28676358/anatomy-and-physiology-of-the-pelvic-floor
#3
REVIEW
Sarah M Eickmeyer
Understanding the anatomic relationship of the pelvic floor muscles with the pelvic girdle, spine, and hips aids the rehabilitation provider in diagnosis, management, and appropriate referrals. The bony anatomy of the pelvic girdle consists of 3 bones and 3 joints. The pelvic floor muscles are comprised mainly of the levator ani muscles with somatic innervation from the lumbosacral plexus. The bony and muscular pelvis is highly interconnected to the hip and gluteal musculature, which together provide support to the internal organs and core muscles...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#4
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28630734/open-treatment-of-dysplasia-other-than-pao-does-it-have-to-be-a-pao
#5
REVIEW
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
Hip dysplasia is a developmental disorder that results in anatomic abnormalities in which the acetabular coverage is insufficient. In the absence of severe degenerative changes, younger active patients with these symptomatic structural abnormalities are increasingly managed with joint-preserving operations. Historically there have been numerous reconstructive pelvic osteotomies. In recent years, the Bernese periacetabular osteotomy (PAO) has become the preferred osteotomy by many surgeons. Even so, as our understanding of the hip advances and new diagnostic and treatment techniques are developed, we sought to put a focus on the long-term results of augmental osteotomies and pelvic osteotomies other than the PAO, to see if any of these surgeries still have a place in the current algorithm of treatment for the dysplastic hip...
July 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28618097/accuracy-of-navigated-cam-resection-in-femoroacetabular-impingement-a-randomised-controlled-trial
#6
Jan Van Houcke, Vikas Khanduja, Naoki Nakano, Peter Krekel, Christophe Pattyn, Emmanuel Audenaert
BACKGROUND: The main cause for revision hip arthroscopy surgery is incomplete bony resection of femoroacetabular impingement (FAI). This study aimed to compare the cam resection accuracy via the conventional hip arthroscopy technique with the navigation technique. METHODS: Two prospectively randomized groups were recruited: navigated (n = 15) and conventional (n = 14). A pre-operative CT and post-operative MRI scan were obtained in all cases to compare alpha angle, range of motion simulation and determine a pre-operative 3D surgical resection plan...
June 15, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28598491/modularity-in-total-hip-arthroplasty-benefits-risks-mechanisms-diagnosis-and-management
#7
Ben M Vierra, Sarah R Blumenthal, Derek F Amanatullah
Modular implants are currently widely used in total hip arthroplasty because they give surgeons versatility during the operation, allow for easier revision surgery, and can be adjusted to better fit the anatomy of the specific patient. However, modular implants, specifically those that have metal-on-metal junctions, are susceptible to crevice and fretting corrosion. This can ultimately cause implant failure, inflammation, and adverse local tissue reaction, among other possible side effects. Surgeons should be aware of the possibility of implant corrosion and should follow a set of recommended guidelines to systematically diagnose and treat patients with corroded implants...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28579262/contact-forces-in-the-tibiofemoral-joint-from-soft-tissue-tensions-implications-to-soft-tissue-balancing-in-total-knee-arthroplasty
#8
Matthias A Verstraete, Patrick A Meere, Gaia Salvadore, Jan Victor, Peter S Walker
Proper tension of the knee's soft tissue envelope is important during total knee arthroplasty; incorrect tensioning potentially leads to joint stiffness or instability. The latter remains an important trigger for revision surgery. The use of sensors quantifying the intra-articular loads, allows surgeons to assess the ligament tension at the time of surgery. However, realistic target values are missing. In the framework of this paper, eight non-arthritic cadaveric specimens were tested and the intra-articular loads transferred by the medial and lateral compartment were measured using custom sensor modules...
May 23, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28573372/a-survey-of-anatomical-items-relevant-to-the-practice-of-rheumatology-pelvis-lower-extremity-and-gait
#9
Cristina Hernández-Díaz, José Alvarez-Nemegyei, José Eduardo Navarro-Zarza, Pablo Villaseñor-Ovies, Robert A Kalish, Juan J Canoso, Angélica Vargas, Karla Chiapas-Gasca, Joseph J Biundo, Francisco Javier de Toro Santos, Dennis McGonagle, Simon Carette, Miguel Ángel Saavedra
This study aimed to generate a minimum list of structural and functional anatomical items about the pelvis/hip, knee, ankle/foot, gait, and lower limb innervation, which are most relevant to the practice of rheumatology. To determine their perceived relevance to clinical practice, seven members of the Mexican Clinical Anatomy Task Force compiled an initial list of 470 anatomical items. Ten local and international experts according to a 0-10 Likert scale ranked these items. Of the original list, 101 (21.48%) items were considered relevant (global rate >40)...
June 1, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28566407/pelvic-reconstruction-following-resection-of-malignant-bone-tumours-using-a-stemmed-acetabular-pedestal-cup
#10
C Hipfl, C Stihsen, S E Puchner, A Kaider, M Dominkus, P T Funovics, R Windhager
AIMS: Pelvic reconstruction after the resection of a tumour around the acetabulum is a challenging procedure due to the complex anatomy and biomechanics. Several pelvic endoprostheses have been introduced, but the rates of complication remain high. Our aim was to review the use of a stemmed acetabular pedestal cup in the management of these patients. PATIENTS AND METHODS: The study involved 48 patients who underwent periacetabular reconstruction using a stemmed pedestal cup (Schoellner cup; Zimmer Biomet Inc...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28551063/-superior-gluteal-nerve-a-new-block-on-the-block
#11
Miguel Sá, Rita Graça, Hugo Reis, José Miguel Cardoso, José Sampaio, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. CLINICAL REPORT: An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28542276/effect-of-combined-actions-of-hip-adduction-abduction-on-the-force-generation-and-maintenance-of-pelvic-floor-muscles-in-healthy-women
#12
Amanda C Amorim, Licia P Cacciari, Anice C Passaro, Simone R B Silveira, Cesar F Amorim, Jefferson F Loss, Isabel C N Sacco
Pelvic floor muscle (PFM) force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation...
2017: PloS One
https://www.readbyqxmd.com/read/28502535/even-cementless-surgeons-use-cement
#13
A Gulati, A R J Manktelow
BACKGROUND: Patients presenting with hip arthritis have huge variability in anatomy, bone quality, and functional expectation. These can contribute to a varying degree of complexity on both the femoral and acetabular sides. Surgeons should be aware of all the various options in fixation, bearing surface, and surgical technique. METHODS: In this article, based on a presentation given at the recent American Association of Hip and Knee Surgeons meeting in Dallas, we will discuss why and how cemented fixation can, and indeed should, be considered when making decisions regarding how a primary, complex primary, or revision hip arthroplasty should be performed...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28498719/surgical-anatomy-of-the-pelvic-vasculature-with-particular-reference-to-acetabular-screw-fixation-in-cementless-total-hip-arthroplasty-in-asian-population
#14
Hironori Ohashi, Shinichi Kikuchi, Shigeo Aota, Michiyuki Hakozaki, Shinichi Konno
PURPOSE: Pelvic vascular injury is a serious complication associated with acetabular component setting with screw fixation in cementless total hip arthroplasty (THA). In this study, we investigated the safety zone for acetabular component setting with screw fixation in cementless THA as a means to prevent pelvic vascular injury. METHODS: Thirty left hip joints of Japanese cadavers (11 males and 19 females) were analyzed. We used a hemispherical measuring cup with 52 guide holes designed to allow vertical insertion of a Kirschner wire...
January 1, 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28493805/creating-three-dimensional-printed-models-of-acetabular-fractures-for-use-as-educational-tools
#15
Matthew S Manganaro, Yoav Morag, William J Weadock, Corrie M Yablon, Kara Gaetke-Udager, Erica B Stein
Acetabular fractures are frequently encountered in some clinical practices, and the precise classification of these fractures greatly influences treatments and outcomes. The authors identified the need for an educational aid when teaching acetabular fracture classifications, given the complex spatial anatomy and the nonintuitive classification system that is commonly used. Three-dimensional ( 3D three-dimensional ) printing is an evolving technique that has applications as an educational aid, providing the student with a tangible object to interact with and learn from...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28478834/3d-printed-liner-for-treatment-of-periprosthetic-joint-infections
#16
Tae Won B Kim, Osvaldo J Lopez, Jillian P Sharkey, Kyle R Marden, Muhammad Ridwan Murshed, Shivakumar I Ranganathan
In the United States, long standing deep infections of joint arthroplasty, such as total knee and total hip replacements, are treated with two-stage exchange. This requires the removal of the prior implant, placement of an antibiotic eluting spacer block made of polymethylmethacrylate (PMMA), followed by re-implantation of a new implant after treatment with intravenous antibiotics for six to eight weeks. Unfortunately, the use of PMMA as a spacer material has limitations in terms of mechanical and drug-eluting properties...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28448713/-ligamentun-teres-of-the-hip-bibliographic-revision
#17
REVIEW
A Porthos-Salas, P J Singh, J M ODonnell
The role and function of the ligamentum teres has drawn our attention in the last years due to the increasing and performance in hip arthroscopy, few is written in the literature, this is why we proposed to perform and assessed a review on the current literature of the anatomy, function, diagnose and rupture of the ligamentum teres of the hip.
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28446184/results-of-167-consecutive-cases-of-acetabular-fractures-using-the-kocher-langenbeck-approach-a-case-series
#18
Lukas L Negrin, David Seligson
BACKGROUND: Acetabular fractures are quite challenging injuries for the orthopedic surgeon because of their low incidence and their deep and complex anatomy. The objective of this study was to evaluate surgeon-independent parameters that might influence radiographic outcome and early complication rates of high-energy acetabular fractures treated by open reduction and internal fixation via the Kocher-Langenbeck approach, the golden standard for posterior access. METHODS: One hundred sixty-seven consecutive patients (111 males and 56 females) with a mean age of 41...
April 26, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28437496/novel-solution-for-massive-glenoid-defects-in-shoulder-arthroplasty-a-patient-specific-glenoid-vault-reconstruction-system
#19
David M Dines, Lawrence Gulotta, Edward V Craig, Joshua S Dines
Complex glenoid deformities present the most difficult challenges in shoulder arthroplasty. These deformities may be caused by severe degenerative or congenital deformity, posttraumatic anatomy, tumor, or, in most cases, bone loss after glenoid failure in anatomical total shoulder arthroplasty. Methods of treating severe bone loss have included inlay and onlay bone-graft options with augmented fixation and, in severe cases, salvage hemiarthroplasty with limited goal expectations. Unfortunately, none of these methods has provided consistently satisfactory reproducible results...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28430719/intertrochanteric-osteotomy-for-femoral-neck-non-union-does-undercorrection-result-in-an-acceptable-rate-of-femoral-neck-union
#20
Brandon J Yuan, David W Shearer, David P Barei, Sean E Nork
OBJECTIVES: To analyze the radiographic outcomes of intertrochanteric osteotomy for the treatment of femoral neck non-union with "undercorrection" of the Pauwels' angle and relative preservation of the proximal femoral anatomy. DESIGN: Retrospective cohort study SETTING:: Level-1 trauma center PATIENTS:: Thirty-two patients with established femoral neck non-unions that had been treated with intertrochanteric osteotomy were retrospectively identified through Current Procedural Terminology (CPT) codes...
April 18, 2017: Journal of Orthopaedic Trauma
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