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Avascular necrosis hip

Linbo Zhuang, Lisheng Wang, Dongming Xu, Zhiyong Wang
BACKGROUNDS: Although most displaced femoral neck fractures of young patients can be repositioned successfully by closed reduction, there are still some can not repositioned successfully by this way and open reductions are required. This type of fracture was defined as irreducible displaced femoral neck fracture in this study. The purpose of this study was to introduce a new technique using anteromedial femoral neck plate with cannulated screws fixation by open reduction for the treatment of irreducible displaced femoral neck fractures in young patients...
June 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Udo Ego Anyaehie, Gabriel Okey Eyichukwu, Cajetan Uwatoronye Nwadinigwe, Amechi Uchenna Katchy
INTRODUCTION: Total hip replacement (THR) surgery is still evolving in Nigeria with increasing awareness as more cases are being done. This has attraction for individuals who hitherto had no solutions for their hip pathologies. These are mostly complex primary hips which present challenging technical difficulties with increased risk of complications, thus requiring detailed planning to ensure successful operation. This work aims to present the pattern of complex primary hips presenting for THR, the challenges and complications...
2018: SICOT-J
Jae-Seong Seo, Jae-Woo Youm, Sang-Min Kim
Femoral nerve palsy after total hip arthroplasty is an uncommon complication. We present a case report of delayed-onset femoral nerve palsy associated with iliopsoas hematoma and bursitis 10 years after primary total hip arthroplasty in a 57-year-old male patient with avascular necrosis of the femoral head. The patient visited our clinic due to swelling of the inguinal area with sudden-onset knee extension weakness. Radiologic examination at admission revealed suspicion of bursitis and hematoma on iliopsoas muscle...
June 2018: Hip & Pelvis
Kevin R Green, Jarelys M Hernandez-Jimenez, Carmen Liliana Isache, Rafik Jacob
A 33-year-old woman with history of HIV presented with 4 months of gradually progressing right hip pain and was found to have avascular necrosis (AVN) of both femoral heads. She had no other risk factors for AVN including sickle cell disease, systemic lupus erythematosus, prolonged steroid used or trauma. She initially failed conservative management and ultimately had bilateral hip core decompressions. After decompression therapy, the left femoral head collapsed and patient underwent a left total hip arthroplasty...
June 6, 2018: BMJ Case Reports
Junting Zang, Katsufumi Uchiyama, Mitsutoshi Moriya, Zhengwei Li, Kensuke Fukushima, Takeaki Yamamoto, Jianguo Liu, Wei Feng, Naonobu Takahira, Masashi Takaso
Intracapsular cuneiform osteotomy was initially introduced to restore the morphology of the proximal femur after slipped capital femoral epiphysis (SCFE). However, whether this procedure results in a higher risk of avascular necrosis (AVN) or lower incidence of cam deformity than in-situ pinning is unclear. The aim of this study was to compare the outcomes of intracapsular cuneiform osteotomy and in-situ pinning to treat SCFE in children. Twenty-three children who suffered from SCFE underwent either intracapsular cuneiform osteotomy (eight patients, eight hips) or in-situ pinning (15 patients, 18 hips) between 2006 and 2014...
June 1, 2018: Journal of Pediatric Orthopedics. Part B
Daniel J Sucato
The treatment of slipped capital femoral epiphysis (SCFE) in North America has seen a change over the past 15 to 20 years due to a better understanding of the blood flow supplying the femoral head, the ability to monitor the pressure/flow in real time and greater access to the deformity with the development of surgical approaches providing that access. These advances have mainly affected the treatment of the unstable SCFE to mitigate the risk of avascular necrosis but have also been utilized for the stable SCFE when severe deformity remains...
July 2018: Journal of Pediatric Orthopedics
Saeed Ahmad, Irfan Qadir, Atiq Uz Zaman, Chiragh Muhammad Khan, Shahzad Javed, Naeem Ahmad, Amer Aziz
INTRODUCTION: Treatment of developmental dysplasia of hip (DDH) diagnosed after 10 years of age is extremely difficult because of the soft tissue and bone deformities. In this study, we evaluated short-term results of a single-stage procedure performed with surgical hip dislocation, femoral shortening and capsular arthroplasty. PATIENTS AND METHODS: A retrospective review of charts of five patients with DDH, older than 10 years, who underwent capsular arthroplasty at Ghurki Trust Teaching Hospital between 2013 and 2015 was performed...
May 2018: Journal of Orthopaedic Surgery
Thomas Schachtner, Natalie M Otto, Petra Reinke
Background: Kidney transplant recipients (KTRs) are at increased risk of avascular necrosis (AVN) due to bone disorder, steroid use and common comorbidities. However, knowledge on risk factors and outcomes of AVN among KTRs in the modern era of immunosuppression remains scarce. Methods: We analysed 765 KTRs between 2001 and 2013 for AVN. Cases of symptomatic AVN were diagnosed by hip X-ray, radioisotope bone scan or magnetic resonance imaging. We evaluated risk factors and clinical characteristics of AVN...
June 3, 2018: Nephrology, Dialysis, Transplantation
Matthaios Bakalakos, Ioannis S Benetos, Meletios Rozis, John Vlamis, Spiros Pneumaticos
The majority of injuries during a football game are contusions, sprains and/or strains in the thigh, knee and ankle. Hip dislocations account for 2-5% of total hip dislocations, and they can be posterior or anterior. Major complications of traumatic hip dislocation include avascular necrosis of femoral head, secondary osteoarthritis, sciatic nerve injury and heterotopic ossification. On the occasion of a case of a 33-year-old football player, who suffered a posterior hip dislocation, associated with a posterior wall fracture of the acetabulum, while playing football, we review the literature and analyze the various mechanisms of injury, the possible complications and the management including surgery and rehabilitation...
June 2, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Yanfeng Tang, Hongjun Li, Youwen Liu, Yuxia Yang, Wuyin Li, Hongmin Cai
Objective: To compare the short-term effectiveness of staged bilateral total hip arthroplasty via different approaches. Methods: Thirty-two patients (64 hips) with bilateral hip disease were treated with total hip arthroplasty between January 2012 and December 2014. There were 20 males and 12 females with the mean age of 45.3 years (range, 30-67 years). There were avascular necrosis of femoral head in 14 cases, developmental dislocation of the hip in 12 cases, ankylosing spondylitis in 4 cases, osteoarthritis in 2 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Vineet S Rolston, Anish V Patel, Thomas J Learch, Dalin Li, Dmitry Karayev, Chadwick Williams, Madhavi L Siddanthi, Stephan R Targan, Michael H Weisman, Dermot P B McGovern
OBJECTIVES: Avascular necrosis (AVN) is associated with significant morbidity potentially causing severe pain and debility; patients with inflammatory bowel disease (IBD) have a higher prevalence of AVN compared with non-IBD populations. The purpose of our study was to determine the prevalence of AVN in our IBD population and to evaluate these subjects for the presence of clinical characteristics associated with AVN on computed tomography (CT) imaging. METHODS: In 1313 IBD patients with abdomen/pelvis CT scans, we identified 27 patients (2...
May 24, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Shanxi Wang, Bohua Li, Jun Li, Fuguo Huang, Zhou Xiang, Gang Zhong, Yue Fang, Min Yi, Xiaodan Zhao, Lei Liu
OBJECTIVE: To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice. METHODS: From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20-65 years). The causes of the fractures included traffic accidents (13 cases), falls from a height (four cases), heavy lifting injuries (three cases), and sport injury (one case)...
April 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Khaled Emara, Mohamed Ahmed Al Kersh, Fahad Abdulazeez Hayyawi
BACKGROUND: There is no consensus about the duration of post-operative immobilization in the treatment of DDH (developmental dysplasia of hip). Our aim in this study is to compare between two post-operative immobilization protocols for patients undergoing open reduction. MATERIALS AND METHODS: Thirty-eight hips in 32 patients assigned to group A were immobilized in hip spica for four weeks followed by abduction brace application which was gradually weaned through the periods of several months and 29 hips in 24 patients assigned to group B immobilized in hip spica for 12 weeks without further bracing...
May 11, 2018: International Orthopaedics
Yuta Tsukagoshi, Hiroshi Kamada, Makoto Kamegaya, Ryoko Takeuchi, Shogo Nakagawa, Yohei Tomaru, Kenta Tanaka, Mio Onishi, Tomofumi Nishino, Masashi Yamazaki
BACKGROUND: Previous reports on patients with developmental dysplasia of the hip (DDH) showed that the prereduced femoral head was notably smaller and more nonspherical than the intact head, with growth failure observed at the proximal posteromedial area. We evaluated the shape of the femoral head cartilage in patients with DDH before and after reduction, with size and sphericity assessed using 3-dimensional (3D) magnetic resonance imaging (MRI). METHODS: We studied 10 patients with unilateral DDH (all female) who underwent closed reduction...
May 2, 2018: Journal of Pediatric Orthopedics
Emily K Schaeffer, Ihdi Study Group, Kishore Mulpuri
There is a lack of high quality evidence available to guide clinical practice in the treatment and management of developmental dysplasia of the hip (DDH). Evidence has been limited by persistent confusion on diagnostic and classification terminology, variability in surgeon decision making and a reliance on single centre, retrospective studies with small patient numbers. To address gaps in knowledge regarding screening, diagnosis and management of DDH, the International Hip Dysplasia Institute began a multicentre, international prospective study on infants with hips dislocated at rest...
May 7, 2018: Medical Journal of Australia
Behzad Vafaeian, Samer Adeeb, Marwan El-Rich, Dornoosh Zonoobi, Abhilash R Hareendranathan, Jacob L Jaremko
Developmental dysplasia of the hip (DDH) in infants under 6 months of age is typically treated by the Pavlik harness (PH). During successful PH treatment, a subluxed/dislocated hip is spontaneously reduced into the acetabulum, and DDH undergoes self-correction. PH treatment may fail due to avascular necrosis (AVN) of the femoral head. An improved understanding of mechanical factors accounting for the success/failure of PH treatment may arise from investigating articular cartilage contact pressure (CCP) within a hip during treatment...
July 1, 2018: Journal of Biomechanical Engineering
Rajesh Kumar Kanojia, Sumit Gupta, Ajay Kumar, Bachha Kanakeya Reddy
BACKGROUND: When treatment of acute septic arthritis of the hip is delayed, severe sequelae can occur. This may take the form of coxa breva, vara, or valga. Pseudoarthrosis of the femoral neck is a rare complication with only a few studies to guide treatment. QUESTION/PURPOSES: In a small series of patients with pseudarthrosis of the femoral neck after acute septic arthritis, we wanted to determine (1) whether femoral neck union can be achieved using a variety of surgical approaches; (2) whether these patients satisfied criteria outlined by Hunka and Choi, defined as a stable hip, a flexion arc ≥ 70° and no fixed adduction or abduction contractures, fixed flexion deformity not more than 20°, pain relief, and restoration of activities of daily living after surgery; and (3) any treatment-related complications if observed...
April 23, 2018: Clinical Orthopaedics and related Research
P Maxwell Courtney, Daniel D Bohl, Edmund C Lau, Kevin L Ong, Joshua J Jacobs, Craig J Della Valle
BACKGROUND: Concerns exist that high-risk patients in alternative payment models may face difficulties with access to care without proper risk adjustment. The purpose of this study is to identify the effect of medical and orthopedic specific risk factors on the cost of a 90-day episode of care following total hip (THA) and knee arthroplasty (TKA). METHODS: We queried the Medicare 5% Limited Data Set for all patients undergoing primary THA and TKA from 2010 to 2014...
March 17, 2018: Journal of Arthroplasty
YiQiang Li, HongWen Xu, Theddy Slongo, QingHe Zhou, Yuanzhong Liu, WeiDong Chen, JingChun Li, Federico Canavese
INTRODUCTION: Bernese-type triple pelvic osteotomy (BTPO) combines periacetabular and triple innominate osteotomy techniques. However, studies that evaluate the clinical and radiographic outcomes of BTPO are scarce. The aim of this study is to report on the clinical and radiographic outcomes of ambulatory children with developmental dysplasia of the hip (DDH) or Legg-Calvé-Perthes disease (LCPD) managed with BTPO that were older than five years of age at the time of surgery. MATERIALS AND METHODS: We retrospectively reviewed the records of 27 consecutive patients with DDH or LCPD (mean age 7...
April 23, 2018: International Orthopaedics
Qurrat U van den Blink, Kate Garcez, Caroline C Henson, Susan E Davidson, Claire E Higham
BACKGROUND: Pelvic radiotherapy is a treatment delivered to an estimated 150,000 to 300,000 people annually across high-income countries. Fractures due to normal stresses on weakened bone due to radiotherapy are termed insufficiency fractures. Pelvic radiotherapy-related interruption of the blood supply to the hip is termed avascular necrosis and is another recognised complication. The reported incidences of insufficiency fractures are 2.7% to 89% and risk of developing avascular necrosis is 0...
April 23, 2018: Cochrane Database of Systematic Reviews
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