Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Acetabulum”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2003

Plasmacup--special design. Aspects of the dysplastic acetabulum.

In Japan, the main reason for osteoarthritis of the hip joint is caused by dysplastic deformities. The implantation technique of cementless press-fit cup with multi-screw fixation and acetabular bone graft to reconstruct the true acetabular center is described. In addition, special design aspects of the BiCONTACT-N stem were optimized for these patients. Between January 1997 and December 1999, 29 patients (33 hips) received a BiCONTACT-N/Plasmacup-M total hip replacement. There were 28 women and one man. Average age at the time of THA of 64 (range 51-76) years. Average time of follow-up was 41 (range 25-59) months. According to the Crowe classification, 18 hips where classified as type 1 (less than 50% subluxation of the femoral head from the acetabulum), nine type 2 (50-75% subluxation), five type 3 (75-100% subluxation), and one type 4 (complete dislocation). At time of follow-up, there was no loosening of the acetabular implant or collapse of the acetabular bone graft. In the radiographic examination, 80% of the femoral implants showed spot welds in the transitional zone of the coated and uncoated area, and 96% sclerotic lines in the coated area. At the uncoated surface, radiolucent lines were seen in 12% and a cortical hypertrophy in 24%. No stress shielding could be observed. Stem subsidence was measured with an average value of 0.32 (range 0-1.6) mm. No patient complained about thigh pain, and no intraoperative complications were observed. Postoperative complications were two anterior dislocations due to cup malposition and excessive lumbar hypnosis. Three deep-venous thromboses where found with venography and treated with warfarin therapy. The limited experience indicates that BiCONTACT-N stem design in combination with the Plasmacup multihole implant is appropriate for the treatment of dysplastic hip deformities in Japanese patients. However, a long-term follow-up study is needed.

Acetabulum↗
PubMed1992

The fetal acetabulum. A histomorphometric study of acetabular anteversion and femoral head coverage.

To study the development of the acetabulum in the early fetal period, 39 embryologic specimens were reviewed in detail. Histologic serial sections were made through 47 hips in the transverse plane. Measurements of acetabular anteversion and femoral head coverage revealed that both parameters depend on the exact level of sectioning. However, when measured at the level of the maximum diameter of the femoral head, they did not show significant variation through the embryonic and early fetal stages (six to 20 weeks). This is in contradistinction to the late fetal period. The hip does remain covered during this early fetal period. Congenital dislocation of the hip is not an early developmental condition. This accounts for the absence of any reports of hip dislocations in the first half of gestation.

Acetabulum↗
PubMed2005

Operative treatment of displaced fractures of the acetabulum. A meta-analysis.

Over the past 40 years, the management of displaced fractures of the acetabulum has changed from conservative to operative. We have undertaken a meta-analysis to evaluate the classification, the incidence of complications and the functional outcome of patients who had undergone operative treatment of such injuries. We analysed a total of 3670 fractures. The most common long-term complication was osteoarthritis which occurred in approximately 20% of the patients. Other late complications, including heterotopic ossification and avascular necrosis of the femoral head, were present in less than 10%. However, only 8% of patients who were treated surgically needed a further operation, usually a hip arthroplasty, and between 75% and 80% of patients gained an excellent or good result at a mean of five years after injury. Factors influencing the functional outcome included the type of fracture and/or dislocation, damage to the femoral head, associated injuries and co-morbidity which can be considered to be non-controllable, and the timing of the operation, the surgical approach, the quality of reduction and local complications which are all controllable. The treatment of these injuries is challenging. Tertiary referrals need to be undertaken as early as possible, since the timing of surgery is of the utmost importance. It is important, at operation, to obtain the most accurate reduction of the fracture which is possible, with a minimal surgical approach, as both are related to improved outcome.

Acetabulum↗
PubMed1992

Periprosthetic bone loss of the acetabulum. Classification and management.

Periprosthetic bone loss, associated with failed acetabular implants, results in disruption of hip mechanics and complicates further reconstruction. To restore normal biomechanics and idealize implant loads, restoration of the normal center of rotation of the hip is recommended. Johnston et al have shown that medial, inferior, and anterior placement of the acetabular component minimizes prosthetic loading, whereas lateralizing the socket relative to the normal center greatly increases joint reactive forces. Since 1984, I have made every effort to restore the normal hip center, within reason, when dealing with the bony deficient acetabulum. In most every socket revision performed during this period, cavitary lesions have been addressed simply with particulate bone grafting or a larger component. To justify the use of structural allografts for the management of segmental defects, I believe the defect must involve the supporting rim, comprise the ability to obtain prosthetic stability, compromise the ability to restore normal hip mechanics, and be located in a high-stress area, i.e., posterior or posterior-superior. Smaller rim defects, in particular those located superior and anterior, can be ignored if they do not lead to prosthetic instability. Some alteration in hip mechanics can be tolerated to avoid structural allografting, but I have elected not to accept a superior translation of greater than 2 cm nor a medial defect that compromises the ability to lateralize the prosthesis adequately towards the normal center. When segmental defects exist while the prosthesis is well contained and stable in host bone (particularly superior and posterior), structural allografts are not necessary. A possible need for bone graft exists when there is questionable stability of the implant, i.e., a segmental defect combined with poor quality host bone, and when a major part of the posterior or superior rim of the component remains uncovered. The age and activity level of the patient enter into this formula at this point, and when the question exists in a younger patient, bone grafting should be performed. A definite need for structural allografting exists when component stability cannot be obtained in host bone, when there is a loss of the weight-bearing portion of the acetabular, particularly posterior, superior, or both, and when a major alteration of hip mechanics has occurred where no medial support or superior translation of greater than 2 cm has occurred. Prosthetic selection can affect the long-term results of acetabular reconstruction. Smooth-threaded components and bipolars have not performed well in revision acetabular surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetabulum↗
PubMed1992

[Surgical therapy of metastases of the proximal femur and acetabulum].

An analysis of indications and operative techniques was carried out in 166 patients with skeletal metastases of the proximal femur and acetabulum. Complications as well as functional and oncological results clearly show advantages and disadvantages of different methods such as osteosyntheses, standard hip prostheses and tumour prostheses referring to the tumour's localization and extent.

Acetabulum↗
PubMed2005

Evaluation, imaging, histology and operative treatment for dysplasia epiphysealis hemimelica (Trevor disease) of the acetabulum: a case report and review.

Dysplasia epiphysealis hemimelica (DEH), or Trevor's disease, is a rare disorder that most commonly affects the epiphysis of long bones in children. Rarely, major joints such as the hip can be involved. In this paper we describe a successfully treated case involving the acetabulum, documented with multiple imaging modalities, intraoperative photographs, histology, and follow-up radiographs.

Acetabulum↗
PubMed2005

Stress fracture of the acetabulum in a ballet dancer. A case report.

The authors report the case of a 26-year old professional ballet dancer with chronic dysmenorrhea and a Body Mass Index of 17, who presented with right hip pain related with a stress fracture of the acetabulum. Plain radiographs were unremarkable and the diagnosis was made with magnetic resonance imaging. Conservative treatment including partial weight bearing with crutches for six weeks resulted in immediate resolution of symptoms. The authors discuss the specific risk factors for stress fractures encountered in professional ballet dancers, such as hypogonadism and eating disorders.

Acetabulum↗
PubMed1991

[The effect of early surgical reposition of congenital hip dislocation and functional postoperative treatment on the development of the acetabulum].

Authors performed early operative reduction from anterior exposure after unsuccessful conservative treatment on 30 hips of 29 patients in 1981 through 1983. The age of the patients was 6-18 months at the time of the operation. After the excision of the obstacle of the reduction with preservation of the limbus the capsule was closed tight so that it could prevent redislocation. This way it became possible to make functional after treatment without plaster fixation and using Pavlik's harness and abduction splint. It was found that the postoperative development of the acetabulum was accelerated and the development of the acetabular roof reached in average during one year the healthy one and the articular movements were free. The development of the joint was the quicker the younger the age was in which the operation was performed.

Acetabulum↗
PubMed2006

Managing bone loss in revision total hip arthroplasty: the acetabulum.

Osteolysis is the greatest threat to the viability of modern acetabular implants. The etiology and natural history of osteolysis remain unknown. Patients with cementless implants who have osteolysis are challenging to treat. There are no standards for follow-up methods or frequency, and there is little evidence to support timing of the decision to begin treatment in these patients. The natural history of proposed treatment options is also unknown. Reconstruction of the acetabulum in the presence of bone loss is difficult. Classifications have been developed to guide management. Multiple options exist for revision acetabular surgery, and it is important to understand the rationale and data in support of these options. A review of the literature was undertaken and algorithms were developed to help address acetabular bone loss in patients undergoing revision surgery.

Acetabulum↗
PubMed1991

[3-dimensional reconstruction of x-ray computed tomographic views in fractures of the acetabulum].

In 21 cases of acetabulum fractures of 19 patients, the authors compare the findings given by three dimensional reconstructions of axial CT scan cuts with the plain films. The number of CT scan cuts is reasonable for each patient. Working time is about 20 to 30 minutes for the technician. In the cases of complex and displaced fractures, three dimensional imaging brings often decisive informations for the therapeutic management of these patients. Unusual views are often allowed but completely adapted to each type of fracture.

Acetabulum↗
PubMed1990

Osteomyelitis of the acetabulum.

The authors describe an 11-year-old boy with hip pain in whom septic arthritis was first suspected. Radionuclide scintigraphy demonstrating increased uptake in the acetabulum led to the diagnosis of osteomyelitis. In the case presented, the value of bone scanning with careful interpretation of even minimally increased uptake and the usefulness of repeated evaluation is demonstrated.

Acetabulum↗
PubMed1990

[Compound acetabulum fracture caused by overstimulation with a PISCES system].

A 56-year-old patient suffered intractable radicular pain from spondylolisthesis L5/S1. There was no help from PLIT-fusion but pain decreased substantially by spinal cord stimulation with a PISCES-system. On Nov 8th 1987 the battery exhausted gradually whereas the patient increased the output up to maximum. When changing to a new battery he suffered an electric shock. Acute opistonus with a jump from his wheelchair occurred with maximal innervation of the muscles of his left leg resulting in a comminuted fracture of his left acetabulum. There seems to be a need for more information and precautions on involuntary overstimulation in the use of neurostimulators.

Acetabulum↗
PubMed1990

[Indications for surgical treatment of fractures of the acetabulum].

The indications for surgery in fractures of the acetabulum within 3 weeks from the accident are currently based on 2 main factors: 1) post-traumatic articular incongruence doubtlessly is the cause of traumatic coxitis: 2) however, it has been proved that fractures with partial post-traumatic incongruence that have not been treated may produce very good results. The current problem is that it is impossible to assess the degree of incongruence that can be tolerated to avoid surgery and guarantee good long-term results. Computers will maybe help to solve this problem. The indications are currently based on the approximate assessment of congruence on the basis of 3 plain radiographs, tomography and CT. Osteonecrosis of the femoral head is much less frequent than it is said to be, and most often actually consists in the wear of the femoral head on a non-reduced line of fracture, whether or not the patient has been operated.

Acetabulum↗
PubMed1990

Aspergillar osteomyelitis of the acetabulum. A case report and review of the literature.

An unusual case of primary osteomyelitis of the acetabulum caused by Aspergillus flavus in a presumed immunocompetent adult is presented. Review of the literature found 25 additional cases of aspergillar osteomyelitis, which occurred predominantly in hosts with either inborn or acquired immune defects. There were notable differences between the adult and the pediatric cases in causation, clinical presentation, and treatment regimens. In children, the underlying cause was usually severe immunocompromise; among adults, the majority of cases occurred in hosts presumed to be immunocompetent. In all but one case, the children were treated with antifungal chemotherapy alone, whereas the adult patients nearly always received surgical debridement in conjunction with chemotherapy.

Acetabulum↗
PubMed1990

Reconstruction of the deficient acetabulum using the bipolar socket.

Although originally conceived as part of a two-stage procedure for the reconstruction of the deficient acetabulum, the use of a bipolar/grafting technique in selected patients can provide acceptable results as a definitive procedure. Critical technical considerations include proper preparation and grafting of the acetabular bed and careful sizing of the outer bipolar shell. Acceptable levels of pain relief and functional gain were obtained in 47 cases, with a follow-up mean Harris hip score of 86. Despite some initial socket migration in all hips, roentgenographic stability was gained after the first year. One acetabular failure was related to graft placement in the superolateral position. Bipolar reconstruction is indicated for contained acetabular defects only. In addition, the surgeon must have access to a complete inventory of socket sizes to ensure a proper fit and a bone bank to obtain adequate amounts of allogeneic bone.

Acetabulum↗
PubMed1990

The acetabulum: a prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty.

Although few studies address the use of three-phase bone scanning (TPBS) and indium-111-labeled white blood cell scintigraphy (111In-WBC) in hip arthroplasty utilizing a porous-coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ form that seen with the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous-coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and 111In-WBC at approximately 7 days, and 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the acetabulum. All 25 prostheses (144 of 144 scans) demonstrated increased uptake on the bone-phase images. Although this activity decreased with time, 76% had persistent uptake at 24 mo. Twenty-three of 25 prostheses (126 of 140 scans) showed increased uptake on 111In-WBC scintigraphy, invariably decreasing with time, but with 37% having significant uptake at 24 mo. Scintigraphic patterns in the uncomplicated porous-coated hip arthroplasty patient appear to differ from patterns described in cemented prostheses.

Acetabulum↗