Hip-preserving surgery for nonunion about the hip

2021 ◽  
Author(s):  
Kenneth A. Egol ◽  
Timothy Walden ◽  
Jonathan Gabor ◽  
Philip Leucht ◽  
Sanjit R. Konda
Keyword(s):  
Hip Preserving Surgery

scholarly journals Complications of hip preserving surgery

2021 ◽  
Vol 6 (6) ◽  
pp. 472-486
Author(s):  
Markus S. Hanke ◽  
Till D. Lerch ◽  
Florian Schmaranzer ◽  
Malin K. Meier ◽  
Simon D. Steppacher ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Periacetabular Osteotomy ◽  
Preoperative Evaluation ◽  
Femoral Torsion ◽  
Labral Tears ◽  
Hip Preserving Surgery ◽  
Technical Advances ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Preoperative evaluation of the pathomorphology is crucial for surgical planning, including radiographs as the basic modality and magnetic resonance imaging (MRI) and case-based additional imaging (e.g. 3D-CT, abduction views). Hip arthroscopy (HAS) has undergone tremendous technical advances, an immense increase in use and the indications are getting wider. The most common indications for revision arthroscopy are labral tears and residual femoroacetabular impingement (FAI). Treatment of borderline developmental dysplastic hip is currently a subject of controversy. It is paramount to understand the underlining problem of the individual hip and distinguish instability (dysplasia) from FAI, as the appropriate treatment for unstable hips is periacetabular osteotomy (PAO) and for FAI arthroscopic impingement surgery. PAO with a concomitant cam resection is associated with a higher survival rate compared to PAO alone for the treatment of hip dysplasia. Further, the challenge for the surgeon is the balance between over- and undercorrection. Femoral torsion abnormalities should be evaluated and evaluation of femoral rotational osteotomy for these patients should be incorporated to the treatment plan. Cite this article: EFORT Open Rev 2021;6:472-486. DOI: 10.1302/2058-5241.6.210019

Is MRI an adequate replacement for CT scans in the three-dimensional assessment of acetabular morphology?

2018 ◽  
Vol 60 (6) ◽  
pp. 726-734 ◽  
Author(s):  
Jens Goronzy ◽  
Sophia Blum ◽  
Albrecht Hartmann ◽  
Verena Plodeck ◽  
Lea Franken ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Three Dimensional ◽  
Ct Scans ◽  
Acetabular Version ◽  
Rater Reliability ◽  
Equal Distribution ◽  
Observer Reliability ◽  
Acetabular Morphology ◽  
Hip Preserving Surgery ◽  
Ct And Mri

Background Appropriate three-dimensional imaging of the hip joint is a substantial prerequisite for planning and performing surgical correction of deformities. Although surgeons still use computed tomography (CT), modern and fast acquisition techniques of volumetric imaging using magnetic resonance imaging (MRI) for pelvic measurements enable similar resolution. Purpose This study was designed to determine if already described measures of acetabular morphology are comparable in both techniques and if assessment can be performed with equal intra-observer and inter-observer reliability. Material and Methods Thirty-two hips (16 patients) were examined with a pelvic CT and a MRI with 3-T. Pelvic orientation was standardized by each observer in coronal, axial, and sagittal planes. Acetabular version as well as seven acetabular sector angles were measured by two observers twice with a minimum of four weeks between sessions. Results Inter-rater reliability showed excellent results for intra- and inter-rater reliability for CT (0.977–0.999) and MRI (0.969–0.998) measuring acetabular version and sector angles. Evaluating the reliability of CT and MRI for each observer revealed excellent results (0.972–0.998). Evaluating the Bland–Altman plots for intra-observer reliability showed an equal distribution of angles, within acceptable 95% limits of agreement. The same results were observed for inter-observer reliability evaluating CT and MRI as well as inter-method reliability. Conclusion Modern MRI scans are equally applicable to assess the bony pelvis as CT scans. In addition, MRI would enable the examination of soft tissues such as chondrolabral structures and muscle in the same examination. Since hip-preserving surgery is mostly conducted in younger patients, the reduction of radiation exposure is a benefit.

Hip preserving surgery for avascular hip necrosis: does terminating exposure to known risk factors improve survival?

2020 ◽  
Vol 48 (3) ◽  
pp. 335-341 ◽  
Author(s):  
Roger Erivan ◽  
Hicham Riouach ◽  
Guillaume Villatte ◽  
Bruno Pereira ◽  
Stéphane Descamps ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Preserving Surgery ◽  
Hip Necrosis

scholarly journals Imaging Methodology for Hip Preservation: Techniques, Parameters, and Thresholds

2019 ◽  
Vol 23 (03) ◽  
pp. 197-226 ◽  
Author(s):  
Vasco V. Mascarenhas ◽  
Olufemi R. Ayeni ◽  
Niels Egund ◽  
Anne G. Jurik ◽  
António Caetano ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Hip Arthroscopy ◽  
Future Research ◽  
Limited Evidence ◽  
High Quality ◽  
The Past ◽  
Hip Impingement ◽  
Hip Preserving Surgery ◽  
Imaging Methodology ◽  
Number Of Publications

The concept of hip impingement and hip-preserving surgery has been appreciated in more detail since 2001 when a new surgical approach was reported and a hypothesis linking femoroacetabular impingement (FAI) with osteoarthritis was presented. Paralleling the introduction of hip arthroscopy, these events led to an increasing interest in the hip, and the number of publications has risen rapidly over the past 15 years, despite limited evidence levels and inconsistent methodology. Accordingly, etiology, diagnosis, prognosis, and the effects of treatment for FAI are still elusive due to a number of uncertainties and a lack of clear diagnostic criteria.Future research must focus on developing high-quality scientific studies, so thorough and reproducible methodology is needed. This review provides researchers, radiologists, and clinicians with a comprehensive approach to hip imaging with a focus on strategies to help guide the clinical diagnosis. Using evidence from current literature and knowledge from experienced clinicians, some of the imaging methodology challenges are deciphered.

Reliability of Tönnis classification in early hip arthritis: a useless reference for hip-preserving surgery

2015 ◽  
Vol 136 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Marius Valera ◽  
Natalia Ibañez ◽  
Rogelio Sancho ◽  
Marc Tey
Keyword(s):  
Hip Arthritis ◽  
Hip Preserving Surgery

scholarly journals Experiences of living with developmental dysplasia of the hip in adults not eligible for surgical treatment: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052486
Author(s):  
Martin Dan Jorgensen ◽  
Sarah Bournonville Frederiksen ◽  
Dorthe Sørensen ◽  
Julie Sandell Jacobsen
Keyword(s):  
Qualitative Study ◽  
Hip Osteoarthritis ◽  
Developmental Dysplasia ◽  
Point Of View ◽  
Joint Disease ◽  
Hip Preserving Surgery ◽  
Considerable Impact ◽  
Physical Limitations ◽  
And Coping ◽  
Dysplasia Of The Hip

ObjectivesAdults with developmental dysplasia of the hip face barriers in their everyday lives due to pain and physical limitations. In Denmark, some patients may not be eligible for hip-preserving surgery due to being overweight, hip osteoarthritis, age above 45 years, negative impingement test or not wishing to undergo surgery. These patients are left with no evidence-based treatment option. The patient perspective when not being eligible for surgery has not yet been investigated. This study aimed to explore the experiences of living with developmental dysplasia of the hip in adults not eligible for hip-preserving surgery.Design and participantsIn this qualitative study, we used a phenomenological–hermeneutic approach to explore the experiences of living with developmental dysplasia of the hip. We conducted semistructured interviews with 17 purposefully selected patients (median age 37 (range 19–50) years). The patients were recruited from a population of 30 patients included in a larger feasibility study evaluating a 6-month exercise and patient education intervention. We used a ricoeur-inspired method to analyse and interpret the interview data.ResultsThree themes were identified. First, developmental dysplasia of the hip is more than just a joint disease. Second, living with pain is difficult when pain has its own life. Third, limitations imposed by hip problems challenge the perception of oneself as young, active and independent. Identity, meaningfulness, control over pain and coping with pain were areas of the patients’ lives that were influenced.ConclusionLiving with developmental dysplasia of the hip had a considerable impact on the patients of this study and their everyday life in several areas. Therefore, it may be relevant to approach patients with developmental dysplasia of the hip from a biopsychosocial point of view. However, further research is required to obtain a better understanding of the experiences of living with developmental dysplasia of the hip.

Hip-Preserving Surgery

The Hip Joint ◽  
2021 ◽  
pp. 393-412
Author(s):  
Hiran Amarasekera
Keyword(s):  
Hip Preserving Surgery

scholarly journals Hip preservation

2020 ◽  
Vol 5 (10) ◽  
pp. 630-640
Author(s):  
Markus S. Hanke ◽  
Florian Schmaranzer ◽  
Simon D. Steppacher ◽  
Till D. Lerch ◽  
Klaus A. Siebenrock
Keyword(s):  
Surgical Planning ◽  
Periacetabular Osteotomy ◽  
Slipped Capital Femoral Epiphysis ◽  
Developmental Dysplasia ◽  
Perthes Disease ◽  
Long Term Results ◽  
Inclusion Type ◽  
Open Treatment ◽  
Hip Preserving Surgery ◽  
Magnetic Resonance Imaging Mri

Classical indications for hip preserving surgery are: femoro-acetabular impingement (FAI) (intra- and extra-articular), hip dysplasia, slipped capital femoral epiphysis, residual deformities after Perthes disease, avascular necrosis of the femoral head. Pre-operative evaluation of the pathomorphology is crucial for surgical planning including radiographs as the basic modality and magnetic resonance imaging (MRI) and/or computed tomography (CT) to evaluate further intra-articular lesions and osseous deformities. Two main mechanisms of intra-articular impingement have been described: (1) Inclusion type FAI (‘cam type’). (2) Impaction type FAI (‘pincer type’). Either arthroscopic or open treatment can be performed depending on the severity of deformity. Slipped capital femoral epiphysis often results in a cam-like deformity of the hip. In acute cases a subcapital re-alignment (modified Dunn procedure) of the femoral epiphysis is an effective therapy. Perthes disease can lead to complex femoro-acetabular deformity which predisposes to impingement with/without joint incongruency and requires a comprehensive diagnostic workup for surgical planning. Developmental dysplasia of the hip results in a static overload of the acetabular rim and early osteoarthritis. Surgical correction by means of periacetabular osteotomy offers good long-term results. Cite this article: EFORT Open Rev 2020;5:630-640. DOI: 10.1302/2058-5241.5.190074

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