scholarly journals Assessment of Acetabulum Deformity During Preoperative Planning for Hip Arthroplasty

2019 ◽  
Vol 25 (3) ◽  
pp. 153-164
Author(s):  
D. V. Martynenko ◽  
V. P. Voloshin ◽  
L. A. Sherman ◽  
K. V. Shevyrev ◽  
S. A. Oshkukov ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Hip Joint ◽  
Preoperative Planning ◽  
Bone Defects ◽  
Lateral Side ◽  
X Rays ◽  
Two Dimensional ◽  
Acetabular Coverage ◽  
Anatomical Features ◽  
Medial Side

Purpose of the study — to improve the two-dimensional planning of total hip joint arthroplasty to ensure precise positioning of the acetabular component in the deformed acetabulum. Materials and methods. Features of roentgenological anatomy of acetabulum and its coverage were studied on 1058 hip joint x-rays in the AP view in accordance with the procedure developed by the authors to define acetabular square — the site of standard positioning of a spherical femoral head in the acetabulum or of a hemispherical acetabular component. The method consisted of identifying the apex of “teardrop” figure; the most lateral points of the pelvic terminal line and roof of the acetabulum; superior part of the acetabular cavity; medial and inferior points of acetabular coverage, and building the sides of acetabular square — medial, inferior, lateral and superior boundary lines. Connection of “teardrop” apex and lateral point of the pelvic terminal line formed the medial side of acetabular square, and a perpendicular to that line drawn through the “teardrop” apex to its inferior side. The lateral side was drawn either through the intersection of the ascending diagonal line — bisector from the top of the “teardrop” figure with the contour of the acetabulum roof, or was a part of the projection of the most lateral point of the acetabular roof on the inferior side of the square. The superior side was a perpendicular connecting the intersection of the ascending diagonal and lateral bounding lines with the medial side of the acetabular square. The area of the deformed acetabular cavity located outside of the acetabular square was assessed as the acetabular defect. Results. Method of defining the acetabular square allowed to identify types of ratios between acetabular cavity and acetabular coverage in transverse (9 types) and longitudinal (7 types) direction. Combination of transverse ratio of acetabular cavity and coverage with longitudinal type allowed to define the options of acetabular deformities in two-dimensional view. The authors identified 25 types of acetabular deformities. Bone defects of acetabular walls were of the major importance among all anatomical features. Cranial defect of acetabulum was observed in 450 cases, medial wall defect — in 38 cases, defect including cranial and medial areas — in 7 cases. Conclusion. The method suggested by the authors to determine acetabular square and acetabular deformity variations allows to screen the anatomical features of the acetabulum during two-dimensional preoperative planning and to make an informed decision on the need to use other planning techniques. The type of acetabular deformity identified during preoperative planning allows to elaborate the indications for replacement of acetabular bone defects and/or resection of acetabular osteophytes.

scholarly journals Influence of General Mineral Condition on Collagen-Guided Alveolar Crest Augmentation

Materials ◽  
2020 ◽  
Vol 13 (16) ◽  
pp. 3649
Author(s):  
Marcin Kozakiewicz ◽  
Piotr Szymor ◽  
Tomasz Wach
Keyword(s):  
Collagen Scaffold ◽  
Bone Defects ◽  
X Rays ◽  
Two Dimensional ◽  
Reference Region ◽  
Normal Bone ◽  
Alveolar Crest ◽  
Tooth Extractions ◽  
Regeneration Of Bone ◽  
Mineral System

The local regeneration of bone defects is regulated by general hormone, enzyme, ion, and vitamin levels. General diseases and dysregulation of the human mineral system can impact this process, even in alveolar crest. The aim of this study is to investigate a relation between bone density, measured in two-dimensional X-rays, and general mineral condition of patients. The study included 42 patients on whom tooth extractions were performed. Data were divided into two groups: the region where collagen scaffold (BRM) was used and the reference region of intact normal bone (REF). Two-dimensional intraoral radiographs were taken in all cases just after the surgery (00 M) and 12 months later (12 M). Thyrotropin (TSH), parathormone (PTH), Ca2+ in serum, HbA1c, vitamin 25(OH)D3, and spine densitometry were checked. Digital texture analysis in MaZda 4.6 software was done. Texture Index (TI: BRM 1.66 ± 0.34 in 00 M, 1.51 ± 0.41 in 12 M, and REF 1.72 ± 0.28) and Bone Index (BI: BRM 0.73 ± 0.17 in 00 M, 0.65 ± 0.22 41 in 12 M, and REF 0.80 ± 0.14) were calculated to evaluate bone regeneration process after 12 months of healing (TI (p < 0.05) and BI (p < 0.01) are lower in BRM 12 M than in REF). This showed a relation between BI and TSH (R2 = 26%, p < 0.05), as well as a between BI and patient age (R2 = 65%, p < 0.001), and a weak relation between TI and TSH level (R2 = 10%, p < 0.05). This study proved that a collagen scaffold can be successfully used in alveolar crest regeneration, especially in patients with a high normal level of TSH in the middle-aged population.

scholarly journals Results of surgical treatment in patients with aseptic instability of components of hip joint endoprosthesis

2021 ◽  
Vol 23 (1) ◽  
pp. 90-97
Author(s):  
H. V. Haiko ◽  
V. M. Pidhaietskyi
Keyword(s):  
Femoral Component ◽  
Acetabular Component ◽  
Hip Joint ◽  
Great Majority ◽  
State Institution ◽  
Bone Defects ◽  
Primary Surgery ◽  
Hip Joint Endoprosthesis ◽  
Significant Difference ◽  
Acetabular Defects

The aim. To study the results of revision endoprosthetics in patients with aseptic instability of the components of the hip joint endoprosthesis. Materials and methods. The basis of this work was the analysis of the revision prosthetics results in 152 patients (158 cases) with aseptic instability of components of hip joint endoprosthesis, who underwent surgery at the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” between 2008 and 2018. Total instability in the endoprosthesis components was observed in 43 cases (27.2 %), acetabular component instability – in 65 cases (41.1 %), femoral component instability was detected in 50 cases (31.6 %). Endoprosthesis dislocation occurred mostly between 5 and 9 years after the primary surgery. Clinical, radiological and statistical methods were used in the work. Results. Patients with acetabular component instability showed the best results of revision replacement for Paprosky I, II types acetabular defects (t = 9.3, P < 0.05). The vast majority of components became unstabile between 5 and 9 years after the primary replacement. The results of unstable femoral component revisions did not reveal any significant difference between cemented and cementless types of component fixation 10 years after the procedure. Recurrent aseptic instability was observed only in 7 cases, 5 of which (71.4 %) were fixated with cement. In the case of total instability, there was no difference in the revision implantation results between the use of primary components alone and in the combination with revision reconstructive systems. Component stability constituted the great majority (35 cases, which was 81.4 %) of cases after 10 years (t = 7.3, P < 0.05). The recurrent instability of one component was observed in 8 cases, which represented 18.6 % of the total number of revisions. Conclusions. In patients with instability of acetabular and femoral components in the presence of Paprosky I–II bone defects, the results of the revision replacement were better when implanting primary components using cementless type of fixation. The use of revision antiprotrusion acetabular and elongate femoral modular or monoblock systems with cementless type of fixation achieved better results in Paprosky III type acetabular and femoral bone defects. The revision of cemented components showed significantly worse results and implant survival rate compared to cementless fixation technique.

Why do subchondral cysts occur at the medial aspect of the femoral head in hip dysplasia?

2020 ◽  
pp. 112070002091216
Author(s):  
Jae Suk Chang ◽  
Joo Ho Song ◽  
Ji Wan Kim ◽  
Hun-Kyu Shin ◽  
Hee-Jin Park ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Ligamentum Teres ◽  
Lateral Side ◽  
X Rays ◽  
3 Dimensional ◽  
Medial Side ◽  
Significant Difference ◽  
Group A ◽  
Tönnis Grade

Introduction: Osteoarthritis in dysplastic hips should develop from the lateral side of the acetabulum and the femoral head just below. However, the existence of subchondral cysts located more on the medial side contradicts the weight-loading theory. The aim of this study was to confirm the presence of medial cysts at the femoral head and to investigate the relationship between medial cysts and injuries of the ligamentum teres in hip dysplasia. Methods: A retrospective analysis was conducted on 257 cases of hip dysplasia. All patients had x-rays and 3-dimensional computed tomographies (3D CT) preoperatively and 123 patients had magnetic resonance arthrographies. A comparison was performed between cases with and without medial cysts according to the severity of damage to the ligamentum teres, the presence of bony spurs around the fovea capitis, and the Tönnis grade. Results: Medial subchondral cysts around the fovea capitis were found in 100 cases. Mild osteoarthritis (Tönnis grade 0 or 1) was present in 89% of cases in the medial cyst group. A significant difference between the groups was observed in the incidence of bony spurs around the fovea capitis ( p < 0.05) and injuries of the ligamentum teres ( p < 0.05). Conclusions: The formation of subchondral cysts at the medial femoral head in hip dysplasia may be related to damage in the ligamentum teres. Considering that subchondral cysts develop in early osteoarthritis, the progression of arthritis in hip dysplasia appears to correlate with damage to the ligamentum teres, as well as compressive pressure on the joint.

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

scholarly journals Study on X-ray Induced Two-Dimensional Thermal Shock Waves in Carbon/Phenolic

Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3553
Author(s):  
Dengwang Wang ◽  
Yong Gao ◽  
Sheng Wang ◽  
Jie Wang ◽  
Haipeng Li
Keyword(s):  
Numerical Simulation ◽  
Shock Wave ◽  
Wave Propagation ◽  
Thermal Shock ◽  
Anisotropic Material ◽  
Energy Deposition ◽  
X Rays ◽  
Two Dimensional ◽  
X Ray ◽  
Deposition Depth

Carbon/Phenolic (C/P), a typical anisotropic material, is an important component of aerospace and often used to protect the thermodynamic effects of strong X-ray radiation. In this paper, we establish the anisotropic elastic-plastic constitutive model, which is embedded in the in-house code “RAMA” to simulate a two-dimensional thermal shock wave induced by X-ray. Then, we compare the numerical simulation results with the thermal shock wave stress generated by the same strong current electron beam via experiment to verify the correctness of the numerical simulation. Subsequently, we discuss and analyze the rules of thermal shock wave propagation in C/P material by further numerical simulation. The results reveal that the thermal shock wave represents different shapes and mechanisms by the radiation of 1 keV and 3 keV X-rays. The vaporization recoil phenomenon appears as a compression wave under 1 keV X-ray irradiation, and X-ray penetration is caused by thermal deformation under 3 keV X-ray irradiation. The thermal shock wave propagation exhibits two-dimensional characteristics, the energy deposition of 1 keV and 3 keV both decays exponentially, the energy deposition of 1 keV-peak soft X-ray is high, and the deposition depth is shallow, while the energy deposition of 3 keV-peak hard X-ray is low, and the deposition depth is deep. RAMA can successfully realize two-dimensional orthotropic elastoplastic constitutive relation, the corresponding program was designed and checked, and the calculation results for inspection are consistent with the theory. This study has great significance in the evaluation of anisotropic material protection under the radiation of intense X-rays.

The Radiological Anatomy of the Scaphoid

1997 ◽  
Vol 22 (1) ◽  
pp. 8-15 ◽  
Author(s):  
J.P. COMPSON ◽  
J.K. WATERMAN ◽  
F.W. HEATLEY
Keyword(s):  
Complex Shape ◽  
X Rays ◽  
Radiological Anatomy ◽  
Anatomical Features ◽  
X Ray ◽  
Radiopaque Markers

The complex shape of the scaphoid and its orientation within the carpus makes the radiological interpretation of scaphoid anatomy difficult. To improve our understanding of how the anatomy appears on plain X-ray, a study was performed using dry cadaver bones. Salient anatomical features were outlined using radiopaque markers, the bones set in wax blocks and the blocks X-rayed in the same axis as six “standard” scaphoid views. The pictures obtained were then compared with clinical X-rays.

scholarly journals Differential Contribution of the Medial and the Lateral Side of the Joint to Symptoms in Knee Osteoarthritis: A Radiographic and Laboratory Analysis in the Nagahama Study

Cartilage ◽  
2021 ◽  
pp. 194760352110258
Author(s):  
Kazuya Nigoro ◽  
Hiromu Ito ◽  
Tomotoshi Kawata ◽  
Shinichiro Ishie ◽  
Yugo Morita ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Knee Pain ◽  
High Sensitivity ◽  
Analysis Of Covariance ◽  
Radiographic Evaluation ◽  
Radiographic Feature ◽  
Lateral Side ◽  
Cross Sectional ◽  
Medial Side

Objective: This cross-sectional study aimed to explore the differences of the medial and lateral sides of the knee joint and precise radiographic abnormalities in contribution to the knee pain and clinical outcomes. Design: Participants 60 years or older who underwent radiographic evaluation were included. Knee radiography was assessed using grading systems of the Osteoarthritis Research Society International (OARSI) atlas. The Japanese Knee Osteoarthritis Measure (JKOM) was evaluated as clinical outcomes. Serum high-sensitivity C-reactive protein (hsCRP) was used to evaluate systemic inflammation. We divided the participants into normal, medial-, lateral-, and medial & lateral-OA types and compared their JKOM using an analysis of covariance. Furthermore, we analyzed the relationship between the knee pain and stiffness of JKOM and the grading of each radiographic feature using a multiple regression model. Results: Lateral- and medial & lateral-OA groups had a significantly worse symptoms in the total and the pain score, especially in movement subscales, in JKOM score. Lateral-OA groups had higher hsCRP than medial-OA group. Multivariate analysis showed that medial joint space narrowing (JSN), and lateral femoral and tibial osteophytes significantly affected knee pain (adjusted odds ratios: 1.73, 1.28, and 1.55, respectively). The radiographic changes are associated with pain more in JSN in the medial side and osteophytes in the lateral side. Conclusion: Lateral- and medial & lateral-OA groups showed worth symptom. In addition, medial JSN and lateral osteophytes have potent effects on the knee pain.

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