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Rotational femoral osteotomy

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27628762/-modified-pembersal-osteotomy-technique-with-lyophilized-human-allograft
#11
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
December 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27475618/femoral-derotation-osteotomy-in-adults-with-cerebral-palsy
#12
C Putz, S I Wolf, A Geisbüsch, M Niklasch, L Döderlein, T Dreher
BACKGROUND: Internal rotation gait constitutes a complex gait disorder in bilateral spastic cerebral palsy (BSCP) including static torsional and dynamic components resulting in lever arm dysfunction. Although femoral derotation osteotomy (FDO) is a standard procedure to correct increased femoral anteversion in children, unpredictable outcome has been reported. The effect of FDO when it is done as part of single-event multilevel surgery (SEMLS) in adulthood has not been investigated. METHODS: In this study mid-term data of 63 adults with BSCP and internal rotation gait, undergoing SEMLS including FDO were analyzed pre- and 1...
September 2016: Gait & Posture
https://www.readbyqxmd.com/read/27475117/the-choice-of-locking-plate-in-the-treatment-of-peri-implant-femoral-fracture-eight-years-after-trans-trochanteric-rotational-osteotomy-a-case-report
#13
Takeshi Utsunomiya, Takuaki Yamamoto, Goro Motomura, Kazuyuki Karasuyama, Kazuhiko Sonoda, Yusuke Kubo, Hiroyuki Hatanaka, Yukihide Iwamoto
INTRODUCTION: Transtrochanteric anterior rotational osteotomy of the femoral head (TRO) was developed as a joint preserving surgery for osteonecrosis of the femoral head. To the best of our knowledge, peri-implant fractures after femoral osteotomy have rarely been reported. PRESENTATION OF CASE: We report a 58-year-old female who suffered a peri-implant femoral shaft fracture following a fall from a stepladder eight years after TRO. Fracture union was achieved six months after a preferred proximal femoral locking plate...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27461924/transtrochanteric-rotational-osteotomy-for-avascular-necrosis-of-the-femoral-head-after-unstable-slipped-capital-femoral-epiphysis-10-year-clinical-results
#14
Yasuharu Nakashima, Takuaki Yamamoto, Jun-Ichi Fukushi, Goro Motomura, Satoshi Hamai, Yusuke Kohno, Yukihide Iwamoto
BACKGROUND: Avascular necrosis of the femoral head (AVN) is the most serious complication after unstable slipped capital femoral epiphysis (SCFE), and is often unsalvageable. We report a minimum 10 years of clinical results for transtrochanteric rotational osteotomy of the femoral head (TRO) for AVN. METHODS: This study included 7 patients (7 hips) with a mean age at surgery of 13.3 years, and the follow-up period was 15.8 years. All patients had prior treatment via closed reduction and pinning of the unstable SCFE, and showed severely collapsed femoral heads...
July 22, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27450671/biomechanical-changes-associated-with-femoral-derotational-osteotomy
#15
Bruce A MacWilliams, Mark L McMulkin, Roy B Davis, David E Westberry, Glen O Baird, Peter M Stevens
Torsional deformities of the femur in children may occur as a result of either idiopathic or neuromuscular disorders and may be corrected with derotational osteotomies. Regardless of the underlying etiology, neither the effects of the torsional pathologies nor the alterations resulting from corrective osteotomies are well understood. A study of children with isolated femoral anteversion undergoing a single corrective procedure may assist in understanding the biomechanics of the pathology and the efficacy of surgical correction...
September 2016: Gait & Posture
https://www.readbyqxmd.com/read/27347235/multiplanar-deformities-correction-using-taylor-spatial-frame-in-skeletally-immature-patients
#16
Lior Koren, Yaniv Keren, Mark Eidelman
BACKGROUND: Taylor Spatial Frame (TSF) is a modern circular external fixator that, using a virtual hinge, is able to correct six axis deformities simultaneously. Despite the growing popularity of this method, few reports exist about its use in children and adolescents. To evaluate the effectiveness of TSF in correcting multiplanar deformities in patients with open physis, we reviewed the results of treatment in children who had at least two planes deformities of lower limbs. METHODS: Over a period of 8 years, we treated 51 patients, 40 boys, 11 girls, with a mean age of 12...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27325569/electromagnetic-bone-segment-tracking-to-control-femoral-derotation-osteotomy-a-saw-bone-study
#17
Andreas Geisbüsch, Christoph Auer, Hartmut Dickhaus, Mirjam Niklasch, Thomas Dreher
Correction of rotational gait abnormalities is common practice in pediatric orthopaedics such as in children with cerebral palsy. Femoral derotation osteotomy is established as a standard treatment, however different authors reported substantial variability in outcomes following surgery with patients showing over- or under-correction. Only 60% of the applied correction is observed postoperatively, which strongly suggests intraoperative measurement error or loss of correction during surgery. This study was conducted to verify the impact of error sources in the derotation procedure and assess the utility of a newly developed, instrumented measurement system based on electromagnetic tracking aiming to improve the accuracy of rotational correction...
June 21, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27318670/percutaneous-rotational-osteotomy-of-the-femur-utilizing-an-intramedullary-rod
#18
Peter M Stevens, Christian J Gaffney, Heather Fillerup
The purpose is to describe the technique and report the results and complications of percutaneous femoral rotational osteotomy, secured with a trochanteric-entry, locked intramedullary rod, in adolescents with femoral anteversion. Our series comprised an IRB approved, retrospective, consecutive series of 85 osteotomies (57 patients), followed to implant removal. The average age at surgery was 13.3 years (range 8.8-18.3) with a female-to-male ratio of 2.8:1. The minimum follow-up was 2 years. Eighty-three osteotomies healed primarily...
August 2016: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/27314923/femoral-deformity-may-be-more-predictive-of-hip-range-of-motion-than-severity-of-acetabular-disease-in-patients-with-acetabular-dysplasia-an-analysis-of-the-anchor-cohort
#19
Peter D Fabricant, Wudbhav N Sankar, Mark A Seeley, Paul E Beaulé, John C Clohisy, Young-Jo Kim, Michael B Millis, Christopher L Peters, David A Podeszwa, Perry L Schoenecker, Rafael J Sierra, Ernest L Sink, Daniel J Sucato, Ira Zaltz
BACKGROUND: It is generally believed that acetabular dysplasia (AD) is associated with increased hip range of motion (ROM). The purpose of this study was to investigate the associations between dysplasia severity and hip ROM in a large multicenter cohort. METHODS: A prospective registry of patients undergoing periacetabular osteotomy for symptomatic AD by 1 of 13 surgeons was used to analyze 1,051 patients (mean age, 26 ± 10 years). Multivariable linear regression modeling was used to investigate for associations between dysplasia severity (severe, <5°; moderate, 5° to 15°; mild, >15°), α angle, and hip ROM...
July 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27299096/complex-primary-total-knee-replacement-tkr-using-prophylactic-gastrocnemius-flap-and-rotating-hinge-knee-in-post-traumatic-infective-arthritis-of-the-knee-a-case-report
#20
Sanjeev Patnaik, Biswaranjan Nayak, Laxmikanta Mishra, Akshaya Kumar Sahoo
INTRODUCTION: Prophylactic gastrocnemius flap with primary rotating hinge knee is technically demanding in a case of neglected post-traumatic, infective arthritis of the knee, with challenges of compromised skin and soft tissues, articular bone defect, limb mal-alignment, gross instability, retained hardware and a contracted extensor mechanism with the patella fixed in the lateral gutter all in combination, is rarely reported. We report such a complex case in this study. CASE REPORT: We report a 48 year male patient with a history of fracture lateral femoral condyle of right knee due to road traffic accident 10 years back, for which he got operated with open reduction and internal fixation with cancellous screws, which subsequently got infected...
October 2015: Journal of Orthopaedic Case Reports
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