Towards a better understanding of the aetiology of Legg–Calvé–Perthes’ disease: Acetabular retroversion may cause abnormal loading of dorsal femoral head–neck junction with restricted blood supply to the femoral epiphysis

Abstract Periacetabular osteotomy (PAO) is effective in the management of developmental dysplasia of the hip and femoroacetabular impingement secondary to acetabular retroversion. During anteverting PAO for acetabular retroversion, the need for both labral treatment and femoral head–neck junction osteochondroplasty remains equivocal. Accordingly, this study evaluated patient-reported outcome measures (PROM) and reoperation rates after anteverting PAO with or without intraarticular intervention. Cases of anteverting PAO performed at a single institution between November 2009 and January 2016 were retrospectively reviewed. Patients were divided into three groups: no intervention and intraarticular intervention with arthrotomy or arthroscopy. Subsequently, patients were reclassified by the intraarticular procedure performed at surgery into major (labral repair, femoral head–neck osteochondroplasty) and minor (labral debridement, femoral/acetabular chondroplasty) groups. The cohort was 75% female, median age was 19.5 years and mean body mass index was 25.0 kg/m2. Preoperative to postoperative improvement was compared to minimal clinically important differences (MCID) for eight PROM. Patients receiving major interventions exceeded MCID in a greater proportion of PROM compared to minor and no intervention groups (P < 0.007); major or minor interventions did not increase the risk of reoperation over no intervention (P ≥ 0.39). Based on the current data, surgeons performing anteverting PAO for acetabular retroversion should perform arthroscopic or open labral repair and assess for impingement after the correction and perform a head–neck junction osteochondroplasty if indicated.

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Arthroscopic Treatment of Femoroacetabular Impingement Syndrome with Bone Cyst at Femoral Head-Neck Junction: Case Report and Literature Review

Journal of Cartilage & Joint Preservation ◽

10.1016/j.jcjp.2021.100020 ◽

2021 ◽

pp. 100020

Author(s):

Hong-Jie Huang ◽

Hao Sun ◽

Xin Zhang ◽

Mamtimin Mahmut ◽

Fan Yang ◽

...

Keyword(s):

Case Report ◽

Femoral Head ◽

Literature Review ◽

Femoroacetabular Impingement ◽

Bone Cyst ◽

Impingement Syndrome ◽

Arthroscopic Treatment ◽

Femoroacetabular Impingement Syndrome ◽

Head Neck ◽

Neck Junction

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Do Normal Radiographs Exclude Asphericity of the Femoral Head-Neck Junction?

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-008-0617-5 ◽

2008 ◽

Vol 467 (3) ◽

pp. 651-659 ◽

Cited By ~ 128

Author(s):

Marcel Dudda ◽

Christoph Albers ◽

Tallal Charles Mamisch ◽

Stefan Werlen ◽

Martin Beck

Keyword(s):

Femoral Head ◽

Head Neck ◽

Neck Junction

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The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.84b4.0840556 ◽

2002 ◽

Vol 84-B (4) ◽

pp. 556-560 ◽

Cited By ~ 263

Author(s):

H. P. Nötzli ◽

T. F. Wyss ◽

C. H. Stoecklin ◽

M. R. Schmid ◽

K. Treiber ◽

...

Keyword(s):

Femoral Head ◽

Head Neck ◽

Neck Junction

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Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset

Hip International ◽

10.1177/1120700018814473 ◽

2018 ◽

Vol 29 (6) ◽

pp. 647-651 ◽

Cited By ~ 1

Author(s):

Giuseppe Valente ◽

Brent Lanting ◽

Steven MacDonald ◽

Matthew G Teeter ◽

Douglas Van Citters ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Head Size ◽

Material Loss ◽

Total Hip ◽

Femoral Heads ◽

Measuring Machine ◽

Head Neck ◽

Neck Junction

Introduction:Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces.Methods:A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included n = 56 of the 28-mm heads and n = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time in vivo and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined.Results:There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters ( p = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems ( p = 0.79), and regular or high-offset stems ( p = 0.95).Conclusion:There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

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Head-Neck Taper Corrosion in Hip Arthroplasty

BioMed Research International ◽

10.1155/2015/758123 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 63

Author(s):

S. Hussenbocus ◽

D. Kosuge ◽

L. B. Solomon ◽

D. W. Howie ◽

R. H. Oskouei

Keyword(s):

Femoral Head ◽

Hip Arthroplasty ◽

Design Feature ◽

Review Article ◽

Femoral Head Size ◽

Leg Length ◽

Wear Properties ◽

Femoral Stems ◽

Head Neck ◽

Neck Junction

Modularity at the head-neck junction of the femoral component in THA became popular as a design feature with advantages of decreasing implant inventory and allowing adjustment of leg length, offset, and soft tissue balancing through different head options. The introduction of a new modular interface to femoral stems that were previously monoblock, or nonmodular, comes with the potential for corrosion at the taper junction through mechanically assisted crevice corrosion. The incidence of revision hip arthroplasty is on the rise and along with improved wear properties of polyethylene and ceramic, use of larger femoral head sizes is becoming increasingly popular. Taper corrosion appears to be related to all of its geometric parameters, material combinations, and femoral head size. This review article discusses the pathogenesis, risk factors, clinical assessment, and management of taper corrosion at the head-neck junction.

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