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At least 415 records · Page 23Linked to original sources
PubMed1993

[Acetabulum without cement. Short-term results of a series of 112 threaded cups].

Between January 1982 and December 1987 we used 112 threaded acetabular cups in 102 patients undergoing total hip replacement. The clinical and radiographic results of 107 implants are reported in this survey. Using the functional grading of the hip advocated by Merle d'Aubigné and Postel, 62% can be classified as excellent, very good or good. On x-ray only 35% of the cups show neither radiolucency at the bone-implant interface nor migration of the component. There is a statistically significant correlation between a radiolucency in 2 of the 3 areas at the bone-implant interface and the clinical result. The revision rate for failure of the cup is 11.6% (13 implants). The actuarial survival of the threaded cup decreased from 0.95 in the 1st year to 0.75 in the 5th year after implantation. Analysis of our failures and of published data suggest that the problem lies in the lack of primary bone integration. We describe our difficulties in assessing risk factors, in interpreting the radiographs and in the intraoperative determination of component instability. The disappointing short term results have prompted us to abandon the use of threaded cups.

Acetabulum↗
PubMed1978

[Osteosynthesis and simultaneous anchorage of a plastic hip cup in an unstable acetabulum (author' transl)].

Attempts at total hip replacement in the presence of unstable acetabula--which may be caused by a recent fracture or pseudarthrosis--are doomed to failure if conventional implantation technics are used. Such attempts lead inevitably to a rapid loosening of the cup. This article describes a newly developed implant which simultaneously re-establishes acetabular stability while solidly anchoring the cup. Use of this implant contributes to early patient mobilization and undisturbed healing of fractures and pseudarthroses.

Acetabulum↗
PubMed1976

[History and present indications for corrective surgery of the acetabulum in hip dysplasia (author's transl)].

F. König published the first shelf-operation above the dislocated femoral head, which could improve the function in 1891. In Europe only after 1920 the techniques of Spitzy and Lance grew popular and are still frequently performed with their different variations. Pelvic osteotomy with medialisation was published 25 years ago for special indications, some years later Salter's Innominate Osteotomy got very well known. Describing the history of these operations the actual indication for the different methods is analised.

Acetabulum↗
PubMed1995

Cancellous bone in human acetabulum: microradiographic and histomorphometric aspects.

The acetabular cancellous bone of 18 subjects aged 57-88 years was characterized by low mass and a poorly ramified pattern according to microradiographic analysis. There was no correlation between the histomorphometric data of this region and those of the iliac crest. Microcalluses were visible in 13 acetabular samples, whereas they were absent from the iliac crest. As the acetabular trabeculae appeared decidedly longitudinal, age-related bone rarefaction is suggested to occur in two different ways: uniform thinning of the trabeculae and selective disappearance of transverse elements. The remaining longitudinal trabeculae are considered to be most useful for the weight-bearing function of the hip joint.

Acetabulum↗
PubMed1994

Curative local control of malignant tumors in the acetabulum by intraoperative radiotherapy.

As treatment for malignant tumors in the acetabular region of the pelvis, radiotherapy, mainly in the form of intraoperative radiotherapy (IORT), was carried out in four patients. One had a malignant fibrous histiocytoma of bone and three had metastatic tumors from the stomach and lung. Over follow-up period, ranging from 3 to 46 months, satisfactory limb function was preserved in three patients; the fourth suffered from femoral nerve palsy as a complication of IORT. Cessation of growth was observed radiologically in all the tumors, and curative local control was proven histologically in two patients at autopsy.

Acetabulum↗
PubMed1997

Dynamic anatomy of the acetabulum: an experimental approach and surgical implications.

The deformations and stresses acting on the acetabular rim have not been very precisely documented. The authors present a study based on an experimental simulation of hip loading with anatomic correlations. 122 dissections were performed in order to define the anatomic aspect of the roof (and especially of Byers's "area 17") and the intermediate area between the anterior and posterior acetabular cornua. Ten fresh cadavers were tested on the lines of previous studies on monopodal or bipodal loading. An extensometric study was performed with special attention to the transverse acetabular ligament, supra-acetabular area and obturator foramen. The area 17 of Byers is a transitional zone and the mobility of the posterior cornu is 3 times that of the anterior cornu. Resection of the acetabular ligament modifies the displacement of the posterior cornu under loading but has no influence on deformation of the oburator foramen. The biomechanical behavior of the acetabular roof in the standing position is influenced by the conditions of monopodal or bipodal loading and by femoral rotation, but a tendency to extrusion was constantly noted.

Acetabulum↗
PubMed1991

Computed tomography measurements of the acetabulum in adult dysplastic hips: which level is appropriate?

A study has been performed to evaluate whether one or several levels are needed with computed tomography (CT) study to provide sufficient information regarding anteversion and acetabular support to the femoral head. A total of 23 hips in 14 adults with uni- or bilateral congenital hip dysplasia (center-edge angle less than 20 degrees) were assessed by obtaining 5-mm contiguous CT slices and performing acetabular measurements at four levels. Both anterior and posterior acetabular supports as quantified by the anterior and posterior acetabular sector angles were significantly lower than normal at all levels. The sector angles increased in the proximal cuts, whereas the acetabular anteversion increased caudally. Because no important additional information was gained by measuring at different levels, we conclude that CT study at one level is sufficient for acetabular measurements and suggest that the slice through the center of the femoral head is the most appropriate one.

Acetabulum↗
PubMed1991

[Experiences with the Spotorno expansion acetabulum].

At 53 hip joints a cupshell developed by L. Spotorno was practiced as replacement for the acetabular joint surface. This cementless CLS expansion-shell was always in combination with an also cementless femoral prosthesis applied in case of medial femur neck fractures, coxarthrosis, or the exchange operation to implantation. The concept of this prosthesis-shell performs the elastic- and mechanical structures of the bone around the joint. The primary stability is guaranteed by cramp points, which penetrate in the bone layer under the cartilage. Secondary the bone, which grows in the surface of the titanium shell takes, over the durable stability. Our experiences up to now with relation to the technique of implantation and the check ups after one till two years of functional weight-bearing are looking foreward to a time which confidences in the results with regard to the regeneration of bone and the cramp-stability.

Acetabulum↗
PubMed1995

[Primary total endoprosthetic hip joint replacement in acetabulum fractures].

Conservative treatment of acetabular fractures mean a long period with immobilisation followed by quite a few of complications that are life-threatening to old patients. Besides that these fractures often cause painful posttraumatic osteoarthritis of the hip joint. Open reduction and osteosynthesis is favored more and more, but the complications described cannot be avoided absolutely by surgical treatment. The sequelae are risky reoperations and the necessity for implantation of total joint prosthesis. As shown in the enclosed case reports, total hip replacement can be emphasized as first step and as definitive surgery. Implantation of an artificial joint allows postoperative remobilisation with full weight bearing and long lasting immobilisation can be avoided. Therefore this kind of therapy is justified for treatment of old and polymorbid patients as an out of rule therapy.

Acetabulum↗
PubMed1998

[Analysis of acetabulum migration in rheumatoid arthritis compared with cementless acetabular revision].

In a retrospective analysis the migration profile of 73 cementless total hip implants (Zweymüller Alloclassic) in 54 patients with rheumatoid arthritis were compared with the results of 58 implants of the same design in 50 patients undergoing cementless revision after loosening of an Endler cup. 258 conventional radiographs of the rheumatoid patients and 164 radiographs of the revision group were digitized. The migration analysis was performed using a modified Dickob's technique that allows for correction of different X-ray magnifications as well as horizontal and vertical tilting of the pelvis. The analysis of migration exceeded 2 mm in eight rheumatoid patients. In three of them clinical loosening of the acetabular cup was obvious. In the group of patients after cup revision a significantly higher amount of cranial migration was detected compared with the rheumatoid patients. This phenomenon could be explained by the destruction of the weight-bearing cranial acetabular sclerosis after reaming.

Acetabulum↗
PubMed2000

Rotational acetabular osteotomy for severely dysplastic acetabulum.

The operative procedures chosen for arthrosis with severe acetabular dysplasia vary among orthopaedic surgeons. We operated on 250 hips using the rotational acetabular osteotomy (RAO) method of Ninomiya and Tagawa [8]. In this report, we describe the technique of RAO and the results of this procedure in patients with severely dysplastic hips. Among the 250 hips, there were 6 which were classified as Severin group V. In those hips, the CE angle was less than 0 degrees, and the femoral head showed superolateral subluxation. After acetabular osteotomy with straight and curved osteotomes, smooth inferolateral rotation could be done in all cases. At the latest follow-up symptoms were improved remarkably, especially pain. Radiographically, adequate coverage of the femoral head was achieved and joint congruence improved in all 6 hips.

Acetabulum↗