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Acetabular dysplasia

X Q Wang, C S Wu, S Sun, J Wang, W Li, W Zhang
Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Amanda T Whitaker, James Kasser, Young-Jo Kim
RATIONALE: The sciatic nerve runs a predictable course combining L4-S3 nerve roots through the true pelvis and under the greater sciatic notch. There are reports of bony protuberances from the sacrum and ilium in cases of spinal dysraphism; however advanced imaging, treatment, or outcomes are not described. There are no cases with associated fibular hemimelia in the current literature. PATIENT CONCERNS: This is a 4-year-old girl with tethered cord, acetabular dysplasia with hip subluxation, congenital short femur, anterior cruciate ligament (ACL) deficiency, and fibular hemimelia with her sciatic nerve coursing through the ilium...
March 2018: Medicine (Baltimore)
Andrea B Mosler, Rintje Agricola, Kristian Thorborg, Adam Weir, Rod J Whiteley, Kay M Crossley, Per Hӧlmich
Study Design Cross-sectional cohort study. Background Athletes with femoroacetabular impingement (FAI) syndrome have cam and/or pincer morphology, pain on orthopaedic testing, and often have reduced hip range of motion (ROM) and strength. However, cam and pincer morphology are also common in asymptomatic hips. Therefore, it is currently unknown whether the ROM and strength deficits observed in athletes with FAI syndrome result from the variance in their bony hip morphology or hip condition. Objectives To investigate the relationship between musculoskeletal screening findings and bony hip morphology in asymptomatic male soccer players...
March 16, 2018: Journal of Orthopaedic and Sports Physical Therapy
Hiroki Shimodaira, Keiji Tensho, Yusuke Akaoka, Suguru Koyama, Masaaki Maruyama, Hiroyuki Kato, Naoto Saito
BACKGROUND: The acetabular fossa is thought to be located in the center of the acetabulum, and acetabular reaming in total hip arthroplasty is conventionally performed in the center of the fossa. However, the actual location of the fossa and the influence that hypoplasia or deformity may have on the position of the fossa are unknown. We hypothesized that the fossa is located in the center of the acetabulum, regardless of hypoplasia or deformity. METHODS: Fifty patients with normal hips (normal hip group), 50 patients with dysplasia who underwent rotational acetabular osteotomy (dysplastic hip group), and 46 patients with osteoarthritis who underwent total hip arthroplasty (osteoarthritic hip group) were evaluated by computed tomography (CT) imaging...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Vahit Emre Ozden, Goksel Dikmen, Burak Beksac, Ismail Remzi Tozun
BACKGROUND: Placement of acetabular cup in the dysplastic hip is a challenging procedure. Using bulk femoral head autograft to increase the bony coverage of the cup is one of the techniques, which have been described. The impact of cup position on cup and autograft survival is a controversial issue. We aimed to determine whether the position of cementless acetabular cup used in conjunction with femoral head autograft in dysplastic hips affected the autograft-host incorporation with its final radiographic appearance and the cup survivorship into the second decade...
March 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Mohsen Sadeghi-Naini, Salameh Taghipour, Azin Gouran Savadkouhi, Paul Kuzyk, Sebastián A León, Mohammad Ghazavi, Mansour Abolghasemian
OBJECTIVE: The purpose of this study was to determine if there is an anatomic relationship between pelvic geometry and acetabular depth. MATERIALS AND METHODS: One hundred and fifty-one anteroposterior pelvic radiographs (157 hip joints) were selected and analyzed in a retrospective fashion. Six parameters, including iliac offset, ischial offset, acetabular offset, pelvic height, center-edge (CE) angle of Wiberg, and acetabular index (AI) angle of Tönnis were measured for each of the hip joints...
February 27, 2018: Skeletal Radiology
Takeyuki Tanaka, Toru Moro, Yoshio Takatori, Hirofumi Oshima, Hideya Ito, Naohiko Sugita, Mamoru Mitsuishi, Sakae Tanaka
PURPOSE: Rotational acetabular osteotomy is a type of pelvic osteotomy that involves rotation of the acetabular bone to improve the bony coverage of the femoral head for patients with acetabular dysplasia. Favourable post-operative long-term outcomes have been reported in previous studies. However, there is a paucity of published data regarding three-dimensional bony coverage. The present study investigated the three-dimensional bony coverage of the acetabulum covering the femoral head in hips before and after rotational acetabular osteotomy and in normal hips...
February 26, 2018: International Orthopaedics
C Klein, A Fontanarosa, N Khouri, B Jonathan, J-P Padovani, C Glorion, P Wicart
BACKGROUND: Triple pelvic osteotomy (TPO) is a treatment option in children and adolescents with residual acetabular dysplasia after developmental dislocation of the hip (DDH). However, TPO to redirect the acetabulum is often blamed for anterior and lateral overcoverage of the femoral head. The main objectives of this study were to assess the potential clinical impact, frequency, and radiological features of acetabular overcorrection. Evidence of post-operative remodelling and associations linking younger age at surgery and/or dysplasia severity to the existence and magnitude of overcorrection were sought...
February 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Katharina Susanne Gather, Eva von Stillfried, Sebastien Hagmann, Sebastian Müller, Thomas Dreher
BACKGROUND: Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia. This challenging treatment may be associated with complications. Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction. METHODS: Twenty-seven children (3.4±2.0 years), including 33 hips with developmental hip dysplasia (DDH) and dislocation of the hip (Tönnis grade 1 to 4), who underwent hip reconstruction (Dega acetabuloplasty, varisation-derotation osteotomy and facultative open reduction) were retrospectively included in this study...
February 20, 2018: World Journal of Pediatrics: WJP
Özgür Çiçekli, Metin Doğan
BACKGROUND: This study aimed at determining the efficacy of the surgical treatment conducted on children with delayed presentation developmental dysplasia of the hip (DDH). The objective was to provide a good comparison of functional and radiographic outcomes and to determine various surgical treatment options. METHOD: In this study, we evaluated the results of 38 hips of 27 patients aged 4 years onset which had been operated due to DDH. Radiographic outcomes were evaluated by using acetabular index, CE angle, Tonnis and the Severin classification system...
February 15, 2018: International Journal of Surgery
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
Dennis Karimi, Thomas Kallemose, Anders Troelsen, Jakob Klit
INTRODUCTION: In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA...
February 10, 2018: Archives of Orthopaedic and Trauma Surgery
Joel Wells, Perry Schoenecker, Stephen Duncan, Charles W Goss, Kayla Thomason, John C Clohisy
BACKGROUND: The Bernese periacetabular osteotomy (PAO) is an alternative to arthroplasty for treating symptomatic acetabular dysplasia, but there have been few studies on the intermediate-term outcomes of this procedure. In the present study, we assessed intermediate-term hip survival and patient-reported outcomes of PAO used to treat symptomatic acetabular dysplasia. METHODS: From July 1994 to August 2008, 238 hips (206 patients) were treated with PAO. Sixty-two had a diagnosis other than classic acetabular dysplasia, and 22 were lost to follow-up...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Zhencun Cai, Qun Zhao, Lianyong Li, Lijun Zhang, Shijun Ji
BACKGROUND: One of the important pathologic changes in developmental dysplasia of the hip (DDH) is increased acetabular version angle (AA). Reasonable correction for excessive AA is an important step in the treatment of DDH, making accurate AA measurement very crucial. However, the results of different AA measurement methods vary. Thus, this study aimed to compare the difference in AA measurements between 2-dimensional computed tomography (2D-CT) and 3-dimensional computed tomography (3D-CT) in children with DDH and to identify the AA degree in children with DDH to guide treatment...
January 19, 2018: Journal of Pediatric Orthopedics
Hannes Kubo, Hakan Pilge, Karoline Nepp, Bettina Westhoff, Ruediger Krauspe
INTRODUCTION: Early diagnosis and treatment of hip dysplasia are widely accepted as major factors for beneficial outcome. However, modalities for reduction and retention as well as for imaging are currently under clinical investigation. Local and general risk factors, e.g., breech presentation and the family's desire to avoid in-hospital treatment are major concerns in the decision-making process and consultation. For treatment of unstable hips in newborns the treatment with the Tübingen splint has proven good results in recent studies...
January 19, 2018: Archives of Orthopaedic and Trauma Surgery
Ryohei Takada, Tetsuya Jinno, Kazumasa Miyatake, Yuki Yamauchi, Daisuke Koga, Kazuyoshi Yagishita, Atsushi Okawa
PURPOSE: The purpose of this study is to clarify morphological changes of acetabular subchondral bone cyst after total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip. METHODS: Two hundred and sixty-one primary cementless total hip arthroplasties of 208 patients, 18 males, 190 females, were retrospectively reviewed. Morphological changes of subchondral bone cyst were evaluated by computed tomography (CT). The mean cross-sectional area of the cyst from CT scans at 3 months postoperatively and after 7-10 years (average 8...
January 3, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Soon Hyuck Lee, Woo Young Jang, Gi Won Choi, Young Keun Lee, Hae Woon Jung
PURPOSE: To investigate the arthroscopic pathoanatomy of the transverse acetabular ligament (TAL) and determine whether a TAL incision is necessary for the concentric reduction of developmental dysplasia of the hip (DDH) in infants and young children. METHODS: We retrospectively reviewed patients who underwent arthroscopic-assisted reduction for DDH between July 2008 and April 2016. The indications for this intervention included patients in whom closed reduction failed and those who did not require bone operations...
December 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
YiQiang Li, YueMing Guo, Ming Li, QingHe Zhou, Yuanzhong Liu, WeiDong Chen, JingChun Li, Federico Canavese, HongWen Xu
PURPOSE: Our objective was to find the best predictor of late residual acetabular dysplasia in developmental dysplasia of the hip (DDH) after closed reduction (CR) and discuss the indications for secondary surgery. METHODS: We retrospectively reviewed the records of 89 patients with DDH (mean age 16.1 ± 4.6 months; 99 hips) who were treated by CR. Hips were divided into three groups according to final outcomes: satisfactory, unsatisfactory and operation. The changes in the acetabular index (AI), centre-edge angle of Wiberg (CEA), Reimer's index (RI) and centre-head distance discrepancy (CHDD) over time among groups were compared...
December 29, 2017: International Orthopaedics
J Vanlommel, L Vanlommel, B Molenaers, J P Simon
BACKGROUND: Multiple Ephiphyseal Dysplasia (MED) is a rare autosomal dominant skeletal dysplasia that causes deformation of the epiphysis of the involved joints. The hips are invariably affected and symptoms due to incapacitating early onset degenerative hip disease often begin between the second and fourth decade of life. Literature regarding the clinical and radiographical outcomes after total hip arthroplasty in this young population are very scarce. HYPOTHESIS: In patients with multiple epiphyseal dysplasia and early onset degenerative hip disease, hybrid total hip arthroplasty is a safe and reliable procedure...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Michael Leunig, Jonathan M Vigdorchik, Aidin Eslam Pour, Silvia Willi-Dähn, Reinhold Ganz
CASE: A large surgical correction was required for severe hip dysplasia, which was associated with a delayed-onset sciatic nerve injury in an adolescent patient. A cortical bone spur on the outside of the acetabular fragment produced an indirect injury that became symptomatic during mobilization of the patient. CONCLUSION: The risk of direct injury to the sciatic nerve during a periacetabular osteotomy is quite low when the osteotomy is executed in extension with abduction of the hip and flexion of the knee to reduce tension on the sciatic nerve...
January 2017: JBJS Case Connector
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