scholarly journals Anterior prompt for debridement and myoplasty femoral neck and head osteomyelitis

2021 ◽  
Vol 8 (2) ◽  
pp. 34-40
Author(s):  
V. M. Bensman ◽  
Yu. P. Savchenko ◽  
V. V. Malyshko
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Research Methods ◽  
Hip Joint ◽  
Proximal Part ◽  
Sartorius Muscle ◽  
Surgical Wound ◽  
Operating Field ◽  
Quadriceps Femoris Muscles

The known anterior prompts to the femoral neck are non-traumatic, but they exclude the possibility of myoplasty and are not large enough for intra-articular sequestrectomy.Objective. The aim of the study was to develop an anterior prompt to the hip joint for sequestrectomy with myoplasty.Materials and research methods. For surgery neck and head of the hip osteomyelitis we perform a semi-oval incision in the projection of the femoral head, from the anterior spines of the ilium we cut off the tendons of the sartorius and rectus head of the quadriceps femoris muscles. An operating field is formed, which allows sequestrectomy to be performed. Plasty of the osteomyelitis cavity is performed with the proximal parts of the two anterior ileofemoral muscles. The operating field, if necessary, can be increased by temporary transection of the lumbar-iliac muscle tendon.Research results. The key to the anterior surgical prompt to the hip joint is the sartorius and rectus head of the quadriceps. The length of the surgical wound reaches 17–22 cm, and the width is 16–18 cm. With the mobilized proximal part of the sartorius muscle, we fill the entire bone cavity in the neck and head of the femur. Of the 12 operated patients, 11 (91.7 ± 7.6 %) had a stable long-term remission.Conclusion. The proposed approach is less traumatic and allows you to operate at an angle of about 90°. It complements the advantages of the known anterior prompts and is devoid of their disadvantages.

Complex Functional Evaluation of Long-Term Results of Femoral Neck and Head Revascularization in Degenerative Dystrophic Hip Joint Diseases

2012 ◽  
Vol 19 (1) ◽  
pp. 35-41
Author(s):  
Evgeniy Aleksandrovich Nazarov ◽  
V G Papkov ◽  
A V Seleznev ◽  
R F Musaeva ◽  
E A Nazarov ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Joint ◽  
Long Term Results ◽  
Functional Evaluation ◽  
Joint Diseases ◽  
Hip Joints ◽  
Functional Changes ◽  
Ct And Mri

Long-term results (7 to 26 years) after femoral neck and head revascularization were analyzed for 41 patients with degenerative dystrophic hip joint diseases: 27 patients with aseptic femoral head necrosis (AFHN), 9 patients with coxarthrosis, 5 - with cystoid remodeling of adjacent surfaces. Results were assessed by Harris scale. Degree of functional changes in hip joints was determined using computed stabilometry. Indirect proof of implanted vascular bundle vitality were radiologically, CT and MRI detected canals in the femoral neck and head that where the implants had been inserted. It was shown that revascularization was most effective (100 points by Harris scale) in patients with early (pre-radiologic) stage of AFHN and in patients with cystic remodeling.

Long-term results of internal-and-transosseous osteosynthesis of intraarticular fractures of the proximal femur

2021 ◽  
pp. 7-11
Author(s):  
Nikolay V. Belinov
Keyword(s):  
Femoral Neck ◽  
Research Methods ◽  
Hip Joint ◽  
Objective Assessment ◽  
Physical Exertion ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Functional Studies ◽  
Intraarticular Fractures

We analyze the condition of 28 patients who underwent internal-and-transosseous metal osteosynthesis of the femoral neck. We use clinical, radiological and functional research methods for the examination. In clinical research methods, the main attention was paid to the patient's gait, pain syndrome, which was evaluated both during physical exertion and at rest. The radiological methods of the study assessed the signs of consolidation of bone fragments, the presence of bone trabeculae, which, without interruption, pass from the neck to the femoral head. In case of pain in the hip joint, a computed tomography was performed with the measurement of the length of the hip neck, which was compared with the length of the hip neck of the healthy side. The congruence of the articular surfaces and the articular gap of the hip joint were studied. Functional studies were carried out using the systems for assessing the state of the hip joint of Luboshitz–Mattis–Schwarzberg and W.H. Harris. The follow-up period ranged from 1 to 7 years. The obtained studies allowed an objective assessment of the long-term results of metal osteosynthesis of femoral neck fractures with an original fixator. A positive assessment of the long-term results of osteosynthesis of the femoral neck allows us to recommend using this fixator in clinical practice.

Free vascularized fibular graft for treatment of pathological femoral neck fracture and osteonecrosis of the femoral head: A case report with a long-term follow-up

Microsurgery ◽  
2008 ◽  
Vol 29 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Alexandros E. Beris ◽  
Marios G. Lykissas ◽  
Alexandros Payatakes ◽  
Vasileios A. Kontogeorgakos ◽  
Alexandros Mavrodontidis ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Femoral Neck ◽  
Fibular Graft ◽  
Vascularized Fibular Graft ◽  
Long Term Follow Up ◽  
Neck Fracture ◽  
Free Vascularized Fibular Graft

scholarly journals Hip Joint Replacement Using Monofilament Polypropylene Surgical Mesh: An Animal Model

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Jacek Białecki ◽  
Marian Majchrzycki ◽  
Antoni Szymczak ◽  
Małgorzata Dorota Klimowicz-Bodys ◽  
Edward Wierzchoś ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Joint ◽  
Surgical Mesh ◽  
Treatment Options ◽  
Pelvic Osteotomy ◽  
Cost Effective ◽  
Clinical Value ◽  
Hip Joint Replacement ◽  
New Surgical Technique

Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur) leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS), triple pelvic osteotomy (TPO), total hip replacement (THR), and femoral head and neck resection (FHNE). The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform.

Dimensions of Proximal Femur - An Anatomical Study

2021 ◽  
pp. 2540-2542
Author(s):  
Gyanaranjan Nayak
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Head And Neck ◽  
Hip Joint ◽  
Proximal Femur ◽  
Hip Replacement ◽  
Anatomical Study ◽  
Morphometric Parameters ◽  
Prosthesis And Implants ◽  
Axis Length

The morphometry of proximal femur is necessary in planning surgeries of hip joint and preparation of prosthesis for hip replacement. The aim of the study was to measure various morphometric parameters of femoral head and neck. The study consisted of sixty adult dry human femora of both sexes (thirty left sided and thirty right sided). Various dimensions of femoral head and neck were measured by slide caliper. Diameter of femoral head was estimated to be 39.28±3.87mm along cranio-caudal axis and 41.18±4.14mm along sagittal axis. Diameter of femoral neck was established as 29.03±3.8mm along cranio-caudal axis and 24.36±3.13mm along sagittal axis. Length of femoral neck was measured to be 50.57±6.77mm. The findings of the study will be useful in manufacturing prosthesis and implants for hip replacement as well as other surgeries involving proximal femur.

scholarly journals The first experience of arthroscopy in the case of aseptic necrosis of the femoral head

2021 ◽  
pp. 39-44
Author(s):  
Maxim Golovakha ◽  
Vadym Kirichenko ◽  
Olexandra Grytsenko ◽  
Rostyslav Tytarchuk ◽  
Stanislav Bondarenko
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Comparison Group ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Hip Joint Replacement ◽  
Therapeutic Exercises

Observation of patients with avascular necrosis of the femoral head formed a hypothesis about inability to eliminate the hip contracture by tunneling the femoral head on the background of drug therapy and therapeutic exercises, which causes an unsatisfactory outcomes. Therefore, the was idea to use arthroscopy for performing capsulotomy, synovectomy and removal of free cartilage and bone fragments. Objective. To evaluate efficiency of arthroscopy in patients with avascular necrosis of the femoral head. Methods. In the period from 2010 to 2018, 60 patients were observed. With the I–II stages, absence of inflammatory processes in the joint, body mass index less than 35. In the comparison group (28 patients) we made  only tunneling of the femoral head, in the study group (32) at first  we performed arthroscopy of the hip joint, capsulotomy, synovectomy, removal of cartilage fragments, and only then — tunneling. We analyzed the proportion of hip joint replacement that was performed in the long term follow up and the intensity of pain by visual analog scale. Results. During arthroscopy we often revealed the joint cartilage lesions — 30 %, articular labrum lesions — 5 %, synovitis — 100 %, CAM impingement — 90 %. In the study group in the first 2 weeks after surgery, the pain was severe more than in the comparison group. Then the pain rate became the same in both groups. In the control group in the period from 3 to 5 years after tunneling of the femoral head, arthroplasty was performed in 11 patients (39.3 %), in the study group for 2 to 3 years after surgery — 8 (25.0 %). Conclusions. Analysis of long-term results of tunneling of the femoral head with arthroscopy of the hip joint in patients with avascular necrosis of the femoral head showed improvement in hip function, no disease progression in 60–75 % patients in 2–3 years after surgery.

scholarly journals Vascular Bundle Transplantation in the Treatment of Avascular Necrosis of the Femoral Head caused by Fracture of the Femoral Neck and Dislocation of the Hip Joint.

1997 ◽  
Vol 46 (2) ◽  
pp. 423-426
Author(s):  
Yoshihide Hori ◽  
Susumu Tamai ◽  
Hiroshi Fujiwara ◽  
Shinzo Ariyama ◽  
Jun Yamauchi ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Vascular Bundle ◽  
Dislocation Of The Hip

Optimal parameters of abrasive flow finishing for hip joint implants

2021 ◽  
pp. 095440542199561
Author(s):  
Yahya Choopani ◽  
Mohsen Khajehzadeh ◽  
Mohammad Reza Razfar
Keyword(s):  
Surface Roughness ◽  
Standard Deviation ◽  
Femoral Head ◽  
Hip Joint ◽  
Spherical Shape ◽  
Shape Deviation ◽  
Head Surface ◽  
Joint Implants ◽  
Finishing Processes ◽  
Abrasive Flow Finishing

Total hip arthroplasty (THA) is one of the most well-known orthopedic surgeries in the world which involves the substitution of the natural hip joint by prostheses. In this process, the surface roughness of the femoral head plays a pivotal role in the performance of hip joint implants. In this regard, the nano-finishing of the femoral head of the hip joint implants to achieve a uniform surface roughness with the lowest standard deviation is a major challenge in the conventional and advanced finishing processes. In the present study, the inverse replica fixture technique was used for automatic finishing in the abrasive flow finishing (AFF) process. For this aim, an experimental setup of the AFF process was designed and fabricated. After the tests, experimental data were modeled and optimized to achieve the minimum surface roughness in the ASTM F138 (SS 316L) femoral head of the hip joint through the use of response surface methodology (RSM). The results confirmed uniform surface roughness up to the range of 0.0203 µm with a minimum standard deviation of 0.00224 for the femoral head. Moreover, the spherical shape deviation of the femoral head was achieved in the range of 7 µm. The RSM results showed a 99.71% improvement in the femoral head surface roughness (0.0007) µm under the optimized condition involving the extrusion pressure of 9.10 MPa, the number of finishing cycles of 95, and SiC abrasive mesh number of 1000.

scholarly journals Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up

2021 ◽  
pp. 112070002098815
Author(s):  
Dammerer Dietmar ◽  
Braito Matthias ◽  
Peter Ferlic ◽  
Kaufmann Gerhard ◽  
Juana Kosiol ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Pelvic Osteotomy ◽  
Perthes Disease ◽  
Total Hip ◽  
Joint Incongruence ◽  
Chiari Pelvic Osteotomy

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.

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