scholarly journals Retained Shrapnel from a Blast Injury as a Rare Cause of Secondary Osteoarthritis of the Hip Joint: A Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Oshan Basnayake ◽  
Ahamed Nihaj ◽  
Ranji Pitagampalage ◽  
Umesh Jayarajah ◽  
Yasith Mathangasinghe ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Foreign Bodies ◽  
Functional Disability ◽  
Bone Destruction ◽  
Blast Injury ◽  
Late Presentation ◽  
Osteoarthritis Of The Hip ◽  
Secondary Osteoarthritis ◽  
The Right

Background. Complications related to intra-articular retained shrapnel are rare and primarily depend on the anatomical location and the reaction with the surrounding tissue. Retained bodies causing severe osteoarthritis with bone destruction and limb shortening are extremely rare. We describe a rare occurrence of retained shrapnel, possibly iron nails causing a late presentation of grade 4 secondary osteoarthritis of the hip joint with destruction of the femoral head and limb shortening. Case Presentation. A 74-year-old otherwise healthy Sri Lankan male with a history of blast injury to the right hip 35 years ago presented with an isolated, right sided mild hip pain with a progressive limp for an 8-year duration. He had a true right limb shortening of 3.6 cm and limited range of motion. However, he had minimal functional disability. An X-ray of the pelvis and hip joints showed grade 4 osteoarthritis of the right hip joint with destruction of the right femoral head. There were three retained metallic nails (shrapnel) in the right hip joint of which two were intra-articular. Although he was offered a total hip arthroplasty, he opted for conservative management due to his minimal functional disability. Modified foot wear and simple analgesics were prescribed, and he had no worsening of symptoms at 6 months of follow up. Conclusion. Late presentation due to shrapnel-induced osteoarthritis with bone destruction and limb shortening is extremely rare. Initial assessment with radiographs is essential following blast injuries to exclude intra-articular or periarticular foreign bodies. Such foreign bodies should be removed to prevent the associated local and systemic complications.

scholarly journals Microvascular Density of Rapidly Destructive Arthropathy of the Hip Joint

2005 ◽  
Vol 13 (1) ◽  
pp. 40-45 ◽  
Author(s):  
T Yamakawa ◽  
A Sudo ◽  
M Tanaka ◽  
A Uchida
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Joint Destruction ◽  
Bone Destruction ◽  
Microvascular Density ◽  
Blood Capillaries ◽  
Secondary Osteoarthritis ◽  
Femoral Heads ◽  
Formalin Fixed Paraffin Embedded ◽  
Destructive Arthropathy

Purpose. To assess the vascularity of the femoral head and determine how it is related to the destruction of the arthritic hip joint. The process of destructive arthropathy in arthritic hip joints is variable. Some patients with osteoarthritis of the hip have rapidly progressive destructive changes resulting in the disappearance of the femoral head. Method. Six femoral heads from patients diagnosed with rapidly destructive arthropathy and 6 femoral heads from patients with secondary osteoarthritis caused by acetabular dysplasia were analysed to reveal the association between blood capillaries and osteoclasts. The von Willebrand Factor immunostaining and counterstaining with Mayer's haematoxylin were used to label the microvessels and osteoclasts in formalin-fixed, paraffin-embedded specimens of femoral heads. The numbers of immunostained microvessels and osteoclasts in selected regions were counted. Result. The microvascular density of the bone surfaces of rapidly progressive arthritic hips was hypervascular. Osteoclasts were also found in increased numbers on the bone surfaces of rapidly progressive arthritic hips. The higher microvascular density coincided with extensive bone destruction and with the increased osteoclast count. Conclusion. These findings suggested that hypervascularity of the granulation in the femoral head may be associated with bone and joint destruction.

Modified trapdoor procedures by surgical dislocation approach to treat chondroblastoma of the femoral head

2019 ◽  
Vol 101-B (6) ◽  
pp. 732-738
Author(s):  
Q. Liu ◽  
H-B. He ◽  
H. Zeng ◽  
Y-H. Yuan ◽  
F. Long ◽  
...  
Keyword(s):  
Femoral Head ◽  
Local Recurrence ◽  
Hip Joint ◽  
Bone Grafting ◽  
Bone Destruction ◽  
Functional Score ◽  
Autogenous Bone ◽  
Secondary Osteoarthritis ◽  
Surgical Dislocation ◽  
Lodwick Classification

Aims The aim of this study was to evaluate the efficacy of the surgical dislocation approach and modified trapdoor procedure for the treatment of chondroblastoma of the femoral head. Patients and Methods A total of 17 patients (ten boys, seven girls; mean age 16.4 years (11 to 26)) diagnosed with chondroblastoma of the femoral head who underwent surgical dislocation of the hip joint, modified trapdoor procedure, curettage, and bone grafting were enrolled in this study and were followed-up for a mean of 35.9 months (12 to 76). Healing and any local recurrence were assessed via clinical and radiological tests. Functional outcome was evaluated using the Musculoskeletal Tumour Society scoring system (MSTS). Patterns of bone destruction were evaluated using the Lodwick classification. Secondary osteoarthritis was classified via radiological analysis following the Kellgren–Lawrence grading system. Steinberg classification was used to evaluate osteonecrosis of the femoral head. Results The epiphyseal plate was open, closing, and closed in five, five, and seven patients, respectively. In total, eight, six, and three patients were classified as having Lodwick classification IA, IB, and IC, respectively. Allogeneic and autogenous bone grafting was used in 13 and four patients, respectively. All patients had good bone healing and no local recurrence was observed. One patient developed osteonecrosis of the femoral head (Steinberg IA) and one developed secondary osteoarthritis of the hip joint (Kellgren–Lawrence Grade II). The mean postoperative MSTS functional score was 27.7 (24 to 30). Conclusion Surgical dislocation and modified trapdoor procedures are safe and effective techniques for treating chondroblastoma in the femoral head. Cite this article: Bone Joint J 2019;101-B:732–738.

scholarly journals WISH-Type Hip Brace for Patients with Osteoarthritis of the Hip

2021 ◽  
Vol 7 (1) ◽  
pp. 1-4
Author(s):  
Hideomi Watanabe ◽  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Osteoarthritis Of The Hip ◽  
User Friendly

We developed a user-friendly WISH-type hip brace that reinforces the hip joint by preventing up- and outward movement of the femoral head.

Asymmetrical lumbosacral transitional vertebrae in dogs may promote asymmetrical hip joint development

2017 ◽  
Vol 30 (02) ◽  
pp. 137-142 ◽  
Author(s):  
Frank Steffen ◽  
Michael Hässig ◽  
Joseph Morgan ◽  
Mark Flückiger
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Transverse Process ◽  
Hip Joints ◽  
Secondary Osteoarthritis ◽  
Pelvic Rotation ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae ◽  
Canine Hip Dysplasia

Summary Objectives: This study examines the relationship between the morphology of the lumbosacral transitional vertebra (LTV) and asymmetrical development of the hip joints in dogs. Methods: A total of 4000 dogs which had been consecutively scored for canine hip dysplasia were checked for the presence of a LTV. A LTV was noted in 138 dogs and classified depending on the morphology of the transverse processes and the degree of contact with the ilium. Results: In dogs with an asymmetrical LTV, the hip joint was significantly more predis-posed to subluxation and malformation on the side of the intermediate or sacral-like transverse process (p <0.01), on the side of the elevated pelvis (p <0.01), or when an asymmetrical LTV resulted in pelvic rotation on its long axis (p <0.01), whereas hip joint conformation was less affected on the side featuring a free transverse process (p <0.01). Clinical significance: The results support our hypothesis that an asymmetrical LTV favours pelvic rotation over its long axis, resulting in inadequate femoral head coverage by the acetabulum on one side. Inadequate coverage of the femoral head favours subluxation, malformation of the hip joint, and secondary osteoarthritis. Asymmetrical hip conformation may therefore be the sequela of a LTV and mask or aggravate genetically induced canine hip dysplasia.

TO EVALUATE THE CHANGES IN HIP JOINT RELATED TO LOWER LIMB DOMINANCE AND ITS ASSOCIATION WITH HIP DISLOCATION

1969 ◽  
Vol 5 (1) ◽  
pp. 635-638
Author(s):  
NIAZ MOHAMMAD ◽  
MAQBOOL ILAHI ◽  
QAISAR ZAMAN
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Lower Limb ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Left Femur ◽  
Horizontal Diameter ◽  
The Mean ◽  
The Right

BACKGROUND: The stability of a joint depends on the arrangement of the articular surfaces. Thefailure of acetabulum to deepen along with associated relaxed capsule can be a causative factor leadingto congenital dislocation of hip in babies. The right traumatic hip dislocation is less uncommon ascompared to left side in adults.OBJECTIVE: To correlate the majority of right-footed population with the bony parameters of hipjoint bilaterally and to find out its association with left congenital and right acquired traumaticdislocation of hip.MATERIAL AND METHODS: As the right footed people are considerably more (90%) than the leftfooted and this study work was correlated with the bones collected from cadavers in Anatomydepartment of KGMC Peshawar from January 2014 to December 2014. We included 14 pairs of femurs,14 pairs of hip bones in this study to see the structural differences when dominant hip joint is comparedwith non-dominant hip joints. The measurements were performed with the help of vernier caliper.RESULTS: The mean horizontal diameter of right (dominant) and left acetabulum was 50.14±0.69 mmand 52.35±0.65mm. The mean horizontal depth of right and left acetabulum was 22.21±0.82mm and25.25±0.52mm. The horizontal diameter of right and left femur was 46.42±0.62mm and 43.85±01mm.The thickness of femoral head was 26.71±01mm on right (dominant) side but this thickness was29.17±01mm on left side.CONCLUSION: The left acetabulum was having a significant larger diameter in adult, allowing thesmaller left femoral head to fit snugly which can be correlated with the more common left congenitaldislocation hip. On the other hand, in adults, the left acetabulum is deeper, allowing the thicker left headof femur as an adjustment for weight bearing functionwhile the larger rightfemoral head fit into acomparatively shallow socket. This may be a factor to improve mobility at the cost of stability; as righttraumatic dislocationhip is less uncommon as compared to left side.KEY WORDS: Hip joint, Ball and socket joint. Dominant lower limb, Right footedness,Left footedness, Congenital dislocation hip, Traumatic dislocation hip.

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