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Rotational femoral osteotomy

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
Maurizio Montalti, Francesco Castagnini, Federico Giardina, Enrico Tassinari, Federico Biondi, Aldo Toni
BACKGROUND: Total hip arthroplasty (THA) in severe developmental dysplasia of the hip (DDH) is a challenging procedure. The most used techniques involve anatomic cup positioning, augmentation femoral osteotomy. However, anatomic cup positioning is not always feasible in severe DDH and osteotomy nonunion may ensue. The purpose of the study was to assess the survivorship, the hip score results, the radiological parameters (fixation, loosening, component position) of a large cohort of patients with Crowe III and IV DDH, treated with high hip center and modular necks THAs...
February 2, 2018: Journal of Arthroplasty
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
Frank Braatz, Thomas Dreher, Sebastian I Wolf, Mirjam Niklasch
BACKGROUND: Femoral derotation osteotomy (FDO) is the standard treatment for internal rotation gait (IRG) in children with cerebral palsy (CP) although high rates of recurrence have been reported recently. Various factors associated with recurrence could be identified, but no predictor named. RESEARCH QUESTIONS: Does FDO lead to a change of internal transversal hip moments? Are preoperative internal transversal hip moments a predictor for recurrence of IRG? METHODS: 41 children with spastic bilateral CP and 72 limbs that received a FDO (10...
January 26, 2018: Gait & Posture
Elyse Passmore, H Kerr Graham, Morgan Sangeux
Hip rotation during gait is a major indicator for femoral derotation osteotomy. However, repeatability of hip rotation is poor because of discrepancies in determining the medial-lateral axis of the femur. Combining 3D gait analysis with medical imaging allows in vivo evaluation of current clinical methods. We used the condylar axis, identified from low dose biplanar radiographs (EOS imaging Inc), as our reference to evaluate conventional, functional calibration and freehand 3D ultrasound methods to define the medial-lateral axis in children with lower-limb torsional deformities...
January 29, 2018: Journal of Biomechanics
Michael A Miranda, Joseph P DeAngelis, George H Canizares, Jeffery W Mast
OBJECTIVE: To evaluate the outcomes of a double oblique osteotomy for the management of distal femoral malunions and a combination malunion/nonunion. DESIGN: Case series. SETTING: Level 1/2 hospital. PATIENTS/PARTICIPANTS: Ten patients with a mean age of 50 years (range 30-69 years) with posttraumatic deformities of the distal femur. INTERVENTION: A 2-level, length-sparing osteotomy was performed in accordance with a detailed preoperative plan for correction of the mechanical axis in a distal femoral deformity...
February 2018: Journal of Orthopaedic Trauma
Mirjam Niklasch, Matthias C Klotz, Sebastian I Wolf, Thomas Dreher
BACKGROUND: Recent studies showed rates of recurrence of internal rotation gait (IRG) after femoral derotation osteotomy (FDO) up to 40%. Some surgeons even advice overcorrection during FDO to avoid a later recurrence. RESEARCH QUESTION: Evaluation of the long-term development of limbs with initial overcorrection after FDO. METHODS: 29 limbs of 20 children (9.9 ± 3.2 years at surgery) with IRG, cerebral palsy (CP) and more than 5° external hip rotation postoperatively were included retrospectively...
January 17, 2018: Gait & Posture
Takaaki Ohmori, Tamon Kabata, Yoshitomo Kajino, Tadashi Taga, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Junya Yoshitani, Takuro Ueno, Hiroyuki Tsuchiya
BACKGROUND: The "grand-piano sign" is a well-known indicator of proper rotational femoral alignment. We investigated changes in the shape of the femoral anterior cutting plane by changing the rotational alignment, anterior portion depth, and cutting plane flexion angle. METHODS: We simulated various cutting planes after cutting the anterior portion of the femur next to the distal femoral osteotomy in 50 patients with varus knee and also a femoral anterior osteotomy with four degree (S group) and seven degree (T group) flexion angles regarding the mechanical axis...
January 2018: Knee
Michal Žilinčík, Marián Hluchý, Ladislav Takáč, Valent Ledecký
OBJECTIVE:  This article aimed to compare measurements of anatomical angles of the femurs, based on radiography, in Yorkshire Terriers without or with various grades of medial patellar luxation (MPL) based on radiography. METHODS:  The skeletally mature Yorkshire Terrier dogs without MPL and with various grades of MPL were included in this prospective study. Cases with other orthopaedic disorders were excluded. For inclusion of the dog, it was required that standardized digital radiographs of both femurs in craniocaudal and axial directions were available...
January 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Kazuyuki Karasuyama, Goro Motomura, Satoshi Ikemura, Jun-Ichi Fukushi, Satoshi Hamai, Kazuhiko Sonoda, Yusuke Kubo, Takuaki Yamamoto, Yasuharu Nakashima
BACKGROUND: This study investigated the risk factors for postoperative complications requiring revision surgery within 3 years after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). METHODS: We reviewed 127 patients (147 hips) who underwent TRO (anterior or posterior rotational osteotomy) for ONFH between January 2002 and December 2014. Two patients were lost to follow-up, and five patients with progression of femoral head collapse requiring a salvage procedure such as total hip arthroplasty within 3 years after TRO were excluded...
January 10, 2018: Journal of Orthopaedic Surgery and Research
Florian B Imhoff, Bastian Scheiderer, Philip Zakko, Elifho Obopilwe, Franz Liska, Andreas B Imhoff, Augustus D Mazzocca, Robert A Arciero, Knut Beitzel
BACKGROUND: Defining the optimal cutting plane for derotational osteotomy at the distal femur for correction of torsion in cases of patellofemoral instability is still challenging. This preliminary study investigates changes of frontal alignment by a simplified trigonometrical model and demonstrates a surgical guidance technique with the use of femur cadavers. The hypothesis was that regardless of midshaft bowing, a cutting plane perpendicular to the virtual anatomic shaft axis avoids unintended valgus malalignment due to derotation...
December 29, 2017: BMC Musculoskeletal Disorders
C Orellana-Reta, L A Valdez-Jiménez
OBJECTIVE: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. MATERIAL AND METHODS: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000...
May 2017: Acta Ortopédica Mexicana
Xiang Zhang, Yun-Fei Ma, Lei Wang, Nan Jiang, Cheng-He Qin, Yan-Jun Hu, Bin Yu
Currently, animal models used in research on implant-associated osteomyelitis primarily use intramedullary fixation and initial inoculum of planktonic bacterial cells. However, these techniques have certain limitations, including lack of rotational stability and instable inoculation. To improve these models, the present study aimed to establish a novel rabbit model of implant-associated osteomyelitis using biofilm as the initial inoculum following plate fixation of the femoral fracture. A total of 24 New Zealand White rabbits were randomly divided into two equal groups...
November 2017: Experimental and Therapeutic Medicine
Hidetoshi Hamada, Masaki Takao, Takashi Sakai, Nobuhiko Sugano
PURPOSE: Reduced range of motion (ROM) in flexion and internal rotation are associated with impaired activities of daily living (ADL) after rotational acetabular osteotomy (RAO). This study focused on the morphological variation of the anterior inferior iliac spine in developmental dysplasia of the hip (DDH) and its impact on post-operative bony ROM after RAO. This study aimed to investigate the association between bony ROM after RAO and pre-operative morphological factors of the pelvis and femur, including a positional variation of the anterior inferior iliac spine...
October 28, 2017: International Orthopaedics
S Logheswaren, A R Sulaiman, I Munajat
The ideal size of intramedullary device to fix corrective osteotomy of proximal femur in abnormal bone in children and small patients may not be easily available. We report the successful use of Rush rod in combination with multiple Kirschner wires to fix the corrective osteotomy of coxa vara and shepherd crook deformity in two patients with osteogenesis imperfecta and fibrous dysplasia. The union was achieved on time, neck shaft angle and rotation were maintained.
July 2017: Malaysian Orthopaedic Journal
Hunter D Archibald, Kathleen F Petro, Raymond W Liu
BACKGROUND: Femoral anteversion is generally asymptomatic but can result in lower extremity issues like patellofemoral instability and pain. Surgical correction of anteversion can be performed proximal, mid shaft or distal. A better understanding of the specific location of the rotational deformity can help guide the optimal location of the osteotomy. In this study we examine the contribution of the femoral neck and shaft to total femoral version. METHODS: We studied 590 pairs of well-preserved cadaveric femurs...
September 22, 2017: Journal of Pediatric Orthopedics
Peter Wilhelm Ferlic, Armin Runer, Christopher Seeber, Maria Thöni, Gerd Seitlinger, Michael Christian Liebensteiner
PURPOSE: De-rotational osteotomies are indicated in patients with pathologic femoral torsion. However, there is disagreement whether an osteotomy should be performed proximally or distally. Conventionally only the total torsion is measured, which does not allow differentiation between a torsional deformity located in the proximal or distal metaphysis or the diaphysis. The aim of this study is to validate a new multi-level measurement protocol for evaluation of the magnitude of torsion of the respective femoral segments in CT...
August 14, 2017: International Orthopaedics
K Sonoda, G Motomura, S Ikemura, Y Kubo, T Yamamoto, Y Nakashima
BACKGROUND: Transtrochanteric anterior rotational osteotomy (ARO) is joint-preserving surgery for patients with osteonecrosis of the femoral head (ONFH). During ARO, femoral neck-shaft varus angulation by changing intertrochanteric osteotomy plane is often designed to obtain a sufficient postoperative intact ratio. However, the effect of intertrochanteric osteotomy plane on postoperative femoral anteversion has not been well examined. Therefore, we performed a simulation study of ARO to determine how intertrochanteric osteotomy plane and preoperative femoral anteversion affect both femoral neck-shaft varus angle and postoperative femoral anteversion...
August 3, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
David E Westberry, Ashley M Carpenter
BACKGROUND: Biplanar radiography with 3-dimensional (3D) modeling (EOS) provides a comprehensive assessment of lower limb alignment in an upright weight-bearing position with less radiation than conventional radiography. A study was performed to assess the consistency and reliability of 2 lower extremity 3D biplanar radiograph models created at least 1 year apart in a pediatric population. METHODS: All patients who had 2 lower extremity radiographic evaluations with EOS performed at visits a minimum of 1 year apart were reviewed...
August 2, 2017: Journal of Pediatric Orthopedics
Bruno Dohin
No abstract text is available yet for this article.
September 2017: Developmental Medicine and Child Neurology
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