Avulsion Fractures of the Femoral Head: Internal Fixation Using a Ventral Approach to the Hip Joint

1997 ◽  
Vol 10 (01) ◽  
pp. 23-26 ◽  
Author(s):  
P. M. Montavon ◽  
H. F. L’Eplattenier
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Joint ◽  
Cartilage Damage ◽  
Kirschner Wire ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Joint Surface ◽  
Avulsion Fractures ◽  
Lag Screw

SummaryAvulsion fractures of the femoral head are encountered in conjunction with craniodorsal luxations of the hip joint and cannot be treated conservatively without risking either reluxation of the joint or considerable cartilage damage resulting in degenerative joint disease. Fixation of the fragment is possible by inserting a Kirschner wire and a lag screw from the articular surface, making sure the implants are well countersunk. A ventromedial approach to the hip joint allows good visibility of the joint surface and easy reduction of the fracture without severing the round ligament. The surgical technique described was used on three cases and combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface, and has the advantages of enabling good reconstruction of the joint surface as well as maintaining postoperative joint stability. Both these factors considerably reduce the development of degenerative joint disease and improve the prognosis for recovery of full limb function.A surgical technique for treatment of avulsion fractures of the femoral head is described. It combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface.

A method for visualizing the dorsal acetabular rim and the coverage of the femoral head

2001 ◽  
Vol 14 (03) ◽  
pp. 151-155 ◽  
Author(s):  
J. Hoskinson ◽  
W. C. Renberg
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Prognostic Value ◽  
Degenerative Change ◽  
Femoral Shaft ◽  
Normal Activity ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Anatomical Landmarks ◽  
Acetabular Rim

SummaryThe authors describe a new technique to visualize the dorsal acetabular rim and the coverage of the femoral head in the nonsedated dog. The technique involves using an overhead beam, directed at an angle tangential to the dorsal rim of the acetabulum, with a film positioned caudal to the standing dog. Anatomical landmarks that can routinely be identified include: the ilial crest, ilial shaft, ischial tuberosity, acetabulum, acetabular rim (particularly the dorsocaudal component), femoral head, greater trochanter, femoral neck, femoral shaft, rectum and the tail. Because the animal is standing and is not sedated, the technique may have additional value as a means of evaluating subluxation of the hip joint. It maintains a posture as close as possible to that experienced by the animal in normal activity. If the technique has prognostic value in that regard, more investigation is needed, but it is useful in itself as a technique to visualize the area of the acetabulum.A new radiographic technique to evaluate the canine hip joint is described. The view involves tangential projection of the acetabulum in the standing, awake dog. Nineteen dogs have been radiographed to develop the technique and the method has been found to be technically simple and consistent. It allows examination of the dorsal acetabular rim and may help examine the amount of subluxation of the hip as well as the presence of any degenerative joint disease. The authors advocate additional study to determine the technique’s prognostic value in predicting degenerative change associated with hip dysplasia.

scholarly journals Selonsertib Alleviates the Progression of Rat Osteoarthritis: An in vitro and in vivo Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiyuan Yan ◽  
Yingchi Zhang ◽  
Gaohong Sheng ◽  
Bowei Ni ◽  
Yifan Xiao ◽  
...  
Keyword(s):  
Therapeutic Potential ◽  
Cartilage Damage ◽  
Cartilage Degradation ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Therapeutic Effects ◽  
Exact Role

Osteoarthritis (OA) is a prevalent degenerative joint disease. Its development is highly associated with inflammatory response and apoptosis in chondrocytes. Selonsertib (Ser), the inhibitor of Apoptosis Signal-regulated kinase-1 (ASK1), has exhibited multiple therapeutic effects in several diseases. However, the exact role of Ser in OA remains unclear. Herein, we investigated the anti-arthritic effects as well as the potential mechanism of Ser on rat OA. Our results showed that Ser could markedly prevent the IL-1β-induced inflammatory reaction, cartilage degradation and cell apoptosis in rat chondrocytes. Meanwhile, the ASK1/P38/JNK and NFκB pathways were involved in the protective roles of Ser. Furthermore, intra-articular injection of Ser could significantly alleviate the surgery induced cartilage damage in rat OA model. In conclusion, our work provided insights into the therapeutic potential of Ser in OA, indicating that Ser might serve as a new avenue in OA treatment.

scholarly journals Outcome of tantalum rod insertion in the treatment of osteonecrosis of the femoral head with minimum follow-up of 1 year: a meta-analysis and systematic review

2020 ◽  
Vol 7 (2) ◽  
pp. 329-339
Author(s):  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Jason Derry Onggo ◽  
Guan Tay ◽  
Parminder J Singh ◽  
...  
Keyword(s):  
Femoral Head ◽  
Subgroup Analysis ◽  
Bone Grafting ◽  
Meta Analysis ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Safe Alternative ◽  
Meta Analyses ◽  
Marginal Risk

Abstract Osteonecrosis of the femoral head (ONFH) is a debilitating disease that can cause deformity and collapse of the femoral head, thus leading to the development of degenerative joint disease that can incapacitate the patient with pain and reduction in hip mobility. This study aims to determine the safety and efficacy of tantalum rod insertion in the treatment of ONFH with a minimum follow-up period of 1 year. A multi-database search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Data from studies assessing the clinical and radiological outcomes as well as complications of tantalum rod insertion in the treatment of ONFH with a minimum follow-up period of 1 year were extracted and analyzed. Ten studies were included in this meta-analysis, consisting of 550 hips. There was a statistically significant increase in HHS (MD = 30.35, 95% CI: 20.60–40.10, P < 0.001) at final follow-up versus pre-operative scores. The weighted pooled proportion (PP) of radiographic progression of ONFH was 0.221 (95% CI: 0.148–0.316), while that of progression into femoral head collapse was 0.102 (95% CI: 0.062–0.162). Conversion to total hip arthroplasty (THA) had a PP of 0.158 (95% CI: 0.107–0.227) with a mean weighted period of 32.4 months (95% CI: 24.9–39.9 months). Subgroup analysis of conversion to THA when tantalum rods were used in conjunction with bone grafting (PP = 0.150, 95% CI: 0.092–0.235) showed a marginal risk reduction than when compared with subgroup analysis of tantalum rods being used alone (PP = 0.154, 95% CI: 0.078–0.282). Tantalum rod is a safe alternative option to the current joint-preserving procedures available in the treatment of ONFH. However, more studies are needed to investigate and identify the most appropriate patients who would benefit most and the synergistic effect brought on by the use of complementary biological augmentation of bone grafting or stem cells with tantalum rods.

scholarly journals Andrographis paniculata Extract Relieves Pain and Inflammation in Monosodium Iodoacetate-Induced Osteoarthritis and Acetic Acid-Induced Writhing in Animal Models

Processes ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. 873
Author(s):  
Donghun Lee ◽  
Chae Yun Baek ◽  
Ji Hong Hwang ◽  
Mi-Yeon Kim
Keyword(s):  
Acetic Acid ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Degenerative Joint Disease ◽  
Andrographis Paniculata ◽  
Joint Disease ◽  
Tnf Α ◽  
Monosodium Iodoacetate ◽  
History Of

Osteoarthritis (OA), being the most prominent degenerative joint disease is affecting millions of elderly people worldwide. Although Andrographis paniculata is an ethnic medicine with a long history of being used as analgesic agent, no study using a monosodium iodoacetate (MIA) model has investigated its potential activities against OA. In this study, experimental OA was induced in rats with a knee injection of MIA, which represents the pathological characteristics of OA in humans. A. paniculata extract (APE) substantially reversed the loss of hind limb weight-bearing and the cartilage damage resulted from the OA induction in rats. Additionally, the levels of serum pro-inflammatory cytokines, such as IL-1β, IL-6, and TNF-α as well as the concentration of matrix metalloproteinases, including MMP-1, MMP-3, MMP-8, and MMP-13 were decreased by APE administration. Acetic acid-induced writhing responses in mice which quantitatively measure pain were significantly reduced by APE. In vitro, APE inhibited the generation of NO and downregulated the expression of IL-1β, IL-6, COX-2, and iNOS in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The above results suggest the potential use APE as a therapeutic agent against OA.

scholarly journals Development of Total Hip Joint Replacement Prostheses Made by Local Material: An Introduction

2019 ◽  
Vol 130 ◽  
pp. 01032
Author(s):  
Tresna Priyana Soemardi ◽  
Agri Suwandi ◽  
Cholid Badri ◽  
Anwar Soefi Ibrahim ◽  
Sastra Kusuma Wijaya ◽  
...  
Keyword(s):  
Hip Joint ◽  
Joint Replacement ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Surgical Removal ◽  
Hip Joint Replacement ◽  
Total Hip ◽  
Joint Replacement Surgery ◽  
Local Material ◽  
Joint Prostheses

Total Hip Joint Replacement Surgery is the procedure of surgical removal of cartilage in the hip joints damaged by disease osteoarthritis to replaced with artificial components. Total Hip Joint Replacement has been indicated to relieve pain in the pelvis due to degenerative joint disease. In Indonesia, this procedure has been practised, but due to the cost of expensive products resulting in limited only to upper classify patients. The high prices caused by importing prostheses products, the technological capabilities and the difficulty to meet the standards of medical devices. The regulation of the Minister of Health of the Republic of Indonesia Number 52, 2016 for standard rates in organising health services Health Assurance Program, explained that the action of these operations entered into the insurance claims BPJS program, but not for the prostheses. This paper discusses the introduction of the development of the hip joint prostheses made from a local material that’s SS 316L, PEEK and Ceramic Dental Stone. The result of this development is the product of the hip joint prostheses has a reasonable price with good quality so that it can become affordable for middle to lower patients.

PPARγ preservation via promoter demethylation alleviates osteoarthritis in mice

2019 ◽  
Vol 78 (10) ◽  
pp. 1420-1429 ◽  
Author(s):  
Xiaobo Zhu ◽  
Fang Chen ◽  
Ke Lu ◽  
Ai Wei ◽  
Qing Jiang ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Knockout Mice ◽  
Cartilage Damage ◽  
Critical Role ◽  
Methylation Status ◽  
Promoter Hypermethylation ◽  
Dna Methyltransferases ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Peroxisome Proliferator

ObjectivesOsteoarthritis (OA) is the most common degenerative joint disease in aged population and its development is significantly influenced by aberrant epigenetic modifications of numerous OA susceptible genes; however, the precise mechanisms that DNA methylation alterations affect OA pathogenesis remain undefined. This study investigates the critical role of epigenetic PPARγ (peroxisome proliferator–activated receptor-gamma) suppression in OA development.MethodsArticular cartilage expressions of PPARγ and bioactive DNA methyltransferases (DNMTs) from OA patients and mice incurred by DMM (destabilisation of medial meniscus) were examined. DNA methylation status of both human and mouse PPARγ promoters were assessed by methylated specific PCR and/or bisulfite-sequencing PCR. OA protections by a pharmacological DNA demethylating agent 5Aza (5-Aza-2'-deoxycytidine) were compared between wild type and PPARγ knockout mice.ResultsArticular cartilages from both OA patients and DMM mice display substantial PPARγ suppressions likely due to aberrant elevations of DNMT1 and DNMT3a and consequential PPARγ promoter hypermethylation. 5Aza known to inhibit both DNMT1 and DNMT3a reversed the PPARγ promoter hypermethylation, recovered the PPARγ loss and effectively attenuated the cartilage damage in OA mice. 5Aza also inhibited the OA-associated excessive inflammatory cytokines and deficit anti-oxidant enzymes, which were blocked by a specific PPARγ inhibitor in cultured chondrocytes. Further, 5Aza-confered protections against the cartilage damage and the associated abnormalities of OA-susceptible factors were significantly abrogated in PPARγ knockout mice.ConclusionEpigenetic PPARγ suppression plays a key role in OA development and PPARγ preservation via promoter demethylation possesses promising therapeutic potentials in clinical treatment of OA and the related joint diseases.

scholarly journals Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

2017 ◽  
Vol 60 (1) ◽  
pp. 225-232
Author(s):  
Szymon Czech ◽  
Jacek Hermanson ◽  
Piotr Rodak ◽  
Tomasz Stołtny ◽  
Łukasz Rodak ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hip Joint ◽  
Degenerative Joint Disease ◽  
Joint Arthroplasty ◽  
Joint Disease ◽  
Harris Hip Score ◽  
Joint Diseases ◽  
Sports Activity ◽  
Level Of Functioning ◽  
Degenerative Joint Diseases

Abstract An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients’ willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

scholarly journals A Perspective on Robotic Assistance for Knee Arthroplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Nathan A. Netravali ◽  
Feimo Shen ◽  
Youngbae Park ◽  
William L. Bargar
Keyword(s):  
Surgical Technique ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Implant Design ◽  
Robotic Assistance ◽  
Surgical Assistance ◽  
Number Of Patients ◽  
Assistance Systems

Knee arthroplasty is used to treat patients with degenerative joint disease of the knee to reduce pain and restore the function of the joint. Although patient outcomes are generally quite good, there are still a number of patients that are dissatisfied with their procedures. Aside from implant design which has largely become standard, surgical technique is one of the main factors that determine clinical results. Therefore, a lot of effort has gone into improving surgical technique including the use of computer-aided surgery. The latest generation of orthopedic surgical tools involves the use of robotics to enhance the surgeons’ abilities to install implants more precisely and consistently. This review presents an evolution of robot-assisted surgical systems for knee replacement with an emphasis on the clinical results available in the literature. Ever since various robotic-assistance systems were developed and used clinically worldwide, studies have demonstrated that these systems are as safe as and more accurate than conventional methods of manual implantation. Robotic surgical assistance will likely result in improved surgical technique and improved clinical results.

Traumatic Coxofemoral Luxation in Dysplastic Dogs Managed with a Triple Pelvic Osteotomy: Results in four Dogs

1997 ◽  
Vol 10 (03) ◽  
pp. 136-140 ◽  
Author(s):  
D. D. Lewis ◽  
S. C. Kerwin ◽  
S. T. Murphy
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
External Rotation ◽  
Pelvic Osteotomy ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Contralateral Limb ◽  
Norberg Angle

SummaryTriple pelvic osteotomy (TPO) was used in the treatment for traumatic coxofemoral luxations in four adult, large breed dogs with hip dysplasia. Initial closed reductions failed in three and one dog had an initial closed reduction and subsequent open reduction of the coxofemoral luxation that failed. Hip dysplasia was thought to be a prominent factor contributing to the reluxation. TPO successfully maintained reduction of the coxofemoral luxation in all of the dogs. An increase in dorsal acetabular coverage of the femoral head following TPO was demonstrated by an increased Norberg angle. The improved congruency was thought to maintain reduction of the femoral head in the acetabulum and decrease stresses on the joint capsule, allowing healing to occur. Long-term (median: 343, mean ± SD: 406 ± 226 days follow-up) function of the affected limb was comparable to the contralateral limb. Three of the four dogs did not have radiographic progression of coxofemoral degenerative joint disease of the affected joint and differences in the progression of degenerative joint disease were not evident between the affected and the contralateral coxofemoral joint. A decrease in abduction and external rotation and an increase in internal rotation following TPO was noted in the affected coxofemoral joint. Our results establish the utility of this procedure in dysplastic dogs with traumatic coxofemoral luxations.Triple pelvic osteotomy used in the treatment for traumatic coxofemoral luxation in four adult, large breed dogs with hip dysplasia successfully maintained reduction and resulted in satisfactory limb function in all patients.

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