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At least 541 records · Page 30Linked to original sources
PubMed1993

Allograft reconstruction of the acetabulum in revision hip surgery.

Acetabular deficiencies seen in revision hip arthroplasty require special attention. Custom components, space-filling cement, relocation of the hip center higher on ilium, and resection arthroplasties have all been used. Allograft reconstruction of acetabular defects has many attractive features, but methods of fixation, long-term success rates, and problems of graft resorption and implant loosening present significant questions. This article presents a classification system for acetabular defects and a surgical technique for correcting them. The results of 218 cementless acetabular reconstructions are reviewed and show the importance of the acetabular rim. When the rim is intact, 97% of reconstructions will remain stable, and 78% of allografts used will consolidate. When the acetabular rim is deficient, special techniques using bulk allograft and internal fixation must be used in order to avoid long-term graft resorption and implant loosening.

Acetabulum↗
PubMed1999

Ultrasound assessment of the acetabulum in the infant hip.

One hundred and fifty infant hips were studied using simultaneous ultrasonography and radiography. The reliability of measurement was found to be similar for alpha angle and d/D ratio. However, the acetabular index correlated much better with the d/D ratio than with the alpha angle. In fact, in hips where the d/D ratio exceeded 56%, radiographs could be dispensed with. Besides, the use of a sector scanner or a linear-array tranducer was found to make no significant difference to the correlation between the acetabular index and the d/D ratio. Sonographic assessment of acetabular development in the infant should permit a reduction in the number of radiographs required during screening and follow-up.

Acetabulum↗
PubMed1999

[Acetabulum surgery. Development, current status and prospects].

The indication for operative treatment of displaced acetabular fractures is widely accepted. The radiologic diagnostics consist of the a.p. pelvic view and the oblique ala and obturator views. With the X-rays and the additional CT images the fracture is classified according to Letournel or to the AO Classification into an A, B or C-type fracture. The appropriate surgical approach is chosen depending on the classification and the site of the main dislocation. Extended or combined approaches are only indicated for complex or older fracture patterns. Osteosynthesis is performed either with small fragment cortical screws in lag screw technique or with reconstruction plates. In about 80% of the cases an anatomical reduction of the joint is possible as prerequisite for good functional results. First clinical trials with computer- and/or CT-assisted procedures are promising. In future computer- and robotics-based procedures will gain increased importance with reduced patient morbidity and improved reconstruction of the joint surface.

Acetabulum↗
PubMed2000

Chondritis dissecans of concave articular surfaces (acetabulum and glenoid fossa). Two case reports.

We report two patients who had chronic mechanical pain due to substantial cartilage defects documented by arthrography. One of these patients had pain in the hip and declined surgical treatment. The other had pain in the glenohumeral joint; surgery found a fissure in the glenoid fossa cartilage and provided prompt pain relief. These two cases serve as reminders that investigation of the cartilage and subchondral bone in young patients with mechanical pain should not be confined to the convex articular surfaces, although these are more likely to sustain trauma-related damage than concave surfaces. In both our patients, the diagnosis required thin-section computed arthrotomography.

Acetabulum↗
PubMed2000

[Use of Spotorno expansive acetabulum in sequel of acetabular fracture].

A series of 14 total hip arthroplasties using the cementless Spotorno expansive acetabular component was performed to treat post traumatic osteoarthrosis that had developed following an acetabular fracture. The mean age of the patients at the time of the arthroplasty was 47 years (range 28-77 years). This study was performed between 1989 to 1999 (11 years), and the mean follow-up was 4 years and 9 months. Clinical results were evaluated by Merle d'Aubigné and Postel scale, which revealed that 78, 50% of the patients presented good and very good results. The radiological evaluation based on DeLee and Charnley criteria demonstrated a radio-lucent-lin in 3 patients. According to the results obtained in the series the authors concluded that the traumatic acetabular osteoarthrosis can be properly handled with the Spotorno acetabular component when arthroplasty is indicated.

Acetabulum↗
PubMed2000

[Simulator for migration processes and wear in the artificial hip acetabulum for radiologic measurement].

For assessing migration of cups, standard X-rays or stereo radiological images (SRI) are available. In addition, software is also available for measurements. The accuracies of the various systems are established statistically, in part combined with phantoms, and compared. To date, no known phantom is available for the simulation of acetabular cup migration with account being taken of the position of the pelvis in the X-ray beam. Such an appliance covering 8 different parameters has now been developed, the cup can be moved horizontally, vertically and in the loading direction. Angular accuracy is +/- 0.5 degree, and wear of a magnitude of 0.25 mm can be simulated. Two degree elevation of the pelvis, left or right, can be simulated. The position of the pelvis around the horizontal axis permits continuous variation. This appliance can simulate migratory movements of the acetabular cup within a pelvis, and wear within the cup. In addition, the spatial position of the pelvis can be varied. The X-ray images can be used to investigate the accuracy of evaluation strategies.

Acetabulum↗