Hip 719 articles
Vigorous sporting activity during the growth years is associated with an increased risk of having a cam-type deformity develop. The underlying cause of this osseous deformity is unclear. One may speculate whether this is caused by reactive bone apposition in the region of the anterosuperior head-neck junction or whether sports activity alters the shape of and growth in the growth plate. If the latter is true, then one would expect athletes to show an abnormal shape of the capital growth plate (specifically, the epiphyseal extension) before and/or after physeal closure.
Femoroacetabular impingement has been proposed as a cause of early osteoarthritis, but it is not known how this develops over time or whether the shape of the proximal femur influences this risk.
The literature comparing limited incision and standard incision THAs is confusing regarding whether limited incision THA improves short-term recovery without compromising long-term durability and survival. Further, previously published meta-analyses cannot conclude that limited incision THA is better. With new data, we seek to discover if the answers now exist.
Slipped capital femoral epiphysis (SCFE) is a common hip problem in adolescents that results in a cam-type femoroacetabular impingement (FAI) deformity. Although the treatment for mild (slip angle of 0°–30°) and moderate (slip angle of 31°–60°) SCFE has historically been in situ fixation, recent studies have demonstrated impingement-related articular damage, irrespective of slip severity. Our series confirms previous reports that acetabular chondral injury occurs in mild to low-moderate (slip angle of ≤ 40°) SCFE.
Component design, size, acetabular orientation, patient gender, and activity level have been suggested as factors leading to elevated metal ion concentrations after-on-metal hip resurfacing arthroplasty (MMHRA). The calculation of the contact patch to rim (CPR) distance integrates component size, design, and acetabular orientation and may be a good predictor of elevated metal ion levels.
Does Femoral Rotation Influence Anteroposterior Alpha Angle, Lateral Center-edge Angle, and Medial Proximal Femoral Angle? A Pilot Study
Femoral rotation on AP radiographs affects several parameters used to assess morphologic features of the proximal femur but its effect on femoroacetabular impingement parameters remains unknown.
Can a Triple Pelvic Osteotomy for Adult Symptomatic Hip Dysplasia Provide Relief of Symptoms for 25 Years?
Many surgeons recommend pelvic osteotomy to treat symptomatic hip dysplasia in younger patients. We previously reported a cohort of patients at 10 and 15 years followup in which 65% of the patients showed no progression of osteoarthritis (OA).
Pelvic flexion affects orientation of the acetabular cup; however, pelvic position is not static in daily activities. During THA it is difficult to know the degree of pelvic flexion with the patient in the lateral position and that position is static. However, surgeons need to appropriately determine pelvic tilt to properly insert the acetabular component.
Recent biplanar radiographic studies have demonstrated acetabular retroversion and increased superolateral femoral head coverage in hips with slipped capital femoral epiphysis (SCFE), seemingly divergent from earlier CT-based studies suggesting normal acetabular version.
Emerging Ideas: Novel 3-D Quantification and Classification of Cam Lesions in Patients With Femoroacetabular Impingement
Femoroacetabular impingement (FAI) can lead to labral injury, osseous changes, and even osteoarthritis. The literature contains inconsistent definitions of the alpha angle and other nonthree-dimensional (3-D) radiographic measures. We present a novel approach to quantifying cam lesions in 3-D terms. Our method also can be used to develop a classification system that describes the exact location and size of cam lesions.