Complete Resection of a Massive Synovial Osteochondromatosis of the Hip Using an Anterior Approach: A Report of Two Cases

Arthroscopic excision of synovial osteochondromatosis of the hip is commonly performed. However, when the lesion extends to the extra-articular space of the hip joint, excision using arthroscopy becomes difficult. Although surgical dislocation of the hip with a trochanteric flip osteotomy is commonly used, manual access to the inferomedial portion of the acetabulum remains difficult. In this case report, we describe arthroscopic resection followed by open surgery using an anterior approach with or without surgical dislocation to excise a synovial osteochondromatosis of the hip that had extended to the extra-articular space and formed a herniation sac. Excision was completed without complications. An anterior approach with or without surgical dislocation should be considered as a surgical option for the treatment of a massive synovial osteochondromatosis of the hip joint.

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Surgical Hip Dislocation for Management of Acetabular Osteochondroma in an Adult

Case Reports in Orthopedics ◽

10.1155/2017/8481563 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Alexandre H. Nehme ◽

Georges F. Haidamous ◽

Hicham G. Abdelnour ◽

Jad N. BouMounsif ◽

Joseph W. Wehbe ◽

...

Keyword(s):

Rare Case ◽

Clinical Presentation ◽

Hip Dislocation ◽

Complete Resection ◽

Open Approach ◽

Surgical Hip Dislocation ◽

Surgical Dislocation ◽

Dislocation Of The Hip

The purpose of this study is to report a rare case of acetabular osteochondroma with a unique clinical presentation occurring in an adult with normally developed hips. The distinctive size and location of the lesion required an open approach with surgical dislocation of the hip for complete resection.

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Acetabular reduction osteotomy using surgical dislocation of the hip joint for treatment of a malunited acetabular fracture

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-004-0731-0 ◽

2004 ◽

Vol 124 (8) ◽

pp. 527-530

Author(s):

D. Haverkamp ◽

J. S. K. Luitse ◽

H. Eijer

Keyword(s):

Hip Joint ◽

Acetabular Fracture ◽

Surgical Dislocation ◽

Dislocation Of The Hip

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Surgical dislocation of the hip in patients with femoroacetabular impingement: Surgical techniques and our experience

Vojnosanitetski pregled ◽

10.2298/vsp131207097m ◽

2015 ◽

Vol 72 (11) ◽

pp. 1004-1009

Author(s):

Marko Mladenovic ◽

Zoran Andjelkovic ◽

Ivan Micic ◽

Desimir Mladenovic ◽

Predrag Stojiljkovic ◽

...

Keyword(s):

Soft Tissue ◽

Surgical Technique ◽

Femoroacetabular Impingement ◽

Hip Joint ◽

Morphological Changes ◽

Surgical Techniques ◽

Acetabular Labrum ◽

Surgical Dislocation ◽

Dislocation Of The Hip ◽

Adjacent Cartilage

Background/Aim. Arthrosis of the hip is the most common cause of a hip joint disorders. The aim of this study was to present our experience in the application of a safe surgical dislocation of the hip in patients with minor morphological changes in the hip joint, which, through the mechanism of femoroacetabular impingement, cause damage to the acetabular labrum and adjacent cartilage as an early sign of the hip arthrosis. Methods. We have operated 51 patients with different morphological bone changes in the hip area and resultant soft tissue damage of the acetabular labrum and its adjacent cartilage. Surgical technique that we applied in this group of patients, was adapted to our needs and capabilities and it was minimaly modified compared to the original procedure. Results. The surgical technique presented in this paper, proved to be a good method of treatment of bone and soft tissue pathomorphological changes of the hip in patients with femoroacetabular impingement. We had no cases with avascular necrosis of the femoral head, and two patients had nonunion of the greater trochanter, 9 patients developed paraarticular ossification, without subjective symptoms, while 3 patients suffered from postoperative pain in the groin during more energetic physical activities. Conclusion. Utilization of our partly modified surgical technique of controlled and safe dislocation of the hip can solve all the bone and soft tissue problems in patients with femoroacetibular impingement to stop already developed osteoarthritis of the hip or to prevent mild form of it.

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Reconstruction of the Hip in Multiple Hereditary Exostoses

Children ◽

10.3390/children8060490 ◽

2021 ◽

Vol 8 (6) ◽

pp. 490

Author(s):

Dong Hoon Lee ◽

Dror Paley

Keyword(s):

Hip Joint ◽

Joint Involvement ◽

Neck Shaft Angle ◽

Multiple Hereditary Exostoses ◽

Femur Neck ◽

Radiographic Outcomes ◽

Surgical Dislocation ◽

Center Edge ◽

Shaft Angle ◽

Coxa Valga

The hip joint involvement in multiple hereditary exostoses (MHE) occurs in 30–90%, causing pain and limitation of motion by femoroacetabular impingement, coxa valga, acetabular dysplasia, hip joint subluxation, and osteoarthritis. The purpose of this study was to investigate the clinical and radiographic outcomes of ten hips in seven patients treated by surgical dislocation and corrective osteotomies between 2004 and 2009. Surgical dislocation and excision of the osteochondromas and varus intertrochanteric osteotomies were performed in all cases when the neck–shaft angle was > 150°. Common sites of osteochondromas were medial, posterior, and anterior neck of the femur. Neck–shaft angle of the femur was improved from a mean of 157° to 139°, postoperatively. On an average, the center-edge angle improved from 20° to 30° postoperatively. We believe that Ganz’s safe surgical dislocation technique is the preferred treatment of MHE. This safeguards the circulation of the femoral head and the osteochondromas can be resected under direct vision. It can be combined with additional corrective osteotomies because the hip affected by MHE is frequently associated with dysplastic changes which can result in premature osteoarthritis.

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CONGENITAL DISLOCATION OF THE HIP JOINT

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1952.tb74970.x ◽

1952 ◽

Vol 1 (3) ◽

pp. 92-92

Keyword(s):

Hip Joint ◽

Congenital Dislocation ◽

Dislocation Of The Hip

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The Functional Treatment of Congenital Dislocation of the Hip-Joint

Proceedings of the Royal Society of Medicine ◽

10.1177/003591574103400404 ◽

1941 ◽

Vol 34 (4) ◽

pp. 215-217 ◽

Cited By ~ 2

Author(s):

Felix Bauer

Keyword(s):

Hip Joint ◽

Functional Treatment ◽

Congenital Dislocation ◽

Dislocation Of The Hip

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Cervical Perimedullary Arteriovenous Shunts

Neurosurgery ◽

10.1227/neu.0000000000000401 ◽

2014 ◽

Vol 75 (3) ◽

pp. 238-249 ◽

Cited By ~ 14

Author(s):

Toshiki Endo ◽

Hiroaki Shimizu ◽

Kenichi Sato ◽

Kuniyasu Niizuma ◽

Ryushi Kondo ◽

...

Keyword(s):

Spinal Cord ◽

Anterior Approach ◽

Open Surgery ◽

Treatment Strategies ◽

Good Recovery ◽

Intraoperative Angiography ◽

Indocyanine Green Videoangiography ◽

Arteriovenous Shunts ◽

Complete Obliteration

Abstract BACKGROUND: Reports of cervical perimedullary arteriovenous shunt (PMAVS) are limited, and treatment strategies have not been established. OBJECTIVE: To describe angioarchitecture and optimal treatment strategies for cervical PMAVS. METHODS: We treated 22 patients with cervical PMAVS between 2000 and 2012 (8 women and 14 men; age, 9-80 years). According to the classification, our patients included type IVa (4 patients), type IVb (16 patients), and type IVc (2 patients). Seventeen patients presented with subarachnoid hemorrhage. RESULTS: A total of 41 shunting points were localized in 22 patients, of which 34 points were located ventral or ventrolateral to the spinal cord. The anterior spinal artery (ASA) contributed to the shunts in 16 patients. Aneurysm formation was identified in 8 patients. Endovascular treatment was attempted in 3 patients, resulting in complete obliteration in 1 patient (type IVc). Overall, 21 patients underwent open surgery. An anterior approach with corpectomy was elected for 2 patients; the other 19 patients underwent the posterior approaches using indocyanine green videoangiography, intraoperative angiography, endoscopy (8 patients), and neuromonitoring. Twenty patients were rated as having a good recovery at 6 months after surgery. No recurrence was observed in any patients during the follow-up (mean, 59.7 months). CONCLUSION: Shunting points of the cervical PMAVS were predominantly located ventral or ventrolateral to the spinal cord and were often fed by the ASA. Even for ventral lesions, posterior exposure assisted with neuromonitoring and endoscopy, and intraoperative angiography provided a view sufficient to understand the relationships between the shunts and the ASA and contributed to good surgical outcomes.

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