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BMC Musculoskeletal Disorders Feb 2023Muscle-sparing techniques, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited...
BACKGROUND
Muscle-sparing techniques, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients' expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint.
METHODS AND SURGICAL TECHNIQUE
In this technical note, we demonstrate for the first time a hybrid modification of traditional Smith-Peterson and Watson-Jones approaches to the hip joint on a standard operating room (OR) table.
CONCLUSIONS
As demonstrated in this article, a precise knowledge of anatomy and clear goals in the surgical approach can minimize complications and facilitate visualization and instrumentation placement in the "direct anterior approach" to the hip joint.
Topics: Humans; Hip Joint; Acetabulum; Fluoroscopy; Muscles; Operating Tables
PubMed: 36855127
DOI: 10.1186/s12891-023-06254-8 -
Clinical Orthopaedics and Related... Jul 2011Gender-specific differences in knee and hip anatomy have been well documented. Although it has been accepted these differences exist, there is controversy regarding if... (Review)
Review
BACKGROUND
Gender-specific differences in knee and hip anatomy have been well documented. Although it has been accepted these differences exist, there is controversy regarding if and how these differences should be addressed with gender-specific implant designs.
QUESTIONS/PURPOSES
(1) What are the anatomic and morphologic differences, if any, in the knee and hip between men and women? (2) Do gender-specific TKA designs provide better clinical functioning, survivorship, and improved fit in women? (3) How have anatomic differences in the hip been addressed, if at all, by THA?
METHODS
We conducted a systematic review of the MEDLINE database to identify all articles reviewing basic science and clinical outcomes of gender-specific total knee and total hip implants. From these, we reviewed 253 studies.
RESULTS
The anatomic studies elucidated multiple differences in the anatomy of knees and hips between men and women. All reviewed studies report similar clinical function and satisfaction scores between men and women for gender-specific TKA and no improvement in these scores when comparing gender-specific TKA to unisex TKA. Current modularity in THA appears to accommodate any anatomic differences in the hip.
CONCLUSIONS
Based on the available literature, there is no difference in the outcome of patients with a gender-specific knee arthroplasty versus a unisex arthroplasty. It does not appear gender-specific THAs would provide any benefit over current systems.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Female; Genetic Variation; Hip Joint; Humans; Knee Joint; Male; Men; Phenotype; Sex Characteristics; Sex Factors; Women; Women's Health
PubMed: 21264555
DOI: 10.1007/s11999-011-1769-2 -
BMC Musculoskeletal Disorders Apr 2020This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified... (Review)
Review
BACKGROUND
This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications.
METHODS
A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded.
RESULTS
Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o'clock on the acetabular rim which may have implications with labral pathology.
CONCLUSION
This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.
Topics: Acetabulum; Hip Joint; Humans; Imaging, Three-Dimensional; Tomography, X-Ray Computed
PubMed: 32276620
DOI: 10.1186/s12891-020-03241-1 -
Acta Orthopaedica Feb 2013A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic... (Review)
Review
A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral anatomy and function, the etiology of labral tears in hip dysplasia, and diagnostic assessment of labral tears, and we discuss treatment strategies for coexisting labral tears and hip dysplasia.
Topics: Acetabulum; Hip Injuries; Hip Joint; Humans; Osteotomy; Radiography
PubMed: 23343376
DOI: 10.3109/17453674.2013.765626 -
Pediatric Rheumatology Online Journal Jan 2017The usefulness of musculoskeletal ultrasonography (MSUS) in paediatric population is limited by lack of reference values. One of such parameters is hip joint capsule...
BACKGROUND
The usefulness of musculoskeletal ultrasonography (MSUS) in paediatric population is limited by lack of reference values. One of such parameters is hip joint capsule thickness, postulated as an early measure for synovitis. However, the joint capsule is hardly a distinguished structure from slit synovial cavity in patients with little or no fluid collection. Therefore, in patients without effusion, it is more convenient to measure hip joint capsule thickness together with synovial cavity. The aim of the study was to establish percentile chart for hip joint capsule and synovial cavity thickness (HJC&SCT) in apparently healthy children.
MATERIAL AND METHODS
The analysis included 816 US of hip joint in 408 children without musculoskeletal disorders, distributed equally throughout the whole developmental period in 18 one-year subgroups. Hip joints US was performed according to standard protocol including measurement of HJC&SCT in a single rheumatology centre by three investigators.
RESULTS
The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th HJC&SCT percentile curves were depicted in the age and height charts for the combined group of girls and boys. The median HJC&SCT values were increasing with age from 3.7 (C10 - C90: 3.3 - 4.2) mm in the first year of life up to 6.7 (5.8 - 7.3) in 16 years old, and above. In a similar way the increase was seen with height from 3.9 (3.5 - 4.7) mm in shorter than 95 cm to 6.9 (6.2 - 7.4) mm in taller than 169 cm subjects. Intra-observer and inter-observer mean precision was less than 1.8 and 12.5%, respectively.
CONCLUSION
The developed centile chart for hip joint capsule and synovial cavity thickness in the paediatric population is expected to improve detection of hip joint capsule disorders, including synovitis in juvenile idiopathic arthritis.
Topics: Adolescent; Child; Child Development; Child, Preschool; Female; Hip Joint; Humans; Joint Capsule; Male; Observer Variation; Reference Values; Regression Analysis; Ultrasonography
PubMed: 28143500
DOI: 10.1186/s12969-017-0136-6 -
Journal of Musculoskeletal & Neuronal... Mar 2013Hip pain and dysfunction are increasingly recognised as important causes of morbidity in younger and older adults. Pathology compromising the passive stability of the... (Review)
Review
Hip pain and dysfunction are increasingly recognised as important causes of morbidity in younger and older adults. Pathology compromising the passive stability of the hip joint, including acetabular labral injury, may lead to increased femoral head translation, greater joint contact pressures and ultimately degenerative hip disease. Activation of hip muscles may play an important role in augmenting the stability in the normal and the passively unstable hip. Research at other joints suggests that the local, rather than global, muscles are well suited to provide subtle joint compression, limiting translation, with minimal metabolic cost. Based on the known characteristics of local muscles and the limited research available on hip muscles, it is proposed that the local hip muscles; quadratus femoris, gluteus minimus, gemelli, obturator internus and externus, iliocapsularis and the deep fibres of iliopsoas, may be primary stabilisers of the hip joint. Interventions aimed at restoring isolated neuromuscular function of the primary hip stabilisers may be considered when treating people with passive hip instability prior to commencing global muscle rehabilitation. Finally, further research is needed to investigate the potential association between function of the hip muscles (including muscles likely to have a role in stabilising the hip) and hip pathology affecting hip stability such as acetabular labral lesions.
Topics: Animals; Hip; Hip Joint; Humans; Muscle, Skeletal
PubMed: 23445909
DOI: No ID Found -
Seminars in Musculoskeletal Radiology Jun 2019Femoroacetabular impingement (FAI) has taken us on a roller-coaster ride of innovation, heightened expectations, disillusionment, and confusing diagnostic and treatment... (Review)
Review
Femoroacetabular impingement (FAI) has taken us on a roller-coaster ride of innovation, heightened expectations, disillusionment, and confusing diagnostic and treatment pathways. This article reviews and analyzes the phases of FAI diagnosis and treatment over the past 15 years and discusses its parallels to Amara's law and Gartner's hype cycle.
Topics: Femoracetabular Impingement; Hip Joint; Humans; Magnetic Resonance Imaging; Mass Media
PubMed: 30699445
DOI: 10.1055/s-0039-1677695 -
International Orthopaedics May 2023Calibration of radiographs is a critical step in digital templating for hip arthroplasty. Calibration errors of > 1.5% lead to over- or undersizing of the templated...
PURPOSE
Calibration of radiographs is a critical step in digital templating for hip arthroplasty. Calibration errors of > 1.5% lead to over- or undersizing of the templated implants and may affect logistics and patient safety. Contemporary calibration methods are known to be imprecise with average errors of 6.5% and wide variance. A novel bi-planar radiograph-based calibration method is proposed, and a phantom study was conducted as proof of concept.
METHODS
A spherical external calibration marker (ECM) is placed in front of the pubic symphysis of a pelvic bone model at twelve different positions. For each marker position, standard anteroposterior radiographs and four corresponding lateral radiographs with different degrees of rotation (0°-30°) are taken (overall, 60 radiographs). Calibration factors are calculated for an internal calibration marker (ICM) at the centre of the right hip (reference) and the ECM using a novel algorithm. Rotation and marker positions simulate foreseeable use errors and misplacements and aim to test robustness of the method against these errors.
RESULTS
ECM calibration factor was 125.9% (range 124.7-127.2), and the mean ICM calibration factor was 126.6% (range 126.2-127.1) ([Formula: see text]). Four images (8.3%) were beyond the 1% error threshold (all with 30° rotation). The mean difference was 0.79% (SD 0.49).
CONCLUSION
The bi-planar method precisely predicts the true calibration factor of the hip joint plane under various conditions. In lateral radiographs, rotation of up to 20° did not adversely affect the precision and all images had calibration errors below the threshold for clinical significance.
Topics: Humans; Arthroplasty, Replacement, Hip; Acetabulum; Hip Prosthesis; Calibration; Hip Joint
PubMed: 36881153
DOI: 10.1007/s00264-023-05747-4 -
Clinical Orthopaedics and Related... May 2021
Topics: Biomechanical Phenomena; Congresses as Topic; Hip Joint; Humans; Joint Diseases; Orthopedic Procedures; Range of Motion, Articular; Recovery of Function; Treatment Outcome
PubMed: 33844666
DOI: 10.1097/CORR.0000000000001760 -
Clinical Orthopaedics and Related... Dec 2014Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing... (Review)
Review
BACKGROUND
Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing arthroplasty (SRA). A variety of imaging tools, including ultrasound (US), CT, and MRI, have been used to diagnose problems associated with wear after MoM hip arthroplasty and corrosion at the head-trunnion junction; however, the relative advantages and disadvantages of each remain a source of controversy.
QUESTIONS/PURPOSES
The purposes of this review were to evaluate the advantages and disadvantages of (1) US; (2) CT; and (3) MRI as diagnostic tools in the assessment of wear-related corrosion problems after hip arthroplasty.
METHODS
A systematic literature review was performed through Medline, EMBASE, Scopus CINAHL, and the Cochrane Library without time restriction using search terms related to THA, SRA, US, CT, MRI, adverse tissue reactions, and corrosion. Inclusion criteria were Level I through IV studies in the English language, whereas expert opinions and case reports were excluded. The quality of included studies was judged by their level of evidence, method of intervention allocation, outcome assessments, and followup of patients. Four hundred ninety unique results were returned and 40 articles were reviewed.
RESULTS
The prevalence of adverse local tissue reactions in both asymptomatic and symptomatic patients varies based on the method of evaluation (US, CT, MRI) and imaging protocols. US is accessible and relatively inexpensive, yet has not been used to report synovial thicknesses in the setting of wear-related corrosion. CT scans are highly sensitive and provide information regarding component positioning but are limited in providing enhanced soft tissue contrast and require ionizing radiation. MRI has shown promise in predicting both the presence and severity of adverse local tissue reactions but is more expensive.
CONCLUSIONS
All three imaging modalities have a role in the assessment of adverse local tissue reactions and tribocorrosion after total hip arthroplasty. Although US may serve as a screening technique for the detection of larger periprosthetic collections, only MRI has been shown to predict the severity of tissue destruction found at revision and correlate to the degree of tissue necrosis at histologic evaluation.
Topics: Arthroplasty, Replacement, Hip; Biomechanical Phenomena; Corrosion; Diagnostic Imaging; Foreign-Body Reaction; Hip Joint; Hip Prosthesis; Humans; Magnetic Resonance Imaging; Metal-on-Metal Joint Prostheses; Predictive Value of Tests; Prosthesis Design; Prosthesis Failure; Risk Factors; Stress, Mechanical; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography
PubMed: 24664197
DOI: 10.1007/s11999-014-3579-9