Arthroscopic removal of osteoid osteoma with gamma probe assistance in the hip joint

2018 ◽  
Vol 29 (3) ◽  
pp. 328-335
Author(s):  
Klemen Stražar ◽  
Ivan Slodnjak ◽  
Oskar Zupanc ◽  
Matej Drobnič
Keyword(s):  
Osteoid Osteoma ◽  
Hip Joint ◽  
Weight Bearing ◽  
Gamma Probe ◽  
Case Series ◽  
Life Questionnaire ◽  
Post Surgery ◽  
Arthroscopic Removal ◽  
Patient Reported ◽  
Weight Bearing Area

Aim: The aim was to present the surgical technique and clinical outcome in a series of patients treated with gamma-probe-assisted arthroscopic removal of osteoid osteoma in the hip joint. Methods: The case series consisted of 10 patients diagnosed with osteoid osteoma of the hip, who were treated by arthroscopic nidus removal. An endoscopic gamma probe was used intraoperatively to locate the nidus and to control the extent of its removal. Residual osteoma cavities were additionally treated with an arthroscopic radiofrequency ablator. Microfracturing was performed when the osteochondral defect was in the weight-bearing area and osteochondroplasty was done in cases of concomitant cam deformity. Nonarthritic Hip Score (NAHS), Tegner activity score, quality of life questionnaire (EQ-5D) and postoperative magnetic resonance imaging (MRI) were used for evaluation before and post-surgery, with a minimum follow-up of 2 years. Results: The relative reduction of the gamma irradiation count immediately after removal of the nidus was 44.9% (range 33.3–54.5%). Postoperatively, all patients experienced prompt pain relief and a significant improvement according to all patient reported outcomes. Control MRI revealed fibro-cartilaginous tissue repair of post-osteoma osteochondral defects in the weight-bearing area; 1 patient showed signs of early degeneration. Conclusions: The results of this case series demonstrated the safety and high efficacy of gamma-probe-assisted arthroscopic removal of the osteoid osteoma from the hip joint. Endoscopic gamma probe was recognised as a very useful device for locating the nidus of the osteoid osteoma exactly and preventing incomplete or excessive removal of the bone.

scholarly journals Gamma-Probe Assisted Arthroscopic Removal of Osteoid Osteoma in the Hip Joint - Long Term Results

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Klemen Stražar ◽  
Ivan Slodnjak ◽  
Oskar Zupanc ◽  
Matej Drobnic
Keyword(s):  
Osteoid Osteoma ◽  
Hip Joint ◽  
Gamma Probe ◽  
Long Term Results ◽  
Arthroscopic Removal

scholarly journals Radiological Outcomes of Third Generation Minimally Invasive Chevron Akin Osteotomies (MICA) for Hallux Valgus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray; David Gordon
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Weight Bearing ◽  
Case Series ◽  
Deformity Correction ◽  
Third Generation ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Category: Bunion Introduction/Purpose: Minimally invasive surgery for hallux valgus has significantly increased in popularity recently due to smaller incisions, reduced soft tissue trauma, and the ability to achieve large deformity corrections compared to traditional treatments. This study aimed to investigate the radiological outcomes and degree of deformity correction of the intermetatarsal angle (IMA) and the hallux valgus angle (HVA) following third generation (using screw fixation) Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus. Methods: A single surgeon case series of patients with hallux valgus underwent primary, third generation MICA for hallux valgus. Pre- and post-operative (6 weeks after surgery) radiological assessments of the IMA and HVA were based on weight-bearing dorso-plantar radiographs. Radiographic measurements were conducted by two foot & ankle fellowship trained consultant surgeons (RR, DG). Paired t-tests were used to determine the statistically significant difference between pre- and post-operative measurements. Results: Between January 2017 and December 2019, 401 MICAs were performed in 274 patients. Pre- and post-operative radiograph measurements were collected for 348 feet in 232 patients (219 female; 13 male). The mean age was 54.4 years (range 16.3-84.9, standard deviation (s.d.) 13.2). Mean pre-operative IMA was 15.3° (range 6.5°-27.0°, s.d. 3.4°) and HVA was 33.8° (range 9.3°-63.9°, s.d. 9.7°). Post-operatively, there was a statistically significant improvement in radiological deformity correction; mean IMA was 5.3° (range -1.2°-16.5°, s.d. 2.7°, p<0.001) and mean HVA was 8.8° (range -5.2°-24.0°, s.d. 4.5°, p<0.001). The mean post-operative reduction in IMA and HVA was 10.0° and 25.0° respectively. Conclusion: This is the largest case series demonstrating radiological outcomes following third generation Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus to date. These data show that this is an effective approach at correcting both mild and severe hallux valgus deformities. Longer term radiological outcome studies are needed to investigate whether there is any change in radiological outcomes. Correlation with patient reported outcomes is planned.

scholarly journals Arthroscopic bullet removal from the hip joint and concurrent treatment of associated full-thickness chondral defects: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982967
Author(s):  
Fernando P Ferro ◽  
Felipe S Bessa ◽  
Leandro Ejnisman ◽  
Henrique MC Gurgel ◽  
Alberto T Croci ◽  
...  
Keyword(s):  
Hip Joint ◽  
Weight Bearing ◽  
Osteochondral Allograft ◽  
Concurrent Treatment ◽  
Chondral Lesions ◽  
Chondral Defects ◽  
Arthroscopic Removal ◽  
Fresh Osteochondral Allograft ◽  
Chondrocyte Implantation

The diagnosis of a bullet inside the hip joint is a rare finding. The usual method to treat this condition has been open surgery, with its associated complications and morbidity. The arthroscopic approach has been increasingly utilized for the diagnosis and treatment of several hip conditions, and the number of indications for this technique has been steadily rising. We report the case of a 35-year-old man who suffered a gunshot wound and was operated on for abdominal perforation. He later presented with groin pain that worsened with weight-bearing on his right leg and then underwent arthroscopic removal of a bullet located inside his right hip joint. After a 2-year follow-up, the patient had an excellent clinical outcome, with no radiologic signs of arthritis. The removal of an intra-articular projectile is necessary to avoid complications such as synovitis, osteoarthritis, septic arthritis, and saturnism. The best access to the hip joint remains a topic of debate. Arthroscopy has the advantage of less soft-tissue damage and quicker recovery. The treatment of associated chondral lesions can be done with several techniques, including microfracture, autologous chondrocyte implantation, mosaicplasty, and fresh osteochondral allograft transplantation. There is no consensus as to the best course of treatment for associated chondral lesions in such cases. Hip arthroscopy can be a safe and effective technique for the removal of intra-articular bullets in the hip.

Femoroacetabular impingement in sports medicine: a narrative review

2015 ◽  
Vol 63 (2) ◽  
Keyword(s):  
Muscle Strength ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Weight Bearing ◽  
Case Series ◽  
Hip Pain ◽  
Hip Surgery ◽  
Hip Muscle ◽  
Hip Function ◽  
Surgical Treatments

Femoroacetabular impingement (FAI) is a pathomechanical process of the hip, which can occur in every individual but has a higher prevalence in physically active subjects such as athletes. It is mainly due to bony deformities at the proximal femur and/or acetabulum in conjunction with rigorous or supraphysiological hip ranges of motion. FAI may lead to chondrolabral lesions, hip pain and development of early hip osteoarthritis. Symptomatic FAI patients may present functional limitations during daily activities and sports, reduced hip muscle strength as well as hip joint kinematic and kinetic alterations during weight-bearing activities. Hip surgery whether open or arthroscopic is currently the mainstay for the management of symptomatic FAI. It consists of the treatment of FAI-related intra-articular pathologies, such as acetabular labral tears and articular cartilage lesions, and the surgical correction of the underlying bony deformities. Hip surgery demonstrated to reduce hip pain and improve hip function of symptomatic FAI patients in most case series. In addition, relatively high rates of return to sport were reported for FAI athletes after hip surgery. Nevertheless, incomplete recovery of hip muscle strength and hip joint kinematics and kinetics during functional tasks were shown after hip surgery for FAI. Non-surgical treatments aimed at restoring normal hip muscle and physical function have not been considered as a valid alternative to hip surgery for the management of symptomatic FAI so far. Future research should propose standardized physical therapy protocols for the non-surgical management of symptomatic FAI, and investigate their effectiveness in reducing hip pain and improving hip function. In addition, randomized controlled trials should compare surgical with non-surgical treatments for FAI so as to provide knowledge about the optimal conditions and time point for hip surgery.

Clinical profile and management of external jugular vein aneurysms

2020 ◽  
pp. 026835552097558
Author(s):  
Uttam Kumar Thakur ◽  
Ajay Savlania ◽  
Anil L Naik ◽  
Charan Singh ◽  
Debajyoti Chatterjee ◽  
...  
Keyword(s):  
Jugular Vein ◽  
Case Series ◽  
Surgical Excision ◽  
External Jugular Vein ◽  
Clinical Profile ◽  
Lateral Side ◽  
Posterior Triangle ◽  
Post Surgery ◽  
Asymptomatic Patients ◽  
Patient Reported

Objective External jugular vein (EJV) aneurysm is an extremely uncommon clinical condition. We have studied the clinical profile and need for surgery in this present seven case series of primary external jugular vein aneurysms. Method Over the past three years, we have diagnosed and managed aneurysms of external jugular vein in seven patients, who presented with swelling in the posterior triangle of the neck. Venous duplex was obtained in all the patients, followed by computed tomography (CT) in three patients and one patient reported with magnetic resonance (MR) venography from another hospital. Three patients had symptoms ranging from mild intermittent discomfort to moderate pain underwent excision of aneurysm after ligation of both ends of EJV. Four patients had swelling on the lateral side of the neck due to EJV aneurysm, with no other associated symptoms. They were kept on six monthly follow-ups. Result We operated three patients, as they were symptomatic, of which only two had thrombus in the aneurysmal sac. All three symptomatic patients had aneurysm of size >5 cm. Post-surgery and on subsequent follow-ups they were asymptomatic. The four asymptomatic patients kept on conservative management did not develop any thrombosis of aneurysm sac in follow up. Conclusion Surgical excision is indicated for symptomatic patients with EJV aneurysm, preferably for size > 5 cm because of their higher association with thrombosis or symptoms. Asymptomatic patients can be managed non-operatively with regular surveillance by clinical examination and venous duplex or can be treated if patients insist due to cosmetic reasons.

scholarly journals THE HUMAN HIP STRESS ANALYSIS: A BALL-SOCKET ELASTIC CONTACT MODELLING

2004 ◽  
Vol 16 (05) ◽  
pp. 233-237
Author(s):  
XISHI WANG ◽  
TIANYING WANG ◽  
FUCHUAN JIANG ◽  
YIXIANG DUAN
Keyword(s):  
Stress Distribution ◽  
Stress Analysis ◽  
Hip Joint ◽  
Weight Bearing ◽  
Peak Stress ◽  
Elastic Contact ◽  
Stress Distributions ◽  
Weight Bearing Area ◽  
Contact Modelling ◽  
Current Modelling

The peak stress, the weight bearing area and the stress distribution of the articular contact at the human hip joint is the most important factors, which determine the location of the degenerative foci that later result in degenerative damage and in the development of osteoarthritis. In the paper, a ball-socket articular elastic contact modelling of the human hip joint is successfully established. This modelling can be used to predict the peak stress, the weight bearing area and the stress distributions of the articular contact at the human hip joint. In order to verify the validation of current modelling, an example is examined. The results show that the predictions from the current modelling are basically agreement with those reported in literatures. This shows the validity of the current modelling.

Asymptomatic and Unnoticed Intra-articular Screw Over 18 Years after Fracture of the Posterior Wall of the Acetabulum – a Question of Stability?

2020 ◽  
Author(s):  
Christof K. Audretsch ◽  
Florian Schmidutz ◽  
Markus Alexander Küper
Keyword(s):  
Hip Joint ◽  
External Rotation ◽  
Weight Bearing ◽  
Posterior Wall ◽  
Acetabular Labrum ◽  
The Stability ◽  
The Right ◽  
Weight Bearing Area ◽  
Acetabular Wall

AbstractFractures of the posterior wall of the acetabulum occur in a frequency of 25 – 30%. Multifragmentary fractures involving 40 – 50% of the acetabular surface, the quality of reduction as well as involvement of cartilage and acetabular labrum are considered to have an impact on the development of a reduced posterior stability of the hip joint. This results in a shift of the main weight bearing area with development of a posttraumatic osteoarthritis. In the presented case, a 42-year old male patient was operated on 18 years ago due to a posterior acetabular wall fracture. Retrospectively, one of the screws was located partially intraarticular. However, the patient was asymptomatic over the 18-year period. The first consultation was due to unspecific symptoms of osteoarthritis of the right hip joint especially during flexion and external rotation. Due to only mild radiological signs of osteoarthritis, we indicated only the removal of the intraarticular screw. The symptoms postoperatively switched to a feeling of instability, so a total hip arthroplasty was performed. Since the operation, the patient is asymptomatic regarding the hip joint. The intraarticular screw seemed to stabilize the hip joint. This case demonstrates the importance of a good posterior guidance for the stability of the hip joint on one hand. On the other hand, it demonstrates the minor stress load of the posterior acetabular region, especially after fracture of the posterior wall. Therefore, a good posterior guidance should be one major aim of treatment of posterior acetabular wall fractures.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

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