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Avascular necrosis hip

Peter Max Halschou-Jensen, Andreas Balslev-Clausen, Peter Søndergaard
Traumatic hip dislocation is uncommon in children. Yet, it represents an orthopaedic emergency, because delayed treatment can lead to avascular necrosis of the femoral head. In this case a four-year-old boy and an eight-year-old girl were treated in an emergency department less than two weeks apart. They both received a posterior hip dislocation after accident during sledging. Their hips were reduced within six hours in the operating theatre, and the patients were discharged few days later. At the follow-up after six and 12 weeks both patients were doing well, and X-rays were normal...
October 10, 2016: Ugeskrift for Laeger
Hannes A Rüdiger, Krzystof Piasecki, Fabio Becce, Stéphane Cherix
BACKGROUND: Surgical access to benign neoplastic lesions of the femoral head are associated with significant morbidity, including contamination of intra-osseous access tracks, articular cartilage lesions, avascular bone necrosis or tumour recurrence due to incomplete curettage. CASE PRESENTATION: We present a case of a 20-year-old female with a giant cell tumour in the femoral head, which was treated with curettage through a trans-foveal approach and bone grafting...
September 22, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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
N Stadler, J Lehner, R Abbas, K Trieb
A large number of short stem prostheses for hip -arthroplasty have been introduced in the past years. Although there is a large increase of publications about short stems, there is still little data available about survival and revision rates. We report prospectively on the outcome of 84 consecutive NANOS® short stem prostheses in 81 patients. We have included 37 female patients and 44 male patients with an average age of 61.6 ± 9.2 years. The main diagnoses were osteoarthritis in 67 patients, dysplastic osteoarthritis in 8 patients and avascular necrosis of the femoral head in 6 patients...
August 2016: Acta Orthopaedica Belgica
Vidyadhar V Upasani, Oliver Birke, Kevin E Klingele, Michael B Millis
BACKGROUND: The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the frequency, timing, and clinical presentation (including complications) associated with iatrogenic instability after the modified Dunn procedure for SCFE...
September 20, 2016: Clinical Orthopaedics and related Research
Ilias Katsougrakis, Alexandros P Apostolopoulos, Samantha Z Tross
UNLABELLED: Femoral-neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We describe the clinical, diagnostic and therapeutic approach of a femoral-neck stress fracture that occurred in a 28-year-old female recreational runner...
2016: Journal of Long-term Effects of Medical Implants
Anne Guro Vreim Holm, Olav Reikerås, Terje Terjesen
PURPOSE: The purposes of this study were to establish long-term outcome of the Spitzy shelf-operation and evaluate whether the procedure would delay osteoarthritis. METHODS: During 1954-1976, 56 patients (70 hips) underwent Spitzy shelf operation at a mean age of 11.9 years (5 to 22). Indications included residual hip dysplasia or subluxation with Centre-Edge angle < 20°. We used survival analysis with conversion to total hip replacements as end-point. For patients without total hip replacement, information was provided from case records and radiographs...
September 16, 2016: International Orthopaedics
D P Dargan, F Callachand, O J Diamond, C K Connolly
INTRODUCTION: Intracapsular femoral neck fractures remain associated with high rates of post-traumatic femoral head necrosis, non-union, and revision surgery. AIM: Our aim was to identify factors associated with revision surgery in intracapsular femoral neck fractures treated with sliding hip screws (SHS) in adults aged <65 years. PATIENTS AND METHODS: Consecutive admissions were identified retrospectively from the Royal Victoria Hospital, Belfast, which was the largest volume hospital on the National Hip Fracture Database...
September 6, 2016: Injury
Zhong-Li Zhang, Zhe Fu, Jian-Ping Yang, Kan Wang, Li-Wei Xie, Shu-Zhen Deng, Zhao-Qiang Chen
OBJECTIVE: To determine the incidence of residual dysplasia after closed reduction (CR) of developmental dysplasia of the hip (DDH) and assess correlations between quality of arthrogram-guided CR and residual dysplasia using a new intraoperative radiographic criterion. METHODS: Data of a consecutive series of 126 patients with DDH in 139 hips treated at our institution by arthrogram-guided CR from March 2006 to June 2013 were reviewed in this retrospective study...
August 2016: Orthopaedic Surgery
Jedidiah E Schlung, Tracey P Bastrom, Joanna H Roocroft, Peter O Newton, Scott J Mubarak, Vidyadhar V Upasani
BACKGROUND: The role of femoral aspiration (FA) in the treatment of septic arthritis of the hip is controversial. The purpose of this study was to determine if FA conducted concomitantly with irrigation and debridement (I&D) of the septic hip aids in microorganism and osteomyelitis identification and alters the treatment plan, or if the risks of the procedure outweigh its potential benefit. We also compare preoperative magnetic resonance imaging (MRI) with FA for diagnosis of osteomyelitis cooccurring with septic arthritis...
September 3, 2016: Journal of Pediatric Orthopedics
Brice Ilharreborde, Vincent Cunin, Saad Abu-Amara
BACKGROUND: There is growing evidence that symptomatic femoroacetabular impingement (FAI) can develop after severe slipped capital femoral epiphysis (SCFE) fixed in situ. Realignment procedures have therefore gained popularity, but complication rates remain controversial. Among them, the subcapital shortening osteotomy without hip dislocation has been progressively adopted in France, but results have never been assessed to date. METHODS: All cases performed in 23 French university hospitals between January 2010 and March 2014 were reviewed to (1) describe the surgical procedure, (2) assess the radiologic and functional outcomes, and (3) report complications and more specifically the avascular necrosis rate (AVN) according to initial stability...
September 3, 2016: Journal of Pediatric Orthopedics
Udai S Sibia, Abigail E Mandelblatt, Maura A Callanan, James H MacDonald, Paul J King
BACKGROUND: Unplanned hospital returns after total joint arthroplasty (TJA) reduce any cost savings in a bundled reimbursement model. We examine the incidence, risk factors, and costs for unplanned emergency department (ED) visits and readmissions within 30 days of index TJA. METHODS: We retrospectively reviewed a consecutive series of 655 TJAs (382 total knee arthroplasty and 273 total hip arthroplasty) performed between April 2014 and March 2015. Preoperative diagnosis was osteoarthritis of the hip or knee (97%) or avascular necrosis of the hip (3%)...
August 12, 2016: Journal of Arthroplasty
M Olsen, P M Lewis, Z Morrison, M D McKee, J P Waddell, E H Schemitsch
AIMS: One method of femoral head preservation following avascular necrosis (AVN) is core decompression and insertion of a tantalum rod. However, there may be a high failure rate associated with this procedure. The purpose of this study was to document the clinical and radiological outcomes following total hip arthroplasty (THA) subsequent to failed tantalum rod insertion. PATIENTS AND METHODS: A total of 37 failed tantalum rods requiring total hip arthroplasty were identified from a prospective database...
September 2016: Bone & Joint Journal
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks...
August 2016: Journal of Hip Preservation Surgery
Mayank Gupta, R-K Arya, Satish Kumar, Vijay-Kumar Jain, Skand Sinha, Ananta-Kumar Naik
PURPOSE: Both cannulated cancellous screw (CCS) and sliding hip screw (SHS) are used in femoral neck fracture fixations, but which is superior is yet to be determined. This study was aimed to compare the clinicoradiological outcome of femoral neck fracture treated with SHS or CCS in young adults. METHODS: Adults (16e60 years) with femoral neck fracture were divided into Group 1 fixed with SHS and Group 2 fixed with three CCS after closed reduction. Pain relief, functional recovery and postoperative radiographs at 6 weeks, 3 months, 6 months and then yearly for upto 4 years were analyzed...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
P Jettoo, P James
PURPOSE: To compare dynamic hip screw (DHS) fixation with multiple screw fixation for intracapsular hip fractures in terms of complications and conversion to hemiarthroplasty or total hip arthroplasty (THA). METHODS: Records of 52 884 patients aged ≥50 years who underwent internal fixation using a dynamic hip screw (n=18 014, 34.1%) or multiple screws (n=34 870, 65.9%) for intracapsular femoral neck fracture from September 2007 to September 2013 were extracted from the hospital admission database that covers all admissions to the National Health Service hospitals in England using the ICD-10 and OPCS-4 codes...
August 2016: Journal of Orthopaedic Surgery
Walid Faraj, Ghina El Nounou, Abdallah Abou Al Naaj, Nancy Nakhoul, Ali Haydar, Mohammad Khalife
Liver transplantation provides an important, often life-saving treatment for end-stage liver disease. Osteoporosis post-liver transplantation has been described in adults; however, this has not been described in the pediatric population to date. We present a case of a 13-year-old female patient who underwent an orthotopic liver transplant for cryptogenic liver cirrhosis. Her immunosuppressants were tacrolimus and prednisone. Four months posttransplant, she started complaining of bilateral lower limb pain and limping while walking, progressing to a point where she was almost immobile...
August 22, 2016: Progress in Transplantation
Hui-Fa Xu, Ya-Bo Yan, Chao Xu, Tian-Qing Li, Tian-Feng Zhao, Ning Liu, Lu-Yu Huang, Chun-Li Zhang, Wei Lei
The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively...
August 2016: Medicine (Baltimore)
Suenghwan Jo, Sang Hong Lee, Hyeon Jun Lee
PURPOSE: This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation. MATERIALS AND METHODS: The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification...
March 2016: Hip Pelvis
Jin-Young Lee, Jae-Woo Kwon, Jung-Seob Park, Kyeol Han, Woo-Jin Shin, Jeong-Gil Lee, Byung Hoon Lee
PURPOSE: To evaluate clinical results of extracorporeal shock wave therapy (ESWT) with radiographic staging on patients with avascular necrosis of femoral head (AVNFH). MATERIALS AND METHODS: We evaluated 24 patients diagnosed with AVNFH (32 hip joints) who were treated with ESWT from 1993 to 2012. Average follow-up period was 27 months, and the average age of patients was 47.8 years. The Association Research Circulation Osseous (ARCO) system was used to grade radiographic stage prior to treatment...
December 2015: Hip Pelvis
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