acetabular wall
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Author(s):  
Jaron Nazaroff ◽  
Bryan Mark ◽  
James Learned ◽  
Dean Wang

Abstract The purpose of this study was to compare measurements of anterior wall index (AWI) and posterior wall index (PWI) on computed tomography (CT) to those on radiographs (XR). A consecutive cohort of 33 patients (45 hips total) being evaluated for hip pain with both XR and CT was examined. Preoperative measurements of AWI and PWI were performed utilizing supine anteroposterior pelvic XR and coronal and swiss axial CT scans by two independent raters. Mean differences between XR and CT measurements were compared, and agreement between measurements was assessed using the concordance correlation coefficient (rc) and Bland–Altman analysis. A total of 39 hips in 28 patients were analyzed. The mean patient age was 31.1 ± 9.0 years, and 50% were female. Mean AWI and PWI on XR was 0.50 ± 0.14 and 0.91 ± 0.12, respectively. Measured values of AWI were consistently larger (0.08 ± 0.10, P < 0.01) on XR compared with both coronal and swiss axial CT, with moderate agreement between XR and CT measurements (rc = 0.68–0.70). Measured values of PWI were consistently smaller (0.15 ± 0.12, P < 0.05) on XR compared with both coronal and swiss axial CT, with poor agreement between XR and CT measurements (rc = 0.37–0.45). Measured values of acetabular wall indices on XR were consistently larger for AWI and smaller for PWI relative to CT. Agreement between XR and CT measures of the indices were moderate to poor. This highlights the need for standardization of XR- and CT-based measurements to improve assessment of acetabular coverage and subsequent clinical decision-making.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. i41-i45
Author(s):  
Jacek Mazek ◽  
Maciej Gnatowski ◽  
Antonio Porthos Salas ◽  
Marcin Domżalski ◽  
Rafał Wójcicki ◽  
...  

Abstract The aim of this case study is to present arthroscopic treatment of recurrent hip instability after acute post-traumatic posterior hip dislocation with a fracture of the posterior acetabular wall. A male patient aged 35 suffered a dislocation of the right hip joint with a fracture of the posterior acetabular wall due to an accident. The fracture was stabilized during emergency surgery with a locking compression plate, and the patient was released home in a hip brace. Multiple dislocations of the hip joint followed with the implant being confirmed as stable. Decision was made to qualify the patient for a right hip arthroscopy. During the surgery, ligamentum teres was reconstructed using gracilis and semitendinous muscle grafts, followed by the labrum and joint capsule repair, where the surgery that stabilized the acetabular wall fracture had damaged them. There were no complications following the procedure. Short-term follow-up of 3 months demonstrates the patient has a stable hip, reduced pain and has returned to pre-injury activities.


2021 ◽  
Vol 7 (5) ◽  
pp. 01-04
Author(s):  
Sule Baba

Protrusion acetabuli is the medial protrusion of the acetabulum in to the pelvic cavity, also known as arthrokatadysis, more common in females and classified etiologically as primary (idiopathic) and secondary forms. This is a 66-year-old female patient that presented for a plain radiograph of the pelvis and hip joints from a peripheral healthcare center on account of pain and inability to stand and move her waist and hips bilaterally, reduced movement of the legs and pain in the knees for more than three-year duration of onset. The plain radiograph of the pelvis and both hip joints demonstrate reduced density of the demonstrated bones, medial protrusion of the medial wall of the acetabulum in to the pelvic cavity bilaterally (distance between the imaginary Kohler’s line and medial acetabular wall is about 22mm bilaterally; Degree: III), obliteration of the hip joints bilaterally, thickening and sclerosis of the acetabular walls and other articular margins, subarticular cysts on the femur, acetabulum and pelvic bones. The patient had no coexisting condition like rheumatoid arthritis, Marfan’s syndrome and psoriatic arthritis. A diagnosis of bilateral idiopathic protrusio acetabuli was made. The patient was advised on bilateral total hip arthroplasty to improve the symptoms. We report a case of bilateral idiopathic protrusion acetabuli in an elderly female patient in order to describe the features of this condition radiographically.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Vera M. Stetzelberger ◽  
Christiane S. Leibold ◽  
Simon D. Steppacher ◽  
Joseph M. Schwab ◽  
Klaus A. Siebenrock ◽  
...  
Keyword(s):  

Author(s):  
Christof K. Audretsch ◽  
Florian Schmidutz ◽  
Markus Alexander Küper

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.


2019 ◽  
Vol 0 (6) ◽  
Author(s):  
O. Ye. Loskutov ◽  
O. O. Kovbasa ◽  
O. Ye. Oliinyk ◽  
V. H. Stryzhenyi ◽  
O. O. Loskutov ◽  
...  

Cureus ◽  
2019 ◽  
Author(s):  
Tahsin Gürpınar ◽  
Barış Polat ◽  
Enes Kanay ◽  
Ayşe Polat ◽  
Yusuf Öztürkmen

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