scholarly journals Surgical correction of trunk balance in spinal deformities and in instability of hip joints

2020 ◽  
Vol 24 (4) ◽  
pp. 256-265
Author(s):  
Oleg B. Chelpachenko ◽  
K. V. Zherdev ◽  
A. P. Fisenko ◽  
A. S. Butenko ◽  
S. P. Yatsyk ◽  
...  
Keyword(s):  
Hip Joint ◽  
Joint Instability ◽  
Reference Group ◽  
Surgical Correction ◽  
Spinal Deformities ◽  
Healthy Children ◽  
Hip Joints ◽  
X Ray ◽  
Spine Deformities ◽  
Trunk Balance

Introduction. Restoration of trunk balance is the basic task in surgical correction of spinal deformities and in hip joint instability of various etiology. Purpose. To analyze and to define the relevance of roentgen-anatomical parameters of spine-pelvis relationships for surgical correction of deformities in the thoracolumbar spine and of hip joint instability of dysplastic and neurogenic etiology. Material and methods. An X-ray analysis of parameters of the frontal and sagittal spine-pelvis balance was performed in 220 patients with dysplastic and neurogenic deformities of the thoracic and lumbar spine (n = 98) and with instability of hip joints (n = 122) but who were able to walk. They were operated in the neuro-orthopedic department with orthopedics in National Medical Research Center for Children’s Health. The reference group included 60 relatively healthy children without any scoliotic deformities of the spine and with stable hip joints. Dynamics of changes in X-ray parameters was analyzed using findings of orthostatic spondylograms from the indicated groups of children. The obtained data were compared with reference values. Results. The trial performed has revealed typical changes in spine-pelvis relationship parameters in patients with hip joint instability and spine deformities and in the reference group . The researchers also found out relations between various parameters of the trunk balance before and after surgical correction. Conclusion. While planning a surgical correction of trunk balance in spinal deformities, one should take into account parameters of spine-pelvis relationships, such as PI, SS, PT, SVA deviation and the mid-sacral line; and in case of hip joint instability - local roentgen-angulometric parameters of the femoral and acetabular components of instability. This is due to the fact that the lower the level of reconstructive surgical manipulation is located, the greater effect it has at the frontal and sagittal balance of the trunk.

scholarly journals BODY BALANCE DISORDERS IN SPINE DEFORMATIONS AND HIP JOINTS INSTABILITY

2020 ◽  
Vol 24 (2) ◽  
pp. 89-95
Author(s):  
Oleg B. Chelpachenko ◽  
K. V. Zherdev ◽  
A. P. Fisenko ◽  
S. P. Yatsyk ◽  
E. Yu. Dyakonova ◽  
...  
Keyword(s):  
Sagittal Alignment ◽  
Reference Group ◽  
The Body ◽  
Published Data ◽  
Spinal Deformities ◽  
Healthy Children ◽  
X Rays ◽  
Hip Joints ◽  
Hip Instability ◽  
Postoperative Changes

Introduction. The balance of the torso is the result of the interaction of various systems of the body, which provides a stable vertical position in space, which includes such components as afferentation, integration, effectors, and the peripheral nervous system. Material and methods. A clinical and radiological study of the coronal and sagittal alignment was carried out: 220 patients with idiopathic and neurogenic deformities of the thoracic and lumbar spine (n = 98) and hip instability (n = 122), capable of walking. The reference group is represented by 60 relatively healthy children without scoliotic spinal deformities with stable hip joints. Radiological parameters were evaluated by orthostatic X-rays for the indicated groups of children when comparing the obtained data with reference values. Results. The features of changes in the pelvic incidence (PI) and other parameters of the spin alignment in patients with hip instability, significantly different from patients with spinal deformities and the reference group, were revealed. Conclusion. The obtained results of the study call us to pay more attention to the parameters of the coronal and sagittal alignment as a total. Assessment and preoperative planning of only local X-ray anatomical parameters in order to predict their postoperative changes does not take into account changes in the coronal and sagittal balance, which, according to most published data, determines the further quality of life of patients.

scholarly journals Radiographic Predictors for Adverse Outcomes Following Surgical Correction of Hammertoe Deformity

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0028
Author(s):  
Samuel D. Maidman ◽  
Amalie A. Erwood ◽  
James Brodsky ◽  
Yahya Daoud ◽  
Amanda Fantry ◽  
...  
Keyword(s):  
Physical Function ◽  
Joint Instability ◽  
Short Form ◽  
Surgical Correction ◽  
X Rays ◽  
Radiographic Findings ◽  
X Ray ◽  
Joint Fusion ◽  
Sf 36 ◽  
Joint Arthritis

Category: Lesser Toes Introduction/Purpose: Hammertoe deformities are common, often painful deformities of the lesser foot and are known to severely affect physical function. When patients seek surgical management, x-ray imagining is utilized for diagnosis, evaluation for surgical candidacy, and selection of the operative technique. Postoperatively, radiographs are retaken to assess bone health, healing status, and alignment. Despite their frequent use, no previous data support particular X-ray findings as being indicative of clinical presentation nor surgical outcomes. The aim of this study is to identify specific radiographic parameters that are predictive of pain and function outcomes after surgical correction of hammertoe deformity. Methods: Prospectively collected data was reviewed on 116 patients who underwent hammertoe correctional surgery. Patient demographics, comorbidities, and postsurgical complications were recorded from their electronic medical records. Clinical outcomes were assessed utilizing preoperative and postoperative pain Visual Analogue Scale (VAS) and Short Form Health Survey Physical Component (SF-36 PCS) scores with 1-year follow-up. Radiographs were scored by a foot & ankle fellowship-trained orthopaedic surgeon to assess preoperative severity, postoperative joint fusion, and both pre- and postoperative joint instability. Data was examined using chi-squared, t-test, and ANOVA analyses. Results: Preoperatively, 14.7% of patients had a deformity classified radiographically as mild, 37.1% as moderate, and 48.3% as severe. X-rays prior to surgery showed that 65.5% had MTP joint instability, 9.5% had joint dislocation, and 18.1% had joint arthritis. Postoperatively, 78.5% had PIP joint fusion, 38.8% had MTP joint arthritis, and 17.2% had MTP joint instability. A significant association was found between postoperative MTP joint instability and a lower 1-year SF-36 PCS (p=0.0032). There were no associations found between the other radiographic findings and postoperative outcomes, and no parameters were associated with pain VAS scores. Conclusion: After undergoing surgical correction of hammertoe deformity, the postoperative radiographic finding of MTP joint instability was determined to be predictive of physical function. However, neither metatarsophalangeal joint arthritis nor PIP fusion were predictive of outcomes. This work informs foot and ankle specialists that proper joint alignment and stabilization is critical to ensuring success in hammertoe surgery.

scholarly journals Pre-Surgery Planning of Lower Limbs Major Joints Arthroplasty

2019 ◽  
Vol 7 (17) ◽  
pp. 2838-2843 ◽  
Author(s):  
Alexey Vladimirovich Lychagin ◽  
Vadim Gennadievich Cherepanov ◽  
Pavel Igorevich Petrov ◽  
Ivan Antonovich Vyazankin ◽  
Galina Eduardovna Brkich
Keyword(s):  
Knee Joint ◽  
Hip Joint ◽  
Computer Tomography ◽  
Axial Load ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
Hip Joints ◽  
Surgery Planning ◽  
X Ray ◽  
Total Knee

BACKGROUND: Knee and hip joints endoprosthetics are the main surgical method of arthrosis treatment. The epidemiological incidence rate of the disease is growing steadily every year, affecting younger and younger people. Despite the proven tactics of joint endoprosthetics, an important issue is quality planning of surgery. AIM: The aim of this research is to develop a device and a method that would contribute to solving the existing challenges of pre-surgery planning of hip endoprosthetics in patients with related pathologies, which have caused compensatory deformation, and making long vertebrarium-pelvis-lower limbs scout images with the patient lying on his back with an axial load in a computer tomography. METHODS: Analog X-ray photographs of the pelvis made on film, digital DICOM images, and special planning programs are used for planning. However, according to numerous studies, the disease of the hip joint is not an independently isolated pathology. In most cases, this pathology is accompanied by changes in the lumbar spine. Often, patients prepared for endoprosthetics have a congenital deformity of tarsus or hip segment, which, during the knee, joint endoprosthetics surgery causes difficulties with the installation of an intramedullary guide. RESULTS: The results after total knee arthroplasty according to the method modified at the Department showed a reduction of the WOMAC index slightly more than twice down to 37.26 ± 7.92. The number of revision surgeries after endoprosthetics decreased from 5 (5.7%) to 1 (1.1%) for the hip joint, and from 7 (4.3%) to 2 (1.3%) for the knee joint, respectively. CONCLUSION: To form a proper guide entry point, it is necessary to assess the segment at the stage of surgery planning and examination of patients, which can be done using the proposed method. To remove the complications during the pre-surgery planning of hip joint endoprosthetics in patients with related pathologies, a device and methods have been developed for obtaining long topograms of the vertebrarium-pelvis-lower limbs complex with the patient lying on his back with the axial load in computer tomography.

scholarly journals Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

2021 ◽  
Author(s):  
Ran Zhao ◽  
Hong Cai ◽  
Hua Tian ◽  
Ke Zhang
Keyword(s):  
Hip Joint ◽  
Morphological Difference ◽  
Medullary Cavity ◽  
Size Difference ◽  
Single Plane ◽  
X Ray ◽  
Stem Size ◽  
The Difference ◽  
Ct Data ◽  
Anatomical Parameters

Abstract Purpose The application of the anatomical parameters of the contralateral hip joint to guide the preoperative template of the affected side relies on the bilateral hip symmetry. We investigated the bilateral hip symmetry and range of anatomical variations by measurement and comparison of bilateral hip anatomical parameters. Methods This study included 224 patients (448 hips) who were diagnosed with osteoarthritis (OA) and avascular necrosis (AVN) of the femur head, and underwent bilateral primary total hip arthroplasty (THA) in our hospital from January 2012 to August 2020. Imaging data included 224 patients X-ray and 30 CT data at the end of the cohort. Anatomical parameters, including the acetabular abduction angle and trochanteric height, were measured using the Noble method. Postoperative measurements included stem size, difference of leg length and offset. Results Except for the isthmus width, there were no significant differences in the anatomical morphology of the hip joint. Among the demographic factors, there was a correlation between body weight and NSA. Among various anatomical parameters, a correlation was present between medullary cavity widths of T + 20, T, and T − 20. The difference in the use of stem size is not due to the morphological difference of bilateral medullary cavity, but due to the different of 1- or 2-stage surgery. Conclusion Bilateral symmetry was present among the patients with normal morphology of the hip medullary cavity, theoretically confirming the feasibility of structural reconstruction of the hip joint using the hip joint on the uninjured side. Additionally, the difference in the morphology of the hip medullary cavity is not present in a single plane but is synergistically affected by multiple adjacent planes.

Morphological patterns of the hip joint structure in students of choreography schools and young athletes involved in sports associated with the art of movement

2020 ◽  
Vol 15 (6) ◽  
pp. 90-93
Author(s):  
O.S. Vasiliev ◽  
◽  
S.P. Levushkin ◽  
E.E. Achkasov ◽  
◽  
...  
Keyword(s):  
Hip Joint ◽  
Young Athletes ◽  
Hip Joints ◽  
Joint Structure ◽  
Normal Limits ◽  
Rhythmic Gymnastics ◽  
Key Words Hip ◽  
Coxa Valga ◽  
Key Words Hip Dysplasia ◽  
Morphological Patterns

Students of choreography schools and young athletes involved in sports associated with the art of movement usually have dysplastic hip joints with normal acetabular coverage and femoral Coxa valga, whose normal limits require further discussion. We have identified 5 X-Ray morphological patterns of the hip joint structure typical of such individuals, and analyzed their association with professional qualities. Key words: hip dysplasia, dysplastic constitution, Coxa valga, young athletes, rhythmic gymnastics, choreography, ballet

scholarly journals Progressive Scoliosis and Syringomyelia - Questions of Surgical Approach

Folia Medica ◽  
2018 ◽  
Vol 60 (2) ◽  
pp. 261-269 ◽  
Author(s):  
Mikhail Mikhaylovskiy ◽  
Vyacheslav Stupak ◽  
Vadim Belozerov ◽  
Nikolay Fomichev ◽  
Anatoliy Lutsik ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Surgical Correction ◽  
Neurological Deficits ◽  
Spinal Deformities ◽  
Loss Of Correction ◽  
Scoliotic Deformity ◽  
Scoliosis Correction ◽  
The Moment ◽  
Comparison Of The Results

Abstract Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.

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