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PubMed1983

[Experimental study of a growing acetabulum shelf (vascularized graft)].

The author has operated on 50 immature rabbits to perform a vascularised transplantation of the growing iliac crest to replace the rim of the acetabulum. Vascularity was preserved through the vascular pedicle and there was no need for vascular anastomosis. The results were assessed radiologically and by histological studies. The subsequent growth of the transplanted epiphysis could be illustrated in 15 out of 16 cases. The growing shelf had the advantage of good adaptation to the shape of the femoral head and produced a satisfactory physiological result.

Acetabulum↗
PubMed1984

[Anatomy and roentgenology of the normal and injured acetabulum].

Assessment of injuries of the hip joint requires a thorough knowledge of the radiological and anatomical conditions and topography of the acetabular region. The authors attempt to present an introduction into the x-ray anatomy of the healthy and of the traumatized acetabulum by means of a juxtaposition of schemes and x-ray films and of pictures of the skeleton.

Acetabulum↗
PubMed1984

Computerized tomography in the evaluation and classification of fractures of the acetabulum.

Sixty-seven consecutive patients with acetabular injuries were assessed first by conventional roentgenograms and Judet oblique views and then by computerized tomography. The fractures were evaluated with Letournel's classification and reclassified by computerized tomographic views alone. The degree of comminution and displacement was further evaluated by Pennal's classification. Computerized tomograms (CT) presented only one classification change in the Letournel system. CT observations significantly changed Pennal's classification by revealing the degree of comminution of the superior articular surface in 14 of the 67 fractures. CT also delineates the superior articular surface of the acetabulum, the degree of comminution in Letournel's complex fractures, the extent and comminution of posterior wall fractures, and the location of intra-articular fragments in postreduction films of hip dislocations.

Accidents, Traffic↗
PubMed1984

Salter innominate osteotomy. The effect of blood supply to the roof of the acetabulum.

Quantitative studies of blood flow (hydrogen washout technique) and bone mineralization rate (tetracycline labeling) were performed in the ilium of 23 immature dogs before and after Salter innominate osteotomy. The vascular anatomy, blood flow rate, and mineralization rate (appositional bone growth) on the roof of the acetabulum were disturbed after operation. Radiographic healing and normal patterns of circulation to the ilium were partially restored within two weeks and completely restored after six weeks. The data suggest that a single iliac osteotomy is without long-term consequence to the viability of acetabular bone.

Acetabulum↗
PubMed1978

Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies.

At autopsy, the hips of six infants who died soon after birth and had unilateral congenital hip dysplasia were found to have a cartilaginous ridge in the acetabulum which separated the hip socket into two sections. In two of the hips with a moderate degree of dysplasia and in one completely dislocated hip the ridge was formed exclusively by a bulge of acetabular cartilage. In three completely dislocated hips the ridge was formed by a bulge of acetabular cartilage covered by the inverted labrum. The acetabular cartilage showed signs of degeneration whereas the triradiate cartilage was normal. Examination of many newborn infants indicated that hip "clicks" are common and are not diagnostic of hip dysplasia. This diagnosis should be made only when the femoral head slides with a jolt over the acetabular ridge, causing a true positive Ortolani sign. Scattered ossification centers in the acetabular cartilage were seen on the roentgenograms of nearly half of fifty-nine hips with congenital dislocation reduced after the child was two years old, but less frequently in hips reduced at an earlier age.

Abnormalities, Multiple↗
PubMedDate not supplied

Tripartite fracture of the acetabulum after total hip arthroplasty: a case report.

A three-part fracture of the acetabulum occurred in a 74-year-old woman seven years after a McKee-Farrar total hip arthroplasty (THA). The hip was successfully reconstructed using an allogenic femoral head for a bone graft and titanium mesh for reinforcement. Thirty-six months after the operation, the revised THA was functional.

Acetabulum↗
PubMed1980

[Aging process of the acetabulum with special reference to the osteophyte formation (author's transl)].

Osteophyte formation at the acetabulum was investigated in connection with aging and osteoarthritis. The materials consisted of 39 specimens of the acetabula obtained from fresh cadavers ranging from 14 to 89 years of age. Of those two of the specimens were in the second decade, two in the third, and others were over 40. Osteophyte appeared at three parts of the acetabula; the peripheral part, the foveal area and the lower portion at the ligamentous attachment. Two types of the peripheral osteophytes were distinguished from their growth direction, and in some sections both types were observed together. Foveal osteophytes were recognized at the rim of the semilunar cartilage in the advanced age group and a double acetabular floor was formed by both the osteophytic projection and the existing foveal trabeculae. In some cases there were small osteophytes formed in the ligamentous tissue at the lower ends of the acetabula. As distribution and growth of the osteophytes in the aging process were in accord with those in osteoarthritis, it would be reasonable to assume that the osteophyte formation in aging might be one of the initial changes of the development of osteoarthritis.

Acetabulum↗
PubMed1980

A new socket design for the dysplastic acetabulum in total hip replacement.

A special socket was designed by holography for total hip replacement for the treatment of the dysplastic acetabulum and correction of the deformation pattern. Excellent clinical results of 12 cases demonstrate that the special socket design provides good stability as well as favorable redistribution of mechanical forces about the hip joint.

Acetabulum↗
PubMed1995

[Results of follow-up of surgical treatment of complicated acetabulum fractures with extended approaches].

Extended approaches are indicated for complex acetabular fractures. The advantage of extended approaches is the simultaneous exposure of both columns of the acetabulum; disadvantages are the wide exposure of the soft tissue and a high rate of heterotopic ossification. Muscle weakness and necrosis of the muscle have been described. Although there is good exposure with an extended approach, the indication for it is restricted. Between 1972 and 1993, 688 patients with acetabular fractures were treated at the Trauma Department of the Hannover Medical School; 322 had open reduction and internal fixation. Thirty-five patients (10%) were treated with an extended approach. In a retrospective study of 24 patients treated with an extended approach between 1985 and 1993, perioperative data, long-term clinical outcome and radiological outcome were investigated. The aim of the study was to compare the outcome of two groups treated using either the classical extended iliofemoral approach or the Maryland modification. Eleven patients were treated with the extended iliofemoral approach, 13 with the Maryland approach. There were no significant differences in age, type of accident, fracture classification, time to operation, time of operation and blood loss. The postoperative X-ray was anatomic or nearly anatomic in 22 cases; 2 patients had a dislocation of more than 2 mm. The main complications were hematomas and seromas. In both groups we found one thrombosis and one nerve injury with partial recovery. Twenty patients were followed up at least 2 years after trauma, 8 after extended iliofemoral approach and 12 after Maryland approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMedDate not supplied

[Massive reconstruction of the acetabulum and proximal femur].

Bone allografts are used in situations of repeated hip surgery to repair bone loss and allow muscle fixation without excessive use of massive metallic prostheses. We examined 51 cases of hip reconstruction after a mean follow-up of 3 and a half years. Indications were: reoperations on arthroplasties, usually after the weight carrying areas of the acetabulum had been destroyed; repeated operations on the upper extremity pellucid femurs; bone tumours (especially chondrosarcomas). Results have been good based on patient satisfaction, mobility and consolidation of the allograft-bone junction. Complications included: post-operative death after major surgery for invasive tumours (n = 4); sepsis (n = 2); hip luxation requiring an anti-luxation crescent (n = 3); and aseptic serous effusion suggestive of possible immunologic reactions against the bone grafts (n = 3). These operations were compared with massive reconstruction prostheses, with arthrodeses with limb shortening and with hanging limbs, and in certain cases with interilioabdominal amputations.

Acetabulum↗
PubMed1994

True three dimensional stereographic display of 3D reconstructed CT scans of the pelvis and acetabulum.

Fractures of the acetabulum can cause the pelvis to shatter into a wide array of complex configurations which can be difficult to fully delineate preoperatively. In addition to plain radiography and standard computed tomography, technology now allows the reconstruction of magnetic resonance imaging (MRI) and computed tomography (CT) data into virtual objects; three dimensional (3D) representations of anatomy which exist only within the computer memory. Printouts and photographs of 3D reconstructions provide another level of anatomic information to the orthopaedic surgeon. However, current standard displays such as computer and video screens and photographic and radiographic film are all two dimensional (2D) modalities. Displaying 3D reconstructions in this standard 2D fashion, inescapably robs the images of up to one third of the information contained within them--all the true depth information which is the essence of 3D. Shading techniques and perspective have both been utilized to simulate depth, but true depth is still lacking. Recently, the authors have begun using a technique of computerized 3D reconstruction and recording which provides a true 3D display of the reconstructed images. The resultant gain in image realism is profound, somewhat similar to hearing full stereo audiophonic recording compared to monophonic, or to seeing in color rather than black and white. The image generation and display process is a computerized mathematical adaptation of the photographic technique of stereophotography. Once in place, the technique is relatively simple to use and can be achieved in several ways with a minimum of additional hardware. Potential benefits lie in the method's ability to convey, in one 3D display, the true 3D, spatial anatomic configuration of the imaged pelvis. The methods described are common to those forming the fundamental basis for virtual reality imaging. Current users of some 3D reconstruction systems can now easily generate images which can be viewed with all of the depth information restored, into a true 3D display.

Acetabulum↗
PubMed1994

Total hip replacement using femoral neck bone to graft the dysplastic acetabulum. Follow-up study of 18 patients with old congenital dislocation of the hip.

We performed total hip replacement on 25 congenitally dislocated hips using corticocancellous bone from the femoral neck as a bone graft to reconstruct the deficient acetabulum. Two patients (two hips) died less than five years after surgery and three hips developed deep infection. We reviewed the remaining 20 hips at an average interval of 8.4 years (5.2 to 12.9). Their functional scores (modified Merle d'Aubigné and Postel) averaged 5.7 for pain, 5.1 for walking ability, and 4.2 for range of motion. Radiographs showed union and remodelling of the grafted bone in every case. There were radiological signs of aseptic loosening in three sockets (15%) without collapse of the grafted bone. None of the femoral stems was loose. No revision operation has been performed. Our results confirm the usefulness in the long term of femoral autografts for severe acetabular deficiency.

Acetabulum↗
PubMed1994

Ectopic ossification associated with osteoid osteoma in the acetabulum. A case report.

Ectopic bone formation was associated with osteoid osteoma in the anterior rim of the acetabulum. A factor, which has been speculated to be secreted from the nidus and is responsible for increased osteoblastic activity, also seemed to have the capacity to stimulate young mesenchymal cells to differentiate into an osteogenic pathway. A case of a 35-year-old woman with osteoid osteoma, which caused ectopic ossification adjacent to the nidus, is presented.

Acetabulum↗
PubMed1993

[Deformations of acetabulum with load before and after prosthetic implantation. An experimental study by extensometry].

Using fresh cadavers pelves, an experimental model of unipodal stance was performed. The skeleton (femurs, pelvis and 2 lumbar vertebrae) was connected to the machine by non constrained junctions. Muscles (gluteus, iliacus and rectus abdominis) were simulated. Using this model, monopodal stance could be maintained under load. Strain measurements were performed on the periphery of the acetabulum. Results showed that periacetabular strains were dependent on the mobility of the lower lumbar intervertebral discs as well as on the type equilibrium (uni or bipodal). It was remarkable that the blockage of intervertebral rotations (experimental lombo-sacral arthrodesis) increased acetabular stiffness. The influence of total hip replacement was also studied. Periacetabular strains remained important around cementless press-fit cups. This would plead for a non weight bearing postoperative period in clinical practice of cementless arthroplasty. Important deformations also persisted around conventional cemented cups, justifying further research to limit periacetabular deformations around total hip prostheses, in the hope of limiting the rate of late acetabular loosening.

Acetabulum↗
PubMed1993

Expression of the differentiated phenotype of chondrocytes in newly synthesized acetabulum.

Human cartilaginous cells produce two types of proteoglycan monomers (PGI and PGII) distinguishable by their molecular size in density gradient centrifugation under dissociative conditions. In order to determine whether connective tissues on the sliding surface of the acetabulum on an endoprosthesis are able to differentiate into cartilaginous tissue, we made histological and biochemical analysis of the incorporation of 35S and the distribution of the molecular size of proteoglycans produced. Histologically, dense collagen fibers were observed both on weight-bearing and non-weight-bearing surfaces, but there was little evidence of cartilaginous metaplasia. Biochemical analysis, however, demonstrated that incorporation of 35S in newly synthesized glycosaminoglycan (GAG) was higher than that in non-cartilaginous tissues, suggesting that cartilaginous differentiation of mesenchymal tissues had occurred.

Acetabulum↗
PubMed1993

[Surgical management of acetabulum fractures].

Author reports on the experiences with the operative treatment of 48 acetabular fractures in his Department during 19 years. He thinks that the operative treatment of the acetabular fractures may be successful only after the exact preoperative diagnosis and classification of the type of the fracture. After this the exposure may be chosen. During the operation one has to strive to the exact reconstruction of the articular surfaces and the performance of such stable osteosynthesis that will enable the early movements of the joint without weight bearing. If, because of the severity of the injury, the exact reconstruction of the acetabulum is not possible an effort must be made to create an anatomical situation that will give favourable conditions to late reconstruction operations (arthrodesis or endoprosthesis). Author describes after discussing the classification, diagnosis and treatment of the acetabular fractures his own results: in more than 3/4 of his cases excellent or good late results could be achieved. For this, with correct indication, the performance of the reconstruction operation is suggested.

Accidents, Traffic↗
PubMed1993

Preoperative assessment of the acetabulum.

Preoperative assessment of the acetabulum requires a good knowledge of the normal acetabular anatomy, good plain radiographs, and a knowledge of the various defect patterns that may influence the surgeon's ability to achieve secure fixation of the component at surgery. In certain situations, special radiographic techniques are advantageous.

Acetabulum↗