scholarly journals Periacetabular Osteotomy Restores the Typically Excessive Range of Motion in Dysplastic Hips With a Spherical Head

2014 ◽  
Vol 473 (4) ◽  
pp. 1404-1416 ◽  
Author(s):  
Simon D. Steppacher ◽  
Corinne A. Zurmühle ◽  
Marc Puls ◽  
Klaus A. Siebenrock ◽  
Michael B. Millis ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Periacetabular Osteotomy ◽  
Spherical Head

Postoperative excessive anterior acetabular coverage is associated with decrease in range of motion after periacetabular osteotomy

2020 ◽  
pp. 112070002091037 ◽  
Author(s):  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Nao Shibanuma ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Internal Rotation ◽  
Hip Dysplasia ◽  
External Rotation ◽  
Periacetabular Osteotomy ◽  
Femoral Anteversion ◽  
Acetabular Coverage ◽  
3 Dimensional ◽  
The Relationship

Purpose: The aim of this study was to evaluate the relationship between acetabular 3-dimensional (3D) alignment reorientation and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Methods: 50 patients (58 hips) with hip dysplasia participated in the study and underwent curved PAO. The pre- and postoperative 3D centre-edge (CE) angles and femoral anteversion were measured and compared with clinical outcomes, including postoperative ROM. Results: The correlation between pre- and postoperative acetabular coverage and postoperative ROM was evaluated. Postoperative abduction and internal rotation ROM were significantly associated with postoperative lateral CE angles (abduction; p < 0.001, internal rotation; p = 0.028); flexion and internal rotation ROM was significantly associated with postoperative anterior CE angles (flexion; p < 0.001, internal rotation; p = 0.028). Femoral anteversion was negatively correlated with postoperative abduction ( p = 0.017) and external rotation ( p = 0.047) ROM. Conclusion: Postoperative anterior acetabular coverage may affect internal rotation ROM more than the lateral coverage. Therefore, the direction of acetabular reorientation should be carefully determined according to 3D alignment during PAO.

Pelvic morphology medial to the femoral head center predicts anterior coverage and range of motion after curved periacetabular osteotomy

2020 ◽  
Vol 38 (9) ◽  
pp. 2031-2039 ◽  
Author(s):  
Tomoyuki Kamenaga ◽  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Koji Fukuda ◽  
Koji Takayama ◽  
...  
Keyword(s):  
Femoral Head ◽  
Range Of Motion ◽  
Periacetabular Osteotomy ◽  
Pelvic Morphology ◽  
Curved Periacetabular Osteotomy ◽  
Femoral Head Center

scholarly journals Ipsilateral Hip Dysplasia in Patients with Sacral Hemiagenesis: A Report of Two Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Tadatsugu Morimoto ◽  
Motoki Sonohata ◽  
Masaaki Mawatari
Keyword(s):  
Range Of Motion ◽  
Periacetabular Osteotomy ◽  
Rare Condition ◽  
Developmental Dysplasia ◽  
Hip Pain ◽  
Neurological Deficits ◽  
Allogeneic Bone ◽  
Leg Length ◽  
Length Discrepancy ◽  
Sacral Agenesis

Sacral agenesis (SA) is a rare condition consisting of the imperfect development of any part of the sacrum. This paper describes two cases of the rare cooccurrence of ipsilateral SA and developmental dysplasia of the hip (DDH) and analyzes possible contributory factors for SA and DDH. Each of a 16-year-old female and 13-year-old female visited our hospital for left hip pain and limping. The findings of physical examinations showed a lower limb length discrepancy (left side) in both cases, as well as left hip pain without limitations of the range of motion or neurological deficits. Initial radiographs demonstrated left subluxation of the left hip with associated acetabular dysplasia and partial left sacral agenesis. MRI revealed a tethering cord with a fatty filum terminale, and periacetabular osteotomy combined with allogeneic bone grafting was performed. After the surgery, the patients experienced no further pain, with no leg length discrepancy and were able to walk without a limp, being neurologically normal with a normal left hip range of motion. The cooccurrence of SA and DDH suggests a plausible hypothesis to explain the embryogenic relationship between malformation of the sacrum and hip.

scholarly journals THE RELATIONSHIP OF ACETABULAR AND FEMORAL VERSION IN PATIENTS UNDERGOING PERIACETABULAR OSTEOTOMY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Andrea M. Spiker ◽  
Kara G. Fields ◽  
Alexandra Wong ◽  
Ernest L. Sink
Keyword(s):  
Range Of Motion ◽  
Patient Reported Outcomes ◽  
Periacetabular Osteotomy ◽  
Patient Reported Outcome Measures ◽  
Harris Hip Score ◽  
Weak Correlation ◽  
Acetabular Version ◽  
Femoral Version ◽  
Patient Reported ◽  
The Relationship

Background: Hip dysplasia is a complex, three dimensional diagnosis. Little is known about version (acetabular, femoral and the relationship between the two) in dysplastic patients. We sought to 1) compare femoral and acetabular version between hips that underwent a primary periacetabular osteotomy (PAO) versus nondysplastic hips (CEA >25degrees); 2) estimate the correlation between femoral and acetabular version in dysplastic hips; 3) estimate the correlation of femoral and acetabular version with preoperative range of motion in dysplastic hips; 4) estimate the association of femoral and acetabular version with patient-reported outcome measures 11-23 months postoperatively in patients that underwent PAO. We hypothesized an association between acetabular and femoral version, and an association between version and patient reported outcomes. Methods: We retrospectively reviewed our institution’s hip registry to identify all PAO patients from March 2010 and June 2016. We included patients who had pre-operative computed tomography (CT) imaging and a minimum of 1 year follow-up. We created a comparison group of non-dysplastic patients (CEA > 25degrees). We calculated the association between acetabular version, femoral version and hip range of motion (ROM), as well as between femoral version, acetabular version, age, sex, and preoperative and 1 year postoperative modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and International Hip Outcome Tool 33 (iHOT33) score. Results: 75 PAO patients met inclusion criteria (93% female, mean age 24) and 1332 non-dysplastic patients (45% female, mean age 25). Pre-operative CT measurements (95% CI) demonstrated mean CEA for our PAO patients was 24, and for the non-dysplastic group 37. We found a very weak correlation between acetabular version and femoral version. Dysplastic patients had significantly greater acetabular and femoral version than nondysplastic patients (8 vs 1 at 1 o’clock; 15 vs 10 at 2 o’clock; 21 vs 16 at 3 o’clock, FV 21 vs 14, all p<0.001). We found only a weak correlation of hip ROM to acetabular version, but there was a moderate correlation of hip ROM and femoral version. We found no evidence of an association between mHHS, HOS-activities of daily living (ADL), HOS-sport specific (SS), or iHOT-33 scores and pre-operative femoral version, acetabular version, age, or sex. Conclusions/Significance: Our current investigation confirmed a statistically higher acetabular and femoral version in dysplastic hips than nondysplastic hips. However, while acetabular version measurements correlated strongly, there was only a very weak correlation between acetabular version and femoral version. Pre-operative ROM was correlated only moderately with femoral version, but not correlated with acetabular version. Additionally there was no association with acetabular or femoral version and patient reported outcomes after PAO, suggesting that femoral version does not need to be addressed at the time of PAO surgery.

scholarly journals Overcorrection of the acetabular roof angle or anterior center–edge angle may cause decrease of range of motion after curved periacetabular osteotomy

2020 ◽  
Author(s):  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Tomoyuki Kamenaga ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Periacetabular Osteotomy ◽  
Weight Bearing ◽  
Linear Regression Analysis ◽  
Femoral Anteversion ◽  
Acetabular Roof ◽  
Acetabular Fragment ◽  
Center Edge ◽  
Roof Angle

ABSTRACT The aim of this study was to evaluate the relationship between the correction of radiographic parameters and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Sixty-nine patients with hip dysplasia were enrolled and underwent curved PAO. The pre- and post-operative 3D center–edge (CE) angles, total anteversion (acetabular and femoral anteversion), and radiographic acetabular roof angle were measured and compared with the post-operative ROM. The aim of surgery was to rotate the central acetabular fragment laterally without anterior or posterior rotation. Multiple linear regression analysis demonstrated that post-operative internal rotation at 90° flexion was significantly associated with the post-operative Tönnis sourcil angle (rr = 0.31, P = 0.02) and that the post-operative ROM of flexion and internal rotation at 90° flexion were significantly associated with the anterior CE (flex; rr = −0.44, P = 0.001, internal rotation at 90° flexion; rr = −0.44, P &lt; 0.001). However, we found no association between the lateral CE, femoral anteversion, or total anteversion and the post-operative ROM. We demonstrated that the overcorrection of the acetabular roof angle or anterior CE angle may cause a decrease in the range of motion after curved PAO. Therefore, surgeons need to be careful during surgery to prevent the overcorrection of the weight-bearing area and anterior acetabular coverage of the acetabular fragment to avoid femoroacetabular impingement after PAO.

Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Disk Herniation ◽  
Fourth Edition ◽  
Recurrent Injury ◽  
Injury Model ◽  
Whole Person ◽  
Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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