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Hip instability

Se Ang Jang, Young Ho Cho, Young Soo Byun, Tae Hoe Gu
Abductor deficiency in native hip joint may cause severe limping and pain. It is more serious situation in case of arthroplasty due to instability and recurrent dislocation. Well-known causes of abductor deficiency are repeated surgery, chronic trochanteric bursitis, superior gluteal nerve injury, failure of repair of abductor tendon insertion to the greater trochanter. Author had experienced primary abductor deficiency during total hip replacement and treated successfully with the transfer of gluteus maximus...
September 2016: Hip Pelvis
Myung-Rae Cho, Won Kee Choi, Jae Jung Kim
Instability and dislocation after total hip arthroplasty are the most common causes of revisions and major complications for failure of inserted prostheses, leading to a reduction in quality of life. Because the use of artificial femoral head sizes smaller than patient's own size is the important cause for dislocation, the use of large femoral head have increased. Femoral head sizes greater than 32 mm offer multiple advantages in physical function and activity levels of patients by improving hip stability, decreasing dislocation rate and increasing range of motion...
September 2016: Hip Pelvis
Xavier Flecher, Benjamin Appy, Sébastien Parratte, Matthieu Ollivier, Jean-Noel Argenson
INTRODUCTION: Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. OBJECTIVES: The objective of this study was to analyse the outcome and survivorship of acetabular revision hip arthroplasty using tantalum components for loosening associated with bone loss at a minimum of five-year follow-up...
October 21, 2016: International Orthopaedics
Rahul Tyagi, Marcin R Zgoda, Rachel Short
National Health Service Quality Improvement Scotland (NHS QIS) published a health technology scoping report in 2006 acknowledging that there are serious concerns within Scotland in relation to Developmental Dysplasia of Hip (DDH) as there is no formal screening program in place and there are significant variations between NHS boards leading to confusion for staff and parents. NHS QIS identified need for audit work to improve hip screening in Scotland. The aim of this study is review of current practice of selective screening for DDH...
September 19, 2016: Orthopedic Reviews
Sherif Galal
: Developmental coxa vara (DCV) develops during early childhood between the age of independent walking and 6 years. The deformity includes a decrease in the neck-shaft angle and femoral retroversion. Recently, good results have been reported using external fixator systems for the correction of proximal femoral deformities secondary to slipped capital femoral epiphysis, Perthes' disease in children, and percutaneous proximal femoral osteotomy for coxa vara. This preliminary study was performed to evaluate the results of percutaneous subtrochanteric osteotomy in restoring the normal alignment and orientation (radiographic outcome), thereby restoring the normal mechanics of the hip joint, overcoming shortening of the limb, and re-establishing the length-tension relationship of the abductor muscles (functional outcome)...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Travis J Menge, Justin J Mitchell, Karen K Briggs, Marc J Philippon
There has been growing interest in recent years on the functional importance of the ligamentum teres and its role in hip stability. Partial or complete tearing has previously been treated with debridement or radiofrequency ablation with good results; however, a subset of patients will continue to experience persistent pain or instability with injury to this structure. Advances in arthroscopic instruments and techniques have led to our ability to provide improved care for these patients by performing a ligamentum teres reconstruction...
August 2016: Arthroscopy Techniques
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
PURPOSE: The purpose of this study was to determine whether or not there is a distinct pattern of injury to the acetabular labrum and/or cartilage in the hip with instability without bony dysplasia. METHODS: Surgical records and intra-operative images of consecutive patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and/or hip instability by the senior author from April 2007 to December 2014 were retrospectively reviewed. Pathological changes were documented and charted on a novel diagram of the acetabulum, and classified into eight patterns corresponding to the lesion's location and size...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mark Eidelman, Julio J Jauregui, Shawn C Standard, Dror Paley, John E Herzenberg
BACKGROUND: Congenital femoral deficiency (CFD) is one of the most challenging and complex conditions for limb lengthening. We focused on the problem of hip instability during femoral lengthening because subluxation and dislocation are potentially catastrophic for hip function. METHODS: We assessed for hip stability in 69 children (91 femoral lengthenings) who had CFD Paley type 1a (43 children) and 1b (26 children). The mean age at first lengthening was 6.4 years...
September 27, 2016: International Orthopaedics
Jorge Chahla, Jacob D Mikula, Jason M Schon, Chase S Dean, Kimi D Dahl, Travis J Menge, Eduardo Soares, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
BACKGROUND: Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension after standard anterosuperior interportal capsulotomy (12 to 3 o'clock)...
September 22, 2016: American Journal of Sports Medicine
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
Michael Worlicek, Markus Weber, Benjamin Craiovan, Michael Wörner, Florian Völlner, Hans R Springorum, Joachim Grifka, Tobias Renkawitz
BACKROUND: Improper femoral and acetabular component positioning can be associated with instability, impingement, component wear and finally patient dissatisfaction in total hip arthroplasty (THA). The concept of "femur first"/"combined anteversion", incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position of the stem relative to the cup intraoperatively. In the present study we asked two questions: (1) Do native femoral anteversion and anteversion of the implant correlate? (2) Do anteversion of the final broach and implant anteversion correlate? METHODS: In a secondary analysis of a prospective controlled trial, a subgroup of 55 patients, who underwent computer-assisted, cementless THA with a straight, tapered stem through an anterolateral, minimally invasive (MIS) approach in a lateral decubitus position were examined retrospectivly...
2016: BMC Musculoskeletal Disorders
P P Mohanty, Monalisa Pattnaik
INTRODUCTION: Segmental instability due to lumbar spondylolisthesis is a potential cause of chronic low back pain. Hypomobility of the spine results in compensatory segmental hypermobility of the segment above or below restricted segments. Therefore, the aim of the study is to determine the effects of mobilisation of the hypomobile upper thoracic spine along with conventional flexion exercises and stretching of short hip flexors on the degree of slippage and the functions of the persons with lumbar spondylolisthesis...
July 2016: Journal of Bodywork and Movement Therapies
Joseph W Maricelli, Qi L Lu, David C Lin, Buel D Rodgers
Limb-girdle muscular dystrophy type 2i (LGMD2i) affects thousands of lives with shortened life expectancy mainly due to cardiac and respiratory problems and difficulty with ambulation significantly compromising quality of life. Limited studies have noted impaired gait in patients and animal models of different muscular dystrophies, but not in animal models of LGMD2i. Our goal, therefore, was to quantify gait metrics in the fukutin-related protein P448L mutant (P448L) mouse, a recently developed model for LGMD2i...
2016: PloS One
Kathryn A Webster, Brian G Pietrosimone, Phillip A Gribble
CONTEXT:  Ankle instability is a common condition in physically active individuals. It often occurs during a jump landing or lateral motion, particularly when participants are fatigued. OBJECTIVE:  To compare muscle activation during a lateral hop prefatigue and postfatigue in individuals with or without chronic ankle instability (CAI). DESIGN:  Cross-sectional study. SETTING:  Sports medicine research laboratory...
September 14, 2016: Journal of Athletic Training
Levent Özgönenel, Sultan Çağırıcı, Murat Çabalar, Gülis Durmuşoğlu
BACKGROUND: Parkinson's disease (PD) predisposes to falls due to postural instability and decreased coordination. Postural and coordination exercises could ameliorate the incoordination and decrease falls. AIMS: In this study, we explored the efficiency of a game console as an adjunct to an exercise program in treating incoordination in patients with PD. STUDY DESIGN: Case-control study. METHODS: In this single-blind, prospective clinical trial, rehabilitation with the Xbox (Microsoft; Washington, USA) game console was used as an adjunct to a standard rehabilitation program...
July 2016: Balkan Medical Journal
Nicholas M Desy, Joshua D Johnson, Rafael J Sierra
BACKGROUND: The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship...
August 10, 2016: Journal of Arthroplasty
Jonathon M Brown, Jaydev B Mistry, Jeffrey J Cherian, Randa K Elmallah, Morad Chughtai, Steven F Harwin, Michael A Mont
Modern primary total hip arthroplasty (THA) is among the most successful operations in medicine. It has been a consistently effective treatment for end-stage osteoarthritis of the hip. With the increasing number of primary THA procedures being performed and the decreasing age of patients undergoing the procedure, there is an inevitable associated increase in revision burden for arthroplasty surgeons. Revision THA is most often indicated for instability, aseptic loosening, osteolysis, infection, periprosthetic fracture, component malposition, and catastrophic implant failure...
August 30, 2016: Orthopedics
X Flores, M Vicente, S Haddad, C Amat, L Carrera, P S Corona
BACKGROUND: Bone loss in the distal femur is a common problem in knee revision surgeries. The problem is exacerbated in the context of an active infection. In extreme cases this bone loss could compromise the feasibility of a two-stage exchange protocol using dynamic spacers due to the inherent instability of this type of spacers. Use of a hip prefabricated spacer in a "reverse" way forming a ball-and- socket joint is a therapeutic option in cases of massive bone defect and infection...
August 18, 2016: Revista Española de Cirugía Ortopédica y Traumatología
André Ferreira, Thierry Aslanian, Thibaud Dalin, Jean Picaud
PURPOSE: Using a ceramic-ceramic bearings, cementless total hip arthroplasty (THA) has provided good clinical results. To ensure longevity a good quality fixation of the implants is mandatory. Different surface treatments had been used, with inconsistent results. We hypothesized that a "bilayer coating" applied to both THA components using validated technology will provide a long-lasting and reliable bone fixation. METHODS: We studied the survival and bone integration of a continuous, single-surgeon, retrospective series of 126 THA cases (116 patients) with an average follow-up of 12...
August 20, 2016: International Orthopaedics
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