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https://www.readbyqxmd.com/read/29661526/a-retrieval-analysis-of-impingement-in-dual-mobility-liners
#1
Trevor P Scott, Lydia Weitzler, Anthony Salvatore, Timothy M Wright, Geoffrey H Westrich
BACKGROUND: Implant-related impingement is likely a major causative factor of total hip arthroplasty (THA) instability. Dual-mobility (DM) cups can theoretically improve stability in THA, but impingement rates with DM cups are not well studied. We examined retrieved DM THA liners to determine if less evidence existed for prosthetic impingement between the neck and the polyethylene liner than historical studies from our institution on fixed-bearing THAs. METHODS: DM components from 93 THAs were identified from 164 THAs whose DM components were revised between 2008 and 2015 through our institutional review board-approved implant retrieval program...
March 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29628687/megaprosthesis-versus-allograft-prosthesis-composite-for-massive-skeletal-defects
#2
REVIEW
Deepak Gautam, Rajesh Malhotra
Massive skeletal defects are encountered in the setting of tumors necessitating excision, failed total hip arthroplasty with periprosthetic bone loss, periprosthetic fracture, complex trauma, multiple failed osteosynthesis and infection. Reconstruction of the segmental defects poses a tremendous challenge to the orthopaedic surgeons. The goal of osseous reconstruction of these defects is to restore the bone length and function. Currently the most commonly employed methods for reconstruction are either a megaprosthesis or an Allograft Prosthesis Composite (APC)...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628670/bilateral-hip-dislocation-an-indicator-for-emergent-full-body-computed-tomography-scan-in-polytraumatized-patients-a-case-report-and-review-of-the-literature
#3
Benjamin Rufer, Marius Johann Baptist Keel, Beat Schnüriger, Moritz Caspar Deml
We present a rare case of traumatic bilateral asymmetric hip dislocation with pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist was transferred to our emergency department with the suspicion of a bilateral hip dislocation after he was trapped between an elevator and the roof. Immediate closed reduction of the hips was not performed because of the expected risk of increasing hemodynamic instability with muscular relaxation. An emergent full-body computed tomography (CT) scan was made to assess injuries with need for further operative treatment...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29609637/primary-total-knee-arthroplasty-using-constrained-condylar-knee-design-for-severe-deformity-and-stiffness-of-knee-secondary-to-post-traumatic-arthritis
#4
Saroj Rai, Xianzhe Liu, Xiaobo Feng, Bimal Rai, Nira Tamang, Jing Wang, Shunan Ye, Shuhua Yang
BACKGROUND: Key to a successful outcome of total knee arthroplasty (TKA) is to attain optimum alignment, adequate balance, and deformity correction. In primary TKA, this can be achieved efficiently by posterior stabilized (PS) design with or without the sub-periosteal release. However, certain circumstances such as post-traumatic arthritis are often associated with severe deformities with a significant bone defect, stiffness, and instability. Such deformities are extremely difficult to balance with soft tissue release only and require additionally constrained prostheses even in primary TKA...
April 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29605559/technical-aspects-and-complications-in-the-surgical-treatment-of-poliomyelitis-affected-lower-limb-fractures
#5
J Mingo-Robinet, J A Alonso, M Moreno-Barrero, L González-García, V Garcia-Virto, H J Aguado
OBJECTIVE: Post-polio patients present problems such as small and deformed bones, with narrow intramedullary canal and osteoporosis, affecting surgical treatment. The aim of this article is to describe the main preoperative and intraoperative complications of the surgical treatment of fractures in this population. MATERIAL AND METHODS: A retrospective analysis was conducted between 1995 and 2014. Data obtained from the medical records included patient age, fracture pattern (AO/OTA), device used, technical aspects of the surgery that changed compared to a standard procedure, and the presence of intraoperative skeletal complications...
March 28, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29590445/atlantoaxial-instability-in-a-patient-with-neck-pain-and-ankylosing-spondylitis
#6
Christian Lyons, Michael Ross, Ryan Elliott, Michael Tall
The purpose of this report is to describe the evaluation and treatment of a patient with neck pain and ankylosing spondylitis who had underlying atlantoaxial instability. The patient was a 31-yr-old man diagnosed with ankylosing spondylitis 1 yr prior who was referred to a physical therapist for the treatment of chronic, worsening low back and hip pain. He also had secondary complaints of neck, upper back, and shoulder pain. The patient worked as a military pilot. As part of the patient's physical examination, a Sharp-Purser test was performed, which was positive for excessive motion...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29578869/orthopedic-injuries-in-professional-surfers-a-retrospective-study-at-a-single-orthopedic-center
#7
Eric Hohn, Sean Robinson, Jarrad Merriman, Robin Parrish, Warren Kramer
BACKGROUND: Literature regarding surfing injuries is scarce and most studies report a high number of minor injuries. Recent literature suggests that musculoskeletal injuries are more common than previously reported. In the mid 2000s, competitive surfing has seen an increase in aerial maneuvers, as they have become more highly rewarded by the judging panel, which may be contributing to a change in injury patterns. Our goal was to evaluate orthopedic injuries in professional surfers. HYPOTHESIS: Orthopedic injuries in professional surfers are diverse and have evolved with skill and technology...
March 23, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29569690/fixation-of-rotationally-unstable-extracapsular-proximal-femoral-fractures
#8
Elsayed Ibraheem Elsayed Massoud
BACKGROUND: It was thought that the AO types A1.2 and A1.3 fractures are rotationally stable; however, it revealed instability when fixed using the dynamic hip screw. Therefore, we hypothesized that these fractures should be treated as rotationally unstable. METHODS: A series of 83 fractures of the AO types A1, A2, and B2.1 were treated using dynamic hip screw with derotation screw (DHS/DRS) composite and then prospectively followed for 24 months. Adequacy of reduction and fixation were immediately assessed after surgery, and fracture collapse was assessed at six months or when fractures healed...
March 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29552471/a-technique-for-arthroscopic-assisted-ligamentum-teres-augmentation-using-a-suture-tape-augmentation
#9
Julie A Neumann, Renee S Greene, Michael B Banffy
Ligamentum teres (LT) tears are a pathologic condition being identified at increasing frequency because of growing use of hip arthroscopy. The exact role of the LT is not well understood, but it has been shown in recent biomechanical studies to contribute to hip stability. Patients with hip pain, instability, and/or mechanical symptoms with advanced imaging findings showing LT pathology may benefit from an LT augmentation. We present an arthroscopic-assisted LT augmentation technique, which can be performed as an isolated procedure or in conjunction with an arthroscopic labral repair and/or debridement, chondroplasty, and femoroplasty...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29529664/the-safe-zone-range-for-cup-anteversion-is-narrower-than-for-inclination-in-tha
#10
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529660/can-dislocation-of-a-constrained-liner-be-salvaged-with-dual-mobility-constructs-in-revision-tha
#11
Brian P Chalmers, Graham D Pallante, Michael J Taunton, Rafael J Sierra, Robert T Trousdale
BACKGROUND: Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobility (DM) construct, but there are few data on this approach. QUESTIONS/PURPOSES: (1) What were the Harris hip scores in a small group of patients whose constrained liners were converted to DM constructs to treat recurrent dislocation? (2) What were the redislocation, rerevision, and DM construct retention rates in these patients? METHODS: We conducted a retrospective analysis of a longitudinally maintained institutional database maintained by individuals other than the treating surgeons to identify patients undergoing conversion of constrained liners to DM constructs in revision THA from 2011 to 2014...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29526410/impingement-type-bony-morphology-was-related-to-cartilage-defects-but-not-pain-in-professional-ballet-dancers-hips
#12
Susan Mayes, Peter Smith, Jill Cook
OBJECTIVES: Professional ballet dancers may have hip bony morphology that predisposes them to cartilage or labral injury. However, the relationship between bony morphology and pathology has not been investigated in ballet. This study investigates associations between bony morphology, chondrolabral defects and hip pain in ballet dancers. DESIGN: Cross-sectional study. METHODS: 33 male and female professional ballet dancers, (mean age 27 years (range 19-39)), completed questionnaires with hip pain measured on a visual analogue scale; and underwent 3...
March 3, 2018: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/29525344/prevention-of-dislocation-after-total-hip-arthroplasty
#13
Fiachra E Rowan, Biju Benjamin, Jurek R Pietrak, Fares S Haddad
BACKGROUND: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning. METHODS: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented. RESULTS: Extremes of age, body mass index >30 kg/m2 , lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA...
March 7, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29525341/constrained-acetabular-liners
#14
Stephen A Jones
BACKGROUND: Dislocation remains one of the most common complications after total hip arthroplasty. Constrained acetabular liners were developed to address the problem of recurrent instability. They have been in clinical use since the mid 1980s and function by capturing the femoral head. METHOD: The aim of this review is to highlight the mechanism of action, development, and advances in constrained liner design, together with an emphasis on the modes of failure and the authors' opinion on the current indications for the use of these implants...
March 7, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29523442/investigation-of-the-unstable-total-hip-arthroplasty
#15
R Michael Meneghini
The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity...
March 6, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29508664/low-sensitivity-of-a-defensin-synovasure-test-for-intra-operative-exclusion-of-prosthetic-joint-infection
#16
Ruben Scholten, Jetze Visser, Job L C Van Susante, Corné J M Van Loon
Background and purpose - The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty. Patients and methods - In a prospective study design, 37 patients who underwent revision surgery for suspected early aseptic loosening (< 3 years after primary arthroplasty) were included...
March 6, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29502964/diagnosis-taper-corrosion-when-is-it-the-taper-and-when-is-it-something-else
#17
Craig J Della Valle, Tyler E Calkins, Joshua J Jacobs
There has been an increasing use of modularity at the head-neck junction in total hip arthroplasty to more closely mimic the native anatomy, allowing for optimal leg length and stability. Corrosion at this junction in metal-on-polyethylene bearings can lead to an adverse local tissue reaction (ALTR). This increasingly prevalent condition should be considered in the differential diagnosis of hip pain and difficulty ambulating. A recent symposium by the American Academy of Hip and Knee Surgeons described the diagnosis, etiology, management, and prevention of taper corrosion...
March 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29500088/dual-mobility-constructs-in-revision-total-hip-arthroplasties
#18
Matthew P Abdel
Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. As with every hip arthroplasty, it is essential to optimize component positioning, minimize impingement, and maintain the integrity of the abductor complex during the revision THAs. However, in several revision circumstances, additional strategies are required to mitigate the risk of dislocation, particularly those being revised for instability or those with cognitive or neuromuscular disorders...
February 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29499471/effect-of-wobble-board-training-on-movement-strategies-to-maintain-equilibrium-on-unstable-surfaces
#19
Priscila de Brito Silva, Natalie Mrachacz-Kersting, Anderson Souza Oliveira, Uwe Gustav Kersting
Standing on unstable surfaces requires more complex motor control mechanisms to sustain balance when compared to firm surfaces. Surface instability enhances the demand to maintain equilibrium and is often used to challenge balance, but little is known about how balance training affects movement strategies to control posture while standing on unstable surfaces. This study aimed at assessing the effects of isolated wobble board (WB) training on movement strategies to maintain balance during single-leg standing on a WB...
February 27, 2018: Human Movement Science
https://www.readbyqxmd.com/read/29456755/preliminary-results-of-an-anteverting-triple-periacetabular-osteotomy-for-the-treatment-of-hip-instability-in-down-syndrome
#20
D A Maranho, Y-J Kim, K A Williams, E N Novais
Purpose: To investigate the outcomes of an anteverting triple periacetabular osteotomy for the treatment of hip instability in skeletally immature patients with Down syndrome. Methods: We evaluated 16 patients (21 hips) with Down syndrome and hip instability who underwent an anteverting triple periacetabular osteotomy between 2007 and 2016. There were nine females and seven males with an average age of 7.4 years SD 2.0. We assessed the level of hip pain, gait ability and clinical stability at a minimum of one year after surgery...
February 1, 2018: Journal of Children's Orthopaedics
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