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Rotational femoral osteotomy

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https://www.readbyqxmd.com/read/28229355/femoral-shaft-osteotomy-for-obligate-outward-rotation-due-to-scfe
#1
Peter M Stevens, Lucas Anderson, Bruce A MacWilliams
Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement...
February 22, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28197751/rotational-acetabular-osteotomy-for-acetabular-dysplasia-and-osteoarthritis-a-mean-follow-up-of-20%C3%A2-years
#2
Takahito Yuasa, Katsuhiko Maezawa, Kazuo Kaneko, Masahiko Nozawa
INTRODUCTION: Rotational acetabular osteotomy (RAO), a joint-conserving surgery in which the femoral head coverage by autologous cartilage is improved to achieve joint stability, is one of the most common joint-conserving surgeries for acetabular dysplasia of the hip in adult patients. Favorable outcome of RAO for pre- and initial coxarthrosis has been reported with middle- to long-term observation; however, surgery should be selected for advanced coxarthrosis. The objective of this study was to investigate the long-term clinical outcomes and radiological arthritis changes in patients who were treated with RAO and could be followed for 15 years or longer, and to investigate the joint conservation rate by preoperative arthritis stage...
February 14, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28148658/long-term-outcomes-of-transtrochanteric-rotational-osteotomy-for-non-traumatic-osteonecrosis-of-the-femoral-head
#3
D Morita, Y Hasegawa, T Okura, Y Osawa, N Ishiguro
AIMS: Transtrochanteric rotational osteotomy (TRO) is performed for young patients with non-traumatic osteonecrosis of the femoral head (ONFH) to preserve the hip. We aimed to investigate the long-term outcomes and the risk factors for failure 15 years after this procedure. PATIENTS AND METHODS: This study included 95 patients (111 hips) with a mean age of 40 years (21 to 64) who underwent TRO for ONFH. The mean follow-up was 18.2 years (3 to 26). Kaplan-Meier survivorship analyses were performed with conversion to total hip arthroplasty (THA) and radiological failure due to secondary collapse of the femoral head or osteoarthritic changes as the endpoint...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28122388/clinical-study-of-3d-imaging-and-3d-printing-technique-for-patient-specific-instrumentation-in-total-knee-arthroplasty
#4
Bing Qiu, Fei Liu, Bensen Tang, Biyong Deng, Fang Liu, Weimin Zhu, Dong Zhen, Mingyuan Xue, Mingjiao Zhang
Patient-specific instrumentation (PSI) was designed to improve the accuracy of preoperative planning and postoperative prosthesis positioning in total knee arthroplasty (TKA). However, better understanding needs to be achieved due to the subtle nature of the PSI systems. In this study, 3D printing technique based on the image data of computed tomography (CT) has been utilized for optimal controlling of the surgical parameters. Two groups of TKA cases have been randomly selected as PSI group and control group with no significant difference of age and sex (p > 0...
January 25, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28094687/successful-management-of-femoral-trauma-in-a-through-knee-amputee-with-a-previous-malunited-fracture-implications-and-functional-outcome
#5
Beth Lineham, Paul Harwood, Peter Giannoudis
BACKGROUND: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management. Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation. Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28060234/reorientational-proximal-femoral-osteotomies-for-arthrogrypotic-hip-contractures
#6
Harold Jacob Pieter van Bosse, Roger E Saldana
BACKGROUND: Severe hip contractures in arthrogrypsosis are multiplanar, which can preclude or can greatly complicate sitting and ambulation. The reorientational osteotomy at the intertrochanteric level preserves preoperative hip motion but moves it to a more functional domain. We retrospectively compared preoperative and postoperative hip motion and evaluated the ambulatory abilities of patients who underwent the procedure. METHODS: Since 2008, 65 patients with arthrogryposis had 119 reorientational proximal femoral osteotomies with a minimum follow-up of 2 years...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28017874/factors-influencing-progressive-collapse-of-the-transposed-necrotic-lesion-after-transtrochanteric-anterior-rotational-osteotomy-for-osteonecrosis-of-the-femoral-head
#7
Yusuke Kubo, Goro Motomura, Satoshi Ikemura, Kazuhiko Sonoda, Takuaki Yamamoto, Yasuharu Nakashima
BACKGROUND: Transtrochanteric anterior rotational osteotomy (ARO) for osteonecrosis of the femoral head (ONFH) can preserve for a long-time collapsed femoral head. Progressive collapse of anteriorly-transposed necrotic lesion leads to secondary arthritic changes and clinical failure. Critical factors influencing collapse of the transposed necrotic lesion after ARO remain largely unknown. Therefore we performed a retrospective study of ARO to determine: 1) if pre-operative collapse influences collapse of the transposed necrotic area, 2) if any other factor may influence collapse of the transposed necrotic area...
December 22, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27988165/increased-femoral-anteversion-influence-over-surgically-treated-recurrent-patellar-instability-patients
#8
Carlos Eduardo Franciozi, Luiz Felipe Ambra, Leonardo José Bernardes Albertoni, Pedro Debieux, Fernando Cury Rezende, Mauricio Ayres de Oliveira, Marcio de Castro Ferreira, Marcus Vinícius Malheiros Luzo
PURPOSE: To verify the influence that increased femoral anteversion (FA) has on patients with recurrent patellar instability (RPI) treated by anteromedialization tibial tubercle osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) and to present the midterm outcomes of these patients. METHODS: From January 2008 to August 2013, skeletally mature patients with RPI and tibial tubercle (TT)-trochlear groove (TG) ≥ 17 mm who underwent anteromedialization TTO combined with MPFLR were evaluated for J sign, patellar glide, apprehension test, increased FA, Caton index, trochlea dysplasia, TT-TG, Kujala, International Knee Documentation Committee subjective knee evaluation form, and Tegner...
December 14, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27977586/application-of-a-3-dimensional-printed-navigation-template-in-bernese-periacetabular-osteotomies-a-cadaveric-study
#9
You Zhou, Xiaopeng Kang, Chuan Li, Xiaoshan Xu, Rong Li, Jun Wang, Wei Li, Haotian Luo, Sheng Lu
The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model.Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. Using Mimics v10.1 software (Materialise, Leuven, Belgium), 3D computed tomographic reconstructions were created and the 4 standard PAO bone cuts-ischial, pubic, anterior, and posterior aspects of the ilium-as well as rotation of the dislocated acetabular bone blocks were simulated for each specimen...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27957592/-lateral-unicompartmental-knee-arthroplasty-a-challenge
#10
T Walker, P R Aldinger, M R Streit, T Gotterbarm
OBJECTIVE: Joint surface replacement in the lateral compartment by unicondylar knee arthroplasty. INDICATIONS: Lateral unicompartmental osteoarthritis of the knee joint, avascular necrosis of the lateral femoral condyle. CONTRAINDICATIONS: Full thickness cartilage defect in the central part of the medial compartment or in the medial aspect of the patellofemoral joint. Instability/contracture of cruciate and collateral ligaments, valgus deformity >15°, valgus deformity not passively correctable, flexion deformity >15°, an intraoperative flexion <100°, failed upper tibial osteotomy, rheumatoid arthritis...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27905061/one-third-of-hips-after-periacetabular-osteotomy-survive-30-years-with-good-clinical-results-no-progression-of-arthritis-or-conversion-to-tha
#11
Till Dominic Lerch, Simon Damian Steppacher, Emanuel Francis Liechti, Moritz Tannast, Klaus Arno Siebenrock
BACKGROUND: Since its first description in 1984, periacetabular osteotomy (PAO) has become an accepted treatment for hip dysplasia. The 30-year survivorship with this procedure has not been reported. Because these patients are often very young at the time of surgery, long-term followup and identification of factors associated with poor outcome could help to improve patient selection. QUESTIONS/PURPOSES: Looking at the initial group of patients with hip dysplasia undergoing PAO at the originator's institution, we asked: (1) What is the cumulative 30-year survival rate free from conversion to THA, radiographic progression of osteoarthritis, and/or a Merle d'Aubigné-Postel score < 15? (2) Did hip function improve and pain decrease? (3) Did radiographic osteoarthritis progress? (4) What are the factors associated with one or more of the three endpoints: THA, radiographic progression of osteoarthritis, and/or Merle d'Aubigné-Postel score < 15? METHODS: We retrospectively evaluated the first 63 patients (75 hips) who underwent PAO for hip dysplasia between 1984 and 1987...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27892801/stability-and-migration-across-femoral-varus-derotation-osteotomies-in-children-with-neuromuscular-disorders
#12
Peter Buxbom, Stig Sonne-Holm, Niels Ellitsgaard, Christian Wong
Background and purpose - Studies have indicated that one-third of children with cerebral palsy (CP) develop dislocation of the hip that needs surgical intervention. When hip dislocation occurs during childhood surgical treatment consists of tenotomies, femoral varus derotation osteotomy (VDRO), and acetabuloplasty. Relapse is observed in one-fifth of cases during adolescence. In this prospective cohort study, we performed a descriptive evaluation of translation and rotation across VDROs in children with neuromuscular disorders and syndromes by radiostereometric analysis (RSA)...
November 28, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27844117/are-advanced-three-dimensional-imaging-studies-always-needed-to-measure-the-coronal-knee-alignment-of-the-lower-extremity
#13
Jean Yves Lazennec, Quentin Chometon, Dominique Folinais, Christopher B Robbins, Aidin Eslam Pour
BACKGROUND: Coronal malalignment of the lower extremity is closely related to the onset and progression of osteoarthritis. Restoring satisfactory alignment after tibial osteotomy improves the long-term success of this conservative surgery. The purpose of our study was to determine (1) if there is a difference between two-dimensional (2D) and 3D measurements of the hip-knee-ankle (HKA) angle between the mechanical axes of the femur and the tibia, (2) which parameter most affects 2D-3D HKA measurement, and (3) the percentage of patients who are at risk of error in HKA measurement...
November 14, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27833839/patient-reported-outcomes-of-femoral-osteotomy-and-total-hip-arthroplasty-for-osteonecrosis-of-the-femoral-head-a-prospective-case-series-study
#14
Yusuke Kubo, Takuaki Yamamoto, Goro Motomura, Kazuyuki Karasuyama, Kazuhiko Sonoda, Yukihide Iwamoto
BACKGROUND: Patient-reported scoring systems have recently been used after surgical procedures. The purpose of this prospective study was to evaluate the patient-reported outcomes of femoral osteotomy and total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH). METHODS: Forty-two symptomatic ONFH patients with asymptomatic contralateral hip underwent either transtrochanteric anterior rotational osteotomy (ARO) or THA as a primary operation. Of these, 20 patients whose contralateral hips remained asymptomatic at the final follow-up (more than 1 year postoperatively) were recruited to participate in this study...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27830486/three-patterns-of-acetabular-deficiency-are-common-in-young-adult-patients-with-acetabular-dysplasia
#15
Jeffrey J Nepple, Joel Wells, James R Ross, Asheesh Bedi, Perry L Schoenecker, John C Clohisy
BACKGROUND: Detailed recognition of the three-dimensional (3-D) deformity in acetabular dysplasia is important to help guide correction at the time of reorientation during periacetabular osteotomy (PAO). Common plain radiographic parameters of acetabular dysplasia are limited in their ability to characterize acetabular deficiency precisely. The 3-D characterization of such deficiencies with low-dose CT may allow for more precise characterization. QUESTIONS/PURPOSES: The purposes of this study were (1) to determine the variability in 3-D acetabular deficiency in acetabular dysplasia; (2) to define subtypes of acetabular dysplasia based on 3-D morphology; (3) to determine the correlation of plain radiographic parameters with 3-D morphology; and (4) to determine the association of acetabular dysplasia subtype with patient clinical characteristics including sex, range of motion, and femoral version...
November 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27791241/comparison-of-femoral-head-translation-following-eccentric-rotational-acetabular-osteotomy-and-rotational-acetabular-osteotomy
#16
Tohru Irie, Daisuke Takahashi, Tsuyoshi Asano, Ryuta Arai, Takuya Konno, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki
PURPOSE: Eccentric rotational acetabular osteotomy (ERAO) is a modification of rotational acetabular osteotomy (RAO); it has been reported that ERAO allows the femoral head to translate medially and distally. However, no study has compared femoral head translation following RAO or ERAO. The purpose of this study was to compare immediate postoperative translation of the femoral head after RAO and ERAO in comparison with the preoperative position by radiological methods. METHODS: Patients treated by RAO or ERAO between 2006 and 2014 were retrospectively evaluated...
October 26, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27783201/comparison-of-rotational-acetabular-osteotomy-performed-with-navigation-by-surgeons-with-different-levels-of-experience-of-osteotomies
#17
Masaki Takao, Takashi Nishii, Takashi Sakai, Nobuhiko Sugano
PURPOSE: Rotational acetabular osteotomy (RAO) is used to treat developmental hip dysplasia (DDH). It requires detailed anatomical knowledge of the pelvic anatomy and three-dimensional cognitive skills. We addressed whether a computer navigation system combined with a preoperative computed tomography-based plan enabled surgeons to perform RAO safely and reliably through a mini-incision regardless of their level of experience with performing osteotomies. METHODS: We enrolled 24 patients (25 hips) with DDH (radiographic grade 0 or 1 osteoarthritic changes: Tönnis classification)...
October 25, 2016: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/27726746/postoperative-imaging-in-the-setting-of-hip-preservation-surgery
#18
Megan K Mills, Colin D Strickland, Mary K Jesse, Peter A Lowry, Omer Mei-Dan, Jonathan A Flug
Osteoarthritis of the hip remains a prevalent disease condition that influences ever-changing treatment options. Procedures performed to correct anatomic variations, and, in turn, prevent or slow the progression of osteoarthritis, are aptly referred to as types of hip preservation surgery (HPS). Conditions that predispose individuals to femoroacetabular impingement (FAI), including pincer- and cam-type morphology, and hip dysplasia are specifically targeted in HPS. Common surgical interventions include acetabuloplasty, osteochondroplasty, periacetabular osteotomy (PAO), and derotational femoral osteotomy (DFO)...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27677011/correction-of-hip-internal-rotation-in-walking-cerebral-palsy-adolescent-using-a-soft-tissue-procedure-an-alternative-to-femoral-rotation-osteotomy
#19
Bruno Dohin, Elie Haddad, Hassan Al Khoury Salem, Mohamed Merhez Kilani
OBJECTIVE: Hip internal rotation (HIR) during gait is one of the main functional disorders related to cerebral palsy (CP) in children. Most of the procedures proposed rotational osteotomy of the femur (FRO), (and/or tibia). However, multilevel surgery (SEMLS) including bone procedure, implicates more difficult and longer rehabilitation. When bone deformity is moderate, the authors hypothesized that FRO could be avoided. They developed a soft tissues procedure to improve HIR. The aim of the study was assessment of the procedure...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27636916/knee-pain-and-activity-outcomes-after-femoral-derotation-osteotomy-for-excessive-femoral-anteversion
#20
Jeffrey B Stambough, Lauren Davis, Deborah A Szymanski, June C Smith, Perry L Schoenecker, J Eric Gordon
BACKGROUND: Excessive femoral anteversion is a developmental condition that can become symptomatic into adolescence and manifest as anterior knee pain, tripping, and or problems with sports. Femoral derotational osteotomy about an antegrade intramedullary nail (IMN) is an accepted option to treat this condition. This is the first report of the clinical and functional outcomes of treatment of excessive anteversion with femoral derotational osteotomy stabilized with an IMN. METHODS: We prospectively enrolled 28 consecutive patients between 2013 and 2014 who underwent derotational osteotomy...
September 15, 2016: Journal of Pediatric Orthopedics
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