Femoral Retroversion

BACKGROUND: Although high-energy trauma mechanisms are generally considered to cause traumatic posterior hip dislocations, femoroacetabular variations are assumed to contribute to low-impact hip dislocations. Thus, the present study aimed to identify morphologic femoral and acetabular risk factors that may also contribute to posterior hip dislocations in high-energy trauma mechanisms. METHODS: The acetabular and femoral morphology of 83 hips with a traumatic posterior dislocation following a high-energy trauma mechanism were analyzed and matched to a control group of 83 patients who sustained high-energy trauma without a hip injury...

Hip capsular preservation literature shows varying outcome. Capsular preservation is most common in the United States. Different surgeons prefer, and different patients require simple periportal capsulotomies versus wider exposure with T-type capsulotomy and traction stitches. Revision cases require wider expose. Paramount is adequate bony decompression in patients with FAI, but capsular preservation may also be universally recommended. Finally, in addition to revision indications, some hip phenotypes may require more aggressive capsular management...

BACKGROUND: Developmental Coxa Vara (DCV) consists on a pathological reduction in head-shaft angle (HSA) and increased femoral retroversion. Several case series reported outcomes on proximal femoral valgus osteotomy (PFVO), but no evidence synthesis had been conducted. This systematic review aimed to (1) analyze success rate and complications, (2) report the degree of correction according to the HSA and the Hilgenreiner Epiphyseal Angle (HEA), compare success rate and degree of correction of subtrochanteric (SVO) vs intertrochanteric (IVO) osteotomy, and (4) difference in success rate and correction between patients in which an internal (IF) or external fixation (EF) technique was used...

We examined the remains of an individual who was unearthed from the Tuchengzi site and was believed to be from the Warring States period in China. The remains exhibited segmental femoral fracture. We aimed to deduce the cause of fracture, medical interventions, healing process, and motion behavior after fracture healing using several techniques, including macroscopic observation, computed tomography (CT), and finite element analysis. Based on the morphology of the long bones, it appeared that the individual was male...

INTRODUCTION AND IMPORTANCE: Total hip arthroplasty is one of the most performed surgical interventions in the world. Adverse local tissue reactions and pseudotumors are infrequent but dangerous eventualities, which are often related with metal-on-metal or metal-on-polyethylene implants. This study wants to highlight how adverse local tissue reactions and pseudotumors must be taken into consideration during the diagnostic process. CASE PRESENTATION: We report the case of a patient with ceramic-on-ceramic modular total hip arthroplasty with titanium neck...

BACKGROUND: Studies have correlated symptomatic femoroacetabular impingement (FAI) with femoral retroversion and cam lesions. PURPOSE: To investigate any association between femoral and acetabular versions with cam deformity in a largely asymptomatic population. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 986 cadaveric hips were selected from a historical osteologic collection. Each hip was assessed to determine the femoral and acetabular versions, anterior offset, and alpha angle...

INTRODUCTION: The genu recurvatum is characterized by a hyperextension deformity of the knee in the sagittal plane. Among its causes are conditions such as arthrogryposis, cerebral palsy, poliomyelitis, sequelae of tibial tuberosity fracture and some syndromes with generalized joint hypermobility. Treatment of this deformity can be challenging and, to date, aggressive methods such as femur or tibial osteotomies are the most used for its correction. OBJECTIVE: This study aimed to describe a new surgical technique for correcting genu recurvatum...

Femoroacetabular impingement (FAI) is a frequent cause of hip pain in young people and athletes. It requires a complete work-up, including X-rays, hip arthro-MRI and CT coxometry with measurement of femoral torsion. The surgical management of CFA must be adapted to the morphological anomalies of the femur (cam), acetabulum (pincer) and femoral torsional disorders. Most CFA can be treated by hip arthroscopy, with correction of the cam and suture of the labrum. Some CFA with a bulky or posterior cam require surgical hip dislocation...

Motion in the spine, pelvis and hips - which make up the spinopelvic femoral complex (SPFC) - implies mechanical relationships that help maintain trunk balance and optimize hip function. When a person sits, the pelvis goes into retroversion and the acetabulum opens towards the front. This frees up the femoral head and neck to allow hip flexion. The inverse - pelvic anteversion - occurs when a person stands. When pelvic mobility is limited, the hip must increase its range of motion to adjust to these changes in posture...

PURPOSE: Virtual reality (VR) training effectiveness in improving hip arthroplasty surgical skills requires further evaluation. We hypothesised VR training could improve accuracy and the time taken by medical students compared to a control group with only video teaching. METHODS: This single-centre randomized controlled clinical trial collected data from March to June 2023. Surgically naïve volunteer undergraduate medical students performed three sessions on a VR training platform, either cup (VR-Cup=Control-Stem) or stem (VR-Stem=Control-Cup) implantation...

INTRODUCTION: With the recent interest in hip-spine relationship, the link between femoroacetabular impingement (FAI) and the lumbar-pelvic-femoral complex (LPFC) appears decisive. The objectives of this study were (1) to compare the pelvic version, as well as (2) all the parameters of the LPFC between two populations of healthy subjects, comparing those with radiological signs of FAI to those without. Finally (3) to evaluate the LPFC parameters according to the type of FAI. HYPOTHESIS: Asymptomatic subjects with radiological signs of FAI had superior pelvic anteversion...

Bone and joint angular deformities are common pediatric orthopaedic problems that are often corrected surgically. Previous studies successfully demonstrated proximal femoral growth modulation in animal models, however outcome measurements were limited by two-dimensional (2D) analysis. In this study, six Yorkshire cross male piglets were treated with unilateral percutaneous transphyseal screw placement across the medial aspect of the proximal femoral physis and analyzed using 3D techniques. Three primary outcome measures were considered-physis angle, version, and femoral length...

AIMS: The primary aim of this trial was to compare the subsidence of two similar hydroxyapatite-coated titanium femoral components from different manufacturers. Secondary aims were to compare rotational migration (anteversion/retroversion and varus/valgus tilt) and patient-reported outcome measures between both femoral components. METHODS: Patients were randomized to receive one of the two femoral components (Avenir or Corail) during their primary total hip arthroplasty between August 2018 and September 2020...

CASE: A 78 year-old man fell 6 months after Sivash-range of motion (S-ROM) total hip arthroplasty (THA), after which he developed hip pain and external rotation deformity. Imaging showed stem malrotation in relative retroversion. Revision THA was delayed because of medical issues, occurring 1.5 years after the fall. No corrosion was observed intraoperatively at the stem-sleeve interface. His symptoms resolved after revision THA. CONCLUSION: We present a rare complication of S-ROM THA-dissociation of the femoral stem from the proximal sleeve, with subsequent re-engagement in static malrotation...

PURPOSE: The purpose of this study was to compare hip survivorship and patient-reported outcomes after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with versus without comorbid borderline hip dysplasia (BHD) at two-year follow-up. METHODS: A retrospective matched-cohort study was conducted involving patients who underwent primary hip arthroscopy for FAIS with a single surgeon from 2010-2019. BHD was defined as lateral center edge angle (LCEA) of 20-25°...

Femoroacetabular impingement syndrome (FAIS) is caused by a repetitive mechanical conflict between the acetabulum and the proximal femur, occurring in flexion and internal rotation. In cam impingement, bony prominences of the femoral head-neck junction induce chondrolabral damage. The acetabular type of FAIS, termed pincer FAIS, may be either due to focal or global retroversion and/or acetabular overcoverage. Combinations of cam and pincer morphology are common. Pathological femoral torsion may aggravate or decrease the mechanical conflict in FAI but can also occur in isolation...

BACKGROUND: The goal of this study was to better understand the variation of femoral neck version according to spinopelvic and lower limb 3D alignment using biplanar X-rays in standing position. METHODS: This multicentric study retrospectively included healthy subjects from previous studies who had free-standing position biplanar radiographs. Subjects were excluded if they presented spinal or any musculo-skeletal deformity, and reported pain in the spine, hip or knee...

OBJECTIVE: Hip arthroscopy for the treatment of symptomatic borderline developmental dysplasia of the hip (BDDH) has been controversial. The purpose of this study was to retrospectively analyze minimum 2-year outcomes of BDDH after arthroscopic surgery and explore the criteria and thresholds of the lateral center-edge angle (LCEA) in arthroscopic surgery for BDDH. METHODS: Data were retrospectively collected from patients aged 18-50 who underwent arthroscopic surgery for BDDH and had an LCEA 18-25° between September 2016 and June 2020...

Radiographs, magnetic resonance imaging, and computed tomography scans have been commonly used to evaluate femoroacetabular impingement (FAI) and are well accepted forms of surgical planning. Assessing and addressing both the femoral and acetabular sides result in a combination of "one-sided" treatments that, in sum, net a successful treatment of FAI. However, combining one-sided approaches may not consider the dynamic interaction of the femoral head with the acetabulum. Elevated alpha angles alone can be indicative of a cam-type lesion without necessitating the presence of functional FAI...

BACKGROUND: Several techniques have been adopted during primary reverse shoulder arthroplasty (RSA) to manage glenoid bone defect. Among bone grafts, humeral head autograft is currently the mainstream option. However, autologous humeral heads may be unavailable or inadequate and allografts may be a viable alternative. The aim of the present study was to evaluate the functional and radiological outcomes of femoral head allografts for glenoid bone defects in primary RSA. METHODS: We conducted a retrospective study with prospective data collection enrolling 20 consecutive patients who underwent RSA with femoral head allografts for glenoid bone defects...