WorldWideScience

Sample records for acetabulum

  1. Biomechanical Analysis of a Novel Acetabulum Reconstruction Technique with Acetabulum Reconstruction Cage and Threaded Rods after Type II Pelvic Resections.

    Singh, Vivek Ajit; Elbahri, Hassan; Shanmugam, Rukmanikanthan

    2016-01-01

    Background. Periacetabular resections with reconstruction has high rates of complications due to the complexity of the reconstruction. We have improvised a novel technique of reconstruction for type II and type II + III pelvic resections with the use of a commercially available acetabulum reconstruction cage (gap II, Stryker) and threaded rods. Objectives. The aim of our study is to determine the biomechanical strength of our reconstruction compared to the traditional cemented total hip replacement (THR) designs in normal acetabulum and establish its mode of failure. Methods. Five sets of hemipelvises were biomechanically tested (Instron® 3848, MA, USA). These constructs were subjected to cyclic loading and load to failure. Results. The reconstructed acetabulum was stiffer and required a higher load to failure compared to the intact pelvis with a standard THR. The mean stiffness of the reconstructed pelvis was 1738.6 ± 200.3 Nmm(-1) compared to the intact pelvis, which was 911.4 ± 172.7 Nmm(-1) (P value = 0.01). The mean load to failure for the standard acetabular cup construct was 3297.3 ± 117.7 N while that of the reconstructed pelvis with the acetabulum cage and threaded rods was 4863.8 ± 7.0 N. Conclusion. Reconstruction of the pelvis with an acetabular reconstruction cage and threaded rods is a biomechanical viable option. PMID:27340368

  2. Biomechanical Analysis of a Novel Acetabulum Reconstruction Technique with Acetabulum Reconstruction Cage and Threaded Rods after Type II Pelvic Resections

    Vivek Ajit Singh

    2016-01-01

    Full Text Available Background. Periacetabular resections with reconstruction has high rates of complications due to the complexity of the reconstruction. We have improvised a novel technique of reconstruction for type II and type II + III pelvic resections with the use of a commercially available acetabulum reconstruction cage (gap II, Stryker and threaded rods. Objectives. The aim of our study is to determine the biomechanical strength of our reconstruction compared to the traditional cemented total hip replacement (THR designs in normal acetabulum and establish its mode of failure. Methods. Five sets of hemipelvises were biomechanically tested (Instron® 3848, MA, USA. These constructs were subjected to cyclic loading and load to failure. Results. The reconstructed acetabulum was stiffer and required a higher load to failure compared to the intact pelvis with a standard THR. The mean stiffness of the reconstructed pelvis was 1738.6±200.3 Nmm−1 compared to the intact pelvis, which was 911.4±172.7 Nmm−1 (P value = 0.01. The mean load to failure for the standard acetabular cup construct was 3297.3±117.7 N while that of the reconstructed pelvis with the acetabulum cage and threaded rods was 4863.8±7.0 N. Conclusion. Reconstruction of the pelvis with an acetabular reconstruction cage and threaded rods is a biomechanical viable option.

  3. Assessment of acetabulum anteversion aligned with the transverse acetabulum ligament: cadaveric study using image-free navigation system

    Tomokazu Fukui

    2013-02-01

    Full Text Available The transverse acetabulum ligament (TAL has been used as an intraoperative anatomical landmark to position the acetabulum cup in total hip arthroplasty (THA. However, the validity of the use of TAL has not been clarified. The purpose of this study was to examine the orientation of the cup component aligned with the TAL in cadaveric study. The 31 hips in 25 whole-body embalmed cadavers were examined. The donors were 12 men and 13 women. Simulated THA procedure using image-free navigation system was performed and a trial cup with a diameter of approximately 2 mm less than the size of the acetabulum were inserted and snugly fitted on the TAL through the posterior wall of acetabulum. The orientation of the cup component was measured using an image-free THA navigation system. The measured radiographic anteversion and inclination angles averaged 18.2±7.2° (range: 2.0-33.2° and 43.5±4.2° (range: 33.1-51.0° respectively. Based on the Lewinnek’s safe zone criteria, 26 hips (80.6% were judged to be within the. Moreover, in the analysis of the gender difference of TAL angles, the average anteversion angle was shown to be significant larger in female than male population. The TAL can be effectively used an intraoperative landmark to align the acetabulum component helping reduce the risk of dislocation after surgery. In the intraoperative judgment, a gender difference in the alignment of the TAL should be taken into consideration.

  4. Assessment of acetabulum anteversion aligned with the transverse acetabulum ligament: cadaveric study using image-free navigation system.

    Fukui, Tomokazu; Fukunishi, Shigeo; Nishio, Shoji; Fujihara, Yuki; Shohei, Okahisa; Yoshiya, Shinichi

    2013-02-22

    The transverse acetabulum ligament (TAL) has been used as an intraoperative anatomical landmark to position the acetabulum cup in total hip arthroplasty (THA). However, the validity of the use of TAL has not been clarified. The purpose of this study was to examine the orientation of the cup component aligned with the TAL in cadaveric study. The 31 hips in 25 whole-body embalmed cadavers were examined. The donors were 12 men and 13 women. Simulated THA procedure using image-free navigation system was performed and a trial cup with a diameter of approximately 2 mm less than the size of the acetabulum were inserted and snugly fitted on the TAL through the posterior wall of acetabulum. The orientation of the cup component was measured using an image-free THA navigation system. The measured radiographic anteversion and inclination angles averaged 18.2±7.2° (range: 2.0-33.2°) and 43.5±4.2° (range: 33.1-51.0°) respectively. Based on the Lewinnek's safe zone criteria, 26 hips (80.6%) were judged to be within the. Moreover, in the analysis of the gender difference of TAL angles, the average anteversion angle was shown to be significant larger in female than male population. The TAL can be effectively used an intraoperative landmark to align the acetabulum component helping reduce the risk of dislocation after surgery. In the intraoperative judgment, a gender difference in the alignment of the TAL should be taken into consideration. PMID:23705063

  5. Chipfracture of the border of acetabulum in a horse

    By means of a case-report the presented paper agrees to the problems of finding the clinical diagnosis of chip-fractures of the caudal part of the acetabulum of horses and their differential diagnosis to other types of fractures of the pelvis. In this connection the purposeful realized radiographic examination is a valuable aid. Considerations about the biomechanical conditions in the region of equine pelvis and hip are discussed. (Author)

  6. Transposition of the acetabulum after iliac ischial osteotomy in the treatment of hip dysplasia in infants

    Владимир Евгеньевич Басков

    2016-06-01

    Full Text Available Background. Transposition of the acetabulum after pelvic osteotomy is the most effective surgical method to treat dysplastic hip joint disorders in patients of different ages. According to Salter, iliac osteotomy of the pelvis is the main surgical method used to correct dysplastic acetabulum in 7- and 8-year-old children. In older patients, the pubic symphysis and pelvic ligaments become more rigid, which significantly limits the degree of rotation of the acetabulum. In these cases, a triple pelvic osteotomy is performed to enhance the mobility of the acetabular fragment. This pubic bone osteotomy is performed near the femoral neurovascular bundle, which may be damaged during the procedure.Aim. To describe a technique for transposition of the acetabulum after iliac and ischial osteotomy of the pelvis, which was developed to reduce trauma, prevent vascular complications, and increase postoperative stability of the pelvic ring.Materials and methods. A method developed by the authors for transposition of the acetabulum after iliac and sciatic pelvic osteotomy is described in detail. The surgical method was performed 99 times on 89 children with dysplastic hip joint disorders, and the results are presented.Conclusion. Transposition of the acetabulum after iliac and ischial pelvic osteotomy is an effective treatment for dysplastic instability of the acetabulum in children aged 9–16 years. The procedure is indicated when it is necessary to rotate the acetabular fragment by more than 25°, and there is no need for hip medialization.

  7. Acute osteomyelitis of the acetabulum induced by Staphylococcus capitis in a young athlete

    Seiji Fukuda

    2010-03-01

    Full Text Available Acute hematogenous osteomyelitis (AHOM of the acetabulum is a rare condition in children and usually caused by Staphylococcus aureus. We present an 11-year-old soccer athlete who suffered from acute osteomyelitis involving the acetabulum caused by S. capitis, a normal flora of the human skin but never reported in this condition. The disease was associated with repetitive skin injuries of the knee and potential osseous microtrauma of the hip joint by frequent rigorous exercise. This unusual case suggests that osseous microtrauma of the acetabulum, in addition to repetitive skin injuries, allowed normal skin flora to colonize to the ipsilateral acetabulum, which served as a favorable niche and subsequently led to AHOM.

  8. Conventional versus virtual radiographs of the injured pelvis and acetabulum

    Bishop, Julius A.; Rao, Allison J.; Pouliot, Michael A.; Bellino, Michael [Stanford University School of Medicine, Department of Orthopaedic Surgery, Stanford, CA (United States); Beaulieu, Christopher [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2015-09-15

    Evaluation of the fractured pelvis or acetabulum requires both standard radiographic evaluation as well as computed tomography (CT) imaging. The standard anterior-posterior (AP), Judet, and inlet and outlet views can now be simulated using data acquired during CT, decreasing patient discomfort, radiation exposure, and cost to the healthcare system. The purpose of this study is to compare the image quality of conventional radiographic views of the traumatized pelvis to virtual radiographs created from pelvic CT scans. Five patients with acetabular fractures and ten patients with pelvic ring injuries were identified using the orthopedic trauma database at our institution. These fractures were evaluated with both conventional radiographs as well as virtual radiographs generated from a CT scan. A web-based survey was created to query overall image quality and visibility of relevant anatomic structures. This survey was then administered to members of the Orthopaedic Trauma Association (OTA). Ninety-seven surgeons completed the acetabular fracture survey and 87 completed the pelvic fracture survey. Overall image quality was judged to be statistically superior for the virtual as compared to conventional images for acetabular fractures (3.15 vs. 2.98, p = 0.02), as well as pelvic ring injuries (2.21 vs. 1.45, p = 0.0001). Visibility ratings for each anatomic landmark were statistically superior with virtual images as well. Virtual radiographs of pelvic and acetabular fractures offer superior image quality, improved comfort, decreased radiation exposure, and a more cost-effective alternative to conventional radiographs. (orig.)

  9. Analysis of the acetabulum by CT scan in Japanese with osteoarthritis of the hip

    The morphology of the acetabulum was analyzed by CT scan in 66 Japanese patients with osteoarthritis of the hip mainly following congenital dislocation or dysplasia. The CT scan data was analyzed to standardize the pelvic inclination in all directions. In these patients, the acetabular floor had thickened and the acetabulum was located in the anterolateral portion. The bilateral difference in the acetabular anteversion angle was not different between patients and normal individuals, but the acetabular sector angle in patients was smaller than in the normal subjects. As the stage of osteoarthritis of the hip advanced, the thickness of the acetabular floor in the center and posterior portions and the anterior sector angle increased, and the lateralization of the acetabulum advanced, but the anteversion angle decreased. A bone-forming change is characteristic of the anterior acetabulum and acetabular fossa in the center and posterior portions in Japanese patients with osteoarthritis of the hip. In comparison with data obtained by standard radiography, these changes detected by CT scan corresponded to an increase of the width of a tear drop, the lateralization of the femoral head and the lack of the support of the femoral head from the acetabulum. (author)

  10. Analysis of the acetabulum by CT scan in Japanese with osteoarthritis of the hip

    Ishibashi, Masanori [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    The morphology of the acetabulum was analyzed by CT scan in 66 Japanese patients with osteoarthritis of the hip mainly following congenital dislocation or dysplasia. The CT scan data was analyzed to standardize the pelvic inclination in all directions. In these patients, the acetabular floor had thickened and the acetabulum was located in the anterolateral portion. The bilateral difference in the acetabular anteversion angle was not different between patients and normal individuals, but the acetabular sector angle in patients was smaller than in the normal subjects. As the stage of osteoarthritis of the hip advanced, the thickness of the acetabular floor in the center and posterior portions and the anterior sector angle increased, and the lateralization of the acetabulum advanced, but the anteversion angle decreased. A bone-forming change is characteristic of the anterior acetabulum and acetabular fossa in the center and posterior portions in Japanese patients with osteoarthritis of the hip. In comparison with data obtained by standard radiography, these changes detected by CT scan corresponded to an increase of the width of a tear drop, the lateralization of the femoral head and the lack of the support of the femoral head from the acetabulum. (author)

  11. Comparison of ESTs from juvenile and adult phases of the giant unicellular green alga Acetabularia acetabulum

    Grotewold Erich

    2004-03-01

    Full Text Available Abstract Background Acetabularia acetabulum is a giant unicellular green alga whose size and complex life cycle make it an attractive model for understanding morphogenesis and subcellular compartmentalization. The life cycle of this marine unicell is composed of several developmental phases. Juvenile and adult phases are temporally sequential but physiologically and morphologically distinct. To identify genes specific to juvenile and adult phases, we created two subtracted cDNA libraries, one adult-specific and one juvenile-specific, and analyzed 941 randomly chosen ESTs from them. Results Clustering analysis suggests virtually no overlap between the two libraries. Preliminary expression data also suggests that we were successful at isolating transcripts differentially expressed between the two developmental phases and that many transcripts are specific to one phase or the other. Comparison of our EST sequences against publicly available sequence databases indicates that ESTs from the adult and the juvenile libraries partition into different functional classes. Three conserved sequence elements were common to several of the ESTs and were also found within the genomic sequence of the carbonic anhydrase1 gene from A. acetabulum. To date, these conserved elements are specific to A. acetabulum. Conclusions Our data provide strong evidence that adult and juvenile phases in A. acetabulum vary significantly in gene expression. We discuss their possible roles in cell growth and morphogenesis as well as in phase change. We also discuss the potential role of the conserved elements found within the EST sequences in post-transcriptional regulation, particularly mRNA localization and/or stability.

  12. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement

    Vasileios Sakellariou; Michael Christodoulou; Gregory Sasalos; George Babis

    2014-01-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4...

  13. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  14. Contact between the acetabulum and dome of a Kerboull-type plate influences the stress on the plate and screw.

    Hara, Katsutoshi; Kaku, Nobuhiro; Tabata, Tomonori; Tsumura, Hiroshi

    2015-07-01

    We used a three-dimensional finite element method to investigate the conditions behind the Kerboull-type (KT) dome. The KT plate dome was divided into five areas, and 14 models were created to examine different conditions of dome contact with the acetabulum. The maximum stress on the KT plate and screws was estimated for each model. Furthermore, to investigate the impact of the contact area with the acetabulum on the KT plate, a multiple regression analysis was conducted using the analysis results. The dome-acetabulum contact area affected the maximum equivalent stress on the KT plate; good contact with two specific areas of the vertical and horizontal beams (Areas 3 and 5) reduced the maximum equivalent stress. The maximum equivalent stress on the hook increased when the hardness of the bone representing the acetabulum varied. Thus, we confirmed the technical importance of providing a plate with a broad area of appropriate support from the bone and cement in the posterior portion of the dome and also proved the importance of supporting the area of the plate in the direction of the load at the center of the cross-plate and near the hook. PMID:25749753

  15. Massive heterotopic ossification associated with late deficits in posterior wall of acetabulum after failed acetabular fracture operation

    Zhang, Yuntong; Xie, Yang; Xu, Shuogui; Zhang, Chuncai

    2013-01-01

    Background Heterotopic ossification is a common postoperative complication of acetabular fracture. However, functionally significant heterotopic ossification with associated late bone defects in the posterior wall of the acetabulum is rare and challenging to treat. When heterotopic ossification is a late complication of failed acetabular fracture operation, it is disabling and may only be treated by THA. THA is highly susceptible to premature failure in young and active patients and may requi...

  16. Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement

    Weill, A.; Kobaiter, H.; Chiras, J. [Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France)

    1998-02-01

    The aim of our study was to describe the technique of percutaneous injection of acrylic surgical cement into acetabulum malignancies [percutaneous acetabuloplasty (PCA)] and determine its efficiency in relieving pain. Eighteen patients (8 men, 10 women; aged 40-81 years) with painful acetabular malignancies (18 lesions; 17 metastases, 1 multifocal bone sarcoma) were treated with PCA. Procedures were done using lateral approach with fluoroscopic guidance. The 18 procedures were evaluated and resulted in 4 (22 %) total improvement, 7 (39 %) clear improvement, 4 (22 %) moderate improvement, 1 (6 %) no improvement, and 2 (11 %) worsening in keeping with a cement leak in contact with the sciatic nerve and a leak towards the joint. Follow-up ranged from 2 to 48 months (average 9.4 months). We observed 2 cases of recurrence of pain at 6 and 39 months, both in keeping with local tumoral progression. PCA of malignancies is a minimally invasive and low-cost procedure that provides immediate and long-term pain relief. (orig.) With 6 figs., 2 tabs., 20 refs.

  17. A preliminary study of bone mineral densities of the proximal femur and acetabulum after hip resurfacing arthroplasty

    Objective: To evaluate periprosthetic bone mineral densities of the femur and acetabulum after hip resurfacing arthroplasty (RSAH). Methods: A comparative study was carried out in 26 patients who underwent RSAH. The bone mineral density was measured with dual energy X-ray absorptiometry 1 year after RSAH. Both the operated and unoperated hips were scanned. In the dual femur bone mineral density analysis, 9 regions of interests (ROIs) were defined: ROIs 1-6 were determined according to Taylor regions; ROIs A1-A3 were determined according to Wilkinson regions. The student t test was used for comparing differences in bone mineral density between the operated and unoperated sides. Results: The bone mineral densities of the proximal femur in ROIs 5 and 6 medial to the stem were significantly increased in the operated side compared to the unoperated side (P<0.05), but no significant differences were found in ROIs 1, 2, 3, and 4 of the proximal femur between two sides (P>0.05). The bone mineral density of acetabulum in cranial ROI A1 of the operated side was significantly decreased compared to the unoperated side (P<0.05), while in the medial and caudal ROIs A2 and A3 showed no significantly differences between two sides (P>0.05). Conclusion: The bone stock of proximal femur can be well preserved and recovered after RSAH. (authors)

  18. The role of acetabulum geometry and femoral head-neck ratio in the development of osteoarthritis in young men

    Halle, B; Halle, D M; Torfing, T;

    2007-01-01

    consequence of acetabular retroversion on standardized x-rays. Men aged 26-55 years who earlier had a total hip arthroplasty were included in the case group. This group was compared to a control-group of men treated as trauma patients. The study indicates that acetabular dysplasia and retroversion and a......We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck and the...... relative decreased head neck ratio are associated with osteoarthritis of the hip in young men....

  19. Research on Damage in Trabecular Bone of the Healthy Human Acetabulum at Small Strains Using Nonlinear Micro-finite Element Analysis

    DING Hai; ZHU Zhen-nan; DAI Ke-rong; YE Ming; WANG Cheng-tao

    2008-01-01

    The mechanical properties of the pelvic trabecular bone have been studied at the continuum level. However, nothing is known about the tissue-level damage in the trabecular bone of the healthy human acetabulum at apparent small strains characteristic of habitual. By a DAWING 4000 A supercomputer, nonlinear micro-finite element (μFE) analysis was performed to quantify tissue-level damage accumulation in trabecular bone at small strains. The data indicate that damage in trabecular bone commence at 0.2% apparent strain. The findings imply that tissue yielding can initiate at very low strains in the trabecular bone of the healthy acetabulum and that this local failure has negative consequences on the apparent mechanical properties of trabecular bone.

  20. Abmessung und Analyse der Bezugsfl(a)che von Acetabulum-Prothese-Transplantation in unterschiedlichen K(o)rperlagen

    ZENG Hui; Eckart Mayr; KANG Bin; XIONG Ao; XIN Feng; Michael Nogler; Martin Krismer

    2006-01-01

    Ziel ist die Analyse der Neigungslage des Beckens im Liegen und im Stehen bzw.die Beobachtung der Stabilit(a)t der Beckenfl(a)che als Beckenfl(a)che für die Acetabulum-Prothese Transplantation. 72 Testpersonen wurden je nach Status ihres Pfannengelenks in 3 Gruppen eingeteilt:Gruppe 1 "mit gesundem Pfannengelenk", Gruppe 2 "mit Arthritis" und Gruppe 3 "nach Implantation der Hüftendoprothese". Unter dem Einsatz von 3D- Digital-Instrument wurde die Fl(a)chen-Neigung vor dem Becken jeweils im Liegen und im Stehen gemessen und die Messwerte wurden verglichen. Die Fl(a)chen-Neigungen vor dem Becken bei allen 3 Gruppen (mit gesundem Pfannengelenk/mit Arthritis/nach Operation) im Liegen sind: 6.37°± 3.70°, 6. 47°± 3.52° und 4.56°±2.39°. Im Stehen sind es 7.33°±3.08°, 6.60°±3.45° und 6.74°±3.43°. Der Fl(a)chen-Neigungsunterschied vor dem Becken im Liegen und im Stehen hat keine grosse Bedeutung (P>0.05).Die (A)nderung der Fl(a)chen-Neigung vor dem Becken vom Liegen bis zum Stehen ist kleiner als 2.5°.Die Fl(a)che vor dem Becken (pelvic anterior plane, PAP) als Bezugsfl(a)che für Hüftpfanne-Prothese Transplantation bei klinischer Operation ist stabil und verlaβlich.

  1. Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria - a correlative study with measurement derived from conventional radiography

    The goal of this study was to identify a method of measurement for acetabulum protrusio and center edge angle (CEA) using MR imaging of the pelvis that correlated with classic methods using radiographic landmarks. MR images and radiographs of the pelvis in 67 patients (132 hips) were used to identify reliable MR-imaging methods for measuring protrusio acetabulum and CEA that correlated strongly with established radiographic measurements. Protrusio acetabulum was determined using the radiographic criterion that the acetabular line projects medial to the ilioischial line by 3 mm or more in men and 6 mm or more in women. Pearson correlation factor was used to determine inter-observer variability and those methods that demonstrated the strongest correlation. The mean and standard deviation of MR-imaging and radiographic measurements for both the normal and protrusio hips were established. Several MR methods correlated strongly with radiographic measurements. The preferred method employed axial MR images at the level of the ischial spine with measurement of the distance between the medial most point of the acetabular fossa and a line perpendicular to the horizontal axis that passed through the lateral margin of the posterior inner pelvic wall. The Pearson's correlation factor between radiographic and MR measurements using this method was 0.84, and inter-observer correlation was 0.80. There were 126 hips in 63 patients (17 female and 44 male) that did not meet the radiographic criteria for protrusio acetabula. In this group of normal hips, the mean and standard deviation of radiographic measurements were 1.9 and 2.8 mm in male patients and -0.5 and 1.7 mm in female patients, and the mean and standard deviation for the preferred MR method was 1.3 and 2.5 mm in male patients and -0.8 and 1.9 mm in female patients. A total of six hips in four patients (two female and two male) met the radiographic criteria for protrusio acetabula. In this group of patients, the mean and

  2. Treatment of Dysplasia of the Acetabulum in Children by Combined Operations%联合手术治疗儿童髋臼发育不良

    姜长明; 吴汝舟; 张中柱; 于天庆; 孙作令; 蔡荣铭; 王立德; 吕德成; 孙立众

    1994-01-01

    Sixty cases (68 hips) of dysplasia of the acetabulum in children were treated by the combined operations from Jan.1974 to Jan.1992.Shelf procedures combined with Pemberton's operation were performed on 50 cases (56 hips).The results of 47 hips were excellent,3 hips were good.The excellent and good cases occupied 89.3%.Salter's operation combined with Pemberton's one were performed on 10 cases (12 hips).10 hips were excellent,and 1 good.The indication of the operation and details of the technique were discussed in the article.%1974年1月~1992年1月应用联合手术治疗髋臼发育不良60例(68髋).其中髋臼造盖与关节囊周围髂骨截骨联合术50例(56髋),优47髋,良3髋;髂骨截骨与关节囊周围髂骨截骨联合术10例(12髋),优10髋,良1髋.介绍了几种联合手术的选择及手术方法.

  3. Application of 3D Printing Technology in the Acetabulum Fracture Intraoperative and Postoperative Rehabilitation%3 D打印技术在髋臼骨折术中及术后康复中的应用

    张锐

    2015-01-01

    目的:分析3 D打印技术应用在髋臼骨折手术和康复中的临床方法和效果。方法选取我院收治的髋臼骨折患者,应用3 D技术将患者的骨盆模型仿真出来,按照模型对钢板螺钉位置、进入途径以及螺钉长度进行设计测量等模拟手术,参照模拟手术情况给予患者行复位手术,并在术后给予康复锻炼,分析术后效果。结果手术圆满成功,且手术时间短,伤害小,恢复快。结论应用3 D打印技术进行髋臼骨折手术治疗,临床效果更佳精确,术中创伤小,有效缩短手术周期,提高患者预后,降低成本。%ObjectiveAnalysis clinical methods and effects of 3 D printing technology application in the acetabulum fracture surgery and rehabilitation. Methods Selected our hospital patients with fracture of acetabulum, application of 3 D technology to patients with pelvic model simulation, according to the model of steel screw location, access, and the length of the screw design measurement simulation operation, such as reference simulation surgery to give patients reduction surgery, and to give rehabilitation training after surgery, postoperative effect were analyzed. ResultsThe success of operation and operation time was short, that small injury, rapid recovery. Conclusion The application of 3 D printing acetabulum fracture surgery treatment, clinical effect is better precision, intraoperative trauma is small, shorten the development period of operation, and improve the prognosis of patients, reduce the cost.

  4. 伴有“海鸥征”表现的髋臼顶压缩性骨折的手术治疗%Surgical treatment of acetabulum top compression fracture with sea gull sign

    庄岩; 雷金来; 魏星; 卢代刚; 张堃

    2014-01-01

    Objective To investigate the surgical method and clinical curative results of acetabulum top compression fractures with sea gull sign. Methods Data of 14 patients who had acetabulum top compression fractures with sea gull sign were retrospectively analyzed and were accepted surgical therapy and followed up. There were 5 females and 9 males, aged from 28 to 71 years (average, 49.9 years). The pre-operative time was from 4 to 14 days (average, 9 days). Letournel-Judet fracture classifica-tion:eight cases for the anterior column+posterior semi-transverse, six cases for a simple anterior column. Three patients with lum-bar compression fracture, two patients with tibial plateau fracture, one patient with multiple rib fractures. All patients were accept-ed open reduction and bone graft and internal fixation through ilioinguinal approach or ilioinguinal approach+Kocher-Langenbeck approach. The quality of fracture reduction was assessed according to the Matta reduction criterion after operation. The hip func-tion was evaluated according to Matta. Results 14 patients were followed up from 6 to 60 months (average, 36 months). All pa-tients reached bone healing;healing time was from 3 months to 4 months (average, 3.4 months). According to the Matta reset stan-dard after operation, there were 6 excellent cases, 5 good cases, 2 fair cases, 1 poor case, the excellent and good rate was 78.5%(11/14). The Matta was from 10 to 18 scores (average, 16.4 scores), 5 excellent cases, 5 good cases, 3 fair cases, 1 poor case, the ex-cellent and good rate was 71.4%(10/14). Traumatic arthritis occurred in 3 patients. Pain was serious in two patients and disap-peared after total hip joint replacement. Pain was mild for one patient and disappeared after accepted non steroidal painkiller. One patient had heterotopic ossification after operation, which was not treatmented because of no obvious symptom. Conclusion The appropriate operation time of acetabular roof compression fracture with sea

  5. 髋臼横行骨折采用前后柱拉力螺钉结合重建钢板固定疗效分析%Analysis of the Effect of the Acetabular Transverse Fracture Using the Lag Screw of the Acetabulum and the Reconstruction Plate With the Reconstruction Plate

    张立峰; 冯卫; 包道日娜; 冬梅; 佟雁翔

    2015-01-01

    Objective To investigate the clinical effect of the application of the acetabular transverse fracture in the treatment of the acetabular fracture and the reconstruction of the plate fixation with the lag screw of the acetabulum. Methods 50 cases of patients with transverse acetabular fracture were selected,and subject to acetabular posterior column lag screw combined with reconstruction plate fixation treatment,Bleeding volume,operation time, the acetabulum repositioning and hip joint function recovery after surgical of patients were observed. Results The average operation time was 3.5 hours, the average amount of bleeding was 950ml, according to Matta reduction, 25 cases of anatomic reduction, satisfactory reduction in 21 cases, 4 cases of unsatisfactory reduction, and the excellent and good rate of hip joint function was 86.0%. Conclusion The clinical effect of the acetabular transverse fracture patients with the acetabular anterior and posterior column lag screw combined with the reconstruction plate fixation is worthy of promotion.%目的:探讨对髋臼横行骨折患者应用髋臼前后柱拉力螺钉结合重建钢板固定治疗的临床疗效。方法选取髋臼横行骨折患者50例,对其进行髋臼前后柱拉力螺钉结合重建钢板固定手术治疗,观察患者手术时出血量、手术时间等,手术治疗后患者髋臼复位情况以及髋关节功能恢复情况。结果平均手术时间为3.5小时,平均出血量为950 ml,根据 matta 复位,25例解剖复位,21例满意复位,4例复位不满意,髋关节功能优良率为86.0%。结论对髋臼横行骨折患者采取髋臼前后柱拉力螺钉结合重建钢板固定手术治疗临床疗效突出。

  6. Finite element analysis of total hip replacement with structural bone graft for acetabulum reconstruction in dysplasia of hip%成人髋臼发育不良伴骨关节炎行髋臼结构性植骨重建关节置换术的力学分析

    许杰; 马若凡; 蔡志清; 李登

    2014-01-01

    Objective To study the stress distribution in the acetabular cup-bone interface affected by the structural bone graft for the acetabulum reconstruction during the total hip replacement (THR) in treating the dysplasia of hip by using the three dimensional (3D) finite element analysis. Methods The acetabulumm of the hip with dysplasia was scanned by CT.The computer simulation technology was used to reconstruct the three-dimensional (3D) model of the pelvic from CT scan picture in order to observe the dysplasia of the hip.The structural bone graft for reconstruction of the acetabulum reconstruction in THR was simulated.Then the pelvis and acetabular cup models were meshed.The mechanical analysis tool was used to analyze the 3D model, and the stress data in the acetabular cup-bone interface was achieved.After the statistical analysis of the experimental results, the structural bone graft affecting the stress distribution in the acetabular cup-bone interface was observed.Results The structural bone graft augmented the deficient acetabulum and improved the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip, which leaded to greater contact area and smaller stress per unit area. The structural autograft which covered the anterior-lateral part of the cup bore greater stress.Conclusion The acetabular reconstruction with the structural bone graft improves the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip.The stress deconcentration due to the larger contact area could benefit the stability of the cup.The coverage of the cup by the graft should not be too much, otherwise, the great stress on the structural bone graft would increase the risk of loosening.%目的:利用三维有限元力学分析方法,研究髋关节发育不良患者髋臼外上缘结构性植骨重建髋臼、增加臼杯假体包容对髋臼假体-骨界面间的应力分布情况的影响。方法选取髋关节发育不良患者的骨盆为

  7. The use of allograft bone in reconstruction of the acetabulum during hip revision arthroplasty

    We have reviewed 80 patients who underwent an allograft acetabular reconstruction between 1987 and 1995. This group had a mean age of 66 years with a mean follow-up of 5.2 years. A mean preoperative Harris hip score of 32 points was improved to a mean postoperative score of 72 points. There was a 16.5% rerevision rate. Acetabular defects were classified according to the American Academy of Orthopaedic Surgeons system. Subgroup classification categories were analysed and reconstruction methodologies have been devised. This paper deals with the relative indications for the use of morsellised bone, block allografts, anatomic specific allografts and reconstruction shells according to type of acetabular defects

  8. Navigated non-image-based positioning of the acetabulum during total hip replacement

    Jenny, Jean-Yves; Boeri, Cyril; Dosch, Jean-Claude; Uscatu, Marius; Ciobanu, Eugen

    2007-01-01

    We tested the hypothesis that the non-image-based navigation system used in our department was able to measure accurately the 3D positioning of the acetabular cup of a total hip replacement (THR) and to increase the accuracy of its implantation during THR. We studied 50 consecutive navigated implantations of a THR and compared the intra-operative measurement of the cup by the navigation system to the post-operative measurement by computed tomography (CT) scan. The mean difference between the ...

  9. Computed tomography measurements of the acetabulum in adult dysplastic hips: Which level is appropriate

    Anda, S.; Kvistad, K.A. (Dept. of Radiology, Trondheim Univ. (Norway)); Terjesen, T. (Dept. of Orthopedic Surgery, Trondheim Univ. (Norway))

    1991-05-01

    A study has been performed to evaluate whether one or several levels are needed with comuted tomography (CT) study to provide sufficient information regarding anteversion and acetabular support to the femoral head. A total of 23 hips in 14 adults with uni- or bilateral congenital hip dysplasia (center-edge angle less than 20deg) were assessed by obtaining 5-mm contiguous CT slices and performing acetabular measurements at four levels. Both anterior and posterior acetabular supports as quantified by the anterior and posterior acetabular sector angles were significantly lower than normal at all levels. The sector angles increased in the proximal cuts, whereas the acetabular anteversin increased caudally. Because no important additional information was gained by measuring at different levels, we conclude that CT study at one level is sufficient for acetabular measurements and suggest that the slice through the center of the femoral head is the most appropriate one. (orig.).

  10. Congenital dislocation of the hip with displasia of acetabulum%先天性髋关节脱位闭合复位后表现的髋臼发育不良

    张德文; 刘正全; 刘传康; 李明; 唐盛平

    2000-01-01

    目的探讨先天性髋关节脱位伴髋臼发育不良的治疗效果.方法本院1970~1990年间,闭合复位治疗小儿先天性髋关节脱位469例,成功421例.经过1~15年平均9年的随访,发现33例髋臼发育不良.结果 33例均作了及时补救手术治疗,获得满意效果.结论先天性髋关节脱位患儿治疗后需长期定时随访,至少要随访至小儿骨骼发育成熟期,一旦发现髋臼发育不良,需及时处理.

  11. Acetabular reconstruction of total hip replacement in congenital acetabulum displasia of adult%成人先天性髋臼发育不良全髋置换术中髋臼重建

    魏福堂; 张洪涛; 张志明; 黄洪; 张本寿

    2006-01-01

    目的 探讨全髋关节置换治疗成人先天性髋臼发育不良术中髋臼的重建方法.方法 对24例32髋成人先天性髋臼发育不良继发骨性关节炎患者进行了全髋关节置换术,21髋行自体股骨头及髂骨移植重建髋臼,11髋单纯行髋臼加深重建髋臼.术后以Harris评分、放射学改变、步态、肢体长度、Trendelenburg征评定治疗效果.结果 所有患者均获得随访,时间6个月~5年.Harris评分由术前平均48.2分恢复到术后平均86.4分,X线片显示,自体股骨头及髂骨移植重建髋臼病例所有移植骨块均愈合良好.旋转中心平均下降55mm(37~69 mm).29髋疼痛消失,3髋术后有轻微疼痛.1例术后Trendelenburg征持续阳性.结论 根据术前评估,选择合适的髋臼重建方法进行全髋关节置换对成人先天性髋臼发育不良可获得较好疗效.

  12. Management of Adult Hip Displasia by means of Total Hip Replacement Plus Acetabulum Deepening Technique%髋臼加深全髋置换治疗成人先天髋臼发育不良

    宋展昭; 徐朋; 张伟; 邵顺建; 赵莉

    2001-01-01

    目的:探索成人先天性髋臼发育不良伴髋关节半脱位的手术治疗方法.材料和方法:12例成人先天性髋臼发育不良伴髋关节半脱位患者采用髋臼加深髋关节置换的方法治疗.结果:经1~8年随访,假体稳定,髋关节疼痛症状消失,关节功能基本正常.结论:髋臼加深全髋关节置换是成人先天性髋臼发育不良伴髋关节半脱位的有效治疗方法.

  13. Ultrasonography for evaluating abnormal values of the osseous acetabulum angle in pediatric developmental dysplasia of the hip%超声观察骨性髋臼角度评价婴幼儿发育性髋关节异常的价值

    栗平; 郭志英; 窦蕊

    2013-01-01

    [Objective] To determine the clinical significance of Graf' s ultrasound examination in the diagnosis of pediatric developmental dysplasia of the hip.[Methods] We studied abnormal hips of 108 infants (216 hips; 35 boys,73 girls; mean age,45 days [range,8 days to 6 months]) with suspected developmental hip dysplasia between August 2010 and September 2012.Graf's conventional ultrasonography examination was used to measure angles a and b to evaluate coronal acetabular form and femoral head position in both hips.For analysis,hips were classified according to the related risk factors.[Results]According to Graf's ultrasound classification,the hips were classified as follows:type Ⅰ,186 (86.1%) ; type Ⅱa,10 (4.9%) ;type Ⅱb,12 (6.0%) ; type Ⅱc,2 (1.1%) ; type Ⅲ,4 (1.9%) ; and type Ⅳ,2 (1.0%).Type D was not seen.Angle a =60° was representative of hip joint osteoarthritis,good concave growth,concave and deep joint socket,and a femoral head that was not easily dislocated.Angle a < 60° was representative of hip joint osteoarthritis,concave dysplasia,relatively shallow or flat joint socket,and a femoral head that was easily dislocated.There was a statistical significant difference in the acetabular angle between boys and girls (P < 0.05).Therefore,sex had an influence on osseous acetabular development.A comparison of left and right hips showed that the right a angle was correlated with the left (P < 0.05).[Conclusion] Ultrasonography can be used to accurately evaluate developmental hip dysplasia in children and can contribute to early diagnosis and effective treatment.%[目的]研究Graf超声检查方法在诊断婴幼儿发育性髋关节异常中的临床价值.[方法]选择2010年8月~ 2012年9月来本院就诊临床疑似发育性髋关节异常的婴幼儿108例(216个髋关节),其中男婴幼儿35例,女婴幼儿73例;年龄8d~6个月,平均45 d;依据Graf常规超声检查法,通过测量α、β角度,评估双侧髋关节髋臼形态、股骨头位置,髋臼与股骨头的关系,并对髋关节进行分型.[结果]Ⅰ型186个(86.1%),Ⅱa型10个(4.9%),Ⅱb型12个(6.0%),Ⅱc型2个(1.1%),Ⅲ型4个(1.9%),Ⅳ型2个(1.0%),D型未见.骨顶线夹角α≥60°时,说明髋关节的骨性关节凹发育较好,关节凹较深,股骨头不易脱出关节,骨顶线夹角α<60°时,说明髋关节骨性关节凹发育不良,关节凹较浅或较平,股骨头易脱出关节,另外,男婴幼儿髋臼α角度较女婴幼儿大,两者差异有统计学意义(P<0.05),提示性别对骨性髋臼发育有影响,双侧比较左侧和右侧髋关节α角右侧较左侧大(P<0.05),提示左侧较右侧髋臼发育差.[结论]超声检查法能够早期准确评价婴幼儿髋关节发育情况,并对髋关节发育不良的治疗过程进行随访观察.

  14. 髋臼加深全髋置换治疗成人先天髋臼发育不良的临床分析%Clinical analysis for deepening acetabular total hip replacement in treatment of congenital dysplasia of acetabulum in adults

    谭光华

    2012-01-01

    目的 通过观察髋臼加深全髋置换(THA)治疗成人髋臼发育不良(DDH)的临床效果,进行评价和分析,以期在临床效果上得到提高.方法 选取本院2000年1月~2009年12月收治的成人先天髋臼发育不良患者38例,术前Harris评分为(43.52±6.85)分,采用髋臼加深全髋置换术进行治疗.用X线平片检测,对比分析患者术前术后Harris评分.结果 患者术后Harris评分为(88.03±5.22)分,术前术后Harris评分差异具有统计学意义(P<0.05).结论 髋臼加深全髋置换术对于成人先天髋臼发育不良的治疗,可以明显消除患者症状,提高患者生活质量,是一种有效的治疗手段,值得在临床上推广应用.

  15. The anatomic basis for the superior acetabular roof notch 'superior acetabular notch'

    Radiographic discontinuity of the acetabulum is a frequently encountered entity which has been described by various authors. We have been unable to find an explanation of the nature of this discontinuity in the literature. By correlating dried skeletal specimens with their radiographic appearances, we found the anatomic basis for this phenomenon was an accessory fossa in the apex of the acetabulum. (orig.)

  16. CT to delineate hip pathology in cerebral palsy

    Surgical intervention for cerebral palsy hip dislocation or subluxation is frequently undertaken without a full comprehension of the three-dimensional aspects of the femoral-acetabular complex. CT with a modified technique allows more accurate measurement of the angle of femoral anteversion. In this exhibit the authors compare the modified technique with the old technique. Details of femoral had deficits, acetabular configuration, the arc of the acetabulum, the relative position of the femoral head within the acetabulum, and the soft tissue interposed between the femoral head and the acetabulum are well demonstrated with the new technique

  17. Taper Hip Prosthesis

    Full Text Available ... We'll see if we can use a large curved retractor just posterior to the acetabulum. I ... old gentleman. Okay. So you're using a large head with very slim tapered head and neck ...

  18. UniProt search blastx result: AK288054 [KOME

    Full Text Available AK288054 J075152E14 P16134|RBS1_ACEAT Ribulose bisphosphate carboxylase small chain 1, chloropla ... ll subunit 1) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 1.00E-31 ...

  19. UniProt search blastx result: AK288054 [KOME

    Full Text Available AK288054 J075152E14 P16137|RBS4_ACEAT Ribulose bisphosphate carboxylase small chain 4, chloropla ... ll subunit 4) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 3.00E-31 ...

  20. UniProt search blastx result: AK287599 [KOME

    Full Text Available AK287599 J065050G24 P16138|RBS5_ACEAT Ribulose bisphosphate carboxylase small chain 5, chloropla ... ll subunit 5) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 6.00E-32 ...

  1. UniProt search blastx result: AK288517 [KOME

    Full Text Available AK288517 J090043B03 P16137|RBS4_ACEAT Ribulose bisphosphate carboxylase small chain 4, chloropla ... ll subunit 4) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 9.00E-31 ...

  2. UniProt search blastx result: AK288054 [KOME

    Full Text Available AK288054 J075152E14 P16138|RBS5_ACEAT Ribulose bisphosphate carboxylase small chain 5, chloropla ... ll subunit 5) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 4.00E-32 ...

  3. UniProt search blastx result: AK288517 [KOME

    Full Text Available AK288517 J090043B03 P16136|RBS3_ACEAT Ribulose bisphosphate carboxylase small chain 3, chloropla ... ll subunit 3) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 1.00E-31 ...

  4. UniProt search blastx result: AK288517 [KOME

    Full Text Available AK288517 J090043B03 P16138|RBS5_ACEAT Ribulose bisphosphate carboxylase small chain 5, chloropla ... ll subunit 5) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 7.00E-31 ...

  5. UniProt search blastx result: AK288517 [KOME

    Full Text Available AK288517 J090043B03 P16134|RBS1_ACEAT Ribulose bisphosphate carboxylase small chain 1, chloropla ... ll subunit 1) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 2.00E-31 ...

  6. UniProt search blastx result: AK288517 [KOME

    Full Text Available AK288517 J090043B03 P16135|RBS2_ACEAT Ribulose bisphosphate carboxylase small chain 2, chloropla ... 2) (Fragment) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 2.00E-31 ...

  7. UniProt search blastx result: AK287599 [KOME

    Full Text Available AK287599 J065050G24 P16137|RBS4_ACEAT Ribulose bisphosphate carboxylase small chain 4, chloropla ... ll subunit 4) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 5.00E-31 ...

  8. UniProt search blastx result: AK288054 [KOME

    Full Text Available AK288054 J075152E14 P16136|RBS3_ACEAT Ribulose bisphosphate carboxylase small chain 3, chloropla ... ll subunit 3) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 8.00E-32 ...

  9. UniProt search blastx result: AK287599 [KOME

    Full Text Available AK287599 J065050G24 P16134|RBS1_ACEAT Ribulose bisphosphate carboxylase small chain 1, chloropla ... ll subunit 1) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 2.00E-31 ...

  10. UniProt search blastx result: AK287599 [KOME

    Full Text Available AK287599 J065050G24 P16136|RBS3_ACEAT Ribulose bisphosphate carboxylase small chain 3, chloropla ... ll subunit 3) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 1.00E-31 ...

  11. UniProt search blastx result: AK288054 [KOME

    Full Text Available AK288054 J075152E14 P16135|RBS2_ACEAT Ribulose bisphosphate carboxylase small chain 2, chloropla ... 2) (Fragment) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 1.00E-31 ...

  12. UniProt search blastx result: AK287599 [KOME

    Full Text Available AK287599 J065050G24 P16135|RBS2_ACEAT Ribulose bisphosphate carboxylase small chain 2, chloropla ... 2) (Fragment) - Acetabularia acetabulum (Mermaid's wine ... glass) (Acetabularia mediterranea) 2.00E-31 ...

  13. Anterior Approach Total Hip Replacement

    Full Text Available ... performed now is commonly attributed to the Jeu de brothers, Robert and John, who practiced orthopedic surgery ... mean this is the traditional Smith Meet Jeu De view of the acetabulum,. I mean you can ...

  14. State-of-the-Art Hip Surgeries for Active Adults

    Full Text Available ... incision will vary depending on a patient’s size, mass, muscle tone, flexibility, bone deformity. This particular patient ... can see that labrum is a pretty chunky mass of tissue detached from the acetabulum. On the ...

  15. Taper Hip Prosthesis

    Full Text Available ... Now are you going to be using the real acetabulum liner or a trial liner? No, we' ... comfortable with this. Now, once you put your real stem in, your true component, are you going ...

  16. State-of-the-Art Hip Surgeries for Active Adults

    Full Text Available ... Now you’re seeing special graters, what we call reamers, which fit into the acetabulum. This is ... marrow content -- the cancellous bone is what we call it. These are specially designed rasps, or we ...

  17. Taper Hip Prosthesis

    Full Text Available ... around the acetabulum, but inferiorly either articularly in theory I could plunge that saw through and do ... posterior trochanter, even onto the posterior neck in theory, as needed. Can you show that to us ...

  18. Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

    Saurabh Jain; Abhishek Pathak; Rajeev Kant Pandey

    2014-01-01

    Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons.We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps.This method is little invasive,easy,time-saving and without need for changing the inital fixation.

  19. Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip

    Watanabe, W.; Itoi, Eiji; Sato, Kozo [Akita Univ. (Japan). Dept. of Orthopedic Surgery

    2000-12-01

    Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip. (orig.)

  20. Association of a single nucleotide polymorphism in growth differentiate factor 5 with congenital dysplasia of the hip: a case-control study

    Dai, Jin; Shi, Dongquan; Zhu, Pengsheng; Qin, Jianghui; Ni, Haijian; XU, YONG; Yao, Chen; Zhu, Lunqing; Zhu, Hongtao; Zhao, Baocheng; Wei, Jia; Liu, Baorui; Ikegawa, Shiro; Jiang, Qing; Ding, Yitao

    2008-01-01

    Introduction Congenital dysplasia of the hip is an abnormal seating of the femoral head in the acetabulum, mainly caused by shallow acetabulum and lax joint capsule. Genetic factors play a considerable role in the pathogenesis of congenital dysplasia of the hip. The gene growth differentiate factor 5 (GDF5) has been implicated in skeletal development and joint morphogenesis in humans and mice. A functional single nucleotide polymorphism (SNP) in the 5'-untranslated region of GDF5 (rs143383) w...

  1. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion

  2. Thynstenopera lobata n.gen. n.sp. (Opecoeliidae: Plagioporinae Another New Trematode from the Fish Thynnus thunnia of Karachi Coast, Pakistan

    Fatima Mujib Bilqees

    2004-01-01

    Full Text Available A new trematode genus Thynstenopera was described here from the intestine of the fish Thynnus thunnia of Karachi coast, in the family Opecoeliidae and subfamily Plagioporinae. The genus is characterized by having flattened body with distinct demarcation of the forebody which is very short. Oral sucker is small, pharynx not visible, caeca long, narrow, terminating near posterior extremity of the body. Acetabulum larger than oral sucker, near anterior extremity. Testes tandem, close together, deeply lobed, postequatorial. Cirrus pouch is curved, very long reaching far posterior to acetabulum. Genital pore slightly submedian at the level of esophageal bifurcation. Ovary lobed, pretesticular and close to it, seminal receptacle lateral to ovary, Laurer`s canal present. Vitellaria prominent in lateral fields of the hind body confluent in the testicular and post testicular region. Uterus was in diagonal spirals between ovary and acetabulum. Eggs relatively large without polar filaments. Species name T. lobata is proposed because of lobed ovary and testes.

  3. Operative treatment for pincer type femoroacetabular impingement:a case report

    Endo,Hirosuke

    2010-04-01

    Full Text Available

    Femoroacetabular impingement (FAI is a condition characterized by the impingement of the femur and acetabulum. In Japan, this disorder has become recognized gradually. Here we report a rare case of surgically treated FAI, associated with an osseous protrusion on the acetabulum of a 30-year-old female. Plain computed tomography (CT and reconstructive 3D-CT images clearly demonstrated an anterolateral bony protrusion. Hip arthroscopy showed no degeneration of the cartilage on either the femoral or acetabular side, but degeneration at the edge of labrum was observed in the region of the bony protrusion. The complete removal of the bony protrusion under hip arthroscopy was thus considered impracticable, and a small skin incision was therefore made anteriorly to approach the acetabulum. The Short-Form 36-Item Health Survey (SF-36 revealed improvement in all scores.

  4. Femoroacetabular impingement

    Anderson, Suzanne E., E-mail: andersonsembach@yahoo.com.au [The University of Notre Dame Australia, School of Medicine Sydney, 160 Oxford Street, Darlinghurst 2010, NSW, Sydney (Australia); Department of Diagnostic, Pediatric and Interventional Radiology, Inselspital, University of Bern, Bern 3010 (Switzerland); Siebenrock, Klaus Arno; Tannast, Moritz [Department of Orthopedic Surgery, Inselspital, University of Bern, Bern 3010 (Switzerland)

    2012-12-15

    Femoroacetabular impingement (FAI) is a pathomechanical concept describing the early and painful contact of morphological changes of the hip joint, both on the acetabular, and femoral head sides. These can lead clinically to symptoms of hip and groin pain, and a limited range of motion with labral, chondral and bony lesions. Pincer impingement generally involves the acetabular side of the joint where there is excessive coverage of the acetabulum, which may be focal or more diffuse. There is linear contact of the acetabulum with the head/neck junction. Cam impingement involves the femoral head side of the joint where the head is associated with bony excrescences and is aspheric. The aspheric femoral head jams into the acetabulum. Imaging appearances are reviewed below. This type is evident in young males in the second and third decades. The main features of FAI are described.

  5. Effects of intertrochanteric varus osteotomy on Norberg angle and percent coverage of the femoral head in displastic dogs.

    Pinna, Stefania; Pizzuti, Enrico; Carli, Fabio

    2013-01-01

    This study was conducted to assess the effects of femoral varus osteotomy on joint congruency in dogs affected by early stage hip dysplasia. Preoperative planning to move the femoral head within the acetabulum was carried out. Varisation of the femoral inclination angle (fIA) was achieved by Intertrochanteric Osteotomy (ITO). Norberg angle (NA), percent coverage (PC) of the femoral head by the acetabulum and fIA was measured from preoperative, immediate postoperative and first and second recheck radiographs of seven dogs that underwent an ITO (joint n = 9). There was significant (p hip dysplasia in dogs with radiological signs of joint incongruency. PMID:23814471

  6. Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults

    Troelsen, Anders

    2009-01-01

    Hip dysplasia is characterized by an excessively oblique and shallow acetabulum with insufficient coverage of the femoral head. It is a known cause of pain and the development of early osteoarthritis in young adults. The periacetabular osteotomy is the joint-preserving treatment of choice in young...... adults with symptomatic hip dysplasia. The surgical aim of this extensive procedure is to reorient the acetabulum to improve coverage and eliminate the pathological hip joint mechanics. Intraoperative assessment of the achieved acetabular reorientation is therefore crucial. The "classic" surgical...

  7. Analysis of hip joint hemiarthoplasty influence to stress field changes in bone tissue

    Kytýř, Daniel; Micka, Michal

    Prague : CTU Publishing House, 2008, s. 428-429. ISBN 978-80-01-04016-4. - (12. 1). [CTU Workshop 2008. Prague (CZ), 18.02.2008-22.02.2008] R&D Projects: GA AV ČR(CZ) IAA200710504 Institutional research plan: CEZ:AV0Z20710524 Keywords : hemiarthoplasty * migration * acetabulum Subject RIV: FI - Traumatology, Orthopedics

  8. A morphological study of the hip joint of coxarthrosis by computed tomography

    The hip joint in coxarthrosis with severe deformities was studied by CT scan. In this disease, the supero-inferior diameter increased according to the degree of incomplete dislocation, while the antero-posterior diameter remained small. The acetabulum was shallow showing a small distance from the femur axis to the outer plate of the floor, but the floor of the acetabulum was thick with a considerable distance from the axis to the inner plate of the floor. The tangenital angle of the acetabulum was around 200, without remarkable changes depending on the degree of incomplete dislocation. The angle of covering the acetabulum at the center of the capitum was normally around 1800, and became smaller in incomplete dislocation, showing poor adaptability. The anterior torsion angle in incomplete dislocation tended to be larger depending upon severity of dislocation. In the cavum medullare of proximal diaphysis of the femur, the antero-posterior diameter was larger than the right-left diameter; and this relation was reversed in the use of artificial joint. Atrophy of the gluteal muscle developed with severeness of coxarthrosis. (Ueda, J.)

  9. Treatment of canine hip dysplasia using triple pelvic osteotomy

    Triple pelvic osteotomy (TPO) was carried out in a total of 22 dysplastic dogs, of which 9 were treated bilaterally and 13 unilaterally, and the position of the acetabulum was changed in a total of 31 hip joints using a special plate. It was established that 16 treated hip joints had severe, 12 medium and 3 mild dysplasia, the Norberg angle was between 70 and 92 deg and the covering rate of the acetabulum over the femoral head changed between 5 and 2 deg. The radiographs taken immediately after the operation showed the covering rate of the acetabulum over the femoral head was very good in 25 hip joints and good in 6 joints. In 5 cases, some of the screws holding the plate in place were seen to loosen in radiographs. However, this did not have any effect on the angle given to the acetabulum. In radiographs obtained 6-8 months later, degenerative joint disease was not encountered in 29 cases, with the exception of 2 cases. It was concluded that hip dysplasia, which is a hereditary disease, can be treated reasonably successfully in young dogs with TPO carried out before degenerative changes begin to occur in the joint

  10. Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

    Kavanagh, E.C. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Read, P.; Carty, F.; Zoga, A.C. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Parvizi, J. [The Rothman Institute of Orthopedics, Philadelphia, PA (United States); Morrison, W.B., E-mail: William.Morrison@Jefferson.edu [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2011-08-15

    Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

  11. Taper Hip Prosthesis

    Full Text Available ... the acetabulum. Sometimes this anterior retractor is what holds us up. But most of the time the ... re going to use today is not to “hold the cup in” or provide additional stability, it’s ...

  12. Anterior Approach Total Hip Replacement

    Full Text Available ... this view, I mean this is the traditional Smith Meet Jeu De view of the acetabulum,. I ... re using only part of what’s called the “Smith-Peterson approach.” The true Smith- Peterson, you would ...

  13. Anterior Approach Total Hip Replacement

    Full Text Available ... box. That’s right. Or in this case the computer. Yeah. Exactly. We’ll make some comments later ... you’re seeing the whole acetabulum, following direct vision. It’s normal anatomy. You’ve got the C- ...

  14. Anterior Approach Total Hip Replacement

    Full Text Available ... dysplastic joint; otherwise having excellent and relatively normal anatomy. Any question or comments, Roger? Yeah. I like ... the whole acetabulum, following direct vision. It’s normal anatomy. You’ve got the C-arm for a ...

  15. Analysis of the Effect of Artificial Hip Replacement in the Treatment of Acetabular Defect%髋臼缺损畸形的人工髋关节置换手术疗效分析

    武豪杰

    2015-01-01

    Objective To study the acetabulum defect deformity treatment methods of artificial total hip replacement. Methods 30 cases of acetabular defects were selected in our hospital, including 13 cases of acetabulum hypoplasia, acetabulum fracture malunion after trauma in 5 cases, 6 patients with rheumatoid arthritis, ankylosing spondylitis hip lesions, 6 cases were performed total hip replacement, take the acetabulum deepening, double cone spiral acetabulum, autologous bone graft and structural methods such as titanium mesh and bone graft line true acetabular reconstruction, all patients preoperative CT three-dimensional reconstruction, with Harris scoring criteria. Results Followed up for 6~36 months, has not occurred during the follow-up period of artificial hip prosthesis loosening and fracture around, etc. Harris scoring (36±6.5) preoperatively, postoperative (93±5.2). Conclusion Deformity of total hip replacement for defects of acetabulum, through the acetabulum, Zweymulle double cone spiral acetabulum, grain pressure distribution, structural bone graft autologous bone graft and titanium mesh and bone graft and so on the many kinds of methods can be a very good reconstruction of acetabulum, restore good stability and the Harris score, can achieve very good effect.%目的探讨髋臼缺损畸形的人工全髋关节置换术的处理方法。方法选取我院收治存在髋臼缺损畸形患者30例,包括髋臼发育不良13例、髋臼创伤骨折后畸形愈合5例、类风湿性关节炎6例,强直性脊柱炎髋关节病变6例,均行全髋关节置换术,采取髋臼加深、双锥  面螺旋型髋臼、自体结构性植骨及钛网加植骨等多种方法行真臼重建,全部病例术前行 CT 三维重建,评分标准采用 Harris 评分。结果随访6~36个月,随访期间未发生人工髋关节假体松动、周围骨折等。Harris 评分术前(36±6.5),术后(93±5.2)。结论对于髋臼缺损畸形的全髋关节置

  16. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  17. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Gavaskar Ashok S

    2012-12-01

    Full Text Available 【Abstract】Total hip arthroplasty (THA for an un-treated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old fe-male patient with untreated column and comminuted poste-rior wall fracture of the acetabulum was treated in our insti-tution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior col-umn with cancellous grafting and cementless THA in a single stage. At 3 years’ follow-up, the patient was independently mobile without limb length discrepancy. Radiological evalu-ation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular recon-struction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. Key words: Acetabulum; Fractures, bone; Hip dislocation; Arthroplasty, replacement, hip

  18. Pelvic proportions in x-ray pictures of german shepherd dog, rottweiler and great dane, a contribution to hip dysplasia

    Measurements of length and breadth were done in 439 X-ray pictures of the pelvis of German Shepherd Dog, Rottweiler and Great Dane. The relation of pelvic proportions to hip dysplasia was checked. In 66 X-ray pictures of the pelvis of young dogs the ischiadic part of the acetabulum was measured. In all breeds the ischium formed 68,8 percent of the acetabulum. Ilium and ischium showed changes in relation to hip dysplasia, which could be proved unequivocally only in Rottweilers. Changes of pelvic proportions in other breeds were not to perceive. In Rottweilers also those changes can be seen distinctly only in severe cases of hip dysplasia. For the special case valid accordance with any degree of hip dysplasia could not be found. (Author)

  19. Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

    Mladenović Marko

    2015-01-01

    Full Text Available Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

  20. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  1. Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

    Narasimhan Ramani

    2014-01-01

    Materials and Methods: 35 children with unilateral DDH were operated between 2002 and 2007 at our institute. Open reduction was performed in all using the standard anterior approach and peroperative test for hip stability was done. Nine children got an additional pelvic procedure in the form of Dega acetabuloplasty. All were followed up for a minimal period of 2 years (range 2-7 years. Results: No hip got redislocated. At the end of 18 months, there were seven cases of RAD with acetabular index (AI of 35° and above. These were all from the group where open reduction alone was done. Conclusion: We feel that a preoperative AI of >40° and a per-operative safe-zone <20° increases the need for supplementary pelvic osteotomy in age group of 18 to 24 months because in such cases, the remodeling capacity of the acetabulum is unable to overcome the dysplasia and to form a relatively normal acetabulum.

  2. Ranking of computed tomography in congenital hip dysplasia and hip dislocation

    Lingg, G.; Nebel, G.; Thomas, W.; Hering, L.

    1983-12-01

    A lot of methods of measurement have been developed to record precisely the degrees of luxation and the deviations from the normal form in the hip joints of the child and adult. The orthopaedic surgeon needs those data for a preoperative ''coxometric program'' before performing acetabuloplastic operations with osteotomia, osteotomia of the pelvis and combined operations. Computed tomography yields a series of informations and of possibilities of measurements which can determine the operative procedure in particular. These informations concern among other things the dimensions of the dysplasia of the acetabulum in the horizontal plane with the extension of the posterior lip and the angle of the acetabular opening, furthermore the physiological or pathological congruence between the head of the femur and the acetabulum, the angle of antetorsion of the neck of the femur and, in the small infant, the direct noninvasive imaging of the tube of the capsule with imaging of possible obstacles to reposition.

  3. Pelvic proportions in x-ray pictures of german shepherd dog, rottweiler and great dane, a contribution to hip dysplasia

    Koeppel, E. (Veterinaermedizinische Univ., Vienna (Austria))

    1983-01-01

    Measurements of length and breadth were done in 439 X-ray pictures of the pelvis of German Shepherd Dog, Rottweiler and Great Dane. The relation of pelvic proportions to hip dysplasia was checked. In 66 X-ray pictures of the pelvis of young dogs the ischiadic part of the acetabulum was measured. In all breeds the ischium formed 68,8 percent of the acetabulum. Ilium and ischium showed changes in relation to hip dysplasia, which could be proved unequivocally only in Rottweilers. Changes of pelvic proportions in other breeds were not perceived. In Rottweilers also those changes can be seen distinctly only in severe cases of hip dysplasia. For the special case valid accordance with any degree of hip dysplasia could not be found.

  4. A new pelvic fragment from Swartkrans and the relationship between the robust and gracile australopithecines.

    McHenry, H M

    1975-09-01

    A recently discovered hominid pelvic fragment from Swartkrans (SK 3155) is described in detail with particular reference to the relationship of the two presently recognized forms of australopithecines in South Africa. Results of this examination and metrical analysis indicate that the acetabulum and iliac blade of the early hominids are similar to Homo sapiens except for a unique pattern of traits: a relatively small sacral articular surface, a relatively small acetabulum, a relatively large iliac fossa, and wide lateral splaying of the iliac blades. The new Swartkrans fossil expresses these traits more strongly than does the gracile australopithecine (Sts 14) and is therefore somewhat less similar to Homo sapiens but it is very unlike any pongid. PMID:810037

  5. Two Different Approaches a Hip Joint Reconstruction

    Kytýř, Daniel; Vyčichl, Jan; Jírová, Jitka; Jíra, J.

    Kippen : Civil-comp. Press, 2008 - (Topping, B.; Papadrakakis, M.), s. 160-160 ISBN 978-1-905088-26-3. [International conference on Engineering computational technology /6./. Athens (GR), 02.09.2008-05.09.2008] R&D Projects: GA AV ČR(CZ) IAA200710504 Institutional research plan: CEZ:AV0Z20710524 Keywords : acetabulum * cement layer * contact stress analysis Subject RIV: FI - Traumatology, Orthopedics

  6. Muscle Unbalance Influence to Hip Implant Migration

    Kytýř, Daniel; Jírová, Jitka; Vyčichl, Jan; Jíra, J.

    Praha : Institute of Thermomechanics AS CR, v. v. i., 2007 - (Zolotarev, I.), s. 151-152 ISBN 978-80-87012-06-2. [Engineering Mechanics 2007. Svratka (CZ), 14.05.2007-17.05.2007] R&D Projects: GA AV ČR(CZ) IAA200710504 Institutional research plan: CEZ:AV0Z20710524 Keywords : muscle unbalance * acetabulum * FE model Subject RIV: FI - Traumatology, Orthopedics

  7. Hip Joint Surgery Problems of Crash and Fall Injures

    Kytýř, Daniel; Jírová, Jitka; Vyčichl, Jan

    Prague : CTU, 2007 - (Kubát, B.; Jírová, J.; Jarura, M.), s. 143-143 ISBN 978-80-01-03699-0. [From Horse-drawn Railway to High-speed Transportation Systems. Prague (CZ), 17.04.2007-19.04.2007] R&D Projects: GA AV ČR(CZ) IAA200710504 Institutional research plan: CEZ:AV0Z20710524 Keywords : migration * acetabulum * FE model Subject RIV: FI - Traumatology, Orthopedics

  8. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients ☆

    Richard Prazeres Canella; Guilherme Pradi Adam; Roberto André Ulhôa de Castillo; Daniel Codonho; Gerson Gandhi Ganev; Luiz Fernando de Vicenzi

    2016-01-01

    OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used...

  9. Microstructural Properties of Acetabular Region of Human Pelvic Bone Revealed Using micro-CT

    Kytýř, Daniel; Jiroušek, Ondřej; Vavřík, Daniel

    Praha : ÚTAM, 2009 - (Náprstek,, J.; Fischer, C.), s. 166-167 ISBN 978-80-86246-35-2. [Engineering mechanics 2009. Svratka (CZ), 11.05.2009-14.05.2009] R&D Projects: GA ČR(CZ) GP103/07/P483 Institutional research plan: CEZ:AV0Z20710524 Keywords : micro-CT * acetabulum * microstructure Subject RIV: FI - Traumatology, Orthopedics

  10. FE Analysis of Non-Uniform Cement Layer in Acetabular Cup of Hip Joint Implant

    Vyčichl, Jan; Kunecký, Jiří; Kytýř, Daniel; Jírová, Jitka

    Plzeň : Západočeská univerzita, 2007, s. 30-31. ISBN 978-80-7043-607-3. [The 1st IMACS International Conference on Computational Biomechanics and Biology ICCBB 2007. Plzeň (CZ), 10.09.2007-13.09.2007] R&D Projects: GA AV ČR(CZ) IAA200710504 Institutional research plan: CEZ:AV0Z20710524 Keywords : pelvic bone * acetabulum * cement layer * FE model Subject RIV: BO - Biophysics

  11. Effect of increased pushoff during gait on hip joint forces

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditi...

  12. A Replication Study for the Association of rs726252 in PAPPA2 with Developmental Dysplasia of the Hip in Chinese Han Population

    2014-01-01

    Developmental dysplasia of the hip (DDH) is a common developmental hip disorder, which ranges from mild acetabulum malformation to irreducible hip dislocation. A previous study suggested a significant association of pregnancy-associated plasma protein-A2 (PAPPA2) with DDH susceptibility in Chinese Han population. But with the consideration of the sample size, the association was still debatable. To confirm the association of the reported single nucleotide polymorphism (SNP) in PAPPA2, rs72625...

  13. Morphology and histology of the adult Paramphistomum gracile Fischoeder, 1901

    Panyarachun, Busaba; Ngamniyom, Arin; Sobhon, Prasert; Anuracpreeda, Panat

    2013-01-01

    In the present study, we evaluated the histological morphology of the adult Paramphistomum (P.) gracile. Adult flukes with bodies 5~15 mm in length and 2~7 mm in width were subjected to histological analysis. Longitudinal and transversal serial-sections were stained with hematoxylin and eosin, and examined. The body surface and longitudinal section of P. gracile were also assessed using scanning electron microscopy. In this species, the anterior sucker and posterior sucker (acetabulum) were p...

  14. Recent changes in macroalgae distribution patterns in the Orbetello lagoon (Italy)

    Giovani, Andrea; Mari, Elena; Specchiulli, Antonietta; Focardi, Silvano; RENZI, Monia

    2014-01-01

    This study related recent distribution changes in seven macroalgae taxa (Acetabularia acetabulum, Chaetomorpha linum, Cladophora sp., Gracilariopsis longissima, Spyridia sp., Ulva laetevirens, Valonia aegagrophyla) to spatial (basin) and temporal (time) trophic differences in a meso-eutrophic Mediterranean coastal lagoon (Orbetello, Italy). In July 2003 and July 2009, the coverage percentage (CP) of each considered taxon was measured in 38 stations equally distributed in the Western and Easte...

  15. Acetabular deepening in the treatment of severe canine hip dysplasia Aprofundamento do acetábulo no tratamento de displasia coxofemoral grave em cães

    Paulo Iamaguti; Luciana S. Iamaguti; Raquel Sartor

    2009-01-01

    A technique to restore acetabular anatomy by deepening the acetabular cavity and reconstructing the femoral head ligament and the joint capsule was tested on nine large breed dogs with severe hip dysplasia and acute subdislocation or dislocation. The technique consisted of two phases. First, all dogs were submitted to bilateral pectinotomy. In a second surgical intervention on the same dogs the acetabulum was approached and deepened, and the femoral head ligament and the joint capsule were re...

  16. Imaging of Developmental Dysplasia of the Hip (DDH

    Nazanin Ahmadi

    2010-05-01

    Full Text Available Ultrasound is not only the best method of screening in the diagnosis of DDH, but the best method of peroperative reduction of the hip joint and the best follow up method after treatment."nHowever, in older children with an abnormal pelvic x-ray, MRI coul be very helpful to assess the degree of ossification of the acetabulum and maturation and covering of the cartilaginous labrum.

  17. The place of computerized axial tomography in the evaluation of acetabular fractures

    Asik, Mehmet; Akman, Senol; Taser, Omer; Aritamur, Ayhan

    2004-01-01

    Besides the importance of standard AP and Judet s 45° iliac and obturator pelvic views, CAT has proved to be very useful in the evaluation of the fractures of the acetabulum. Of 96 patients with acetabular fractures, who applied to the Orthopaedics and Traumatology Department, Istanbul Medical Faculty, Istanbul University between 1987 and 1991 in addition to conventional radiography, CAT investigation was done in 32 patients for whom it was considered necessary. The results of both convention...

  18. Impingement of lesser trochanter on ischium as a potential cause for hip pain

    Patti, Jay W.; Ouellette, Hugue; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Radiology, Boston, MA (United States)

    2008-10-15

    The bony anatomy of the hip leads to a limited array of impingement syndromes, more frequently resulting from abnormal contact between the femoral neck and acetabulum. We report an unusual case of osseous impingement between the lesser trochanter and ischium, with involvement of the intervening quadratus femoris muscle. While the prevalence and etiology of this finding is unclear, it may represent a cause for hip pain. (orig.)

  19. Computed tomography in abnormalities of the hip

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip join can be measured by means of computed tomography. (Auth.)

  20. Computed tomography in abnormalities of the hip

    Visser, J.D.; Jonkers, A.; Klasen, H.J. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis); Hillen, B. (Rijksuniversiteit Groningen (Netherlands). Lab. voor Anatomie en Embryologie)

    1982-06-26

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip joint can be measured by means of computed tomography.

  1. Cinco espécies de Lecithodendriidae (Trematoda) en murcielagos de Colombia, incluyendo tres nuevos generos

    Imelda Velez; Vernon E. Thatcher

    1990-01-01

    Velez, I. & V.E. Thatcher: Five species of Lecithodendriidae (Trematoda) in bats from Colombia, including three new genera. Three new neotropical genera and species of Lecithodendriidae (Trematoda) are described from Colombian bats. Sturniratrema umbilicata gen. et sp. nov. from Sturnira lilium differs from other genera in having an oval ventral depression, a dorso-ventrally curved cirrus and a genital pore lateral to the acetabulum. Chiropterotrema antioquiense gen. et sp. nov. from Carollia...

  2. 髋关节造架手术%Shelf Operation on Hip

    吴守义; 汪启筹; 杨根兴; 陈瑾英; 贺小桦

    1987-01-01

    本文介绍一种新的造架手术、并报道了10例临床经验.作者讨论了有关造架手术的几个重要问题,指出了生物力学、骨质电力学与造架生长的关系.%Infection,dislocation and trauma of the hip often cause destruction of the head and neck of the femur and a shallow acetabulum.To restore the normal relationship between the acetabulum and the femur head, shelf operation is a logical method. A bone graft about 4×5 cm in size is taken from ilium,the graft is set into a slot made around the acetabulum,presenting with an angle of 30-45°and it is fixed into the ilium with a long screw.The head of femur should be covered by the graft completely.Ten cases had undergone this operation and followed up more than 2 years.All the grafts have fused,graft hypertrophy has appeared in 8 of them.The movement of the hip is not limited.There has been no sign of breakage or absorption or displacement of the graft.The authors state that firm fixation of the graft and restoring the bearing stress to the ilium are the key to the success on this operation.

  3. Imaging diagnosis of acetabular dysplastic coxarthrosis in adult

    Objective: To investigate the imaging diagnosis of acetabular dysplastic coxarthrosis. Method: The imaging of the acetabular dysplasia was analyzed in 51 patients (87 hips). All but four patients were women. The age ranged from 22 to 78 years, and the mean age was 42.6 years. Pelvis radiographs were studied in all cases, and CT scan was performed in 18 cases and MRI in 10 cases. Results: The fundamental signs on the plain film included shallow acetabulum, increased obliquity and insufficient coverage of the femoral head by the acetabulum. The CE angles were determined in all the cases, ranging from -10 degree to 30 degree, mean 12.9 degree. The sharp angles ranged from 35 degree to 67 degree, mean 45.3 degree. The secondary osteoarthritis were revealed in 75 hips (84.2%). 54 hips (62.1%) had cyst-like lesions in weight-bear area of the acetabulum or femoral head. 19 hips had subluxation of femoral head. CT and MRI displayed small cyst-like lesions and forward shift of the femoral head, which could not be shown on plain film, respectively in 13 and 10 hips. Conclusion: The cyst-like lesion of subarticular region is a common sign in acetabular dysplastic coxarthrosis. CT or MRI can show the early osteolytic lesion and forward subluxations

  4. Prediction of bone loss in elderly female subjects by MR perfusion imaging and spectroscopy

    To determine whether MR perfusion indices or marrow fat content at baseline can predict areal bone mineral density (BMDa) loss. Repeat dual x-ray absorptiometry (DXA) of the hip was performed in female subjects at 2 years (n = 52) and 4 years (n = 45) following baseline MR perfusion imaging and spectroscopy of the hip. Percentage reduction in femoral neck BMDa at 4 years post-baseline was greater in subjects with below median acetabulum enhancement slope (Eslope) (-5.6 ± 1.2 Vs -1.1 ± 1.2 (mean ± standard error) p = 0.014) or muscle maximum enhancement (Emax) (-5.7 ± 1.2 Vs -0.23 ± 1.2, p = 0.009) after adjusting for baseline co-variables. Baseline MR parameters correlated with reduction in BMDa at 4 years (acetabulum Eslope r = 0.517, p = 0.0003; muscle Emax r = 0.306, p = 0.043) as well as traditionally applied clinical risk factors. Acetabulum Eslope, femoral neck Emax and marrow fat content at baseline had sensitivities of 89%, 81% and 72% respectively at distinguishing between fast (>1%/annum) (n = 18) and slow (<1%/annum) (n = 27) BMD losers. Elderly female subjects with reduced perfusion indices at baseline had increased femoral neck bone loss at 4 years. Selected perfusion indices and marrow fat content have a moderate to high sensitivity in discriminating between fast and slow bone losers. (orig.)

  5. Retrieval analysis of a failed TriboFit polycarbonate urethane acetabular buffer.

    Biant, Leela C; Gascoyne, Trevor C; Bohm, Eric R; Moran, Matthew

    2016-03-01

    The purpose of this research was to determine the failure mechanisms and damage features of a TriboFit acetabular buffer implanted directly against a native, prepared acetabulum which was revised after 11months. Retrieval analyses were carried out via light microscopy, gravimetric wear assessment, and observer scoring of visible damage features on the buffer. The volume of material abraded from the backside of the buffer was estimated via three-dimensional reconstruction using a laser scanner. Scanning electron microscopy was used to confirm damage features and mechanisms. Severe abrasion to the backside of the buffer was the primary damage feature, while stippling damage was seen on the articular surface of the buffer. Material loss due to backside abrasion was approximated to be between 0.13360.085 g (gravimetric analyses) and 0.19360.053 g (three-dimensional reconstruction). Implantation of the TriboFit buffer against the patient's native acetabulum without a metal backing allowed for significant movement of the buffer against the bone, resulting in the abrasion seen on this implant. The stippling damage on the articular surface indicates an adhesive wear mechanism which exacerbates movement of the buffer against the acetabulum, thereby increasing backside abrasion. PMID:26833696

  6. Hip Joint Replacement Using Monofilament Polypropylene Surgical Mesh: An Animal Model

    Jacek Białecki

    2014-01-01

    Full Text Available Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS, triple pelvic osteotomy (TPO, total hip replacement (THR, and femoral head and neck resection (FHNE. The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform.

  7. Quantitative measurement and analysis for detection and treatment planning of developmental dysplasia of the hip

    Liu, Xin; Lu, Hongbing; Chen, Hanyong; Zhao, Li; Shi, Zhengxing; Liang, Zhengrong

    2009-02-01

    Developmental dysplasia of the hip is a congenital hip joint malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Conventionally, physicians made diagnoses and treatments only based on findings from two-dimensional (2D) images by manually calculating clinic parameters. However, anatomical complexity of the disease and the limitation of current standard procedures make accurate diagnosis quite difficultly. In this study, we developed a system that provides quantitative measurement of 3D clinical indexes based on computed tomography (CT) images. To extract bone structure from surrounding tissues more accurately, the system firstly segments the bone using a knowledge-based fuzzy clustering method, which is formulated by modifying the objective function of the standard fuzzy c-means algorithm with additive adaptation penalty. The second part of the system calculates automatically the clinical indexes, which are extended from 2D to 3D for accurate description of spatial relationship between femurs and acetabulum. To evaluate the system performance, experimental study based on 22 patients with unilateral or bilateral affected hip was performed. The results of 3D acetabulum index (AI) automatically provided by the system were validated by comparison with 2D results measured by surgeons manually. The correlation between the two results was found to be 0.622 (p<0.01).

  8. The Analysis of X-ray and CT Features of the Femoroacetabular Impingement Syndrome%股骨髋臼撞击综合征的X线及CT表现分析

    胡剑波; 刘冠霖; 肖林; 吴泽文; 陈焱君

    2012-01-01

    Objective Through analyzing the characteristic appearances on X-ray plain film and CT of hips with Femoroacetabular Impingement (FAI), to find and conclude the image features of FAI. Methods 78 cases FAI with 96 FAI hips in X-ray plain film and CT images were analysed and typed. Results ①The characteristic features include: aspheric femoral head, pistol-grip deformity, femoral neck Osseous bumps, deep acetabulum, cross-over sign or "eight" sign, acetabulum medial extrusion, "linear indentation sign", herniation pits; the non-characteristic features include: osteophytes, ossification or calcification in acetabulum superior, cystic lesions under the joint surface of acetabulum and femoral head, narrowed lateral joint space. ② In all 96 FAI hips, Cam-type 23 hips, Pincer-type 14 hips, Mixed-type 59 hips. Conclusion Femoral head-neck junction deformity and abnormality of acetabulum are the key image features of FAI diagnosis, the other abnormity of osseous arthritis can only be a indicative signs for diagnosis of FAI.%目的 通过对诊断为股骨髋臼撞击综合征(FAI)的髋关节的X线及CT表现的特征分析,归纳总结其影像特点.方法 对78例96个FAI髋关节的X线及CT片进行影像特征分析、分型.结果 ①、FAI的特征性X线及CT征象包括:非球形股骨头、股骨颈枪柄样畸形、股骨颈骨突.深髋臼、“交叉征”或“8”字征、髋臼内突、股骨颈前方凹痕征及皮质硬化、骨颈疝窝;FAI的非特异性改变包括:髋臼外上缘增生、髋臼外缘骨化或钙化,髋臼关节面下囊变、股骨头囊变、髋关节外侧间隙狭窄.②、96个FAI中,Cam型23个,Pincer型14个,混合型59个.结论 股骨头颈交界处的畸形和髋臼的异常形态是FAI诊断的主要征象,其他骨性关节炎的异常影像表现是诊断FAI的参考征象.

  9. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    Needell, Steven D.; Borzykowski, Ross M. [Boca Radiology Group, Boca Raton, FL (United States); Carreira, Dominic S.; Kozy, John [Broward Health Orthopedics and Sports Medicine, Fort Lauderdale, FL (United States)

    2014-11-15

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  10. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  11. Study of the morphology and biomechanics of sacral fracture

    QUAN Ren-fu; YANG Di-sheng; WANG Yi-jin

    2006-01-01

    Objective: To observe the morphological characteristics of sacral fracture under different impact loads.Method: Ten fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded.Morphological characteristics were observed under scanning electron microscope.Results: The form of sacral fracture was related to the impact energy. Under low-energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high-energy impact loads, three types of sacral fracture occurred according to the classification of Denis: sacral ala fracture, Type Ⅰ fracture; sacral foramen cataclasm fracture, Type Ⅱ fracture; central vertebral canal fracture, Type Ⅲ fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture.The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different.When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury.When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 ~ 25 J, Type Ⅰ fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards.Conclusions: In dynamic state, sacrum fracture mostly belongs to Type Ⅰ and Type Ⅱ, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.

  12. "In vivo" determination of hip joint separation and the forces generated due to impact loading conditions.

    Dennis, D A; Komistek, R D; Northcut, E J; Ochoa, J A; Ritchie, A

    2001-05-01

    Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening. PMID:11311703

  13. Outcome of operative treatment of acetabular fractures: short term follow-up

    Fractures of the acetabulum result from high energy accidents. The anatomic location of the acetabulum, as well as the three-dimensional structure of the bone, makes the treatment of these injuries extremely challenging. The objective of this study was to determine the outcome of operative treatment of acetabulum fractures with one year follow-up. Methods: In this descriptive case series, 31 patients with acetabular fracture were admitted in North West General Hospital, Peshawar, from July 2010 to Sept 2013. Patients were followed-up till one year. In follow-up, patients were assessed clinically with Merle Aubigne and Postel grading method. Radiological assessment was done using Matta criteria. Results: All patients were male. Twelve (38.7 %) were managed non-operatively, as they fulfilled criteria for non-operative treatment and 19 (61.3%) patients were operated after fulfilling the criteria for internal fixation; they were included for analysis. Ages ranged from 20-60 years with mean age of 37.21 ± 10.07 years. Fourteen (73.7%) patients had anatomic reduction and 5 (26.3 %) patients had imperfect reduction based on Matta radiographic criteria. At 1 year follow-up, we had 16 (84.2 %) excellent hips, 2 (10.5%) good hips and 1 (5.3%) poor hip , based on radiographs; and clinically we had 9 (47.4 %) hips with excellent function, 7 (36.8 %) hips with good outcome, 2 (10.5 %) had fair function and 1 (5.3 %) patient had poor function. Conclusion: Our results show that internal fixation of acetabular fractures lead to good outcome in majority of patients. (author)

  14. Study of the three-dimensional orientation of the labrum: its relations with the osseous acetabular rim

    Bonneau, Noémie; Bouhallier, July; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    Understanding the three-dimensional orientation of the coxo-femoral joint remains a challenge as an accurate three-dimensional orientation ensure an efficient bipedal gait and posture. The quantification of the orientation of the acetabulum can be performed using the three-dimensional axis perpendicular to the plane that passes along the edge of the acetabular rim. However, the acetabular rim is not regular as an important indentation in the anterior rim was observed. An innovative cadaver study of the labrum was developed to shed light on the proper quantification of the three-dimensional orientation of the acetabulum. Dissections on 17 non-embalmed corpses were performed. Our results suggest that the acetabular rim is better represented by an anterior plane and a posterior plane rather than a single plane along the entire rim as it is currently assumed. The development of the socket from the Y-shaped cartilage was suggested to explain the different orientations in these anterior and posterior planes. The labrum forms a plane that takes an orientation in between the anterior and posterior parts of the acetabular rim, filling up inequalities of the bony rim. The vectors VL, VA2 and VP, representing the three-dimensional orientation of the labrum, the anterior rim and the posterior rim, are situated in a unique plane that appears biomechanically dependent. The three-dimensional orientation of the acetabulum is a fundamental parameter to understand the hip joint mechanism. Important applications for hip surgery and rehabilitation, as well as for physical anthropology, were discussed. PMID:22360458

  15. Modes of lubrication in human hip joints.

    Roberts, B J; Unsworth, A; Mian, N.

    1982-01-01

    Cadaveric hip joints were tested in a hip function simulator which subjected the femoral head to a cycle of loading and oscillation similar to that experienced during walking and measured the frictional torque transmitted to the acetabulum. Silicone fluids with viscosities from 10-2 Pa s (pascal second) to 30 Pa s were used as lubricants and the transition from mixed to full fluid film lubrication was observed around 5 x 10(-2) Pa s. Sodium carboxymethylcellulose solutions were also tested at...

  16. Fyzioterapie u pacientů se zlomeninou kosti stehenní v krčku

    PRINCOVÁ, Pavlína

    2013-01-01

    This bachelor thesis focuses on physiotherapy for patients with fracture of the femur bone in the neck of the femur. The femur is the strongest and longest bone in the human body, securing the stability of the latter. A femoral neck fracture is a fracture in the narrowest place of the bone, where the long femur bone goes over to the head of femur, connecting the femur bone with the acetabulum. Considering the influence of high energetic effects on the bone, the most often during sports or acc...

  17. Exclusion of COL2A1 and VDR as Developmental Dysplasia of the Hip Genes

    Rubini, Michele; Cavallaro, Alessandra; Calzolari, Elisa; Bighetti, Giulia; Sollazzo, Vincenzo

    2008-01-01

    Developmental dysplasia of the hip (DDH) is a spectrum of disorders affecting the proximal femur and/or acetabulum leading to an abnormal formation of the hip. Genetic factors are involved in the etiology of DDH. Early recognition of DDH affords the best results from treatment and a better knowledge of the genetics of DDH could enhance early diagnosis. Variants in the Type II collagen (COL2A1) and vitamin D receptor (VDR) genes have been associated with patients with osteoarthritis of the hip...

  18. Distant outcomes of the Chiari osteotomy 30 years follow up evaluation.

    Piontek, Tomasz; Szulc, Andrzej; Głowacki, Maciej; Strzyzewski, Wojciech

    2006-02-28

    Background. The aim of my paper was to assess distant treatment results of patients who were treated because of hip displasia and the Chiari osteotomy was performed on those patients. Material and methods. I evaluated treatment outcomes of 27 patients who were treated at Poznan University of Medical Sciences, Clinic of Orthopedics, in 1965-1990. The Chiari osteotomy was performed on all patients for hip decenteration or hip subluxation after developmental displasia. 34 hips were evaluated (20 female and 7 male). The average age of patients was 13 years in the moment of the operation. The follow up examination was conducted 10-36 years after the Chiari osteotomy Results. After many years (30 years after the operation on the average), 37% of patients could fit into groups of very good and good results. I could assess the hips before the operation using only parameters marked on anteroposterior films. The radiographs of the hips showed displasia characterized by shallowness and steepness of the acetabulum, an increased apparent neck-corpus angle, low submersion of the femoral head in the acetabulum, and insufficient coverage of the femoral head by the acetabulum. On the radiographs taken one year after the operation I observed very good coverage of the femoral head proved by higher values (above quota) of the Wiberg angle, the Sharp angle, the Heyman and Herndon acetabulum-head indicator. I defined also a course of the osteotomy drafting an osteotomy angle, setting a degree of bone fragments displacement (medialisation), and a height of the osteotomy. Conclusions. 1. The Chiari osteotomy as a hip saving operation allows patients to function in satisfactory clinical conditions for many years. 2. When conducted correctly, the Chiari osteotomy considerably improves femoral head coverage not only in the frontal plane but also in the transverse plane. 3. Too wide osteotomy angle, more than 20 degrees , further than 50% displacement of a distal bone fragment and too low

  19. Shoulder joint dysplasia in the Dachshund. 1. Clinical and radiological findings

    In 175 Dachshunds radiological examination revealed shoulder joint dysplasia as the cause of lameness. The dysplastic changes in the scapula took the form of hypoplasia of the joint ends, flattening of the acetabulum and disturbances of fusion of the centre of ossification of the supraglenoid tubercle and acetabular wall apophysis. The head of the humerus is flattened, small and slopes caudoventrally. The result is a looseness manifested as an incongruence of the articular space and habitual or stationary subluxation extending to complete luxation. Arthrosis is very common and develops quite early

  20. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation.

    Papakonstantinou, Olympia; Mohana-Borges, Aurea V R; Campell, Loretta; Trudell, Debra; Haghighi, Parviz; Resnick, Donald

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. PMID:15316682

  1. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  2. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    Papakonstantinou, Olympia [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Mohana-Borges, Aurea V.R.; Campell, Loretta; Trudell, Debra; Resnick, Donald [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); Haghighi, Parviz [Veterans Affairs Medical Center, University of California, Department of Pathology, San Diego, California (United States)

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  3. Radiographic signs of acetabular dysplasia of the adult hip

    Lingg, G.; von Torklus, D.

    1981-06-01

    Many papers have been published about the different types of measurements used in the evaluation of hip dysplasia in the pediatric age group. However, there are no publications that deal with this topic regarding adults. The authors present an initial series of measurements of the angle of the roof of the acetabulum in 100 randomized asymptomatic adult males. The normal value ranged from -10/sup 0/ to +10/sup 0/. These measurements were correlated with those described by Wiberg. The combination of both methods yields highly reliable information in the evaluation of hip dysplasia.

  4. Three-dimensional study of pelvic asymmetry on anatomical specimens and its clinical perspectives.

    Boulay, Christophe; Tardieu, Christine; Bénaim, Charles; Hecquet, Jérome; Marty, Catherine; Prat-Pradal, Dominique; Legaye, Jean; Duval-Beaupère, Ginette; Pélissier, Jacques

    2006-01-01

    The aim of this study was to assess pelvic asymmetry (i.e. to determine whether the right iliac bone and the right part of the sacrum are mirror images of the left), both quantitatively and qualitatively, using three-dimensional measurements. Pelvic symmetry was described osteologically using a common reference coordinate system for a large sample of pelvises. Landmarks were established on 12 anatomical specimens with an electromagnetic Fastrak system. Seventy-one paired variables were tested with a paired t-test and a non-parametric test (Wilcoxon). A Pearson correlation matrix between the right and left values of the same variable was applied exclusively to values that were significantly asymmetric in order to calculate a dimensionless asymmetry index, ABGi, for each variable. Fifteen variables were significantly asymmetric and correlated with the right vs. left sides for the following anatomical regions: sacrum, iliac blades, iliac width, acetabulum and the superior lunate surface of the acetabulum. ABGi values above a threshold of +/- 4.8% were considered significantly asymmetric in seven variables of the pelvic area. Total asymmetry involving the right and the left pelvis seems to follow a spiral path in the pelvis; in the upper part, the iliac blades rotate clockwise, and in the lower part, the pubic symphysis rotates anticlockwise. Thus, pelvic asymmetry may be evaluated in clinical examinations by measuring iliac crest orientation. PMID:16420376

  5. Three-dimensional study of pelvic asymmetry on anatomical specimens and its clinical perspectives

    Boulay, Christophe; Tardieu, Christine; Bénaim, Charles; Hecquet, Jérome; Marty, Catherine; Prat-Pradal, Dominique; Legaye, Jean; Duval-Beaupère, Ginette; Pélissier, Jacques

    2006-01-01

    The aim of this study was to assess pelvic asymmetry (i.e. to determine whether the right iliac bone and the right part of the sacrum are mirror images of the left), both quantitatively and qualitatively, using three-dimensional measurements. Pelvic symmetry was described osteologically using a common reference coordinate system for a large sample of pelvises. Landmarks were established on 12 anatomical specimens with an electromagnetic Fastrak system. Seventy-one paired variables were tested with a paired t-test and a non-parametric test (Wilcoxon). A Pearson correlation matrix between the right and left values of the same variable was applied exclusively to values that were significantly asymmetric in order to calculate a dimensionless asymmetry index, ABGi, for each variable. Fifteen variables were significantly asymmetric and correlated with the right vs. left sides for the following anatomical regions: sacrum, iliac blades, iliac width, acetabulum and the superior lunate surface of the acetabulum. ABGi values above a threshold of ± 4.8% were considered significantly asymmetric in seven variables of the pelvic area. Total asymmetry involving the right and the left pelvis seems to follow a spiral path in the pelvis; in the upper part, the iliac blades rotate clockwise, and in the lower part, the pubic symphysis rotates anticlockwise. Thus, pelvic asymmetry may be evaluated in clinical examinations by measuring iliac crest orientation. PMID:16420376

  6. An anatomical study of corona mortis and its clinical significance

    洪华兴; 潘志军; 陈欣; 黄宗坚

    2004-01-01

    Objective: To provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis.Methods: The course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues.Results: During the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm ( range, 38-68 mm).Conclusions: Vascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.

  7. Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

    Pawel Zwolak

    2011-05-01

    Full Text Available Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

  8. CT findings of traumatic posterior hip dislocation after reduction

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin Wook

    2008-06-15

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.

  9. Reliability of measures used in radiographic evaluation of the adult hip

    Bjarnason, J.A.; Reikeras, O. [Oslo University Hospital, Department of Orthopedics, Oslo (Norway); Pripp, A.H. [Oslo University Hospital, Department of Biostatistics, Oslo (Norway)

    2015-02-20

    The reliability of radiographic measurements has been studied in pediatric hips, but less has been published on the adult hip, and none have examined the reliability of measurements for the location of the center of rotation (COR) of the hip joint. We have investigated the reliability of various radiographic variables with a focus on the COR. The study was carried out on a standardized format for anterior-posterior radiographs of the pelvis. The measured variables were; (A) the distance from a sagittal reference line to the COR, (B) the distance from the sagittal reference line to the proximal end of the lateral cortical line of the femur, (C) the distance from the sagittal reference line to the medial rim of the acetabulum, (D) the distance from the horizontal reference line to the roof of the acetabulum, and (E) the distance from the horizontal reference line to the COR. One observer (JAB) conducted the measurements twice separated by a time interval of 45-60 days to assess intra-observer reliability, and the first measurements of JAB were compared to those performed by another observer (OR) to assess inter-observer reliability. Intraclass correlation coefficients were above 0.98 for all measurements, and the minimum and maximum values that statistically include 95 % of the observer differences were all within -3 to +3 mm. These measurements proved to have high reliability and agreement of both within the same observer and between two observers. They should therefore be reproducible in a clinical setting. (orig.)

  10. Cotylophoron panamensis (digenea: paramphistomidae) in cattle from Meta and Guaviare, Colombia

    Some species of Paramphistomidae (Trematoda: Digenea) that parasitize the digestive system of ruminants can cause decreases in milk and meat production. In Colombia, paramphistomosis cattle have been recorded from 1) dairy farms at high altitudes in the mountains of Antioquia (northwestern Colombia) where Cotylophoron cotylophorum was described as the causative agent; and 2) from lowland savannas in eastern Colombia, which has been attributed to several species of Paramphistomidae but with records remaining to be confirmed. Therefore, the discovery of digenea of cattle slaughtered in Guamal, Meta (eastern Colombia), was an opportunity to start with the description of the Paramphistomidae in this region. Between 2006 and 2008, we sampled 715 adult flukes from the rumen of 32 cattle from the departments of Meta and Guaviare. The morphological analysis shows that the adult has the following features typical of the family Paramphistomidae: Laurers canal crossing the excretory vesicle and opening posteriorly to the excretory pore; acetabulum small as in the genus Cotylophoron; pharynx as in Calicophoron; genital sucker without sphincter; absence of esophageal bulb and the lateral and dorsal vitellaria converging posteriorly in the body, below the acetabulum, as in C. panamensis. This study confirms the presence of paramfistomosis in Meta and it is the first report of Cotylophoron panamensis in cattle from the department of Guaviare, therefore expanding its geographic range in Colombia.

  11. 泪点影像在观察儿童发育性髋发育不良的应用%Interpretation of the Teardrop Shadow of the Developmental Dysplasia of the Hip in Children

    吴占金; 王承武

    1994-01-01

    观察了80例发育性髋发育不良患儿的系列X线片,其泪点影出现时间在正常侧为1岁,而脱位侧泪点的出现明显延迟,往往在股骨头复位后才能出现,并随着年龄增长而逐渐变窄.测量了部分患儿正常侧的泪点宽度,用统计学方法证实泪点宽度随年龄增大而变窄具有临床意义.%A series of pelvic roentgenograms of 80 children with developmental dysplasia of the hip(DDH)were studied.The teardrop shadow appeared at the age of 1 year in the normal hip,but never in the diseased hip before the femoral head being reduced into the acetabulum.The width of the teardrop shadow became narrower as the patient growing up.We also measured the width of teardrop shadow in some normal acetabula.That was confirmed by statistical analysis that the narrowing change of the teardrop shadow with growth of the acetabulum has its clinical significance.

  12. Magnetic resonance imaging of labral cysts of the hip

    Schnarkowski, P. [Department of Radiology, University of California, San Francisco, CA (United States)]|[Department of Radiology, Ludwig-Maximilians-University, Munich (Germany); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Tirman, P.F.J. [Department of Radiology, University of California, San Francisco, CA (United States)]|[San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Peterfy, C.G. [Department of Radiology, University of California, San Francisco, CA (United States); Genant, H.K. [Department of Radiology, University of California, San Francisco, CA (United States)

    1996-11-01

    Objective. To present the magnetic resonance (MR) imaging findings in patients with labral cysts adjacent to the acetabulum and to examine their association with hip pathology. Design. MR images and conventional radiographs of seven patients with paralabral cysts were retrospectively reviewed by three musculoskeletal radiologists. Patients. The patients included three men and four women with hip pain, ranging in age from 29 to 82 years. Two patients had developmental dysplasia of the hip and six had a history of remote trauma/dislocation. Clinical history and follow-up were obtained in all patients. Surgery was performed on one patient. Results and conclusions. Paralabral cysts were located in the posterosuperior aspect of the hip joint in five patients and in the anterior aspect in two patients. A tear of the adjacent acetabular labrum was confirmed surgically in one patient, and in all patients the MR features suggested the presence of an abnormal labrum. Osteoarthritis was observed in three patients and there was associated subchondral cyst formation in the acetabulum adjacent to the cyst in three patients. The paralabral cyst of the hip is well visualized on MR imaging and is seen in patients with a predisposition to labral pathology. (orig.). With 3 figs., 1 tab.

  13. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  14. Multiple osteolytic lesions in a 14-year-old boy with HIV disease

    S Murugan

    2015-01-01

    Full Text Available A 14 year old boy, said to have had multiple transfusions during infancy, was brought to the hospital for complaints of pain over right thigh for one week duration. MRI reveals multiple osteolytic lesions with enhancing hyperintense bone marrow lesions over iliac bones, right acetabulum and lumbar vertebral bodies and enlarged para-aortic, iliac and inguinal lymph nodes. CT of the whole body revealed osteolytic lesions on skull, mandible, right scapula, head of both humeri, L1 and L4 vertebrae, 5 th and 10 th ribs, both acetabulum and ala of sacrum along with enlargement of cervical, axillary and mesenteric, iliac and inguinal nodes. HIV ELISA was positive. Viral load was 141,700 copies/ml. CD4 count was 226 cells/mm 3 . Multiple biopsy from the lesions and bone marrow revealed no evidence of tuberculosis and malignancy. Now the boy is on ART (ZDV + 3TC + EFV since August 2013. His CD4 count improved and viral load became undetectable and he gained weight within 5 months of ART. Due to the rarity of its presentation, this case report is being reported.

  15. The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

    Croci Alberto Tesconi

    2000-01-01

    Full Text Available We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81. The mean follow-up was 14 months (2 - 48. The diagnoses were: osteosarcoma (14 cases, metastatic carcinoma (10, Ewing's sarcoma (4, giant cell tumor (4, malignant fibrous histiocytoma (3, chondrosarcoma (1, and aneurysmal bone cyst (1. Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases, dislocation (3, module loosening (1, and ulnar nerve paresthesia (1. We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

  16. Irreducible traumatic posterior hip dislocation with entrapment and a buttonhole effect

    Uzel Andre Pierre

    2012-02-01

    Full Text Available 【Abstract】The authors reported the case of a 27-year-old man who sustained an irreducible postero-lateral traumatic dislocation of the hip with capsular and labral entrapment. Initial X-rays showed only a small acetabular fragment. After two attempts to reduce the hip with muscle paralysis under general anaesthesia failed, the patient was treated by immediate open reduction through a postero-lateral approach. Surgical exploration of the hip revealed a small osteochondral fragment attached to a large piece of labrum and capsule, clogging the acetabulum. The femoral head crossed over the torn capsule with a buttonhole effect. These elements were relieved, the bone fragment was fixed with a 2 mm screw and the capsule was repaired. At the 10-year follow-up, the functional outcome was excellent with a Harris score of 100 points and no signs of necrosis or osteoarthritis. The authors propose a literature review of this uncommon lesion. Key words: Hip dislocation; Tears; Acetabulum; Necrosis

  17. Estimation of pelvic tilt on anteroposterior X-rays - a comparison of six parameters

    To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty. Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis. One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7-59.1 years) were studied. The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use. This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist's ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum. (orig.)

  18. Estimation of pelvic tilt on anteroposterior X-rays - a comparison of six parameters

    Tannast, M. [University of Bern, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland); New England Baptist Hospital, Center for Computer Assisted and Reconstructive Surgery, Boston, MA (United States); Tufts University School of Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Murphy, S.B. [New England Baptist Hospital, Center for Computer Assisted and Reconstructive Surgery, Boston, MA (United States); Tufts University School of Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Langlotz, F. [University of Bern, MEM Research Center for Orthopaedic Surgery, Institute for Surgical Technologies and Biomechanics, Bern (Switzerland); Anderson, S.E. [University of Bern, Department of Diagnostic Interventional and Pediatric Radiology, Bern (Switzerland); Siebenrock, K.A. [University of Bern, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland)

    2006-03-15

    To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty. Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis. One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7-59.1 years) were studied. The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use. This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist's ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum. (orig.)

  19. Cinco espécies de Lecithodendriidae (Trematoda en murcielagos de Colombia, incluyendo tres nuevos generos

    Imelda Velez

    1990-01-01

    Full Text Available Velez, I. & V.E. Thatcher: Five species of Lecithodendriidae (Trematoda in bats from Colombia, including three new genera. Three new neotropical genera and species of Lecithodendriidae (Trematoda are described from Colombian bats. Sturniratrema umbilicata gen. et sp. nov. from Sturnira lilium differs from other genera in having an oval ventral depression, a dorso-ventrally curved cirrus and a genital pore lateral to the acetabulum. Chiropterotrema antioquiense gen. et sp. nov. from Carollia perspicillata is distinguished by having the acetabulum within a triangular ventral pit as well as an separation between the the male and female genital pores. Topsiturvitrema verticalia gen. et sp. nov. from Carollia perspicillata has a different orientation of the body, being nearly spherical but somewhat flatened in an anterior-posterior direction. This genus also has a deep ventral cleft separating two ventral lobes which are filled with eggs. Castroia silvai Travassos, 1928, is also reported from Anoura caudifer and Peropteryx macrotis. The first of these represents a new host record for the species. Addiotionally, Limatulum gastroides Macy, 1935, is reported from Lonchophyla robusta wich is another new host record.

  20. A new gorgoderid species of the urinary bladder of Rana zweifeli from Michoacán, Mexico Una nueva especie de gorgodérido de la vejiga urinaria de Rana zweifeli de Michoacán, México

    Rosario Mata-López

    2006-12-01

    Full Text Available Gorgoderina tarascae n. sp. is described from the urinary bladder of Rana zweifeli, from Cutzaróndiro, Michoacán, Mexico. Gorgoderina tarascae differs from the other species of the genus by possessing the following combination of characters: follicular vitelline glands, arranged in two clusters of 4-7 follicles dorsal to the ovary, compact and smooth reproductive organs situated far from each other and from the acetabulum, suckers close to each other, and a slender, spindle shaped body with a flexed position due to the situation of the acetabulum.Gorgoderina tarascae n. sp. se describe como parásita de la vejiga urinaria de Rana zweifeli de Cutzaróndiro, Michoacán, México. Gorgoderina tarascae difiere del resto de las especies del género por la siguiente combinación de características: posee glándulas vitelógenas arregladas en dos racimos de 4-7 folículos situados dorsalmente al ovario, órganos reproductivos compactos y de bordes lisos, muy separados entre si y con respecto del acetábulo, ventosas cercanas una de la otra y cuerpo delgado, en forma de huso y flexionado debido a la posición del acetábulo.

  1. Computer aided diagnosis and treatment planning for developmental dysplasia of the hip

    Li, Bin; Lu, Hongbing; Cai, Wenli; Li, Xiang; Meng, Jie; Liang, Zhengrong

    2005-04-01

    The developmental dysplasia of the hip (DDH) is a congenital malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Early diagnosis and treatment is important because failure to diagnose and improper treatment can result in significant morbidity. In this paper, we designed and implemented a computer aided system for the diagnosis and treatment planning of this disease. With the design, the patient received CT (computed tomography) or MRI (magnetic resonance imaging) scan first. A mixture-based PV partial-volume algorithm was applied to perform bone segmentation on CT image, followed by three-dimensional (3D) reconstruction and display of the segmented image, demonstrating the special relationship between the acetabulum and femurs for visual judgment. Several standard procedures, such as Salter procedure, Pemberton procedure and Femoral Shortening osteotomy, were simulated on the screen to rehearse a virtual treatment plan. Quantitative measurement of Acetabular Index (AI) and Femoral Neck Anteversion (FNA) were performed on the 3D image for evaluation of DDH and treatment plans. PC graphics-card GPU architecture was exploited to accelerate the 3D rendering and geometric manipulation. The prototype system was implemented on PC/Windows environment and is currently under clinical trial on patient datasets.

  2. Proximal focal femoral deficiency: evaluation by MR imaging

    Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2012-01-15

    Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

  3. Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia.

    Giorgi, Mario; Carriero, Alessandra; Shefelbine, Sandra J; Nowlan, Niamh C

    2015-09-18

    Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH. PMID:26163754

  4. Three-fin acetabular prosthesis for superior acetabular bone defects: a three-dimensional finite element analysis

    LIU Yu-zeng; HAI Yong; ZHAO Hui

    2012-01-01

    Background Given that three-dimensional finite element models have been successfully used to analyze biomechanics in orthopedics-related research,this study aimed to establish a finite element model of the pelvic bone and three-fin acetabular component and evaluate biomechanical changes in this model after implantation of a three-fin acetabular prosthesis in a superior segmental bone defect of the acetabulum.Methods In this study,three-dimensional finite element models of the pelvic bone and three-fin acetabular component were first established.The prosthesis model was characterized by three different conformational fins to facilitate and optimize the prosthetic design.The spongy and cortical bones were evaluated using a different modulus of elasticity in this established model.Results The maximum and minimum von Mises stresses on the fins of the acetabular component were 15.2 and 0.74,respectively.The maximum and minimum micromotion between the three-fin acetabular component and the acetabulum bone interface were 27 and 13 μm,respectively.A high primary stability and implied better clinical outcome were revealed.Conclusion Finite element analysis may be an optimal strategy for biomechanics-related research of prosthetic design for segmental acetabular bone defects.

  5. Roles of radiograph, magnetic resonance imaging, threedimensional computed tomography in early diagnosis of femoro-acetabular impingement in 17 cases

    GU Gui-shan; ZHU Dong; WANG Gang; WANG Cheng-xue

    2009-01-01

    Objective: To evaluate the roles of radiograph, magnetic resonance imaging (MRI), three-dimensional computed tomography (3-D CT) in early diagnosis of femoro-acetabular impingement (FAI) in 17 cases. Methods: Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting (i.e. hip flexion). There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior (AP) view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral (General Electric Company, USA) at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto (Siemens Company, Germany)1.5T supraconducfion magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results: The plain radiographs of the pelvis showed that among the 17 patients, 12 (70.59%) had "Cam" change of the femoral head, 6 (35.29%) had positive "cross-over" sign, and 17 (100%) had positive "Pincer" change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases (100%). The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases (88.33%), subchondral ossification in 3 cases (17.6%), and labium tears in 3 cases (17.6%). Conclusions: Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.

  6. 三维记忆内固定与髋臼重建钛板系统修复髋臼后壁骨折伴关节后脱位的比较%Three-dimensional memory fixationversusreconstruction titanium plate to repair posterior wall acetabular fracture with posterior dislocation

    梁云扬

    2015-01-01

    通过对髋臼三维记忆内固定系统在髋臼后壁骨折伴髋臼关节后脱位中临床应用效果的分析,了解其治疗髋臼后壁骨折伴髋臼关节后脱位的可行性与特点。研究发现,其在固定时间及术后功能恢复等方面较之重建钛板内固定都具有明显的应用优势。%BACKGROUND:Posterior wal fractures of the acetabulum with posterior dislocation of the acetabular joint mostly require the operation of open reduction and internal fixation. Different materials can be chosen for internal fixation operation. OBJECTIVE: To explore the effect of acetabular three-dimensional memory fixation system on acetabular posterior wal fractures accompanying the acetabulum joint dislocation. METHODS: A retrospective analysis was performed on clinical data of 92 cases of acetabular posterior wal fracture and dislocation at the Heze Municipal Hospital of Shandong Province from February 2010 to February 2014. Al patients received the operation of open reduction and internal fixation. They were divided into three-dimensional memory fixation group (45 cases) and reconstruction titanium plate group (47 cases) according to different fixators. Al patients were folowed up for 12 months after fixation. RESULTS AND CONCLUSION:The operation time and intraoperative blood loss were significantly longer or higher in the reconstruction titanium plate group than in the three-dimensional memory fixation group (P < 0.05). Harris score was significantly greater in the three-dimensional memory fixation group than in the reconstruction titanium plate group during final folow-up (P < 0.05). Thromboembolic complications or deep infection were not detected after fixation in both groups. These findings confirm that three-dimensional memory fixation system obtained good effects in the treatment of the posterior wal fractures of the acetabulum with posterior dislocation.

  7. Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study

    Purpose: A prospective multicenter study was carried out to estimate the treatment outcome of radiotherapy in Stage II seminoma after the application of modern staging and radiotherapy techniques. The lower margin of the iliac field was positioned on the upper rim of the acetabulum to reduce the amount of scattered irradiation to the remaining testicle. Methods and Materials: The study was carried out in 25 centers in Germany. Patients with pure seminoma, negative AFP-values, and retroperitoneal lymph node metastases of less than 5 cm in diameter were entered into the study. All patients received a ventrodorsal opposed field irradiation of the para-aortic and the ipsilateral iliac lymph nodes. The fields extended from the top of the 11th thoracic vertebra to the top of the acetabulum. Patients in Stage IIA (lymph nodes <2 cm) received 30 Gy, and patients with Stage IIB (lymph nodes between 2 and 5 cm) 36 Gy total dose. Results: 39 patients in Stage IIA and 19 patients in Stage IIB were evaluated. After a median observation time of 37 months all patients are alive and disease free. Recurrence free survival in stage IIA was 100%. Two patients in Stage IIB experienced a recurrence 10 and 17 months after the end of radiotherapy. The actuarial recurrence free survival estimate in Stage IIB was 94.1% for 1 year and 87.4% for 2 years. One recurrence in Stage IIB occurred in the mediastinum, one in the mediastinum, and one the lung. Both patients could be salvaged by chemotherapy. There were no pelvic recurrences. The treatment was well tolerated, with nausea being the most common side effect (56.9% Grade 1, 15.5% Grade 2, and 8.6% Grade 3). Diarrhea occurred in 15.5% (Grade 1), 15.5% (Grade 2), and 5.2% (Grade 3) of the patients. Conclusions: The outcome of para-aortic and ipsilateral iliac irration in Stage IIA/B testicular seminoma is excellent with the currently available staging methods and treatment facilities. The treatment is well tolerated. The lower margin of the

  8. Cell probing by delayed luminescence

    Musumeci, Francesco; Ballerini, Monica; Baroni, Giuliana; Costato, Michele; Ferraro, Lorenzo; Milani, Marziale; Scordino, Agata; Triglia, Antonio

    1999-05-01

    Delayed luminescence (D.L.) is a measure that provides important information on biological systems fields, structures and activities, by counting impinging and emitted photons. Many recent experimental works have shown the existence of a close connection, sometimes analytically expressed between the biological state of the system and D.L. parameters. Our investigations aim to show that D.L. is a workable analytical technique covering a large number of disciplinary fields, from agriculture to pollution control and from medical diagnostics to food quality control. The authors have conducted systematic research about D.L. from unicellular alga Acetabularia acetabulum to Saccharomyces cerevisiae yeast cultures and about more complex systems such as Soya seed (Glycine max, L.) and its dependence on sample preparation, history, intracellular signaling, metabolism and pollutant presence. We will discuss the most relevant results together with theoretical considerations on the basic interaction at work between biological systems and electromagnetic fields.

  9. Acetabular prosthesis: Proff of migration with ruler and pencil?

    Conventional X-ray films were made with varying degrees of tilt of a pelvic phantom containing an acetabular prosthesis. The position of the prosthesis was then reconstructed graphically. The measurement errors were calculated and an estimate was made for the tilt. There is a linear correlation between the measurement error and the tilt of the prosthesis. Therefore a tilt dependent maximum error can be calculated. This error is very small for small degrees of tilt, so that acetabular migration can in this instance be evaluated with greater confidence than with other graphical methods. The error also correlates with the determination of the selected region of the acetabulum, but not with the position of the central focus spot or image magnification. (orig.)

  10. Synovial hemangioma of the hip joint in a pediatric patient

    Demertzis, Jennifer L.; Loomans, Rachel; Wessell, Daniel E. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, St. Louis, MO (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopedic Surgery, St. Louis, MO (United States)

    2014-01-15

    Hemangiomas of the articular synovium are rare and commonly associated with recurrent joint swelling and painful limitation of motion. The knee joint is the most commonly involved site, with most patients diagnosed in the second to third decade of life [1]. Although over 200 cases have been reported in the English-language medical literature, only three have originated within the hip joint, all of which were in adult patients reported in the surgical literature [2-4]. We describe a histologically proven synovial hemangioma of the hip joint in a pediatric patient that invaded the femur, acetabulum, and adjacent soft tissues, with a detailed discussion of the differential diagnosis based on the radiographic and magnetic resonance imaging (MRI) findings. (orig.)

  11. A 10-year minimum follow-up of hydroxyapatite-coated threaded cups: clinical, radiographic and survivorship analyses with comparison to the literature.

    Epinette, Jean-Alain; Manley, Michael T; D'Antonio, James A; Edidin, Avram A; Capello, William N

    2003-02-01

    We evaluated the clinical, radiographic, and survivorship outcomes in a series of 418 threaded hydroxyapatite-coated acetabular cups (Arc2f; Osteonics, Allendale, NJ) implanted in a consecutive series of 384 patients undergoing primary total hip arthroplasty. In all cases, the cup was screwed into the prepared acetabulum. Bone screws were used to provide secondary fixation. At a minimum 10-year follow-up, 304 cups were available for analysis. The cumulative survivorship (mechanical failure as endpoint) at that time was 99.43% +/- 0.0104. Two hundred seventy-six hips were available for full clinical and radiographic review at or after the tenth anniversary. No unstable implants were noted; all implant fixation interfaces were classified as "stable bone ingrown," and the cup migration rate was zero. Based on the survivorship achieved with this implant, our results compare favorably with survivorship reported for the best cemented and cementless acetabular implant designs. PMID:12629602

  12. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation....... Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17...

  13. Ipsilateral femoral neck and shaft fractures: An overlooked association

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

  14. Techniques and results for open hip preservation

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

  15. Femoroacetabular impingement

    Kassarjian, Ara [Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: akassarjian@partners.org; Brisson, Melanie [Department of Radiology, Centre Hospitalier Universitaire de Quebec, Que. (Canada); Palmer, William E. [Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2007-07-15

    Femoroacetabular impingement is a relatively recently appreciated 'idiopathic' cause of hip pain and degenerative change. Two types of impingement have been described. The first, cam impingement, is the result of an abnormal morphology of the proximal femur, typically at the femoral head-neck junction. Cam impingement is most common in young athletic males. The second, pincer impingement, is the result of an abnormal morphology or orientation of the acetabulum. Pincer impingement is most common in middle-aged women. This article reviews the imaging findings of cam and pincer type femoroacetabular impingement. Recognition of these entities will help in the selection of the appropriate treatment with the goal of decreasing the likelihood of early degenerative change of the hip.

  16. Analysis of slipped capital femoral epiphysis

    CT with multiplanar reconstruction (CT/MPR) was used to assess 25 adolescents with known or suspected slipped capital femoral epiphysis (SCFE). CT/MPR localizes the epiphysis in three planes, establishing its relationship to the acetabulum and the metaphyseal neck. MPR facilitates measurements of head-neck angles, residusal head-neck contact, and relative retrovision. CT/MPR may establish the true age of the epiphyseal failure and can reveal subtle SCFE in the face of normal plain films. Patients often present with confusing histories; clues to the true age of failure include subtle signs of healing, remodeling, or new bone buttressing. Characterization of acute versus chronic conditions influences preoperative planning. Postoperatively, CT/MPR confirms early results and follows epiphyseal fusion and remodelling. It also detects complications, such as pin or graft migration avascular necrosis (AVN), or chondrolysis

  17. Contribution to the lichen biota of the Stawy Milickie nature reserve and its adjacent area (Lower Silesia, southwestern Poland

    Edyta Kaźmierska

    2016-07-01

    Full Text Available The paper presents the results of lichenological investigations conducted in the eastern part of the Stawy Milickie nature reserve and its buffer zone (Barycz Valley, southwestern Poland. The study area is a famous waterfowl refuge, consisting of several fishpond complexes, together with adjacent forests, meadows, and villages. In total 72 lichen taxa were recorded, growing on bark and branches of trees and shrubs, stumps, wood, soil, and anthropogenic rock substrates (mortar, concrete, bricks, etc.. Six species, namely Evernia prunastri, Flavoparmelia caperata, Hypogymnia tubulosa, Parmelina tiliacea, Physconia distorta, and Pleurosticta acetabulum, are threatened in Poland. As represented by single young thalli, they indicate the recent improvement of environmental conditions. The lichen biota of the study area is typical for the lowland regions of western and southwestern Poland.

  18. PATHOLOGICAL AND MORPHOLOGICAL RESEARCH OF EXPERIMENTAL ACETABULAR DYSPLASIA

    张自明; 马瑞雪; 吉士俊; 牛之彬

    2004-01-01

    Objective To investigate the pathological mechanism of hip dysplasia. Methods The left knee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the xray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow acetabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films.Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.

  19. Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures

    Beall, Douglas P. [University of Oklahoma, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); D' Souza, Sharon L. [University of Oklahoma, Oklahoma City, OK (United States); Costello, Richard F.; Stapp, Annette M. [Clinical Radiology of Oklahoma, Edmond, OK (United States); Prater, Scott D. [University of Oklahoma College of Medicine, Edmond, OK (United States); Van Zandt, Bryan L. [University of Oklahoma College of Medicine, Oklahoma City, OK (United States); Martin, Hal D. [Oklahoma Sports Science and Orthopaedics, Oklahoma City, OK (United States)

    2007-10-15

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. (orig.)

  20. Custom acetabular component design with interactive two-dimensional CT

    This paper reports on a revision of failed acetabular components that must accommodate existing segmental and cavitary bone defects and global loss of bone stock. Two-dimensional CT can be used to determine which patients may benefit from a custom acetabulum and to design such a prosthesis. Ninety-one sequential failed hip arthroplasties were reviewed to find 12 potential custom cup candidates, of whom seven underwent CT assessment and subsequent cup design and placement. Coronal and sagittal CT was used to review existing bone stock and bone defects, to measure and map the contour of the defect into which the new cup must fit and to determine the precise placement, angulation, and depth of screw holes to provide purchase for the new cup. A template was produced for approval, followed by cup manufacture and placement

  1. MR evaluation of femoral neck version and tibial torsion

    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  2. Two new species of Pseudotelorchis (Digenea, Telorchiidae, parasites of the Caiman, Caiman crocodilus yacare (Reptilia, Crocodylia from the Pantanal Mato-Grossense, Brazil

    Joäo B. Catto

    1993-12-01

    Full Text Available Pseudotelorchis caimanis n. sp. and P. yacarei n. sp. are described based on specimens collected from Caiman crocodilus yacare (Daudin in the Pantanal Mato-grossense, Brazil. This is the first record of any species of Telorchiidae Stunkard, 1924, parasitizing crocodilians. Pseudotelorchis caimanis n. sp. differs from P. comapactus, the only species described in the genus with seminal receptacle, testes in tandem, and genital pore lateral to acetabulum. Pseudotelorchis yacarei n. sp. differs from the two other species for its body shape, for infecting the intestine instead of the uterus, by having regularly disposed instead of irregulary disposed uterine loops, and by having the vitelline glands disposed in longitudinal lateral lines instead of in lateral bunches.

  3. The role of spiral CT in pelvic trauma management

    Rapid and accurate assessment of pelvic injury is critical for good patient management. Plain X-ray is often used as a preliminary evaluation of the injury but this may not give adequate diagnosis of the acetabulum fracture, subtle fracture of the pelvic bone and the associated soft tissue injuries. Nowadays, spiral CT has taken an increasing role in the evaluation of pelvic trauma. It gives a rapid assessment of the bone and soft tissue injuries as compared to conventional CT. Besides, 2-D (multiplanar imaging) and 3-D image reconstruction with multiple angle views, provide the maximum information which facilitates detailed pelvic trauma evaluation. Three cases were used to illustrate the role of spiral CT in pelvic trauma management. Copyright (1999) Blackwell Science Pty Ltd

  4. Cementless Hydroxyapatite Coated Hip Prostheses

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  5. Morphological and histological identification of Paramphistomum cervi (Trematoda: Paramiphistoma in the rumen of infected sheep

    Vijayata Chaoudhary

    2015-01-01

    Full Text Available Aim: This study was undertaken to identify Paramphistomum cervi on the basis of its morphology and histology to be the common cause of paramphistomosis in infected sheep and its differentiation from other similar Paramphistomes in Gujarat. Materials and Methods: Adult rumen flukes were recovered from the rumen of naturally infected sheep slaughtered in various abattoirs in Gujarat. Some adult flukes were flattened and stained in Borax carmine, and some were sectioned in the median sagittal plane and histological slides of the flukes were prepared for detailed morphological and histological studies. Result: Microscopic pictures of the parasite used in identification define the similarity in the morphology and histology of the anterior sucker, pharynx, esophagus, genital atrium, posterior sucker (acetabulum and testes to the P. cervi. Conclusion: It can be concluded that the most common species found in sheep infected with Paramphistomosis is P. cervi on the basis of its histo-morphological appearance in Gujarat.

  6. Legg-Calve-Perthes disease: Detection of cartilaginous changes by MR imaging

    T1-weighted spin-echo images were obtained in ten patients with Legg-Calve-Perthes disease (unilateral in nine cases, bilateral in one). Measurement of acetabular and femoral head cartilage disclosed a significant increase in the thickness of all articulating surfaces in affected hips. The range of average increase above normal varied from 1.3 to 5.0 mm, depending on location within the joint. Loss of femoral head containment by the acetabulum was identified in most cases, but with variability in degree. MR imaging is a noninvasive means of evaluating the articulating cartilage of the hip affected by Legg-Calve-Perthes disease, allowing assessment of femoral head containment

  7. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  8. Arthroscopic Bullet Removal From the Central and Peripheral Compartments of the Hip Joint.

    Howse, Elizabeth A; Rogers, Jason P; Stone, Austin V; Mannava, Sandeep; Stubbs, Allston J

    2016-04-01

    Recent advances in hip arthroscopy offer an approach for treating an uncommon but highly disabling injury from intra-articular missile injury to the hip. Hip arthroscopy affords the patient the benefit of minimally invasive surgery while allowing for the diagnosis and treatment of concomitant pathology, which may be either acute, from the trauma of the missile, or chronic. We present a technique for the removal of projectiles from the central and peripheral compartments of the hip joint. Through a surgical series of a variety of gunshot wounds, we detail the unique aspects of retrieval for the various missile endpoints. We describe this technique for bullets or pieces of bullets lodged within the hip joint space, bone of the acetabulum, or femoral head. Furthermore, we provide an example in which hip arthroscopy is not a suitable option for treatment because of the resulting fracture pattern, which necessitates open reduction along with internal fixation. PMID:27489755

  9. Parasitic castration in Fissurella crassa (Archaeogastropoda due to an adult Digenea, Proctoeces lintoni (Fellodistomidae

    Marcelo E. Oliva

    1992-03-01

    Full Text Available Specimens of Fissurella crassa (Archaeogastropoda from Ilo, southern Perú, are infected with the adult stage of the digenetic trematode Proctoeces lintoni (Fellodistomidae. The histopatological analysis of the male and female gonads show a strong effect of the parasite on the structure and function of these organs. P. lintoni live unencysted in the gonads, and the main mechanical damage is originated by the action of a well developed acetabulum. Chemical actions of parasitic secretions may also be involved. The infected gonads show altered structure and the gametogenic processes is aborted. There is no evidence of hemocytic response, but leucocite infiltration is evident at least in male infected gonads. An increased content of polysaccarides is evident in infected gonads.

  10. Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures.

    Beall, Douglas P; D'Souza, Sharon L; Costello, Richard F; Prater, Scott D; Van Zandt, Bryan L; Martin, Hal D; Stapp, Annette M

    2007-10-01

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. PMID:17492442

  11. Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. (orig.)

  12. The results of a press-fit-only technique for acetabular fixation in hip dysplasia.

    Takao, Masaki; Nakamura, Nobuo; Ohzono, Kenji; Sakai, Takashi; Nishii, Takashi; Sugano, Nobuhiko

    2011-06-01

    The purpose of the present study was to evaluate the 6- to 11-year follow-up results of hemispherical porous-coated cups implanted into dysplastic hips using press-fit technique without screws focusing on the amount of host bone coverage. There were 87 patients who underwent 98 primary total hip arthroplasties. Bony coverage was measured as the angle between the vertical line and the line drawn from the cup center to the lateral edge of the acetabulum, which was named the cup center-edge angle (cup-CE angle). All 98 cups were judged to be bone ingrown. The minimum cup-CE angle was 8.4° (mean, 26.3°). Bone-cup contact of more than 8.4° of the cup-CE angle was large enough for press-fit cups to resist superior directed loads during this follow-up period. PMID:20647158

  13. 髋关节发育不良

    罗殿中

    2010-01-01

    @@ 髋关节发育不良(Developmental dysplasia of the hip,DDH)既往又称先天性髋关节脱位(Congenital dislocation of the hip,CDH)、发育性髋关节脱(Developmental dislocation of the hip,DDH)、先天性髋关节半脱位(Congenital subdislocation of the hip)、髋臼发育不良(Dysplasia of acetabulum),是在胎儿和新生儿期因股骨头和髋臼关系紊乱,进而发育至不同程度的髋关节异常的一组疾病,包括髋臼异常、股骨头及股骨近端异常、髋关节囊与软组织异常.

  14. Octreotide scintigraphy localizes somatostatin receptor-positive islet cell carcinomas

    Tyr-3-octreotide is a synthetic derivative of somatostatin and a somatostatin-receptor analogue. The iodine-123-labelled compound localizes somatostatin-receptor-positive tumours. In this paper two patients are reported in whom somatostatin receptors were demonstrated in vitro. In a 60-year-old female with an islet cell carcinoma of the pancreas, multiple liver metastases and previously uncrecognized bone metastases in the right acetabulum could be diagnosed as the reason for a persistent hypoglycaemia. In a 60-year-old male an islet cell carcinoma of the pancreas was localized with 123I-Tyr-3-octreotide. The somatostatin receptors were demonstrated in vitro and the tumour was successfully treated with somatostatin. These studies demonstrate that 123I-Tyr-3-octreotide offers the possibility of localizing somatostatin-receptor-positive tumours and their metastases. Moreover the method makes it possible to determine the receptor status of a tumour in vivo. (orig.)

  15. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    Dandachli, Wael; Najefi, Ali; Iranpour, Farhad; Lenihan, Jonathan; Hart, Alister; Cobb, Justin [Imperial College London, Charing Cross Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

    2012-10-15

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  16. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  17. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  18. A comparative study of "plasmacup" and "porous-coated" acetabular components: survival after 10 to 12 years of follow-up

    José Ricardo Negreiros Vicente

    2010-01-01

    Full Text Available OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1 absence of radiolucent lines, (2 presence of a superolateral buttress, (3 medial stress-shielding, (4 radial trabeculae, and (5 an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4% with a PCA versus nine (12.3% with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful

  19. Effect of increased pushoff during gait on hip joint forces.

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to "push more with your foot when you walk". We collected motion data of markers placed on the subjects' trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to "push more with your foot when you walk" reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  20. Fixation of total hip components in rheumatoid arthritis and arthrosis. A radiographic, roentgen stereophotogrammetric, densitometric and histomorphometric study

    Oensten, I.

    1994-10-14

    The radiographic survival of the Charnley prosthesis was studied in two retrospective, matched-pair cohorts of rheumatoid arthritis (RA) and arthrosis (OA) patients. In RA, the 7-year radiographic socket survival improved from 87% to 96% after the introduction of flanged sockets, bone transplants in cases of acetabular protrusion and the rejection of the pilot hole technique. In OA the 10-year radiographic socket survival was 95%. In both groups the 7-year radiographic stem survival improved from 80% to 96% following the introduction of the new cementing technique. Migration of the Charnley prosthesis in the first two years was evaluated by roentgen stereophotogrammetric analysis (RSA) in RA and OA patients, and related to the histomorphometric characteristics of trabecular bone in the acetabulum and the femur. In RA, sockets migrated six times more in the proximal direction as compared with OA; there was no difference in migration in other directions. Stem fixation was equally secure in RA and OA. RA cases had more osteoid in both the femur and the acetabulum, but the amount of osteoid was not correlated with the degree of migration. The bone mineral content (BMC) of RA and OA hips was assessed by dual photone roentgen absorptiometry prior to hip replacement. Patients with RA had 20% less BMC than those with OA but there were no signs of a relative peri-acetabular deficit. In two randomized trials of 81 OA patients, migration of the uncemented, Harris-Galante type I socket was evaluated by RSA and compared with Charnley sockets. After a minimum follow-up of 2 years, no difference in migration between the two socket designs was found. 98 refs, 18 figs, 2 tabs.

  1. Computerized tomography in evaluation of decreased acetabular and femoral anteversion; Besonderheiten bei der Bestimmung der Hueftpfannenanteversion und Schenkelhalsantetorsion durch Computertomographie

    Toennis, D.; Skamel, H.J. [Institut fuer Strahlendiagnostik, Klinikum Dortmund GmbH (Germany)

    2003-09-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [German] Fuer die Computertomographie hat sich eine neue Aufgabe ergeben. Es hat sich gezeigt, dass verringerte Pfannenanteversion und Schenkelhalsantetorsion haeufige Ursachen von Hueftschmerz und -arthrose sind, v. a. wenn beide gegen 0 gehen. Da operative Massnahmen vor Eintreten der Arthrose ergriffen werden sollten, sind genaue Messwerte erforderlich. Die Untersuchung sollte in Bauchlage durchgefuehrt werden, um eine einheitliche und weitgehend normale Beckenkippung zu gewaehrleisten. Die Schenkelhalstorsion wird zwischen der Kniegelenk- und der Schenkelhalsachse gemessen. Zur Festlegung der Sagittalebene legt man am besten eine Mittellinie zwischen die Beckenschaufeln. Die Messung der Pfannenanteversion sollte in der Schnitthoehe erfolgen, wo die Bewegungseinschraenkung der Innenrotation auftritt. (orig.)

  2. Radiographic assessment of developmental dysplasia of the hip – A novel radiology reporting process and one year review of referrals

    Introduction: Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disorder of childhood. Despite the introduction of ultrasound screening radiography remains the most common imaging investigation for children over 4–6 months. The use of picture archive and communications system (PACS) tools to review key measures is standard but annotation of these images supplemented by a radiology report has not been described previously. Method: Referral and demographic data were identified of all children under the age of 2 years attending for a non-trauma pelvic radiograph within a single NHS Trust between January and December 2012. Retrospective review of all radiographs and reports identified the clinical history, co-morbidities and outcome. Results: A total of 313 referrals were received, 230 initial and 83 follow-up examinations. 37 examinations identified a dysplastic acetabulum (n = 37/230; 16.1%) with the majority being girls (n = 23/37; 62.1%). A total of 25 abnormal findings in relation to the femoral head epiphyses were identified (n = 25/230; 10.9%) with 12 also having acetabular dysplasia. Children with a dysplastic acetabulum were significantly more likely to have a subluxation or dislocation (X2 183.78, 2df, p ≤ 0.001). Children with acetabular dysplasia were significantly more likely to have been born in the autumn or winter months (proportional difference = 11.0%; 95% CI [0.019,0.202]; p = 0.024). Conclusion: This article presents a novel reporting process which is helping to standardise the results in young children undergoing investigation for DDH. The review of referrals confirmed the published evidence that DDH is more prevalent in girls and children born in the autumn and winter months

  3. HEMIPELVECTOMY: ERASTO GAERTNER HOSPITAL'S EXPERIENCES WITH 32 CASES IN 10 YEARS

    Freitas, Rosyane Rena de; Crivellaro, André Luiz Soares; Mello, Glauco José Pauka; Neto, Múrio Armani; Filho, Geraldo de Freitas; Silva, Letícia Viani da

    2015-01-01

    Objective: To show the experience of the Erasto Gaertner Hospital with hemipelvectomy surgery over a 10-year period. Methods: This was a retrospective study on 32 patients who underwent hemipelvectomy at Erasto Gaertner Hospital between 1998 and 2008, assessing clinical and surgical characteristics. Results: Among the 32 patients, 15 were female and 17 were male. The mean age was 37.94 years. Eight cases showed involvement of the neurovascular bundle: three were located in the iliac and extended to the thigh, two were in the acetabulum and extended to the thigh and three were in the acetabulum and pubis. Twenty-three cases presented a neurovascular bundle free from neoplasia: 11 were restricted to the iliac, six were in the acetabular region, two were in the pubic ramus and four extended to the whole hemipelvis bone. One case involved the iliac-femoral vessels: one in the pubic ramus. Seven cases of chondrosarcoma and four cases of Ewing's sarcoma represented the majority. Eight cases underwent external hemipelvectomy and 24 underwent internal hemipelvectomy (11 were type I; four were type II; two were type II + III; three were type III and four were type IV). Of these 24 cases, 13 did not have any reconstruction, 10 had a fibular graft and one had an iliacfemoral vein and artery prosthesis. Twenty-six surgeries were curative and six were palliative. There were 14 deaths. Survival of two and five years was seen in 11 and 10 cases, respectively. For six cases, less than two years had passed since the operation. Three cases were lost during follow-up. Conclusion: This study shows the experiences of an oncology reference service specializing in highly complex surgical treatment. PMID:27022573

  4. Increasing thickness and fibrosis of the cartilage in acetabular dysplasia: a rabbit model research

    LI Tian-you; MA Rui-xue

    2010-01-01

    Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp's angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp's angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.

  5. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)

    2011-11-15

    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  6. Periacetabular osteotomy for acetabular dysplasia%髋臼周围截骨术治疗髋臼发育不良

    李华; 王云清; 魏东

    2011-01-01

    目的 探讨髋臼周围截骨术治疗髋臼发育不良的方法 及疗效.方法 对36例髋臼发育不良患者(43髋)行手术治疗,通过髋臼周围截骨、旋转髋臼向前外侧移位恢复髋臼的正确位置,并增加髋臼覆盖面.结果 36例均获随访,时间 6个月~3年.术后髋痛、跛行完全消失或有明显改善,髋关节活动范围基本正常.CE角和Sharp角均基本恢复正常.结论 髋臼周围截骨术可有效改善临床症状,恢复髋关节的生物力学特点,是治疗髋臼发育不良的有效方法.%Objective To discuss the method and effect of the treatment of acetabular dysplasia by periacetabular acetabular osteotomy. Methods Periacetabular osteotomy was performed to correct 36 patients( 43 hips )with dysplastic acetabulum through rotating the acetabulum anterolaterally, by which the position and acetabular coverage of the femoral head was restored to nearly normal. Results 36 patients with acetabular dysplasia were all followed up for six months to three years. After operation, in the majority, the hip limp or pain with exertion disappeared, and a satisfactory range of motion had been restored. CE angle and Sharp angle were restored to nearly normal value. Conclusions Periacetabular osteotomy is effectively to improve the clinical symptoms, and restore the hip biomechanics characteristics,which is ideal for the treatment of developmental acetabular dysplasia.

  7. Research Progress in the Association between Gene Polymorphism and Developmental Dysplasia of the Hip%基因多态性与髋关节发育不良的相关性研究进展

    侯华成; 史冬泉

    2013-01-01

    Developmental dysplasia of the hip( DDH )is a common skeletal disease during the period of infant and child, and its morbidity is nearly 1‰-2‰. Hip dysplasia refers to an anomaly in the size, shape, o-rientation, or organization of the femoral head, acetabulum, or both. This disease usually comprises shallow ac-etabulum and/or lax joint capsule. Hip instability, joint pain, gait abnormalities and premature arthritis are common clinical signs. It is important to prevent,diagnose and treat DDH as early as possible. More about the etiopathogenesis should be learned for the prevention, and genetic factor is one of the most important etiologi-cal factors of the disease.%髋关节发育不良(DDH)是婴幼儿时期一种常见的骨科疾病,发病率为1‰ ~2‰.其是由股骨头和(或)髋臼的大小、形态、取向和(或)组织构成异常导致,通常指关节囊松弛和(或)髋臼太浅.DDH可导致膝关节不稳定、关节疼痛、步态异常及早发型骨性关节炎,因此早期预防、早期诊断和早期治疗显得尤为重要.预防该病必须了解病因,而遗传因素是DDH的重要病因之一.

  8. Uma nova espécie de Dadayius Fukui, 1929 (Digenea: Cladorchiidae parasita do trato intestinal de Metynnis maculatus (Kner, 1858 (Characidae da planície de inundação do alto rio Paraná, Brasil - DOI: 10.4025/actascibiolsci.v25i2.2044 A new species of Dadayius Fukui, 1929 (Digenea: Cladorchiidae, parasite of the intestinal tract of Metynnis maculates (Kner, 1858 (Characidae from the Upper Paraná River floodplain, Brazil - DOI: 10.4025/actascibiolsci.v25i2.2044

    Ricardo Massoto Takemoto

    2003-04-01

    Full Text Available Uma nova espécie de Cladorchiidae (Trematoda, Digenea foi encontrada no trato intestinal do peixe de água-doce “pacu peva”, Metynnis maculatus (Kner, 1858 na planície de inundação do Alto Rio Paraná, Brasil. A nova espécie foi classificada no gênero Dadayius Fukui, 1929 por apresentar testículos não lobados e acetábulo ventro-terminal com um “entalhe” postero-mediano na margem interior, características do gênero que possui apenas duas espécies conhecidas. Algumas características que diferem a espécie nova de D. marenzelleri (Daday, 1907 e D. pacuensis Thatcher, 1996 são cecos não alcançando o acetábulo, vitelária de extensão limitada e não atingindo o nível do testículo posterior e a presença de dois tamanhos diferentes de ovos em dois estágios de maturação diferentes.A new species of Cladorchiidae (Trematoda, Digenea was found in the intestinal tract of freshwater fish “pacu peva”, Metynnis maculates (Kner, 1858 from the Upper Paraná River floodplain, southern Brazil. The new species was classified in the genus Dadayius Fukui, 1929 by having non-lobate testis and a ventro-terminal acetabulum with postero median notch on rim, characters of the genus wich has only two previously known species. Some characters that differ the new species from D. marenzelleri (Daday, 1907 and D. pacuensis Thatcher, 1996 are: ceca not reaching acetabulum, vitellaria of limited extension, not reaching the level of posterior testis and the presence of two different egg sizes in two different maturity stages.

  9. Fixation of total hip components in rheumatoid arthritis and arthrosis. A radiographic, roentgen stereophotogrammetric, densitometric and histomorphometric study

    The radiographic survival of the Charnley prosthesis was studied in two retrospective, matched-pair cohorts of rheumatoid arthritis (RA) and arthrosis (OA) patients. In RA, the 7-year radiographic socket survival improved from 87% to 96% after the introduction of flanged sockets, bone transplants in cases of acetabular protrusion and the rejection of the pilot hole technique. In OA the 10-year radiographic socket survival was 95%. In both groups the 7-year radiographic stem survival improved from 80% to 96% following the introduction of the new cementing technique. Migration of the Charnley prosthesis in the first two years was evaluated by roentgen stereophotogrammetric analysis (RSA) in RA and OA patients, and related to the histomorphometric characteristics of trabecular bone in the acetabulum and the femur. In RA, sockets migrated six times more in the proximal direction as compared with OA; there was no difference in migration in other directions. Stem fixation was equally secure in RA and OA. RA cases had more osteoid in both the femur and the acetabulum, but the amount of osteoid was not correlated with the degree of migration. The bone mineral content (BMC) of RA and OA hips was assessed by dual photone roentgen absorptiometry prior to hip replacement. Patients with RA had 20% less BMC than those with OA but there were no signs of a relative peri-acetabular deficit. In two randomized trials of 81 OA patients, migration of the uncemented, Harris-Galante type I socket was evaluated by RSA and compared with Charnley sockets. After a minimum follow-up of 2 years, no difference in migration between the two socket designs was found. 98 refs, 18 figs, 2 tabs

  10. Quantitative MRI Evaluation of Articular Cartilage Using T2 Mapping Following Hip Arthroscopy for Femoroacetabular Impingement

    Mayer, Stephanie W.; Wagner, Naomi; Fields, Kara G.; Wentzel, Catherine; Burge, Alissa; Potter, Hollis G.; Lyman, Stephen; Kelly, Bryan T.

    2016-01-01

    Objectives: Cam-type femoroacetabular impingement (FAI) causes a shearing and delamination injury to the acetabular articular cartilage due to a mismatch between the size of the femoral head and the acetabulum. This mechanism is thought to lead to early osteoarthritis in this population. Cam decompression has been advocated to eliminate impingement, with the ultimate goal of halting the progression of articular cartilage delamination. Although outcomes following this procedure in the young adult population have been favorable at short and medium term follow up, it is not known whether the articular cartilage itself is protected from further injury by changing the biomechanics of the joint with decompression of the cam morphology. The purpose of this study is to compare the pre- and post-operative integrity of the acetabular articular cartilage using T2 mapping to determine if hip arthroscopy is protective of the articular cartilage at short- to medium term follow up. Methods: Males between 18 and 35 years of age who had pre-operative T2 mapping MRIs, underwent hip arthroscopy for cam or mixed-type FAI with an alpha angle greater than 50°, and had at least 2 year follow-up were identified. Post-operative MRIs were performed and T2 relaxation times in the transition zone and weight bearing articular cartilage in the anterosuperior acetabulum at deep and superficial chondral layers were recorded at nine points on three sagittal sequences on pre and post-operative MRIs. A paired t-test was used to compare T2 relaxation values between pre-operative and post-operative scans. Results: Eleven hips were evaluated. Mean age was 26.3 years (range 21 - 35). Mean follow up time to post-operative T2 mapping MRI was 2.6 years (range 2.4 - 2.7). The change in T2 relaxation time was not significantly different between pre- and post-operative MRI scans for any of the nine regions in the deep zone of the acetabular cartilage (p=0.065 - 0.969) or the superficial zone of the

  11. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  12. Bone remodelling after hip prostheses surgery: normal evolution patterns by bone scintigraphy

    Evaluation of hip prostheses is a common task in nuclear medicine practice. Physicians usually have problems to differentiate between changes in bone remodelling related to surgical procedures and complications like infection or loosening. Aim: To assess changes in bone remodelling after hip prostheses surgery by bone scintigraphy, and to determine normal evolution patterns of tracer uptake. To relate changes in bone remodelling with type of prostheses and clinical outcome. Materials and Methods: We studied 18 patients (6 males, mean age 68±10 years) who receipt a hip prostheses. Every patient underwent 3 bone scintigraphies, at 3 months, 1 year and 2 years after surgical implant of hip prostheses. Twelve prostheses were non-cemented, 3 were cemented and 3 hybrids. A semi-quantification of tracer uptake was performed, obtaining an uptake index from the average counts per pixel of regions of interest (ROIs) drawn around sacroiliac joints, acetabulum, greater trochanter, calcar, femur shaft, tip, and opposite normal femur. Sacroiliac joints and opposite normal femur were selected as reference areas. The uptake index was calculated by the formula: (ROI-reference)/reference. Clinical follow-up was performed at 3 months, 6 months, 1 year and 2 years. Results: While tracer uptake indexes of non-cemented prostheses decreased significantly in greater trochanter, calcar, femur shaft, and tip between 3 months-1 year studies, 1 year-2 years studies and between 3 months and 2 years studies (t-student, p<0.05), tracer uptake indexes did not decrease in acetabulum, opposite normal femur, and sacroiliac joint. On the contrary, cemented and hybrid prostheses did not show any significant difference in studied areas during the follow-up. All patients presented good clinical outcome, without pain and with correct mobility of the leg. Conclusion: These preliminary results indicate that, when non-cemented hip prostheses are implanted, there are important bone remodelling changes at 3

  13. Application of uncemented Zweymüller hip prosthesis in adult patients with hip osteoarthritis secondary to developmental dysplasia

    XU Yong-sheng; WANG Yan; LU Long; WEI Bao-gang

    2012-01-01

    Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ‘high-riding' hip.It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty (THA) for coxarthrosis.The aim of this study was to evaluate efficiency and safety of THA using Zweymüller hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip (DDH) in adults.Methods From January 2000 to February 2008,35 patients (40 hips) with developmental dysplasia of the hip were included.Five were male and 30 were female,with ages ranging from 26 to 65 years and an average age of 45 years.According to Hartofilakidis classification,there were type Ⅰ in 5 hips,type Ⅱ in 20 hips,type Ⅲ in 15 hips.All the patients were performed the THA using the Zweymüller hip implant.The preoperative average Harris score was 44.The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients.The patients mainly suffered from pain and claudication.Clinical and radiological results were analyzed.The Harris score was used for outcome measurement.Results Thirty five patients (40 hips) were followed and the mean follow-up period was 46 months (ranged from 24 months to 96 months).The latest follow-up average Harris score was 88.9 (97.1% of good rate).All the patients were pain-free and there was no sign of infection,aseptic loosening and subsidence.Conclusions In summary,THA using Zweymüller hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults.The key techniques for the total hip replacement are as follows:good preoperative plan,firmly placing the acetabular component in the true acetabulum,proper preparation of proximal femur,suitable femoral component choosing and improving the techniques of the bone graft.

  14. 改良Zahradnicek手术治疗大龄儿童发育性髋脱位临床应用研究%Clinical Application of Treatment of Developmental Dysplasia of the Hip in Older Children with Improved Zahradnicek Operation

    刘金煜; 刘洋; 董平; 张楠; 李晓光

    2012-01-01

      Objective:To discuss the best methods to treat Developmental Dysplasia of the Hip in older children anddecrease the complications. Methods:41 joints of 37 cases congenital hip joint dislocation were underwent improved Zahradnicek operation.The re-construction of acetabulum arch structure were made to restore the concentric relation between head and acetabulum withspecial drill meanwhile corrected anteversive angle 5~10° and cervical shaft angle 120° with curved steel fixed. Results:The curative assessment were 22 joints excellent,14 joints good and 5 joints bad effects.The curative ratio was 88%.Conclusion:This methods could completely or nearly restore the hip joint to normal anatomic and functional position.%  目的:探讨7~12周岁大龄儿童发育性髋脱位(DDH)治疗优化方法,减少并发症。方法:自2005~2011年应用改良Zahradnicek手术治疗大龄儿童发育性髋脱位37例、41个关节,用特制的小儿髋臼钻有限切削臼软骨,重建髋臼孤形结构,恢复其头臼同心圆关系,同时矫正前倾角至5°~10°,颈干角至120°,用专用的120°鹅颈钢板固定。结果:术后疗效评定:优22髋,为54%;良14髋,为34%;可3髋,为7%;差2髋,为5%,优良率占88%。结论:此种手术在1次手术中使股骨头、髋臼、股骨颈及股骨干恢复或接近恢复正常解剖和功能的方法,使大年龄DDH患儿获得一个功能良好、稳定无痛的关节。

  15. Assessment of a New Axis of Radiation in Hip Joint Radiographies

    "A. Esmaeelzadeh

    2005-08-01

    Full Text Available Introduction & Background: The harmful effects of x-rays on sensitive cells such as those of sex gonads are a well-established fact. Therefore, special care should be taken in hip radiographies to protect the gonads. According to the most recent references, to locate the head of femur and its joint in hip radiographies, a line should be drawn from the ASIS to symphysis pubis. To locate the head of the joint, we had to move 2.5cm inferior and laterally from the middle of the men-tioned line. The outer end of this new line indicates the position of the femur head. However, due to the lack of accurate instruments in wards and the variety of diseases and also to avoid repetitive hip radiogra-phies, we decided to apply an experimental method. Patients & Methods: In this study, hip radiographies with FFD=100 were done for 50 patients of both sex with different ages. In all instances the distances be-tween symphysis pubis and the greater trocanter, the base of the lesser trocanter, and upper edge of acetabulum, and symphysis pubis and the center of femur, were measured on the radiographs by means of a standard ruler. The findings were then statisti-cally analyzed. The radiography apparatus was Phil-lips 500MA model D7. Results: In this study, it was shown that in 27 cases, the distance between symphysis pubis and the center of the head of femur was equal to the distance be-tween the base of the lesser trocanter and the upper edge of acetabulum. There was also a difference of 0.5, 1, and 2.5 centimeters in 14, 10, and 3 cases re-spectively. Conclusion: These findings were statistically signifi-cant and new. This is notable with regard to the ease of locating the hip joint in small radiographs. In addi-tion it has the advantage of a small degree of gonadal protection.

  16. Procedure DEGA type by double approach

    The following is an observational, retrospective, descriptive study, including case studies of patients with developmental acetabular dysplasia of the hip with neuromuscular changes. We examined (11) eleven hips in (3) three women and (5) five men who undergone incomplete marginal trans-iliac DEGA osteotomy in the form of a semicircular acetabuloplasty with double surgical approach, performed in conjunction with a previous open reduction and a femoral variant twisting osteotomy. We evaluated these patients with 3DCAT scan and simple x-ray. The following were evaluated: the acetabular depth, the percentage of lateral and anterior femoral head extrusion, the center edge, anterior wall deficit, sharp angle, acetabular anteversion, percentage of unoccupied medial acetabulum and center rotation asymmetry, sphericity of the femoral head (Mose), acetabular support angle (WBZ) (Bombelliand Aronson), migration percentage (Reimers), articular consistency (Coleman), and the arthrosis according to Tonnis. The clinical follow up was carried out for 24.6 months on average, with radiological three dimensional Tomographic scans up to 23.6 months with an interval of between 6 and 49 months. Results were excellent in 80% of the cases, good in 14%, regular in 0%, bad in 6%. The results suggest that this a good alternative in the treatment of dysplasia in a number of patients, bearing in mind their indications and contraindications as well as the magnitude of correction that can be expected

  17. Driven Around the Bend: Novel Use of a Curved Steerable Needle

    Murphy, Darra T., E-mail: darra.murphy@vch.ca; Korzan, Jeffrey R.; Ouellette, Hugue A.; Liu, David M. [Vancouver General Hospital, Department of Radiology (Canada); Clarkson, Paul W. [Vancouver General Hospital, Department of Orthopedic Surgery (Canada); Munk, Peter L. [Vancouver General Hospital, Department of Radiology (Canada)

    2013-04-15

    This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles. Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum. All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients. Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles.

  18. Morfologia externa de espécimes adultos de Paratanaisia bragai (Santos, 1934 (Digenea: Eucotylidae External morphology of the adults specimens of Paratanaisia bragai (Santos, 1934(Diginea; Eucotylidae

    Solange V.P.B. Brandolini

    2007-09-01

    Full Text Available Espécimes adultos de Paratanaisia bragai foram coletados de ductos renais de Columba livia infectados naturalmente, fixados em glutaraldeído 2,5% e processados para microscopia eletrônica de varredura. Foram identificados dois tipos distintos de escamas, escamas bífidas e simples, dispostas em fileiras transversais no tegumento das faces dorsal e ventral do corpo. Também mostrando em detalhes a ventosa oral subterminal, bem desenvolvida e acetábulo de tamanho reduzido, localizado no terço médio do corpo, circundado por pequenas protuberâncias e quatro papilas dispostas regularmente na sua margem.Adult specimens of Paratanaisia bragai collected from renal ducts of Columba livia naturally infected, were fixed in glutaraldehyde 2.5% and processed for scanning electron microscopy. Two distinct types of scales had been identified, bifid and simple scales, disposed in transversal rows, on the tegument of dorsal and ventral face of the body. Also show in details the oral sucker subterminal, well developed and acetabulum of size reduced, located in third medium of the body, surrounded for small protuberance and four papillae on its edge.

  19. A semi-active milling procedure in view of preparing implantation beds in robot-assisted orthopaedic surgery.

    Van Ham, G; Denis, K; Vander Sloten, J; Van Audekercke, R; Van der Perre, G; De Schutter, J; Simon, J P; Fabry, G

    2005-05-01

    Bone cutting in total joint reconstructions requires a high accuracy to obtain a well-functioning and long-lasting prosthesis. Hence robot assistance can be useful to increase the precision of the surgical actions. A drawback of current robot systems is that they autonomously machine the bone, in that way ignoring the surgeon's experience and introducing a safety risk. This paper presents a semi-active milling procedure to overcome that drawback. In this procedure the surgeon controls robot motion by exerting forces on a force-controlled lever that is attached to the robot end effector. Meanwhile the robot constrains tool motion to the planned motion and generates a tool feed determined by the feed force that the surgeon executes. As a case study the presented milling procedure has been implemented on a laboratory set-up for robot-assisted preparation of the acetabulum in total hip arthroplasty. Two machining methods have been considered. In the first method the surgeon determines both milling trajectory and feed by the forces that he/she executes on the force-controlled lever. In the second method the cavity is machined contour by contour, and the surgeon only provides the feed. Machining experiments have shown that the first method results in large surface irregularities and is not useful. The second method, however, results in accurate cavity preparation and has therefore potential to be implemented in future robot systems. PMID:15934392

  20. Muscle architecture during the course of development of Diplostomum pseudospathaceum Niewiadomska, 1984 (Trematoda, Diplostomidae) from cercariae to metacercariae.

    Petrov, A; Podvyaznaya, I

    2016-05-01

    Recent confocal microscopy studies have greatly expanded our knowledge of muscle systems in cercariae and adult digeneans, but the gross anatomy and development of metacercarial musculature remain relatively little known. To further our understanding of metacercarial development, this study used phalloidin staining and confocal microscopy to examine changes in muscle architecture over the course of development from cercariae to infective metacercariae in Diplostomum pseudospathaceum Niewiadomska, 1984. The paper describes muscle development in the body wall, anterior organ (oral sucker), acetabulum, pharynx and midgut and in the musculo-glandular organs that first appear in metacercariae (lappets and holdfast). The muscle architecture of the cercarial tail is also described. The results of the study support previously reported observations that diplostomid musculature undergoes substantial transformation during metacercarial development. The most profound changes, involving extensive remodelling and replacement of cercarial muscles, were seen in the body-wall musculature and in the anterior organ as it developed into the oral sucker. Muscle systems of other cercarial organs showed more gradual changes. The adaptive importance of developmental changes in musculature is discussed. PMID:25997697

  1. Diagnostic value of pelvic radiography in the initial trauma series in blunt trauma

    Their, Micael E.A.; Bensch, Frank V.; Koskinen, Seppo K. [Toeoeloe Trauma Center, Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Handolin, Lauri [Toeoeloe Trauma Center, Department of Orthopaedics and Traumatology, Helsinki (Finland); Kiuru, Martti J. [Toeoeloe Trauma Center, Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Research Institut of Military Medicine, Helsinki (Finland)

    2005-08-01

    The purpose of the study was to evaluate the diagnostic value of pelvic radiography in the initial trauma series when compared to multidetector CT (MDCT) findings in serious blunt trauma. Inclusion criteria were blunt trauma and pelvic radiography in the initial trauma series, followed by a whole-body MDCT. A total of 1386 patients (874 male, 512 female, age 16-91 years, mean 41 years) met the inclusion criteria. Imaging studies were evaluated retrospectively by anatomical region and classified, when possible, using the Tile classification. Based on MDCT, a total of 629 injuries occurred in 226 (16%) of these 1386 patients. Radiography depicted 405 fractures in these 226 patients, giving an overall sensitivity of 55%. In 24 patients (11%) radiography was false-negatively normal. The sensitivity of radiography was mainly good in the anteroinferior parts of the pelvis, fair in the acetabulum and ileum, and poor in the posterior ring. By MDCT 141 (62%) patients were classified using the Tile classification and by radiography 133 patients (59%) were classified. MDCT and radiography showed the same type of pelvic injury in 72 patients (59%) and the subtype in 17 patients (14%). In 48 patients (40%) the pelvis was shown to be stable by radiography but unstable by MDCT. In conclusion, the sensitivity of pelvic radiography is low, and it is not reliable for determining if the pelvic injury is stable or not. (orig.)

  2. Modular noncemented total hip arthroplasty for congenital dislocation of the hip. Case report and design rationale.

    Gorski, J M

    1988-03-01

    The highest rate of failure and the greatest technical difficulty in total hip arthroplasty occurs with congenital dislocation of the hip (CDH). Predisposing factors are failure to secure special femoral components to fit an extremely narrow and straight medullary cavity with space for only a very thin mantle of cement. The acetabulum is usually atrophic, and bone grafts are commonly required to support a small-diameter cup. The young age of the average patient and high levels of activity contribute to cement failure. A new modular cementless prosthesis provides excellent immediate skeletal fixation and pain relief in CDH patients. Five modular components are screwed or press-fit into bone. The modular approach facilitates implantation, reduces inventory, and is adaptable to unforeseen problems. These advantages are ordinarily absent with standard or custom cemented components. Modular components may also permit easier revision. The prosthesis is made of titanium alloy for its superalloy strength, elastic modulus, and bioinertness. By omitting the cement mantle, press-fit is obtained with the largest possible implant. The large size minimizes stem breakage in these young, small bones. Excellent short-term results suggest that modular cementless implants are indicated in some patients with CDH. PMID:3342552

  3. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

    This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMDHG). Radiographs of 271 adult patients with SEMDHG were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips. Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores. Degenerative arthritis of the hip develops in the majority of patients with SEMDHG; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned. (orig.)

  4. Bone scintigraphy as a process control with hemi-alloarthroplasty of the hip joint

    For the diagnostic of prosthesis complications in the treatment of femur fractures near the hip joint ('intermediate prostheses') 216 skeletal scintigrams with 99mTc MDP were made of 143 patients from 1977 to 1982, partially retrospective and partially prospective. The evaluation of the photoscan was achieved visually and photodensitometrically and divided into 10 intensity levels with the following results: 1. Increased activity concentration in the acetabulum is pathological (activated arthrosis); 2. Increased activity concentration-temporary or also continuous - in the trochanter region is pathological (loosening process); 3. Non-pathological metabolic activity as a result of the bone healing process may last longer than 1 year postoperatively; 4. Heterotopic ossification, non-fixed bone fragments and pseudoarthrosis cause continuous or newly appearing concentrations; 5. Skeletal scintigraphy is an important supplement to radiological diagnostic and a sensitive method for the recognition of metabolic activities in bone. It is recommended for progress control after hemi-alloarthrosculpture of the hip joint. (orig./TRV)

  5. An MRI-based semiautomated volumetric quantification of hip osteonecrosis

    Objective: To objectively and precisely define the spatial distribution of osteonecrosis and to investigate the influence of various factors including etiology. Design: A volumetric method is presented to describe the size and spatial distribution of necrotic lesions of the femoral head, using MRI scans. The technique is based on the definition of an equivalent sphere model for the femoral head. Patients: The gender, age, number of hips involved, disease duration, pain intensity, limping disability and etiology were correlated with the distribution of the pathologic bone. Seventy-nine patients with 122 hips affected by osteonecrosis were evaluated. Results: The lesion size ranged from 7% to 73% of the sphere equivalent. The lateral octants presented considerable variability, ranging from wide lateral lesions extending beyond the lip of the acetabulum, to narrow medial lesions, leaving a lateral supporting pillar of intact bone. Patients with sickle cell disease and steroid administration presented the largest lesions. The extent of the posterior superior medial octant involvement correlated with the symptom intensity, a younger age and male gender. Conclusion: The methodology presented here has proven a reliable and straightforward imaging tool for precise assessment of necrotic lesions. It also enables us to target accurately the drilling and grafting procedures. (orig.)

  6. Triple osteotomy of the pelvis and trochanteric osteotomy as a treatment for hip dysplasia in the immature dog: the surgical technique and results of 77 consecutive operations

    Triple osteotomy of the pelvis with transplantation of the greater trochanter was performed in 41 immature dogs (77 hips) with hip dysplasia. Before surgery, all hips were moderately to severely subluxated and unstable on palpation. The juxta-acetabular location of the ilial, ischial, and pubic osteotomies allowed repositioning of the acetabulum over the femoral head even when subluxation was severe. The acetabular fragment was rotated 70 degrees to 90 degrees in all hips. After surgery, craniodorsal coverage of the femoral head was increased and each hip was stable on palpation. Bilateral procedures were performed 4 to 7 weeks apart. The functional status of the limb was assessed and physical examination and radiography were performed in 71% (55) of the hips 1.0 to 5.5 years (mean, 2.7 years) after surgery. Functional ability was considered satisfactory in 93% (51) of the limbs, though few dogs had a normal gait. On palpation, all hips were stable and all but one were evaluated as nonpainful. In most instances, contact between the femoral neck and the repositioned acetabular rim resulted in a variable amount of crepitus and restriction of motion when the hip was abducted and rotated externally and internally. Eighty-two percent (45) of the hips had little or no evidence of degenerative joint disease. A satisfactory functional, physical, and radiographic result was obtained in 73% (40) of the hips

  7. Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

    Beall, Douglas P. [University of Oklahoma Health Science Center, Oklahoma City, OK (United States); Clinical Radiology of Oklahoma, Edmond, OK (United States); Oklahoma City, OK (United States); Datir, Abhijit [Royal National Orthopaedic Hospital, Department of Radiology, Middlesex (United Kingdom); D' Souza, Sharon L.; D' Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima [University of Oklahoma Health Science Center, Oklahoma City, OK (United States)

    2010-02-15

    Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

  8. Rapidly destructive osteoarthritis of the hip joint: a case series

    McMurtrie A

    2008-01-01

    Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.

  9. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients

    Richard Prazeres Canella

    2016-04-01

    Full Text Available OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI, using computed tomography (CT. METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third, femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. RESULTS: There were inverse correlations between the following angles: (1 acetabular coverage versus alpha angle (p = 0.019; (2 acetabular version (supraequatorial versus alpha angle (p = 0.049. For patients with femoral anteversion lower than 15 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.026; (2 acetabular version (middle third versus alpha angle (p = 0.02. For patients with acetabular version (supraequatorial lower than 10 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.004; (2 acetabular version (middle third versus alpha angle (p = 0.009. CONCLUSION: There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases.

  10. 髋关节撞击综合征诊断与治疗的研究进展%Advances in the research of the diagnosis and treatment of femoroacetabular impingement

    熊元; 赵振国; 邹亮; 鲍同柱

    2014-01-01

    The etiology of femoroacetabular impingement ( FAI ) is abnormal stresses acting on the proximal femur and the acetabulum resulting from abnormally structural relationship between them caused by various factors. FAI plays an important role in inducing early hip osteoarthritis, and the main manifestation is chronic hip pain. Early diagnosis and early treatment help to improve the quality of life of patients and delay the incidence of arthritis. The common X-ray can provide an important reference for the diagnosis and classiifcation of FAI, and the CT scan can provide multi-faceted and multi-dimensional images for hip joint diseases. The sensitivity and speciifcity of MRI are better for the cartilage damages and soft tissue injuries. Therefore, the diagnosis of this disease is not difficult when the clinical symptoms, signs and imaging are combined together. Conservative treatment of FAI is ineffective, and while better therapeutic effects can be achieved with early open surgery or arthroscopic surgery according to the disease conditions. Because FAI has not been found and studied until recent decades, many doctors still do not know it and often misdiagnose it. The key words included “the femur”, “the acetabulum”, “impingement”, “imaging”, “open surgery” and “arthroscope” in this article.

  11. Radiographic Markers of Femoroacetabular Impingement: Correlation of Herniation Pit and Femoral Bump with a Positive Cross-Over Ratio

    Max J. Scheyerer

    2014-01-01

    Full Text Available Introduction. The goal of this study was to research the association of femoral bumps and herniation pits with the overlap-ratio of the cross-over sign. Methods. Pelvic X-rays and CT-scans of 2925 patients with good assessment of the anterior and the posterior acetabular wall and absence of neutral pelvic tilt were enrolled in the investigation. Finally pelvic X-rays were assessed for the presence of a positive cross-over sign, and CT-scans for a femoral bump or a herniation pit. Additionally, if a positive cross-over sign was discovered, the overlap-ratio was calculated. Results. A femoral bump was found in 53.3% (n=1559, and a herniation pit in 27.2% (n=796 of all hips. The overlap-ratio correlated positively with the presence of a femoral bump, while a negative correlation between the overlap-ratio and the presence of a herniation pit was found. The latter was significantly more often combined with a femoral bump than without. Conclusions. We detected an increased prevalence of femoral bump with increasing overlap-ratios of the cross-over sign indicating a relation to biomechanical stress. The observed decreased prevalence of herniation pits with increasing overlap-ratios could be explained by reduced mechanical stress due to nontightened iliofemoral ligament in the presence of retroversion of the acetabulum.

  12. Imaging findings of femoroacetabular impingement syndrome

    Beall, Douglas P.; Sweet, Clifford F.; Martin, Hal D.; Lastine, Craig L.; Grayson, David E.; Ly, Justin Q.; Fish, Jon R. [University of Oklahoma Health Sciences Center, Department of Radiologal Sciences, Oklahoma City (United States)

    2005-11-01

    Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement - cam impingement and pincer impingement - are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients' symptoms. (orig.)

  13. Percutaneous radiofrequency ablation for osteoid osteoma: How we do it

    To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment. We evaluated 40 patients in whom RFA was performed for osteoid osteomas between October 2005 and February 2008. The lesions were located in the femur (n = 22), tibia (n = 10), humerus (n = 2), acetabulum (n = 2), radius (n = 1), fibula (n = 1), patella (n = 1), and calcaneum (n = 1). The procedure was performed using a standard technique. Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. All patients were fully weight bearing 2–3 h after the procedure. Successful pain relief was achieved in all patients within 48 h. Immediate complications included a case of minor thermal skin burn and a small cortical chip fracture, which healed on its own. There were no delayed complications. The average follow-up period was 12 months. Two patients (5% of cases) had recurrence of pain after intervals of 5 and 8 months, respectively, following the ablation; this was due to recurrence of the lesion. Complete pain relief was however achieved after a second ablation in both cases. Thus, our primary and secondary clinical success rates were 95 and 100%, respectively. RFA is a safe, quick, minimally invasive, and extremely effective method for the management of osteoid osteomas

  14. Pigmented Villonodular Synovitis Causing Osteonecrosis of the Femoral Head: A Case Report

    Tomohiro Mimura

    2013-01-01

    Full Text Available We report a case of a 27-year-old man with pigmented villonodular synovitis of the hip joint with coincident osteonecrosis of the femoral head. According to our review of the English-language literature, no detailed report of osteonecrosis of the femoral head complicated with pigmented villonodular synovitis has been published. Preoperative X-ray images showed joint narrowing and severe multiple bone erosions at the acetabulum and femoral neck. Magnetic resonance imaging revealed a low-intensity band attributable to osteonecrosis of the femoral head and massive diffuse pigmented villonodular synovitis lesions. Comparison of a three-dimensional computed tomographic image of this patient with an angiographic image of a normal individual demonstrated proximity of the pigmented villonodular synovitis-induced bone erosions to the medial and lateral femoral circumflex arteries and retinacular arteries, suggesting likely the compromise of the latter by the former. We propose that the massive pigmented villonodular synovitis may have contributed to the pathogenesis of osteonecrosis of the femoral head in this patient. We performed open synovectomy and total hip arthroplasty. No operative complications occurred, and no recurrence of the pigmented villonodular synovitis was detected for 3 years after the operation.

  15. Validation of a standardized mapping system of the hip joint for radial MRA sequencing

    Intraarticular gadolinium-enhanced magnetic resonance arthrography (MRA) is commonly applied to characterize morphological disorders of the hip. However, the reproducibility of retrieving anatomic landmarks on MRA scans and their correlation with intraarticular pathologies is unknown. A precise mapping system for the exact localization of hip pathomorphologies with radial MRA sequences is lacking. Therefore, the purpose of the study was the establishment and validation of a reproducible mapping system for radial sequences of hip MRA. Sixty-nine consecutive intraarticular gadolinium-enhanced hip MRAs were evaluated. Radial sequencing consisted of 14 cuts orientated along the axis of the femoral neck. Three orthopedic surgeons read the radial sequences independently. Each MRI was read twice with a minimum interval of 7 days from the first reading. The intra- and inter-observer reliability of the mapping procedure was determined. A clockwise system for hip MRA was established. The teardrop figure served to determine the 6 o'clock position of the acetabulum; the center of the greater trochanter served to determine the 12 o'clock position of the femoral head-neck junction. The intra- and inter-observer ICCs to retrieve the correct 6/12 o'clock positions were 0.906-0.996 and 0.978-0.988, respectively. The established mapping system for radial sequences of hip joint MRA is reproducible and easy to perform. (orig.)

  16. Minimally invasive medial hip approach.

    Chiron, P; Murgier, J; Cavaignac, E; Pailhé, R; Reina, N

    2014-10-01

    The medial approach to the hip via the adductors, as described by Ludloff or Ferguson, provides restricted visualization and incurs a risk of neurovascular lesion. We describe a minimally invasive medial hip approach providing broader exposure of extra- and intra-articular elements in a space free of neurovascular structures. With the lower limb in a "frog-leg" position, the skin incision follows the adductor longus for 6cm and then the aponeurosis is incised. A slide plane between all the adductors and the aponeurosis is easily released by blunt dissection, with no interposed neurovascular elements. This gives access to the lesser trochanter, psoas tendon and inferior sides of the femoral neck and head, anterior wall of the acetabulum and labrum. We report a series of 56 cases, with no major complications: this approach allows treatment of iliopsoas muscle lesions and resection or filling of benign tumors of the cervical region and enables intra-articular surgery (arthrolysis, resection of osteophytes or foreign bodies, labral suture). PMID:25164350

  17. Congenital insensitivity to pain with anhidrosis (CIPA): the spectrum of radiological findings

    Background: Congenital insensitivity to pain with anhidrosis (CIPA) is an exceedingly rare, hereditary, sensory autonomic neuropathy (HSAN). Aim: To evaluate the various skeletal manifestations and cranial CT features in children affected by CIPA. Materials and methods: In the semidesert area of the Negev, the Bedouin tribes constitute a closed society where consanguineous marriages are the custom. This has resulted in a group of 20 children being affected by this rare autosomal recessive HSAN. The skeletal surveys and CT scans of these 20 Bedouin patients, 12 girls and 8 boys, ages ranging between 1 month and 8 years, were retrospectively analysed. Cranial CT scans were performed in ten children because of neonatal hypotonia and psychomotor retardation. The skeletal findings were classified as follows: fractures, joint deformities, joint dislocations, osteomyelitis, avascular necrosis and acro-osteolysis. Results: All 20 patients had fractures of the extremities and acro-osteolysis of the fingers. Six had joint deformities. Three children had recurrent hip joint dislocations and another three had avascular necrosis. Ten patients presented with osteomyelitis of the limbs, acetabulum and scapula. The cranial CT scans disclosed mild brain volume loss with some ventriculomegaly. Conclusions: CIPA is a severe autosomal recessive condition that leads to self-mutilation early in life and to fractures, osteomyelitis and limb amputation in older children. Mental retardation is common. Death from hyperpyrexia occurs in almost 20 % of patients in the first 3 years of life. (orig.)

  18. Community-Associated Methicillin-Resistant Staphylococcus aureus Lacking PVL, as a Cause of Severe Invasive Infection Treated with Linezolid

    Catarina Gouveia

    2013-01-01

    Full Text Available Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA is an emerging public health problem worldwide. Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL. In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia. The MRSA isolated from blood and synovial fluid was PVL negative and staphylococcal enterotoxin type P (SEP and type L (SEL positive, with a vancomycin MIC of 1.0 mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted to multiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused by CA-MRSA in Portugal, which was successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.

  19. MR imaging of transient osteoporosis

    Objective: To evaluate MR imaging of transient osteoporosis. Methods: MR imaging of transient osteoporosis in eight patients was retrospectively reviewed. In all eight patients, routine scanning was performed in axial and coronal planes, including T1-weighted and T2-weighted images. Of the eight patients, five were male and three were female, with the age ranging from 12 to 70 years. Neither of the women was pregnant when they visited our hospital. Results: The bilateral hips were affected in seven patients, the left shoulder in one. The MR images demonstrated low signal intensity in all eight patients on T1WI, and normal signal intensity (2 cases), medium-high signal intensity (3 cases), or high signal intensity (3 cases) on T2WI. The bone marrow edema (BME) pattern involved the acetabulum (one hip), both the femoral head in 5 hips, the femoral neck and the intertrochanteric region through the upper femur in 7 hips, and the upper humerus in one. A small joint effusion was observed in six hips on T2WI. Conclusion: MRI is useful in defining the location and extent of transient osteoporosis. (authors)

  20. Automated measurement of diagnostic angles for hip dysplasia

    de Raedt, Sepp; Mechlenburg, Inger; Stilling, Maiken; Rømer, Lone; Søballe, Kjeld; de Bruijne, Marleen

    2013-03-01

    A fully automatic method for measuring diagnostic angles of hip dysplasia is presented. The method consists of the automatic segmentation of CT images and detection of anatomical landmarks on the femur and acetabulum. The standard angles used in the diagnosis of hip dysplasia are subsequently automatically calculated. Previous work in automating the measuring of angles required the manual segmentation or delineation of the articular joint surface. In the current work automatic segmentation is established using graph-cuts with a cost function based on a sheetness score to detect the sheet-like structure of the bone. Anatomical landmarks are subsequently detected using heuristics based on ray-tracing and the distance to the approximated acetabulur joint surface. Standard diagnositic angles are finally calculated and presented for interpretation. Experiments using 26 patients, showed a good agreement with gold standard manual measurements by an expert radiologist as performed in daily practice. The mean difference for the five angles was between -1:1 and 2:0 degrees with a concordance correlation coefficient between 0:87 and 0:93. The standard deviation varied between 2:3 and 4:1 degrees. These values correspond to values found in evaluating interobserver and intraobserver variation for manual measurements. The method can be used in clinical practice to replace the current manual measurements performed by radiologists. In the future, the method will be integrated into an intraoperative surgical guidance system.

  1. A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis

    Tomoya Takasago

    2015-01-01

    Full Text Available A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA, secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient’s hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.

  2. Acetabular rim and surface segmentation for hip surgery planning and dysplasia evaluation

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.

    2008-03-01

    Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent level set algorithm that can evolve on the surface of a 3D object represented by a triangular mesh we automatically extracted rims and surfaces of acetabulae. The level set is guided by curvature features on the mesh. It can segment portions of a surface that are bounded by a line of extremal curvature (ridgeline or crestline). The rim of the acetabulum is such an extremal curvature line. Our material consists of eight hemi-pelvis surfaces. The algorithm is initiated by putting a small circle (level set seed) at the center of the acetabular surface. Because this surface distinctively has the form of a cup we were able to use the Shape Index feature to automatically extract an approximate center. The circle then expands and deforms so as to take the shape of the acetabular rim. The results were visually inspected. Only minor errors were detected. The algorithm also proved to be robust. Seed placement was satisfactory for the eight hemi-pelvis surfaces without changing any parameters. For the level set evolution we were able to use a single set of parameters for seven out of eight surfaces.

  3. Total Hip Arthroplasty for the Paralytic and Non-paralytic Side in Patient with Residual Poliomyelitis

    Sonohata, Motoki; Kitajima, Masaru; Kawano, Shunsuke; Mawatari, Masaaki

    2016-01-01

    Background: Total hip arthroplasty (THA) for poliomyelitis is a problematic procedure due to difficulty in positioning the cup of the prosthesis in the true acetabulum and the risk of dislocation after THA due to the low muscle tone. Methods: We herein present a case of bilateral hip pain with a history of poliomyelitis. Radiograph showed bilateral hip osteoarthritis caused by hip dysplasia due to residual poliomyelitis in right hip joint or developing dysplasia of the hip joint in left hip joint. THA was performed to bilateral hip joints. Results: Six years after bilateral THA, bilateral hip pain significantly improved. Additionally, the muscle strength on the paralyzed right side partially improved. However, the muscle strength on the non-paralyzed left side did not significantly improve. No complications related to the surgery were observed. Conclusion: Promising early results were obtained for THA in our patient with residual poliomyelitis. However, surgeons should pay attention to the potential development of complications concerning THA that may arise due to the residual poliomyelitis. PMID:27347238

  4. Imaging findings of femoroacetabular impingement syndrome

    Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement - cam impingement and pincer impingement - are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients' symptoms. (orig.)

  5. Efficient radiologic diagnosis of pelvic and acetabular trauma

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.)

  6. Calculating the hip center of rotation using contralateral pelvic anatomy.

    Durand-Hill, Matthieu; Henckel, Johann; Satchithananda, Keshthra; Sabah, Shiraz; Hua, Jia; Hothi, Harry; Langstaff, Ronald J; Skinner, John; Hart, Alister

    2016-06-01

    Failure to place an artificial hip in the optimal center of rotation results in poor hip function and costly complications. The aim of this study was to develop robust methodology to estimate hip center of rotation (hCoR) from preoperative computed tomography (CT) scans, using contralateral anatomy, in patients with unilateral diseased hips. Ten patients (five male, five female) with normal pelvic anatomy, and one patient with a unilateral dysplastic acetabulum were recruited from the London Implant Retrieval center image bank. 3D models of each pelvis were generated using commercial software. Two methods for estimation of hCoR were compared. Method 1 used a mirroring technique alone. Method 2 utilized mirroring and automatic alignment. Predicted versus actual hCoR co-ordinates were compared using intraclass correlation coefficients and paired T-tests. Both methods predicted hCoR with excellent agreement to original co-ordinates (>0.9) in all axes. Both techniques allowed prediction of the hCoR within ± 5 mm in all axes. Both techniques provided useful clinical information for planning acetabular reconstruction in patients with unilateral defects. Method 1 was less complex and is suitable for patients with developmental and degenerative pathologies. Method 2 may provide greater accuracy in a discrete group of patients with normal development prior to pathology (e.g., acetabular fractures). © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1077-1083, 2016. PMID:26630078

  7. Experimental validation of a new biphasic model of the contact mechanics of the porcine hip.

    Li, Junyan; Wang, Qianqian; Jin, Zhongmin; Williams, Sophie; Fisher, John; Wilcox, Ruth K

    2014-05-30

    Hip models that incorporate the biphasic behaviour of articular cartilage can improve understanding of the joint function, pathology of joint degeneration and effect of potential interventions. The aim of this study was to develop a specimen-specific biphasic finite element model of a porcine acetabulum incorporating a biphasic representation of the articular cartilage and to validate the model predictions against direct experimental measurements of the contact area in the same specimen. Additionally, the effect of using a different tension-compression behaviour for the solid phase of the articular cartilage was investigated. The model represented different radial clearances and load magnitudes. The comparison of the finite element predictions and the experimental measurement showed good agreement in the location, size and shape of the contact area, and a similar trend in the relationship between contact area and load was observed. There was, however, a deviation of over 30% in the magnitude of the contact area, which might be due to experimental limitations or to simplifications in the material constitutive relationships used. In comparison with the isotropic solid phase model, the tension-compression solid phase model had better agreement with the experimental observations. The findings provide some confidence that the new biphasic methodology for modelling the cartilage is able to predict the contact mechanics of the hip joint. The validation provides a foundation for future subject-specific studies of the human hip using a biphasic cartilage model. PMID:24878736

  8. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases

    Nakamura, Junichi; Takahashi, Kazuhisa

    2016-01-01

    Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga. PMID:27293934

  9. Functional and radiographic evaluation and quality of life analysis after cementless total hip arthroplasty with ceramic bearings: minimum of 5 years follow-up

    Rafael Borghi Mortat

    2013-12-01

    Full Text Available Objective: The aim of the study is to analyze and correlate functional and radiographic results and quality of life in patients undergoing cementless total hip arthroplasty with ceramic surface, performed at Hospital Servidor Publico de Sao Paulo from 2001 to 2006. Methods: We retrospectively analyzed 35 hips treated with cementless total hip arthroplasty with ceramic surfaces with a minimum follow-up of 5 years. Functional evaluation was based on the Harris Hip Score (HHS. Radiographic evaluation was based on the method proposed by Charles Engh for evaluation of femoral osseointegration and on DeLee and Charnley zones for acetabulum. Quality of life was assessed by SF-36 questionnaire. Results: The HHS presented excellent and good results in 91% of patients postoperatively (mean of 93.14 points HHS. As for radiographic evaluation, we found excellent results in 100% of evaluated hips (proven osseointegration. SF-36 scores were not compared to the control group for the following components: pain, vitality, mental health and social aspects. The difference between HHS pre and postoperatively had a statistically significant correlation with physical functioning of the SF-36. Conclusion: Total hip arthroplasty with ceramic surface is a treatment that enables functional improvement of the hip and increases quality of life of patients to levels close to those of people without joint diseases.

  10. Validation of a standardized mapping system of the hip joint for radial MRA sequencing

    Klenke, Frank M.; Hoffmann, Daniel B.; Cross, Brian J.; Siebenrock, Klaus A. [Bern University Hospital, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland)

    2014-10-14

    Intraarticular gadolinium-enhanced magnetic resonance arthrography (MRA) is commonly applied to characterize morphological disorders of the hip. However, the reproducibility of retrieving anatomic landmarks on MRA scans and their correlation with intraarticular pathologies is unknown. A precise mapping system for the exact localization of hip pathomorphologies with radial MRA sequences is lacking. Therefore, the purpose of the study was the establishment and validation of a reproducible mapping system for radial sequences of hip MRA. Sixty-nine consecutive intraarticular gadolinium-enhanced hip MRAs were evaluated. Radial sequencing consisted of 14 cuts orientated along the axis of the femoral neck. Three orthopedic surgeons read the radial sequences independently. Each MRI was read twice with a minimum interval of 7 days from the first reading. The intra- and inter-observer reliability of the mapping procedure was determined. A clockwise system for hip MRA was established. The teardrop figure served to determine the 6 o'clock position of the acetabulum; the center of the greater trochanter served to determine the 12 o'clock position of the femoral head-neck junction. The intra- and inter-observer ICCs to retrieve the correct 6/12 o'clock positions were 0.906-0.996 and 0.978-0.988, respectively. The established mapping system for radial sequences of hip joint MRA is reproducible and easy to perform. (orig.)

  11. Relation between fracture site of pelvic ring and severity of injury. Significance of bilateral ischiopubic fracture

    Here studied is the relation in the title since the fracture of pelvic ring often occurs along with multiple traumas by strong external force, and diagnosis of which severity is important for the following treatment of complicated injuries. Subjects are 75 patients (M 51/F 24, 18-80 years old) with the fracture, treated in authors' hospital during the time 1998-2006, whose diagnoses for the fracture site are performed by the simple X-radiography and CT. Subjects are divided in 4 groups of A-D, where the fracture is seen at the lateral (Group A, 15 cases) and bilateral (Group B, 5 cases) ischiopubis, acetabulum (Group C, 14 cases) and posterior pelvic ring (Group D, 41 cases). Made is comparison of the sites for hemoglobin value (HGV) at hospital arrival, necessity of transfusion within 1 week after injury and dose of red cell preparation (DRC), complicated traumas like musculoskeletal and organ ones, injury severity score (ISS) and death cases. B case is found to be significantly higher in ISS and rate of injuries of important organs, and to be tended high in HGV and DRC. Thus the bilateral fracture is possibly complicated with important organ injuries and can be a measure of serious injury at the early diagnosis. (T.T.)

  12. Palliative surgery for acetabular metastasis with pathological central dislocation of the hip joint after radiation therapy. A case report

    Orthopedic surgery for bone metastases is mainly a palliative treatment. Pathological central dislocation of the hip joint secondary to osteonecrosis of acetabular metastasis after radiation therapy brings severe suffering to cancer patients. We performed minimally invasive palliative surgery for an elderly woman, and excellent pain relief was achieved. An 80-year-old female suffering from right hip pain was referred to our hospital. She had undergone surgery for lung cancer 5 years previously and her right acetabulum was subsequently affected by metastasis. With the aim of controlling the metastasis, radiation therapy was performed. Two years later, pathological central dislocation of the hip joint occurred with sudden onset of severe pain, and she was unable to maintain a sitting position and became bedridden. After she was referred to our hospital, we created an intentional pseudarthrosis in the femoral neck for palliation. After the surgery, excellent pain relief and remarkably improved mobility were achieved during her limited remaining lifetime. In this report, we introduce a novel method of producing a pseudarthrosis in the femoral neck for pathological dislocation. This procedure is a minimally invasive treatment and an alternative option for palliative surgery for pathological dislocation of the hip joint due to osteonecrosis after radiation therapy. (author)

  13. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients☆

    Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

    2016-01-01

    Objective To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). Methods We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. Results There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). Conclusion There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases. PMID:27069890

  14. Cementoplasty for managing painful bone metastases outside the spine

    Sun, Gang; Jin, Peng; Liu, Xun-wei; Li, Min; Li, Li [Jinan Military General Hospital, Department of Medical Imaging, Jinan, Shandong Province (China)

    2014-03-15

    To illustrate the effect of treatment with cementoplasty in patients with painful bone metastases in the extraspinal region. A retrospective study was conducted to review 51 consecutive patients who underwent cementoplasty under CT or fluoroscopic guidance, a total of 65 lesions involving the ilium, ischium, pubis, acetabulum, humeral, femur and tibia. In 5 patients with a high risk of impending fracture in long bones based on Mirels' scoring system, an innovative technique using a cement-filled catheter was applied. The clinical effects were evaluated using the visual analogue scale (VAS) preoperatively and postoperatively. All patients were treated successfully with a satisfying resolution of painful symptoms at 3 months' follow-up. Cement leakage was found in 8 lesions without any symptoms. VAS scores decreased from 8.19 ± 1.1 preoperatively to 4.94 ± 1.6 at 3 days, 3.41 ± 2.1 at 1 month and 3.02 ± 1.9 at 3 months postoperatively. There was a significant difference between the mean preoperative baseline score and the mean score at all of the postoperative follow-up points (P < 0.01). Cementoplasty is an effective technique for treating painful bone metastases in extraspinal regions, which is a valuable, minimally invasive, method that allows reduction of pain and improvement of patients' quality of life. (orig.)

  15. Orthopedic and interventional applications at low field MRI with horizontally open configuration

    The recently introduced horizontally open configuration imagers allow imaging of knee, hip or shoulder during whole range of motion, which is not possible in conventional MR imagers. Special joint motion devices can be used to provide accurate and reproducible studies. In cervical spine, functional MR imaging may be useful in evaluating alarligament stability in patients with late sequelae of a whiplash injury, and in patients with rheumatoid arthritis who are clinically suspected of having a cervical myelopathy or superior migration of the odontoid process. In shoulder, full range of motion abduction study may be helpful in assessing the supraspinatus tendon impingement. To evaluate patellofemoral malalignment, quadriceps loading is recommended since associated contracting muscles and related soft tissue structures can be evaluated. The position of the femoral head relative to the acetabulum during different positions can be assessed. Open-configuration scanners provide an access to patients during scanning procedure, and therefore permit interventional procedures to be monitored with MRI. Such interventions include aspiration cytology/biopsy and different drainage procedures. (orig.)

  16. An appraisal of the short lateral rotators of the hip joint.

    Yoo, Sarang; Dedova, Irina; Pather, Nalini

    2015-09-01

    The short lateral rotators (piriformis, obturator internus, superior and inferior gemelli, obturator internus, and quadratus femoris) are functionally important muscles, significantly contributing to hip joint stability. They act as "postural muscles", holding the femoral head in the acetabulum during hip movements, thus are frequently monitored in gait analysis and for muscle rehabilitation post-injury. Despite the need to precisely identify and repair these muscles for stability postoperatively, clinical complications have resulted from the inadequate and inconsistent understanding of their morphological and functional anatomy. Furthermore, the short lateral rotators have complex entheses (osteotendinous insertions on bone) and may be subject to overuse injury in sport. This study aims to review the reported morphology of the short lateral rotators in order to ascertain whether discrepancies exist in our understanding of these muscles, and if further investigation is required to aid in gait analysis, clinical management of hip pathologies, and prevention of overuse injuries. Following a literature search strategy, 59 primary references were retrieved from three databases, with additional 26 anatomical textbooks selected for critical evaluation. Numerous inaccuracies and inconsistencies in the anatomical descriptions of the attachments, patterns of innervation and actions exist, and often insufficiently supported by primary findings. There is also a paucity of information regarding the architectural pattern of the muscles, which would be useful in clarifying the function of these dynamic stabilizers of the hip joint. A better anatomical understanding of these muscles will better inform hip reconstruction and lead to improved surgical outcomes by reducing post-operative complications. PMID:26032283

  17. Cementoplasty for managing painful bone metastases outside the spine

    To illustrate the effect of treatment with cementoplasty in patients with painful bone metastases in the extraspinal region. A retrospective study was conducted to review 51 consecutive patients who underwent cementoplasty under CT or fluoroscopic guidance, a total of 65 lesions involving the ilium, ischium, pubis, acetabulum, humeral, femur and tibia. In 5 patients with a high risk of impending fracture in long bones based on Mirels' scoring system, an innovative technique using a cement-filled catheter was applied. The clinical effects were evaluated using the visual analogue scale (VAS) preoperatively and postoperatively. All patients were treated successfully with a satisfying resolution of painful symptoms at 3 months' follow-up. Cement leakage was found in 8 lesions without any symptoms. VAS scores decreased from 8.19 ± 1.1 preoperatively to 4.94 ± 1.6 at 3 days, 3.41 ± 2.1 at 1 month and 3.02 ± 1.9 at 3 months postoperatively. There was a significant difference between the mean preoperative baseline score and the mean score at all of the postoperative follow-up points (P < 0.01). Cementoplasty is an effective technique for treating painful bone metastases in extraspinal regions, which is a valuable, minimally invasive, method that allows reduction of pain and improvement of patients' quality of life. (orig.)

  18. MRI在儿童发育性髋关节发育不良中的应用及进展%The application and progress of MRI in developmental dislocation of the hip

    周颖; 楼跃

    2014-01-01

    发育性髋关节发育不良(DDH)是儿童最常见的先天四肢畸形之一,是指于出生前及出生后股骨头和髋臼在发育和(或)解剖关系中出现异常的一系列髋关节病症。早期诊断及治疗对该病预后影响很大,MRI在其辅助诊断及治疗方案制订中起到了显著的作用。本文重点阐述MRI在发育性髋关节发育不良病例中的应用价值及进展。%Developmental dysplasia of the hip (DDH) is a common congenital childhood disorder of the limbs. It refers to a series of the hip joint disease in development and/or abnormal anatomical relationships of femoral head and acetabulum before and after the birth. Early diagnosis and treatment have a great influence on the prognosis of the disease, and MRI has played an important role. This contribution summarizes the application and progress of MRI in developmental dislocation of the hip.

  19. Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

    Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)

    2007-06-15

    While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

  20. 成人先天性髋关节发育不良的围手术期护理%Nursing Care of Perioperative Period in Adult Congenital Hip Dysplasia

    刘倩; 周莉; 何晓凤

    2011-01-01

    Adult congenital hip dysplasia(ACHD) is a congenital defect of acetabular disease. It may develop subluxation or luxation of hip after a long term, and osteonecrosis of the femeral head may occur at last. Now the patients with ACHD at early stage are treated with the operation of rotational osteotomy of the acetabulum, but in later period it can only be treated with the operation of total hip replacement. No matter which method is selected, nursing care of perioperative period plays a very important role in recoveries of the patients.%成人先天性髋关节发育不良是一种髋臼先天性发育缺陷的疾病,长期发展会形成髋关节半脱位、脱位,最终甚至可能出现股骨头坏死等严重合并症.对于早期患者目前主要采用髋臼旋转截骨手术治疗,而晚期出现股骨头脱位及坏死则只能通过全髋关节置换进行治疗.不论哪种手术方式,围手术期的护理时于患者的健康恢复都有着非常重要的意义.

  1. Application of three-dimensional computed tomography in total hip arthroplasty of adult developmental dysplasia of hip%3DCT技术在成人髋臼发育不良全髋关节置换术中的应用

    徐永胜; 魏宝刚; 吕龙; 马秉贤

    2012-01-01

    , male 5, female 20, aged 21 - 63 years old, mean age 47.9 years old. All of patients underwent pre—operative digital radiography (DR) and 3DCT reconstruction, and measured some parameters to obtain relevant data, then performed THA accorded guideline of the data. All the patients underwent pelvic DR after operation, the horizontal distance and vertical distance from femoral head center to ideal rotation center between contralateral and ipsilateral at pre-operation and post-operation were compared, and recovery level of rotation center in ipsilaieral hip were evaluated. Results The CT showed that anteroposterior diameter of acetabulum became smaller, posterior thickness of acetabulum became thicker and depth of acetabulum was shallower, and there were statistically significant differences in morphological parameters of femur and acetabulum between 2 groups(P 0.05). The mean horizontal distance in pre-operation was 20.15 mm (16 — 38 mm), and mean horizontal distance in post-operation was 2.95 mm (- 2.0 - 9.3 mm). The lateral side of idea center of rotation was positive numeric, and the difference between pre -operation and post -operation were statistically significant (t = 6.74, P < 0.01). The mean vertical distance in pre-operation was 23.58 mm (18 - 42 mm), and mean vertical distance in post-operation was 3.25 mm(- 6.0 - 13.4 mm). The upper side of idea center of rotation as positive numeric, and the difference between pre-operation and post-operation were statistically significant(t=4.53, P< 0.01). Conclusion It is demonstrated that 3DCT reconstruction could provide preferred design for DDH patients with THA, including the customization of acetabular prosthetic, the position of acetabular bone graft and reconstruction, and acetabular component placement angle. The 3DCT plays an important role in recovery of concentric reduction, restoration of anatomical structure and hip joint function.

  2. Pseudoachondroplasia: A case report

    Radlović Vladimir

    2013-01-01

    Full Text Available Introduction. Pseudoachondroplasia (PSACH is an autosomal dominant osteochondrodysplasia due to mutations in the gene encoding cartilage oligomeric matrix protein. It is characterized by rhizomelic dwarfism, limb and vertebral deformity, joint laxity and early onset osteoarthrosis. We present the girl with the early expressed and severe PSACH born to clinically and radiographically unaffected parents. Case Outline. A 6.5-year-old girl presented with short-limbed dwarfism (body height 79.5 cm, acetabulum. Conclusion. PSACH is an achondroplasia-like rhizomelic dwarfism recognized by the absence of abnormality at birth, normal craniofacial appearance, characteristic epiphyseal and metaphyseal radiographic finding and joint hyperlaxity.

  3. Congenital insensitivity to pain with anhidrosis (CIPA): the spectrum of radiological findings

    Schulman, H.; Tsodikow, V.; Hertzanu, Y. [Dept. of Radiology, Soroka University Medical Centre, Beer-Sheva (Israel); Einhorn, M.; Levy, Y.; Shorer, Z. [Dept. of Pediatrics, Soroka University Medical Centre, Beer-Sheva (Israel)

    2001-10-01

    Background: Congenital insensitivity to pain with anhidrosis (CIPA) is an exceedingly rare, hereditary, sensory autonomic neuropathy (HSAN). Aim: To evaluate the various skeletal manifestations and cranial CT features in children affected by CIPA. Materials and methods: In the semidesert area of the Negev, the Bedouin tribes constitute a closed society where consanguineous marriages are the custom. This has resulted in a group of 20 children being affected by this rare autosomal recessive HSAN. The skeletal surveys and CT scans of these 20 Bedouin patients, 12 girls and 8 boys, ages ranging between 1 month and 8 years, were retrospectively analysed. Cranial CT scans were performed in ten children because of neonatal hypotonia and psychomotor retardation. The skeletal findings were classified as follows: fractures, joint deformities, joint dislocations, osteomyelitis, avascular necrosis and acro-osteolysis. Results: All 20 patients had fractures of the extremities and acro-osteolysis of the fingers. Six had joint deformities. Three children had recurrent hip joint dislocations and another three had avascular necrosis. Ten patients presented with osteomyelitis of the limbs, acetabulum and scapula. The cranial CT scans disclosed mild brain volume loss with some ventriculomegaly. Conclusions: CIPA is a severe autosomal recessive condition that leads to self-mutilation early in life and to fractures, osteomyelitis and limb amputation in older children. Mental retardation is common. Death from hyperpyrexia occurs in almost 20 % of patients in the first 3 years of life. (orig.)

  4. 钳夹型髋关节撞击综合征的影像学表现%Imaging characteristics of pincer femoroacetabular impingement syndrome

    杨涛; 曾卫珊; 王学松; 马方煜

    2013-01-01

    Objective To investigate the imaging features of pinccr fcmoroacctabular impingement syndrome (FAI). Methods Imaging features of pinccr FAI were investigated in 22 patients (24 abnormal hips) by using digital radiography (DR). Lateral center edge angle (LCE) , acctabular index (AI) and femoral head extrusion index (FHEI) were measured in all patients on conventional radiographs of the pelvis, which were compared with a normal control group. Among abnomal 24 hips, CT was carried out in 10, and the CT features were also observed. Results Fifteen of 24 hips with pincer FAI were manifested as extensive acctabular ovcreover-age, exhibiting the fossa acetabuli line within or overlapping the ilioischial line. Meanwhile, their LCE, AI and FHEI were different significantly compared with the control group (P<0. 05). Other nine abnormal hips were manifested as focal acctabular overcover-age, exhibiting "8" sign or posterior line of acetabulum shifting to the outside. On CT images, there were five cases with profund acetabulum and three with acctabular retrovcrsion. The osteosclcrosis, reactive ossification and calcification, and fracture of the acetabular rim, herniation pits and subchondral cystic degeneration were showed on both DR and CT images. Conclusion FAI can easily be determined by conventional radiographs of the pelvis. CT may provide more detailed and reliable images for the rational decision of clinical treatment.%目的 探讨钳夹型髋关节撞击综合征(FAI)的影像学表现.方法 采用DR观察分析22例钳夹型FAI患者,共24例异常髋关节的X线表现,在骨盆前后位上测量外侧中心边缘角(LCE)、髋臼指数(AI)、股骨头突出指数(FHEI)并与正常组比较.24例中10例另行髋关节CT平扫检查,分析其表现.结果 24例钳夹型FAI,15例属于髋臼广泛过度覆盖,表现为髂臼线与髂坐线重叠或位于其内侧,其LCE角、AI、FHEI与正常组比较均有显著差异性(P<0.05).9例属于髋臼

  5. Structural autograft for acetabular reconstruction in total hip arthroplasty of developmental hip dysplasia%结构植骨重建髋臼在髋关节发育不良全髋置换中的应用

    任翀旻; 张元凯; 李德强; 刘培来; 李明

    2013-01-01

    Objective To evaluate the result of bulk femoral head autograft for acetabular reconstruction in total hip arthroplasty for developmental hip dysplasia patients with severe acetabular deficiency.Methods Twenty-five patients (31 hips) with development hip dysplasia were performed with bulk femoral head autograft for the acetabular reconstruction in THA during 2005-2010.Twenty-nine hips in 23 patients were successfully followed up in average 5.1 years with mean age of 52.According to Crowe classification,19 hips in 15 patients were stage Ⅲ and 10 hips in 8 patients were stage Ⅳ.The deficient acetabula were reconstructed by bulk femoral head autograft.With bone guaranteed coverage,patients had prosthesis installed at the original level or closed level of true acetabulum.Radiographic changes and Harris score were evaluated.Results None suffered from loosening and collapse during the follow-up.One was revised for dislocation.Harris scores increased from 44 preoperative to 88 at last follow-up.Conclusion To reconstruct acetabulum at true acetabular level with satisfactory bone coverage by using bulk femoral head autograft is an effective and safe way for THA in developmental hip dysplasia.%目的 评价自体股骨头结构植骨重建髋臼在髋关节发育不良的全髋关节置换术中的效果.方法 选取2005年1月至2010年11月对髋Crowe分型在Ⅲ型和Ⅳ型的髋关节发育不良患者25例31髋,34 ~ 69岁,平均52岁;Ⅲ型15例19髋,Ⅳ型8例10髋;采用结构植骨重建髋臼的全髋关节置换术.术中行股骨头结构植骨,保证覆盖率的基础上,于真臼或近真臼水平重建髋臼并安装假体.术后行影像学检查和Harris评分.成功随访23例29髋,平均随访5.1年.结果 植骨愈合良好,无植骨塌陷,1例1髋术后脱位,所有病例无假体松动发生.术前Harris评分平均44分,术后1年平均89分,最后1次随访平均88分.结论 应用自体股骨头结构植骨,满足覆盖率前提下在真

  6. Análise radiográfica dos fatores prognósticos no tratamento do quadril displásico inveterado Radiographic analysis of prognostic factors in DDH treatment after walking age

    Eduardo Ferreira Cordeiro

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico da Displasia do Desenvolvimento do Quadril na idade da marcha. MÉTODOS: Avaliamos 33 quadris operados entre novembro de 1992 e setembro de 1997. A média de idade foi 4 anos e 5 meses na ocasião da cirurgia e 11 anos e 7 meses quando avaliamos os resultados. O seguimento médio foi de 10 anos e 2 meses. Realizamos o encurtamento femoral, redução cruenta e osteotomia pélvica (Salter ou Chiari. Radiograficamente avaliamos: grau da luxação, índice acetabular; ângulo acetabular; arco de Shenton; linha de Hilgenheiner; coeficientes c/b, c/h, centro-acetábulo e cabeça-acetábulo; largura da cartilagem trirradiada; relação cabeça trocânter; esfericidade da epífise femoral; ângulo de Wiberg; necrose avascular e anisomelia. Os parâmetros radiográficos foram avaliados nos períodos pré-operatório, pós-operatório imediato e tardio. RESULTADOS: Verificamos estatisticamente melhora significante destes no momento pré-operatório para o pós-operatório imediato (p=0,0001 porém não houve variação significante entre o pós-operatório imediato e o tardio (p=0.5958. CONCLUSÃO: Pela classificação utilizada para avaliação dos resultados observamos 23 (69,70% bons, 5 (15,15% regulares e 5 (15,15% maus resultados.OBJECTIVE: To evaluate the results of surgical treatment of Developmental Dysplasia of the Hip (DDH treated in the walking age. METHODS: We evaluated 33 hips in 30 patients operated between November of 1992 and September of 1997. The mean age was 4 years and 5 months at surgical period and the mean age at the last evaluation was 11 years and 7 months. The mean follow up time was 10 years and 2 months. We performed femoral shortening, open reduction and pelvic osteotomy (Salter or Chiari. Radiographic assessment considered: acetabular index; acetabular angle; Shenton's line; Hilgenreiner's line; the c/b, c/h, acetabulum-center and acetabulum-head ratios; the width of

  7. The morphology and adhesion mechanism of Octopus vulgaris suckers.

    Francesca Tramacere

    Full Text Available The octopus sucker represents a fascinating natural system performing adhesion on different terrains and substrates. Octopuses use suckers to anchor the body to the substrate or to grasp, investigate and manipulate objects, just to mention a few of their functions. Our study focuses on the morphology and adhesion mechanism of suckers in Octopus vulgaris. We use three different techniques (MRI, ultrasonography, and histology and a 3D reconstruction approach to contribute knowledge on both morphology and functionality of the sucker structure in O. vulgaris. The results of our investigation are two-fold. First, we observe some morphological differences with respect to the octopus species previously studied (i.e., Octopus joubini, Octopus maya, Octopus bimaculoides/bimaculatus and Eledone cirrosa. In particular, in O. vulgaris the acetabular chamber, that is a hollow spherical cavity in other octopuses, shows an ellipsoidal cavity which roof has an important protuberance with surface roughness. Second, based on our findings, we propose a hypothesis on the sucker adhesion mechanism in O. vulgaris. We hypothesize that the process of continuous adhesion is achieved by sealing the orifice between acetabulum and infundibulum portions via the acetabular protuberance. We suggest this to take place while the infundibular part achieves a completely flat shape; and, by sustaining adhesion through preservation of sucker configuration. In vivo ultrasonographic recordings support our proposed adhesion model by showing the sucker in action. Such an underlying physical mechanism offers innovative potential cues for developing bioinspired artificial adhesion systems. Furthermore, we think that it could possibly represent a useful approach in order to investigate any potential difference in the ecology and in the performance of adhesion by different species.

  8. Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com; Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy); Ballicu, Nicola, E-mail: nicolaballicu77@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy)

    2016-01-15

    PurposeTo retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture.Materials and MethodsThirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure.ResultsIn all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients’ walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites.ConclusionOur results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.

  9. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  10. The geometry of the bone structure associated with total hip arthroplasty.

    Zhang Yang

    Full Text Available Close adaptation of the prosthesis to the bone is the key to achieving optimal stability and fixation for total hip arthroplasty (THA. However, there have been no adequate studies of bone morphology, especially in different races. The aim of this study was to analyze the geometry of the acetabulum and proximal femur of people from South China, based on three-dimensional reconstruction, and to detect differences between different population subsets. CT scans were performed on 80 healthy volunteers (160 hips from South China, comprising 40 males (80 hips and 40 females (80 hips. The images were imported into Mimics 10.01 to perform 3D reconstruction. THA-associated anatomical parameters were measured and compared with other published data. In comparison with published data, it seemed that people from South China have smaller acetabular abduction angle, larger acetabular supro-inferior diameter, larger neck-shaft angle, smaller offset, thinner femoral shaft and more proximal isthmus, which needed to be further confirmed. There were significant differences between the genders in most parameters. As significant differences in canal flare index (CFI and distal canal flare index (DCFI were found between genders, it was concluded the most significant differences lay in the isthmus of the femur. Among the femora, according to Noble's classification we identified more normal types and fewer stovepipe and champagne-flute types than expected from the literature, indicating that uncemented prostheses would be suitable for most people from South China. Our findings reveal that simply choosing the smallest of a series of prostheses would not necessarily provide a good fit, due to the different trends from the proximal to the distal part of the femur. Significant variation exists in THA-associated anatomy between genders and population subsets. It is therefore imperative that each patient receives individual consideration rather than assuming all patients have