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Afsar T Ozkut, Yusuf Iyetin, Omer K Unal, M Salih Soylemez, Esat Uygur, Irfan Esenkaya
OBJECTIVE: To evaluate the midterm clinical and radiological outcomes of the medial approach using two intervals for developmental hip dysplasia (DDH). METHODS: The study involved 62 hips of 47 patients (41 girls, 6 boys) treated with medial approach for DDH from 1999 to 2010. The age of the patients at surgery was 18.7 ± 2.25 months. Follow up of the patients was 11.3 ± 3.07 years. The age of the patients at the last follow up was 12.6 ± 1.74 years. According to the Tönnis classification, 13 hips were grade II, 27 hips were grade III and 22 hips were grade IV...
February 14, 2018: Acta Orthopaedica et Traumatologica Turcica
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
Luca Andriolo, Giulia Merli, Carlos Tobar, Sante Alessandro Altamura, Elizaveta Kon, Giuseppe Filardo
PURPOSE: The aim of this study was to document the available evidence on the use of regenerative techniques for the treatment of femoral head osteonecrosis (or avascular necrosis of femoral head, AVN) and to understand their benefit compared to core decompression (CD) alone in avoiding failure and the need for total hip replacement (THR). METHODS: The search was conducted on three medical electronic databases according to PRISMA guidelines. The studies reporting number and timing of failures were included in a meta-analysis calculating cumulative survivorship with a Kaplan-Mayer curve...
February 6, 2018: International Orthopaedics
Sarah Walton, Emily Schaeffer, Kishore Mulpuri, Peter Cundy, Nicole Williams
INTRODUCTION: Developmental dysplasia of the hip (DDH) affects 4-6 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction...
January 29, 2018: BMJ Open
Seyed Amir Reza Mesbahi, Ali Ghaemmaghami, Sara Ghaemmaghami, Pouya Farhadi
Objective: To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures. Methods: This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016...
January 2018: Bulletin of Emergency and Trauma
Takuya Otani, Yasuhiko Kawaguchi, Keishi Marumo
Slipped capital femoral epiphysis (SCFE) is not frequently encountered during routine practice and diagnosis and treatment are often delayed. It is important to understand symptoms and imaging features to avoid delayed diagnosis. After the diagnosis is made correct classification of the disease is required. The classification should be based on the physeal stability in order to choose safe and effective treatment. However, surgeons should bear in mind that the assessment is challenging and actual physeal stability is not always consistent with the stability predicted by a clinical classification method...
January 17, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Alexandru Ulici, Madalina Carp, Iulia Tevanov, Catalin Alexandru Nahoi, Alin Gabriel Sterian, Dan Cosma
Objective This study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement. Methods We conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI)...
January 1, 2017: Journal of International Medical Research
J Mcfarlane, J H Kuiper, N Kiely
The treatment of developmental dysplasia of the hip (DDH) in children remains controversial. We describe the clinical and radiological outcomes of  47 hips in 43 children treated with open surgery by one surgeon between 2004 and 2008 for DDH. The mean age at operation was 25 months (5 to 113) with a mean follow up of  89 months  (22 to 169). At the latest follow up 40 of the 45 hips where Severin grades were recordable (89%) were graded as excellent or good, Severin class I or II. Clinically significant AVN (grade II to III  according to the Kalamchi and MacEwen classification) was seen in 6  (13%) of the hips...
December 2016: Acta Orthopaedica Belgica
Sung Il Wang, Eun Hae Park, Sun Jung Yoon, Jung Ryul Kim
Osteochondromas are usually extra-articular lesions originating from the metaphysis of long bones. Intra-articular osteochondromas may also occur, causing pain and discomfort and restricting the range of motion. Osteochondromas of the femoral neck are intra-articular lesions that are difficult to access for surgical resection, particularly when located posteriorly. We herein present a rare case of an intra-articular osteochondroma involving the posteroinferior aspect of the femoral neck associated with secondary synovial osteochondromatosis (SOC) of the hip joint in a 25-year-old woman...
November 2017: Molecular and Clinical Oncology
Soo Min Cha, Hyun Dae Shin, Byung Kon Shin
BACKGROUND: Developmental dysplasia of the hip (DDH) diagnosed in older postnatal children can be effectively treated by closed reduction (CR) alone. However, no prospective or comparative trial to explore the differential effectiveness of CR between non-walking and walking postnatal children has yet been reported. This study investigated the clinical and radiologic outcomes of CR in the age range of interest (12-18 months old) via a prospective trial and compared these results with those of a younger age group who also underwent CR...
November 13, 2017: International Orthopaedics
Ghulam Mustafa Kaim Khani, Kamran Hafeez, Muhammad Bux, Nusrat Rasheed, Naveed Ahmed, M Perwez Anjum
Objective: To present the clinical outcome of patients with neglected femur neck fracture treated with fibular bone graft. Methods: During May 2010-February 2013, 15 patients younger than 35 years of age with neglected fracture neck of femur were managed with non-vascularized fibular graft and cannulated screws. Fractures were classified according to Sandhu Classification. Hip function was assessed using Harris hip score. Results: Fifteen patients with mean age of 28...
November 2017: International Journal of Health Sciences
Pierre Campenfeldt, Margareta Hedström, Wilhelmina Ekström, Amer N Al-Ani
BACKGROUND AND PURPOSE: Prospective studies on patient related outcome in patients <70years with a femoral neck fracture (FNF) are few. We aimed to investigate functional outcome and health-related quality of life (HRQoL) in 20-69years old patients with a FNF treated with internal fixation. PATIENTS AND METHODS: 182 patients, 20-69years with a FNF treated with internal fixation were prospectively included in a multicenter study. Follow up included radiographic and clinical examination at 4, 12 and 24 months...
December 2017: Injury
L Phillips, K Hesketh, E K Schaeffer, J Andrade, J Farr, K Mulpuri
PURPOSE: Progressive hip displacement is one of the most common orthopaedic pathologies in children with cerebral palsy (CP). Reconstructive hip surgery has become the standard treatment of care. Reported avascular necrosis (AVN) rates for hip reconstructive surgery in these patients vary widely in the literature. The purpose of this study is to identify the frequency and associated risk factors of AVN for reconstructive hip procedures. METHODS: A retrospective analysis was performed of 70 cases of reconstructive hip surgery in 47 children with CP, between 2009 and 2013...
October 1, 2017: Journal of Children's Orthopaedics
Sandra Basic-Kinda, Ivan Karlak, Nadira Durakovic, Zvonimir Ivan Lubina, Ivo Radman, Snježana Dotlic, Zinaida Peric, Ida Hude, Igor Aurer
BACKGROUND: Escalated BEACOPP (eBEACOPP) is an effective but fairly toxic regimen for treatment of Hodgkin lymphoma (HL). Avascular necrosis of femoral head (AVN) was previously reported to be increased in patients treated with eBEACOPP, but so far no systematic analysis of its frequency has been published. AIMS: We aimed to analyze frequency and identify possible risk factors for AVN development in patients treated with eBEACOPP. METHODS: We identified 26 patients treated with eBEACOPP for newly diagnosed high-risk advanced stage HL, 25 patients alive at the time of study...
October 25, 2017: Internal Medicine Journal
Charlotte L Williams, Susie Weller, Lisa Roberts, Isabel Reading, Andrew Cook, Louisa Little, Wendy Wood, Louise Stanton, Andreas Roposch, Nicholas Mp Clarke
BACKGROUND: Developmental dysplasia of the hip (DDH) is a very common congenital disorder, and late-presenting cases often require surgical treatment. Surgical reduction of the hip may be complicated by avascular necrosis (AVN), which occurs as a result of interruption to the femoral head blood supply during treatment and can result in long-term problems. Some surgeons delay surgical treatment until the ossific nucleus (ON) has developed, whereas others believe that the earlier the reduction is performed, the better the result...
October 2017: Health Technology Assessment: HTA
Jesper Holbeck-Brendel, Bjarne Møller-Madsen, Ivan Hvid, Michel B Hellfritzsch, Line K Pedersen, Peter Dalsgaard, Ole Rahbek
INTRODUCTION: Ludloff's procedure for open reduction of congenital dislocation of the hip (CDH) is recommended for its minimal tissue damage, but is criticised for the risk of late avascular necrosis (AVN) of the femoral head. The aim of present study was primarily to assess the risk of late AVN of the femoral head and secondly the range of motion (ROM) of the hip and the quality of life in children following Ludloff's procedure. METHODS AND MATERIALS: 13 hips in 11 children after Ludloff's procedure due to CDH were included retrospectively from 1997 to 2005 at Aarhus University Hospital...
October 12, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
C E H Scott, D MacDonald, M Moran, T O White, J T Patton, J F Keating
AIMS: To evaluate the outcomes of cemented total hip arthroplasty (THA) following a fracture of the acetabulum, with evaluation of risk factors and comparison with a patient group with no history of fracture. PATIENTS AND METHODS: Between 1992 and 2016, 49 patients (33 male) with mean age of 57 years (25 to 87) underwent cemented THA at a mean of 6.5 years (0.1 to 25) following acetabular fracture. A total of 38 had undergone surgical fixation and 11 had been treated non-operatively; 13 patients died at a mean of 10...
October 2017: Bone & Joint Journal
Sherif Galal, Mohamed Nagy
INTRODUCTION: Current literature shows divergence of views regarding screws positioning in femoral neck fractures fixation. The goal of this study is to evaluate the efficiency of divergent screw fixation for fracture neck of femur (NOF). METHODS: The study was conducted at an academic Level 1 Trauma Center. This is a retrospective study conducted from October 2013 to October 2016. The study included 41 patients (33 males, 8 females) suffering from fracture NOF who were fixed using BDSF technique (26 within 24 h...
July 2017: Journal of Clinical Orthopaedics and Trauma
J B Erickson, W P Samora, K E Klingele
PURPOSE: Treatment of slipped capital femoral epiphysis (SCFE), including the modified Dunn procedure, restores anatomy with significant risk for avascular necrosis (AVN), if performed in the setting of moderate to severe, stable SCFE. The Imhauser osteotomy has been shown to be an effective way to correct residual deformity without the risk of AVN. We sought to evaluate the effectiveness and safety of a combined Imhauser osteotomy and osteochondroplasty, performed via a surgical hip dislocation approach for the acute and delayed treatment of stable SCFE...
August 1, 2017: Journal of Children's Orthopaedics
Sun-Ho Lee, Gun-Woo Lee, Young-Jun Seol, Kyung-Soon Park, Taek-Rim Yoon
BACKGROUND: The objective of this study was to compare clinical and radiological outcomes of total hip arthroplasty (THA) between ankylosing spondylitis (AS) of the hip joint and avascular necrosis (AVN) of the femoral head. METHODS: Thirty patients (30 hips) underwent cementless THA for AS between 2003 and 2012. They were compared to 30 patients (30 hips) who underwent the same procedure for AVN of the femoral head. Each group was matched for age and gender, and both groups had similar preoperative demographic characteristics...
September 2017: Clinics in Orthopedic Surgery
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