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Anatomy of the hip

Colin G Murphy, Michel P Bonnin, Antoine H Desbiolles, Yannick Carrillon, Tarik Aїt Si Selmi
BACKGROUND: Varus inclination of the uncemented stem is not necessarily a technical error. The proximal femoral anatomy of hips with a coxa vara deformity frequently predisposes varus inclination. METHODS: We reviewed a series of 200 patients undergoing primary uncemented THA with the Corail® hip system. Preoperative data were based on patient demographics, diagnosis, and radiographic information (preoperative templating-CT measurements), and compared postoperative alignment for each stem and type of stem used...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
Alexandre Terrier, Valérie Parvex, Hannes A Rüdiger
INTRODUCTION: In total hip arthroplasty, cup medialisation with compensatory increase of femoral offset has been proposed to increase the moment arms of abductor muscles. However, this technique is associated with a loss of acetabular bone stock. Previous data indicates that the potential benefit is not constant among patients and is likely related to patient anatomy. METHOD: Therefore, to be able to select patients who would benefit most from this technique, we measured several anatomical parameters of the pelvis and femur in 15 patients; and evaluated correlations between them and the changes of moment arms associated with cup medialisation...
October 8, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
A Zioła-Frankowska, M Dąbrowski, Ł Kubaszewski, P Rogala, A Kowalski, M Frankowski
The study was carried out to determine the content of mercury in bone tissue of the proximal femur (head and neck bone) of 95 patients undergoing total hip replacement due to osteoarthritis, using CF-AFS analytical technique. Furthermore, the investigations were aimed at assessing the impact of selected factors, such as age, gender, tobacco smoking, alcohol consumption, exposure to chemical substance at work, type of degenerative changes, clinical evaluation and radiological parameters, type of medications, on the concentration of mercury in the head and neck of the femur, resected in situ...
October 13, 2016: Environmental Science and Pollution Research International
Katherine R Kavanagh, Valerie Cote, Yvonne Tsui, Simon Kudernatsch, Donald R Peterson, Tulio A Valdez
OBJECTIVE: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible...
October 12, 2016: Laryngoscope
M Cody O'Dell, Diego Jaramillo, Laura Bancroft, Laura Varich, Gregory Logsdon, Sabah Servaes
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Hal D Martin, Anthony N Khoury, Ricardo Schröder, Eric Johnson, Juan Gómez-Hoyos, Salvador Campos, Ian J Palmer
PURPOSE: To determine the isolated function of the pubofemoral ligament of the hip capsule and its contribution to hip stability in external/internal rotational motion during flexion greater than 30° and abduction. METHODS: Thirteen hips from 7 fresh-frozen pelvis-to-toe cadavers were skeletonized from the lumbar spine to the distal femur with the capsular ligaments intact. Computed tomographic imaging was performed to ensure no occult pathological state existed, and assess bony anatomy...
October 5, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brian Cohen, Dominic Kleinhenz, Jonathan Schiller, Ramin Tabaddor
Athletic Pubalgia, more commonly known as sports hernia, is defined as chronic lower abdominal and groin pain without the presence of a true hernia. It is increasingly recognized in athletes as a source of groin pain and is often associated with other pathology. A comprehensive approach to the physical exam and a strong understanding of hip and pelvic anatomy are critical in making the appropriate diagnosis. Various management options are available. We review the basic anatomy, patholophysiology, diagnostic approach and treatment of athletic pubalgia as well as discuss associated conditions such as femoroacetabular impingement...
October 4, 2016: Rhode Island Medical Journal
Jorge Chahla, Jacob D Mikula, Jason M Schon, Chase S Dean, Kimi D Dahl, Travis J Menge, Eduardo Soares, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
BACKGROUND: Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension after standard anterosuperior interportal capsulotomy (12 to 3 o'clock)...
September 22, 2016: American Journal of Sports Medicine
Verena U Fenner, Henrik Behrend, Markus S Kuster
BACKGROUND: Modern knee designs do not fully restore the anatomy and kinematics of the natural knee. This study evaluates the kinematic and kinetic changes of well-functioning patients with total knee arthroplasty (TKA) in comparison to a healthy age-matched control group while descending stairs and level walking. The aim was to have a baseline for further investigations of TKA patients with problems. METHODS: Fifteen patients satisfied with TKA (8♀/7♂; 66.8 ± 7...
August 13, 2016: Journal of Arthroplasty
I Hujazi, T Jones, S Johal, P Bearcroft, G Muniz-Terra, V Khanduja
The aim of this study is to measure the ischiofemoral distance (IFD) in the normal hip with healthy surrounding soft tissues and describe its variations caused by gender, age and proximal femoral anatomy so that this could serve as a reference for future studies on this subject. This is a retrospective study in which we reviewed the CT scans of 149 patients (298 hips) who had a CT of their pelvis for non-orthopaedic (abdomino-pelvic) pathology. The images were reviewed by two independent observers and the IFD (the smallest distance between the lateral cortex of the ischial tuberosity and the posteromedial cortex of the lesser trochanter), offset (the perpendicular distance from the centre of the femoral head to a line running down the middle of the shaft of the femur) and the neck-shaft angle (the angle between the lines in the middle of the neck to the line forming the axis of the femoral shaft) were measured...
August 2016: Journal of Hip Preservation Surgery
Joshua D Harris
The importance of the acetabular labrum has been increasingly recognized, playing a critical role in both normal anatomy and abnormal pathology of the hip joint. The labrum increases acetabular surface area and volume, providing a stable and durable articulation. The fibrocartilaginous composition affords a tissue capable of a lifetime of normal function in the absence of significant osseous pathology. In the setting of femoroacetabular impingement (FAI) or dysplasia, bony biomechanics may cause labral injury, which may translate to patient symptoms...
August 31, 2016: Current Reviews in Musculoskeletal Medicine
Peter G Collin, Anthony V D'Antoni, Marios Loukas, Rod J Oskouian, R Shane Tubbs
As elderly populations rise worldwide, the amount of hip fractures have continued to increase and result in substantial medical burdens in many countries. This increase goes hand-in-hand with an increase in surgical procedures to correct hip fractures. The medical burden imparted by hip fractures and their corrective surgeries necessitate a clinically relevant understanding of the hip joint including the vascular, neural and musculoskeletal structures directly associated with and neighboring the joint. It is critical to appreciate how the normal hip anatomy is disrupted by a fracture and how this disruption is heavily influenced by the fracture's location...
August 31, 2016: Clinical Anatomy
Swapnil B Shah, Theodore T Manson, Jason W Nascone, Marcus F Sciadini, Robert V O'Toole
A retrospective review was conducted at an academic trauma center to determine whether fracture characteristics or aspects of native anatomy are predictive of early failure after fixation of posterior wall acetabular fractures. A chart review of posterior wall acetabular fractures treated from 2004 to 2009 yielded the study group that met the inclusion criteria. The study group included 18 consecutive patients who had clinical failure. The control group included 27 patients who did not have clinical failure...
August 30, 2016: Orthopedics
Peter G Collin, Rod J Oskouian, Marios Loukas, Anthony V D'Antoni, R Shane Tubbs
Elderly patients face distinct health challenges and have an increased demand for specific medical procedures. As the aging population continues to increase, age-associated conditions such as congestive heart failure, hip fractures, spine degeneration, dementia and airway compromise will increase in prevalence and procedures to correct these conditions will be increasingly performed. A clear understanding of the clinical anatomy of these diseases and procedures is imperative for anatomists and clinicians alike in order to best treat patients and continue to advance aging research and better teach future medical practitioners about the specific anatomy often involved in this group...
August 25, 2016: Clinical Anatomy
Seung-Jae Lim, Yoon-Soo Park
Plain radiographic examination is a fundamental approach to the diagnosis and treatment decision-making of the hip. A thorough understanding of standard radiographic techniques, radiographic anatomy, and disease patterns affecting the hip can be helpful in improving diagnostic accuracy. This article reviews the standard protocols used to obtain radiographic projections of the hip and addresses specific signs and various radiographic measurements used to adequately and reliably recognize structural diseases of the hip...
September 2015: Hip Pelvis
Stijn G M Ghijselings, Ronald Driesen, Jean-Pierre Simon, Kristoff Corten
BACKGROUND: The direct anterior approach (DAA) is becoming more popular as the standard surgical approach for primary total hip arthroplasty. However, femoral complications of up to 2.8% have been reported. Therefore, it is important for surgeons to understand the periarticular neurovascular anatomy in order to safely deal with intraoperative complications. METHODS: Anatomic dissections were performed on 20 cadaveric hips. The neurovascular structures anterior to the femur and distal to the intertrochanteric line were dissected and its position was described in relation to anatomic landmarks easily identified through the DAA: anterior superior iliac spine (ASIS), the insertion of the gluteus minimus (GM), and the lesser trochanter (LT)...
July 15, 2016: Journal of Arthroplasty
Ziqiang Huang, Yonggang Zhou, Wei Chai, Weiping Ji, Guopeng Cui, Miaoqun Ma, Yin Zhu
[Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13...
July 2016: Journal of Physical Therapy Science
Marco Yeung, Moin Khan, Dale Williams, Olufemi R Ayeni
The increasing use of hip arthroscopy has led to further development in our understanding of hip anatomy and potential post-operative complications. Iatrogenic gross hip instability following hip arthroscopy is a concerning complication described in recent orthopaedic literature. Post-arthroscopy hip instability is thought to be multifactorial, related to a variety of patient, surgical and post-operative factors. Given its infrequency, there is scarcity of literature describing appropriate surgical management and operative technique for addressing this instability...
August 4, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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