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Hip & Pelvis

Matthew Pina, Alexander D Gaukhman, Brett Hayden, Eric L Smith
Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip...
March 2019: Hip & Pelvis
J P H van Leur, T S C Jakma, S P Willemsen, B J Punt
Purpose: This study was performed to compare outcomes of the Trochanteric Fixation Nail (TFN®) with a helical blade versus TFN® with a femoral neck screw for the treatment of intertrochanteric femoral fractures. Materials and Methods: A single center, retrospective cohort study. Patients (>18 years of age) with an intertrochanteric femoral fracture, who were operated on between January 1, 2012 and December 31, 2016 were included. Primary and secondary outcome measures were cut-out rate and intervention variables, respectively...
March 2019: Hip & Pelvis
Sandeep Kashyap, Yogesh Diwan, Shweta Mahajan, Deepa Diwan, Mukand Lal, Randhir Chauhan
Purpose: Corona mortis is an abnormal arterial or venous anastomosis between the external iliac and the obturator system of vessels and may cause significant hemorrhage during pelvi-acetabular fracture surgeries, hernia repair and laparoscopic gynecological procedures. Previous studies have estimated a prevalence of corona mortis between 34% and 70%. This cadaveric study was conducted to estimate the prevalence of corona mortis in the North Indian population. Materials and Methods: Twelve cadavers (24 hemipelvises; 11 males and 1 female) with a mean age of 68 (range, 54-82) years were included in this study...
March 2019: Hip & Pelvis
Kenta Kamo, Hidehiko Kido, Satoshi Kido
Purpose: The difficulty of femoral preparation with supine-position hip hemi-arthroplasty (HA) often leads to intra-operative fractures (IOFs). We aimed to clarify the incidence and types of IOFs in HA for hip fractures performed in the supine and lateral positions. Materials and Methods: We retrospectively investigated cases of HA for acute femoral neck fractures from June 2013 to May 2018. We examined the incidence and types of IOFs according to different approaches...
March 2019: Hip & Pelvis
Jongho Noh, Kee Haeng Lee, Sehoon Jung, Sunwook Hwang
Purpose: Isolated greater trochanteric (GT) fractures are often identified using plain radiography of patients with post-traumatic hip pain. In many cases, the fracture extends to form an occult intertrochanteric fracture. We conducted a study to determine the frequency of occult intertrochanteric fractures in patients diagnosed with isolated GT fractures using plain radiographs. Materials and Methods: Among 3,017 individuals who visited our emergency department with a trauma-induced pertrochanteric femur fracture between July 2004 and March 2018, 100 patients diagnosed with isolated GT fractures using plain radiographs were retrospectively analyzed...
March 2019: Hip & Pelvis
Pradyumna Raval, Alistair I W Mayne, Phey Ming Yeap, Thomas Barry Oliver, Arpit Jariwala, Sankar Sripada
Purpose: Occult hip fractures in the elderly can be missed on standard radiographs and are a known cause of morbidity. These are generally diagnosed on either magnetic resonance imaging (MRI) or computed tomography scan, depending upon local hospital policy. While there is an abundance of literature on hip fractures in general, little is known about the clinical outcome of patients with occult hip fractures. The aim of this study was to review the demographics, injury characteristics, management and clinical outcome of patients diagnosed with occult femoral neck fractures on MRI...
March 2019: Hip & Pelvis
Soong Joon Lee, Kang Sup Yoon
Purpose: Short stems have recently become widely used; however, concerns about the initial secure fixation of a short stem in osteoporotic bone remain. The aim of this study was to evaluate the short-term clinical and radiological results of using a short cementless metaphyseal stabilizing tapered stem for senile osteoporotic femoral neck fractures. Materials and Methods: Thirty-eight arthroplasties (31 bipolar hemiarthroplasties and 7 total hip arthroplasties) were performed for osteoporotic femoral neck fractures in patients older than 65 years (10 males and 28 females)...
March 2019: Hip & Pelvis
Sang Hong Lee, Chae Won Lim, Kwi Youn Choi, Suenghwan Jo
When spine-pelvic motion is normally coordinated, the pelvis may tilt posteriorly and acetabular anteversion may increase as the patient's position changes from standing to sitting; this scenario allows for improved clearance of the femoral head and neck during hip flexion. However, changes in the mobility of the spine and pelvis may result in impingement after total hip arthroplasty (THA), with the most obvious complication being dislocation. Understanding the spinal-pelvic relationship in the sagittal plane is essential for planning THA in patients with spinal fusion or a known spine disease...
March 2019: Hip & Pelvis
Javad Parvizi, Kyung-Hoi Koo
Periprosthetic joint infection (PJI) is one of the most serious complications after total joint arthroplasty (TJA). The prevalence of urinary tract infection (UTI) is common, particularly among elderly women, a group for whom TJA may be required. The association between preoperative UTI and increased risk of PJI after TJA is unclear. We reviewed key articles concerning the relationship between UTIs and PJI, and summarized recommendations of international consensus on PJI, which was established in Philadelphia in July of 2018...
March 2019: Hip & Pelvis
Lokesh Gudda Naik, Won Yong Shon, I C Clarke, Jun-Gyu Moon, Piyush Mukund, Sang-Min Kim
Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty...
December 2018: Hip & Pelvis
Avinash Kumar Rai, Rajesh Goel, Chirag Bhatia, Sumer Singh, Srikiran Thalanki, Ashwin Gondane
Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun...
December 2018: Hip & Pelvis
Irfan Qadir, Saeed Ahmad, Atiq Uz Zaman, Chirag Muhammad Khan, Shahzad Ahmad, Amer Aziz
Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015...
December 2018: Hip & Pelvis
Cheon-Gon Park, Taek-Rim Yoon, Kyung-Soon Park
Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ≥45 years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed...
December 2018: Hip & Pelvis
Jun-Il Yoo, Yong-Han Cha, Kap-Jung Kim, Ha-Yong Kim, Won-Sik Choy, Sun-Chul Hwang
Purpose: This study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies. Materials and Methods: Systematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types...
December 2018: Hip & Pelvis
Jae Han Ko, Suhan Lim, Young Han Lee, Ick Hwan Yang, Jin Hwa Kam, Kwan Kyu Park
Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015...
December 2018: Hip & Pelvis
Kazumasa Maeda, Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA...
December 2018: Hip & Pelvis
Dae-Kyung Kwak, Ick-Hwan Yang, Sungjun Kim, Sang-Chul Lee, Kwan-Kyu Park, Woo-Suk Lee
Purpose: Ischiofemoral impingement (IFI)-primarily diagnosed by magnetic resonance imaging (MRI)-is an easily overlooked disease due to its low incidence. The purpose of this study was to evaluate the usefulness of false profile view as a screening test for IFI. Materials and Methods: Fifty-eight patients diagnosed with IFI between June 2013 and July 2017 were enrolled in this retrospective study. A control group (n=58) with matching propensity scores (age, gender, and body mass index) were also included...
December 2018: Hip & Pelvis
Joong-Myung Lee, Young-Suk Sim, Dae-Sung Choi
Purpose: This is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the Bencox® hip stem-the first Korean-developed hip prosthesis. Materials and Methods: A consecutive series of 1,000 hip arthroplasties using the Bencox® hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84)...
December 2018: Hip & Pelvis
Kyung-Jae Lee, Byung-Woo Min
Atypical femoral fractures differ from ordinary femoral diaphyseal or subtrochanteric fractures in several aspects. Although several authors have reported the results of surgical treatment for atypical femoral fractures, the rate of complications (e.g., delayed union, nonunion, fixation failure, and reoperation) is still high. Therefore, we reviewed principles of surgical treatment and describe useful methods for overcoming femoral bowing in these high-risk patients.
December 2018: Hip & Pelvis
Jun-Shik Kim
In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors...
December 2018: Hip & Pelvis
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