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PubMed1996

[Enlargement plasty of the acetabulum by vascularized iliac crest cartilage transfer in children].

INTRODUCTION: Following an experimental study with rabbits published in 1983, the authors report the results of a surgical technique for the enlargement plasty of the acetabulum in children. This study was preceded by an anatomical study of the vascularization of foetal iliac crest epiphysis. MATERIAL: 10 children were operated on at an average of 8 years old. The indications were 5 dysplastic hips (short acetabulum), and 5 Perthes diseases. The results were evaluated by the acetabular index of the weight-bearing zone, Wilberg center-edge angle and joint congruence. The comparison with the non operated side estimated the growth due to the graft. METHODS: An iliac crest cartilaginous fragment 4 to 5 cm long is harvested from the endopelvic side. This graft is pediculized on the deep circonflex iliac vessels. The hip joint is opened and the labrum is partially resected. The graft is correctly oriented, placed at the periphery of the acetabulum in an intra-articular position and fastened with two trans osseous stitches. The length of the vascular pedicle allows to place the graft without any microanastomosis. RESULTS: At maximum follow-up (range 3.3 to 8 years), in average values, the coverage Wilberg angle increased of 4 degrees on the non operated side and of 23 degrees on the operated side (increase of 19 degrees due to the graf). The acetabular index decreased of 2 degrees on the non operated side and of 10 degrees on the operated side (decrease of 8 degrees due to the graft). The joint congruence showed that the graft molds itself on the femoral head and ensured harmonius coverage. It seemed that it favoured growth remolding of the femoral head. DISCUSSION: The results showed the growth pursuit of an iliac crest cartilage vascularized graft placed intra-articularly. This graft increases the acetabulum size by adjusting itself to the femoral head. The hyalin cartilage cells of the graft which are in contact with the femoral head, are likely to transform themselves into articular cartilage cells. This surgical technique seems to have its place with the enlargement techniques of the acetabulum as long as remolding of the head and acetabulum is required.

Acetabulum↗
PubMed1997

A study of the arterial supply of the human acetabulum using a corrosion casting method.

This anatomical study concerns the arterial supply of the human acetabulum. The purpose is to contribute to prevention of postoperative necrosis of the acetabular bone fragment after rotational acetabular osteotomy (RAO). The arterial supply of the acetabulum was determined using a corrosion casting method. The acetabular branch of the obturator artery supplies the acetabulum through the acetabular notch. The pubic branches supply the pelvic surface of the acetabulum. Deep branches of the superior gluteal artery supply the superior region and the inferior gluteal artery supplies the postero-inferior region. From these results, we recognized that the important artery for achieving successful RAO is the acetabular branch of the obturator artery that supplies the acetabulum through the acetabular notch.

Acetabulum↗
PubMed2005

Morphologic features of the acetabulum.

INTRODUCTION: The embryology and development of the hip joint are complex. The acetabulum is not always of the same shape, width, or depth. Minor anatomical abnormalities in the acetabular shape, joint congruences are frequent. Controversies still exist on the importance of these variations and help to prevent problems following in surgical procedures such as acetabular reconstruction and femoracetabular impingement. MATERIAL AND METHODS: The aim of this study is to provide the location of the unusual facets, the acetabular point, and the anterior ridge of the acetabulum based on a morphological study of human pelvic bones. Morphologic features of the acetabulum, particularly determination of unusual facets, were studied in 226 human coxal bones. RESULTS: In adult coxal bones the acetabular fossa has an irregular clover-leaf shape, the superior lobe being smaller than the anterior and the posterior lobes. Measured lunate surface area varied between 14.5 and 30.5 cm2. A smooth unusual facet was found anteroinferior to the lunate surface in 62 acetabulums. Measured along the long axis, its size varied between 11 and 17 mm. Three different shapes of the unusual facet were as follows: oval (32.26%), piriform (45.16%), and elongated (22.58%). The prevalence of the piriform facet shape was higher in males. In 59.68% of the bones it extended to the superior ramus of the pubis, and in the remaining 40.32% it was limited within the acetabular margin. It is postulated that this facet could be a consequence of a particular posture, which results in traction of the ligaments attached to this area. Four distinct configurations were identified relative to the anterior acetabular ridge. The majority 98 (43.36%) were curved; 64 (28.33%) were angular; 37 (16.37%) were irregular; and 27 (11.94%) were straight. CONCLUSION: There have been no reports on details such as unusual facets, acetabular point, and anterior ridge of the acetabulum in a single research. These findings will be of help in planning reorientation procedures, using spikes, screws, and press-fitting for fixation.

Acetabulum↗
PubMed2005

Regional load bearing of the feline acetabulum.

OBJECTIVE: To test if the caudal acetabulum of the cat is unloaded at mid-stance as has been asserted. MATERIALS AND METHODS: A kinematic study of five healthy cats was performed to ascertain the mid-stance angle of the hip joint, and the orientation of the pelvis and femur. Femora and pelves from 10 feline cadavers were loaded at physiological load at the mid-stance angle. Impression material placed within the acetabulum was extruded from areas of load bearing. Digital images before and after loading were used to assess whether three areas of the acetabulum, cranial, central and caudal, were fully, partially or non-load bearing. RESULTS: There was a significant difference in load bearing in the three regions (p < 0.001, Kruskal-Wallis test), with a significant difference in load bearing between the cranial and central thirds (p < 0.001) and the cranial and caudal thirds (p < 0.001) but no difference between the central and caudal thirds of the acetabulum (Mann-Whitney-U test). CONCLUSIONS: The load bearing areas of the feline acetabula are the caudal and central thirds. CLINICAL RELEVANCE: The caudal acetabulum of the cat is loaded, therefore the recommendations for simple fractures being treated conservatively needs to be reconsidered.

Acetabulum↗
PubMedDate not supplied

[Arterial vascularization of the bony acetabulum].

The arterial supply of the acetabulum is studied in 30 human hip-pelvis specimens utilizing conventional angiography, 3 D-CT and maceration. 3 specimens out of 30 had to be excluded due to extravasation and incomplete filling. The arteries of the pelvis were filled with barium sulfate in 16 cases and in 11 cases with a solution of resin and lead powder. Conventional angiograms were performed in all specimens. In preparations with resin/lead powder additional CT with 3 D reconstructions of the surface of the acetabulum and arteries were done. 3 D-CTs show precise relationship of the arteries to the acetabulum. Filling with resin and lead powder is optimal for anatomical studies. It permits comparative 3 D-CT and conventional X-ray examination and subsequent preparation of the vessels in corrosion technique. The central parts of the acetabulum are vascularized by the obturator artery, the cranio-lateral part by the a. glutea superior and the ischial parts by the a. glutea inferior. The arterial supply of the acetabulum can be saved knowing the way and entry of the arteries into the bone. This is of importance for triple osteotomies of the pelvis but as well for difficult total hip replacements and revisions. The described method can be used for anatomical studies of the vessel to bone correlation in different anatomical sites.

Acetabulum↗
PubMed1998

Periosteal augmentation of the acetabulum.

The periosteum in children and especially infants has significant osteogenic potential. To determine the efficacy of periosteal flaps to assist in improving acetabular coverage in children with acetabular dysplasia, a series of experiments were designed using young rabbits. Three groups of five rabbits each had periosteal flaps fashioned and brought down from the anterolateral aspect of the innominate bone superior to the acetabulum and sutured to the capsule of the hip. The study was designed to examine the effects of the periosteal cambium layer in the formation of new bone to augment the acetabulum and to determine the effects of a periosteal flap plus cancellous bone graft. A control group of five rabbits underwent a sham operation of an open arthrotomy of the hip. Radiographic and histologic examination at 12 weeks revealed augmentation of the acetabulum with periosteal flaps that resulted in an average improvement of the acetabular index of 3.5 degrees and 6.6 degrees, without and with bone graft, respectively. New bone formation from the rim of the acetabulum averaged 3.9 mm with periosteal flaps alone and 4.6 mm with bone graft added. Periosteal augmentation of the acetabulum in conjunction with established procedures for augmenting acetabular coverage would appear to be a useful procedure for improving coverage of the femoral head in children with acetabular dysplasia.

Acetabulum↗
PubMedDate not supplied

The role of the acetabulum in Perthes disease.

The purpose of this study is to evaluate the changes in the shape of acetabulum from the onset of the disease to the skeletal maturity in Legg-Calvé-Perthes disease. The study population consisted of 243 patients with unilateral involvement who had reached skeletal maturity at last follow-up. All hips were treated by containment methods (which included bed rest and traction in abduction, Petri cast, brace, varus osteotomy, Salter osteotomy, and shelf acetabuloplasty). Necrosis of the femoral head was estimated according to the lateral pillar classification and late results according to the Stulberg classification. Changes in the shape of the acetabulum were divided into 3 groups: type I-normal, concave lateral acetabulum margin; type II-flat, horizontal lateral acetabulum margin; and type III-convex, sloping acetabular margin. Roentgenograms performed during the fragmentation stage revealed type I changes in 78 (32.1%) hips, type II in 136 (55.7%), and type III in 29 (12.2%). At the last follow-up, there were type I changes in 124 (51.2%) hips, type II in 81 (33.5%), and type III in 38 (15.3%). The statistical analysis revealed no significant statistical difference between the age at the onset and gender with regard to acetabular changes. There was significant statistical correlation between the lateral pillar classification, subluxation of the femoral head, the range of hip abduction, and the Stulberg classification with regard to acetabular changes. A type III was statistically associated with lateral pillar classification group C, major subluxation of the femoral head, limited hip abduction, and in Stulberg group 3, 4, or 5. Only surgical methods of treatment improved the acetabular shape at the last follow-up (P<0.05). In our opinion, the lateral acetabulum shape plays a very important role during the remodeling of the deformed proximal femoral epiphysis.

Acetabulum↗
PubMed2006

Concomitant fractures of the acetabulum and spine: a retrospective review of over 300 patients.

BACKGROUND: The incidence and spectrum of concomitant acetabulum and spine trauma has not been clearly defined. METHODS: We retrospectively reviewed 307 acetabulum fracture patients over 5 years, and evaluated this cohort for concomitant spine injuries. Patient and injury demographics, spine and neurologic injury and delay in diagnosis were examined. RESULTS: Complete data were available for 275 (90%) of the cohort, and 55 spine injuries (54 fractures and 1 traumatic disc herniation) were identified in 34 patients. Thus, the incidence of concomitant acetabulum and spine fractures was approximately 13% (34 of 275). Four percent of the patients sustained significant thoracolumbar fractures (burst, flexion-distraction, or dislocation). An average 8.6-day delay in diagnosis occurred in three spine fracture patients. One suffered progressive neurologic injury. CONCLUSIONS: It is essential that the traumatologists have a high index of suspicion for spine injury, particularly thoracolumbar injury in patients who sustain fractures of the acetabulum. We recommend early thoracolumbar computed tomography imaging in patients with fractures of the acetabulum if plain radiographs are not possible or inadequate.

Accidental Falls↗
PubMed2005

Anteversion of the acetabulum and femoral neck in early walking age patients with developmental dysplasia of the hip.

Computed tomography measurements were made to quantify the relationship between the anteversion of the acetabulum and femoral neck in 27 early walking age patients (age range; 18-48 months) with developmental dysplasia of the hip. The centre-edge angle and acetabular index were measured in standard pelvis radiographs, and anteversion of acetabulum and femoral neck were measured by use of two-dimensional computed tomography in 25 complete dislocated, 19 subluxated and 10 unaffected hips (a total of 54 hips). The diagnosis of dysplasia, subluxation and complete dislocation of developmental hip dysplasia were determined radiographically using Ishida's criteria. There were statistically significant differences between the three groups for the centre-edge angle, the acetabular index, and acetabulum anteversion. There was no statistically significant difference between the three groups for femoral neck anteversion. The acetabular anteversion was found to be 13.4+/-2.8 degrees (mean+/-SD) in unaffected hips, 16.7+/-1.9 degrees in subluxated hips and 19.8+/-2.5 degrees in complete dislocated hips. There was statistically significant difference between the three groups, with a wide range of acetabular anteversion values noted in all groups (9-26 degrees ). The acetabular anteversion was increased on the dislocated side in each patient and we found no retroverted acetabulum. On the other hand there was no significant difference between the groups with regards to femoral neck anteversion. We conclude that confirming anteversion of the acetabulum and the femoral neck by two-dimensional computed tomography is needed in treatment planning of early walking age patients with developmental hip dysplasia.

Acetabulum↗
PubMed1993

Dealing with the deficient acetabulum in revision hip arthroplasty: the importance of implant migration and use of the jumbo cup.

The complexity of acetabular anatomy makes operative planning for revision difficult. Plain radiographs do not provide as much detail about structural damage to the acetabulum as the surgeon would like in order to decide on the need for special components and bone grafts. The authors have found that analysis of acetabular implant migration has been a reliable surgical planning technique to indirectly assess residual acetabular bone stock. Superior shift on the anterioposterior radiograph implies posterior superior acetabular roof loss, seriously compromising the major weight-bearing area of the acetabulum. Although this may require a structural allograft, the authors have found that bone stock at the level of the true acetabulum is much better than in the false acetabulum created by the migration. Therefore, rather than a small cup placed high on the ilium, a large jumbo cup can frequently restore better hip biomechanics and take advantage of all of the remaining host bone for component stability and support, without the need for structural grafts. Medial shift implies medial superior migration leaving the physiologically strong rim of the acetabulum intact and therefore, less structurally damaging than posterior superior migration. Because the acetabular rim is anatomically designed for load bearing, a rim fit cup restores physiological weight transfer across the pelvis. Bone graft behind such a cup is protected from full weight-bearing forces and has proven to be very reliable.

Acetabulum↗
PubMed2001

[Reconstruction of the acetabulum during replacement of the aseptically loosened polyethylene cup].

THE PURPOSE OF THE STUDY: The aim of the study was to verify the method after Slooff in our modification, i.e. "a cemented cup--cancellous bone grafts--a metal net" for the revision surgery of aseptic loosening of cemented polyethylene acetabular cup in combined defects of acetabulum. MATERIAL: The followed-up group of 52 patients (36 women and 16 men), average age of 65 years (age range, 50-81 years) with aseptic loosened cemented polyethylene Poldi cups included 52 operated on hip joints. The average interval between the primary implantation and the revision surgery was 9 years (2-21 years). METHOD: We reconstructed acetabulum with combined bone defects (AAOS III Degree--as a result of aseptic loosening and migration of cemented acetabular cups) by means of cancellous bone allografts, a shaped Howmedica metal net, Simplex bone cement and a polyethylene cup. RESULTS: Average follow-up was 36 months (range, 14-49 months). Clinical evaluation of the group was performed after Harris Hip Score averaging 80 points. Radiological evaluation focused on the density and presence of bridging trabeculae between the grafts and the host bone. Positive finding was in 46 patients, i.e. 90%. Further, we evaluated migration of the cup after Conn. In 4 patients (7.7%) it was less than 2 mm and in 3 patients (5.7%) it was greater than 5 mm. Reconstruction failed in 1 patient (1.9%). Radiolucent line was found in the zone between the host bone and bone grafts only in III zone after De Lee and Charnley in 8 cases (15.3%), in zones I and II it was not encountered in any of the patients in the group. One case required another revision surgery in which Burch-Schneider ring, bone allografts and Müller cemented cup were used for the reconstruction. In two patients of this group there developed a phlebographically verified phlebothrombosis without signs of embolism into pulmonary artery. In two cases there occurred a superficial inflammation of the wound which subsided before the removal of the suture. No deep infection of the wound was encountered. Particular ossifications were assessed after Brooker. Type I occurred in 7 cases and Type II in 1 patient. DISCUSSION: At present several methods are used for the reconstruction of acetabulum and their choice is limited by the extent of the bone loss. For cavitary defects it is possible to use the combination of bone grafts with cementless cups. In segmental and combined defects the situation is more complicated and it can be solved by the application of a solid bone graft. In case the solid bone graft assumed greater load, the situation logically resulted in the fatigue fracture of screws and failure of the whole reconstruction prior to the bone graft-host bone osteointegration. In cementless cups and solid bone grafts the situation is slightly more favourable. If there is a timely biological (secondary) osteointegration of the cup the reconstruction has a chance to survive. The timeliness of biological (secondary) osteointegration is significantly influenced also by the quality of the applied bone graft and a good contact of the bone graft and the host bone and the surface of the cementless cup. Our method of the reconstruction of acetabulum by means of cancellous bone grafts, metal net and cemented cup allows a relatively good primary stability of the cup. Due to its partial elasticity the metal net does not prevent transmission of forces on the bone grafts which are placed under the net. As a result there occurs a faster union of bone grafts with the host bone. CONCLUSION: The method of cemented cup--cancellous bone grafts--metal net after Slooff is in our modification one of the accepted options of the reconstruction of acetabulum. Its benefit is the possibility of early weight bearing of the limb operated on. The stress on the bone grafts under an elastic construction conduces to a relatively fast good secondary osteointegration. The method can be recommended for II and III Degrees of acetabular bone loss according to AAOS classification. Of no less importance is also the economic aspect of the whole reconstruction.

Acetabulum↗
PubMed2006

[Treatment of dysplastic acetabulum using total hip arthroplasty: our intermediate-term results].

PURPOSE OF THE STUDY: The aim of the study is a retrospective evaluation of our patients with a dysplastic acetabulum treated by total hip arthroplasty (THA), who were followed up for at least 5 years, and a comparison of our intermediate-term results with those in the relevant literature. MATERIAL: In the period from June 1995 to June 2005, a total of 1305 total hip replacements were performed. Of these 293 were done in patients (213 women and 48 men) with the diagnosis of a dysplastic acetabulum; bilateral total hip arthroplasty was carried out in 18 women and four men. The evaluation was based on the Harris scoring system. The condition of at least 5-year follow-up was met by 65 patients (54 women and 11 men; average age, 53 years; average follow-up, 82 months). Eventually, 63 patients were assessed, because one patient died and one moved away. METHODS: The Hartofilakidis radiological system was used for preoperative evaluation. In more severe cases, 3D CT and multiplanar reconstruction were used. Intraoperative findings were assessed by the AAOS classification, and postoperative radiograms were evaluated on the basis of Gruen's criteria. The Bauer transgluteal approach to the hip joint was used. Antibiotics in prophylactic doses and medication for prevention of thromboembolic disease were administered in all cases. The final assessment of Harris hip scores was carried out in 63 patients in September and October 2005. All underwent implantation of a Zweymüller Bicon-Plus acetabular component. As diagnosed according to the Hartofilakidis radiological system, 42 type I, 21 type II and two type III hips were operated on for a dysplastic acetabulum. RESULTS: The average preoperative and postoperative Harris scores were 39 (range, 21-58) and 85 (range, 66-98) points. All patients reported satisfaction with the results; excellent outcomes were achieved in 41, good in 10 and satisfactory in six patients. No radiographic cup loosening was found at 3- and 6-month follow-up or at 1 year. None of the patients received a solid bone graft. DISCUSSION: The crucial problem in treating hip arthritis due to acetabular dysplasia is precise surgical reconstruction of the acetabulum. This involves implantation of an acetabular component into the original anatomical position in order to sufficiently cover the cup and provide mechanical stability. Various operative procedures discussed in the literature include the use of a small cup placed into the original acetabulum, techniques of acetabular component medialization, with perforation or "controlled fracture" of the acetabular wall, when indicated, and involvement of bone grafts to repair the acetabular defect in both cemented and cementless acetabular components. CONCLUSIONS: Our intermediate-term results with the use of Zweymüller Bicon-Plus acetabular components give support to the previous good experience with this prosthesis in the treatment of hip arthritis following acetabular dysplasia.

Acetabulum↗
PubMed1979

[A clinical study on the development of the acetabulum after various treatment in congenital dislocation of the hip (author's transl)].

In the treatment of congenital dislocation of the hip, prognosis varies greatly according to the status of the development of the acetabulum. In most of the patients with osteoarthritis of the hip primary causes are found. In this series, 50% had congenital dislocation of the hip and 35% had acetabular dysplasia. In order to identify the conditions of hip joints in which the acetabular development can be expected from conservative treatment and to estimate the limit of age for indication of this treatment, the status of the development of the acetabulum was investigated after various treatment. This is expected to provide valuable data for the establishment of the method of treatment for cases without hope for the development of the acetabulum. According to the results, patients with acetabular angle of more than 30% at the age of 3 years have less possibility of normalization in the future and therefore active means for formation of the acetabulum should be considered in these patients. As such active means included are formation of the acetabulum through the pelvic osteotomy and the derotation-varus osteotomy are available in order to improve concentric position of the femoral head. It was also indicated that more favourable results could be obtained in patients who had undergone the pelvic osteotomy. The most favourable results were obtained in patients in whom both operations were used in combination. It was concluded from the results of the study that the best method is to perform the pelvic osteotomy first and to add the derotation-varus osteotomy as indicated.

Acetabulum↗
PubMed1978

Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies.

Postmortem studies of ten normal full-term infants and of three children, seven, nine, and fourteen years old, showed that the acetabular cartilage complex is a unit that is triradiate medially and cup-shaped laterally and is interposed between the ilium, ischium, and pubis. This complex is composed of epiphyseal growth-plate cartilage adjacent to these bones, of articular cartilage adjacent to these bones, of articular cartilage around the acetabular cavity, and, for the most part, of hyaline carilage. Interstitial growth within the triradiate part of the cartilage complex causes the hip socket to expand during growth. The concavity of the acetabulum develops in response to the presence of the spherical femoral head. The depth of the acetabulum increased during development as the result of interstitial growth in the acetabular cartilage, of appositional growth at the periphery of this cartilage, and of periosteal new-bone formation at the acetabular margin. At puberty, three secondary centers of ossification appear in the hyaline cartilage surrounding the acetabular cavity. These centers are homologous with other epiphyses in the skeleton. The os acetabuli, which is the epiphysis of the os pubis, forms the anterior wall of the acetabulum. The epiphysis of the ilium, which has been called the acetabular epiphysis, forms a good part of the superior wall of the acetabulum. A small epiphysis of the ischium was seen in the oldest patient, who was fourteen years old. The bone in these epiphyses expands toward the periphery of the acetabulum and thus contributes to its increase in depth.

Acetabulum↗
PubMed1987

[Therapeutic problems of acetabulum fracture in polytrauma].

Fractures of the pelvis and the acetabulum now occur more frequently in multiple injured patients. Anatomical and biomechanical considerations have led to special classifications of acetabulum fractures and to clear indications of operative stabilization. Because of the difficulty of operation including good preparation the biomechanical concept in treatment often must be modified, especially in patients with multiple injuries. 12 multiple injured patients with acetabulum fractures underwent operative stabilization of this fracture during the last 2 years. Nearly all types of fractures were seen. The acetabulum fractures more frequently showed difficult forms than otherwise reported. Sometimes the severe condition of the patient prevented an optimal treatment according to biomechanical points of view. Very often the operation was considerably delayed by general or local problems of the patient. The concept in diagnosis and indication of operation and the problems of operative treatment are demonstrated by the aid of several cases.

Acetabulum↗
PubMed1992

Arterial supply of the acetabulum in the fetus: application to periacetabular surgery in childhood.

The need to perform triple osteotomies of the pelvis passing very close to the articular surface leads to the isolation of bony fragments whose vascularisation may be precarious. To assess the risks of such surgery, we undertook an anatomic study of the vascularisation of the acetabulum in the fetus. 53 specimens were injected to study the vessels to the acetabulum and their distribution within the osteocartilaginous specimen. The acetabular a., a branch of the obturator a., gives a central pedicle distributed to the acetabular fossa, the triradiate cartilage and ending in the three primary bony components. The superior gluteal, inferior gluteal, internal pudendal and obturator aa. form a periacetabular vascular circle. The abundant vascularity of the acetabulum makes massive necrosis improbable in the child. However, there is a zone of precarious anastomosis at the anterior portion of the acetabulum.

Acetabulum↗
PubMed2006

Hip joint remodeling in an adult following excision of a giant cell tumor involving the acetabulum: a case report and literature review.

We describe a 47-year-old man with a giant cell tumor of bone involving the acetabulum treated with curettage and bone grafting which resulted in good remodeling of the hip joint. The patient had a 15 x 18-cm(2) mass lesion extending from the right ischium to the acetabulum. Treatment included curettage, phenol, and ethanol application as an adjuvant, and cancellous bone allografting was performed on the subchondral area of the acetabulum. The posterior column of the acetabulum was disappeared by tumor invasion. Despite central migration of the femoral head, adequate hip joint repair was achieved without surgery 5.5 years postoperatively and with no tumor recurrence. The patient could walk without pain or ambulation aids; hip range of motion was 100 degrees for flexion, 0 degrees for extension, 30 degrees for abduction, 45 degrees for external rotation, and 10 degrees for internal rotation, and the functional result was 93.3% in the Enneking scoring system. We performed intralesional curettage with phenol and ethanol adjuvant therapy for pelvic giant cell tumor without tumor recurrence, and good repair of a hip joint adaptation can be achieved even in an adult patient.

Acetabulum↗
PubMedDate not supplied

Effects of degree of acetabular rotation after triple pelvic osteotomy on the position of the femoral head in relationship to the acetabulum.

OBJECTIVE: To assess the effect of rotating the acetabulum 20 degrees and 30 degrees on percent coverage (PC) of the femoral head by the acetabulum and Norberg angle (NA) after triple pelvic osteotomy (TPO). STUDY DESIGN: Retrospective study. ANIMAL POPULATION: Fifty-six client-owned dogs. METHODS: PC and NA were measured from preoperative, immediate postoperative, first recheck, and second recheck radiographs to compare the effects of 20 degrees and 30 degrees of rotation of the acetabulum after TPO for treatment of hip dysplasia. RESULTS: Within the 20 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for NA between the first and second recheck times. Within the 30 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for PC and NA between the first and second recheck times. No significant differences between the 20 degrees and 30 degrees rotation groups were found at any corresponding times for either PC or NA. CONCLUSIONS: Acetabular rotation of 20 degrees provided the same degree of improvement in acetabular femoral head coverage as 30 degrees of rotation after TPO at the immediate postoperative, first recheck, and second recheck evaluation times. CLINICAL RELEVANCE: Based on PC and NA, 20 degrees rotation of the acetabulum provides as much benefit as 30 degrees of acetabular rotation when performing a TPO.

Acetabulum↗