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At least 973 records · Page 54Linked to original sources
PubMed1997

Comparative morphometry of coxal joint angles.

The angles related to the coxal joints were comparatively studied in four-limbed walking animals and two-limbed ones including man and birds. Between animals with both types of walking, no significant difference was observed in the neck-shaft angles (NSA), which was equivalent to the acetabulum angles (ACA) at the connection of the femoral head with the acetabulum. The anteversion angles (AVA) were equivalent to the horizontal ACA. Canine species showed two different forms of the femoral neck with or without modification by the femoral AVA, probably being breed-specific and nutrition-dependent. In the narrow-striped wallaby as well as avian species, the femoral head showed a postversion with a minus-version angle for lifting the body axis in the frontal and upward direction to hold the whole body weight on the hind-limbs, in particular at the anterior part of the acetabulum. In man, the connection between the femur and acetabulum greatly varied among individuals, possibly according to differences in the life style.

Animals↗
PubMed1992

[The first record of human natural infection of Echinochasmus liliputanus].

Human natural infection with Echinochasmus liliputanus was found for the first time from the inhabitants of Hexian county of Anhui Province in Spring, 1991. Sixty worms collected from 3 infected persons were studied morphologically. The adult worms are leaf-shaped, 1519.4-2056.3 x 466.4-564.0 microns in size. The width of the collar is 235.8-297.3 microns. A row of 24 collar spines with size of 22.5-35.6 x 8.8-10.6 microns is arranged on the collar symmetrically with dorsal and ventral interruption. The oral sucker is terminal, 107.6-148.6 x 102.5-148.6 microns. The length of the prepharynx is 25.6-66.7 microns, the pharynx, 97.3-127.8 microns and the oesophagus 117.9-205.0 microns. The caeca 764.3-1,248.8 x 21.0-39.0 microns extends to the distal end of the body. The acetabulum is anterior to the middle level of the body, 205.0-240.9 x 205.0-235.8 microns in size. Two testes, situated in the posterior one third of the body, is slightly oval, in tandem; the anterior one is 133.3-199.9 x 199.9-256.4 microns in size, and the posterior one, 178.9-251.3 x 164.0-246.0 microns. The Cirrus pouch is kidney-shaped, 211.5-248.5 x 112.8-194.8 microns in size, located between the bifurcation of the intestine and the acetabulum, containing the seminal vesicle and cirrus. The ovary is oval in shape, 71.8-92.3 x 76.8-97.4 microns in size, situated in the middle of the body. The vitellaria are distributed on each side from the acetabulum to subterminal, consisting of many follicles. The uterus is short, convoluted between the anterior testis and the acetabulum, containing 0-6 eggs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

[The prognostic factors in perthes disease].

The purpose of this study was to evaluate the role of selected factors which may play role in the estimation of late result during Perthes disease and which one can be eliminated during treatment period. The study population consisted of 311 patients (50 patients with bilateral disease, 361 hips joint) who had reached skeletal maturity at last follow up. All hips were treated by containment methods (bed rest and traction in abduction, Petri cast, brace, varus osteotomy, Salter osteotomy and shelf acetabuloplasty). Both clinical and radiological parameters (taken during fragmentation stage) were included in our study: gender, age at the onset, hip joint abduction, type of treatment, extend of the femoral head necrosis according to the Herring and Catterall classification, LLD, premature growth plate arrest, ATD and ATD index, lateral acetabulum shape - type I - normal, concave lateral acetabulum margin, type II--flat, horizontal and type III--convex, sloping, femoral head subluxation, femoral head sphericity disturbance according to the Mose, risk factors according to the Catterall, Wiberg angle, Eyre-Brook index. Long-term results were evaluated according to the Stulberg classification and were divided into two groups: good result--Stulberg group 1 or 2 and poor and bad result--Stulberg group 3, 4 or 5. The unilateral and bilateral Perthes disease was estimated separately. The statistical analysis revealed in unilateral Perthes disease that next risk factors may lead to poor or bad late result: age at the onset 9 and more years, group 3 or 4 according to Catterall and group C according to Herring classification, type III lateral acetabulum shape, hip joint abduction less than 10 degrees, premature growth plate arrest, ATD index less than 0.8, femoral head subluxation more than 20%, femoral head sphericity disturbance more than 5mm, Gage sign, calcification laterally to the femoral head (sensitivity 85.0%, specificity 98.7%). Bilateral Perthes disease: age at the onset over 6 years, group 3 or 4 according to Catterall and group C according to Herring classification, hip joint abduction less than 10 degrees and calcification laterally to the femoral head (sensitivity 81.8%, specificity 92.3%). The statistical analysis showed which clinical and radiological factors may play an important role in estimation of late results during Perthes disease. Additionally during fragmentation stage of Perthes disease we have possibility to correct or eliminate some of the risk factors - femoral head subluxation, lateral acetabulum shape and hip joint abduction and improve the late result.

Adolescent↗
PubMed1990

[Pelvic osteotomies: Salter, triple osteotomy, Chiari. Philosophy, technic, choice, indications].

Pelvic osteotomies were proposed in order to preserve as much as possible of the acetabular cartilage. The aims were twofold: centering of the head of the femur in the acetabulum, to improve its stability; correction of the delay in growth of the acetabulum: there is a potential correction, allowing for the femoral growth, or a passive correction by widening a deep acetabulum. Two types of osteotomy are proposed: reorientation osteotomies (Salter, triple osteotomy) which have both a mechanical and biological effect and widening osteotomies (Chiari), which are in fact extracapsular arthroplasties. All the techniques of reorientation osteotomy are very similar and achieve a reorientation of the acetabulum on the femoral head by varization, retroversion and, when possible, medialization. The Chiari osteotomy, which is technically difficult, should be performed according to the very precise rules described by Chiari.

Adolescent↗
PubMed1985

Determination of sex with a discriminant analysis of new pelvic bone measurements: Part II.

The pelves of 100 white skeletons were measured on both sides for the following: (1) length from the superiormost aspect of the pubic symphysis to the nearest rim of the acetabulum (PS-A), (2) length from the highest point of the pubic tubercle to the nearest rim of the acetabulum (PT-A), (3) acetabular diameter (AD), (4) the vertical distance from the anterior aspect of the ischial tuberosity to the farthest rim of the acetabulum (IT-A), and (5) greatest femur head diameter. From these, three indices were derived: AD/PS-A (acetabulum/pubis index), AD/PT-A (acetabular diameter/pubic tubercle-acetabular rim index), and IT-A/PS-A (ischium-acetabulum height/pubic symphysis-acetabular rim index). The left AD/PS-A ratio and left IT-A height proved statistically to be of greatest discriminating value. Using these two variables, a discriminant function was derived which correctly separated 98% of our sample. The acetabulum/pubis ratio alone correctly assigned 95%. With either the discriminant function analysis of two variables or the acetabulum/pubis index as a single predictor, 97% of our sample of known sex was correctly identified if all specimens that fell within a doubtful or overlapping range of values were sorted by femur head diameter.

Anthropology, Physical↗
PubMed1980

[Late results of conservative treatment of congenital dislocation of the hip--over twenty-five years follow-up observation and statistical analysis of roentgenograms (author's transl)].

The present study was based on the findings of 87 cases of CDH (132 joints) published by Prof. Igari and his colleagues in 1960. All these patients had been treated with conservative methods between 1935 and 1952. The average age at the time of the first follow-up examination was 11 years. Fortunately in 1978, after an average follow-up of 29 years (range 25 to 39 years), the author was able to reexamine 59 (90 joints) of the original 87 cases. The average age of the patients reexamined in 1978 was 31 years. In addition, 18 cases (26 joints) of CDH which were not treated and reached the age over 18 years were studied for comparison. The following observations were made: 1) Of the 90 joints examined, 18 joints (20.0%) showed normal findings in the roentgenograms. Twenty (39.9%) of the 59 cases were healed from a clinical standpoint. 2) The measurements which were taken at school age (1960), especially acetabular angle, approximate-acetabular-quotient, C.E. angle and acetabulum-head-quotient had a statistical correlation with those of the present reexamination. 3) Joints with a well-developed acetabulum at school age, even those with slight deformities of the femoral head and neck, were found to have become congruous by middle age. 4) The femoral head growth in untreated dislocated joints was poorer than the femoral head growth in joints which received conservative methods. The following conclusions were made: 1) The results of the reexamination were poorer in patients above 30 years of age than in patients under 29 years of age. However, it cannot be said without reserve that the results become poorer with an increase in patients' ages. The progrnosis is dependent on the time when treatment was started and the degree of displacement. 2) In patients who were treated on late stage the acetabulum seems to have developed poorly. The severity of the deformity of the femoral head and neck is related to the degree of displacement. 3) The disturbance of the femoral head nucleus during the treatment period gives some influences on the growth of acetabulum and femoral concentration, making its prognosis poorer. 4) The acetabular angle and C.E. angle at the end of treatment had a prognostic value. Joints with an acute acetabular angle (above 31 degrees) at the end of treatment should be treated with surgical methods.

Adult↗
PubMed1994

An unusual pattern of growth disturbance of the hip in juvenile rheumatoid arthritis.

OBJECTIVE: An unusual deformity in the hip in juvenile rheumatoid arthritis (JRA) consisting of a small femoral head in a capacious acetabulum has been described as an isolated finding, but no explanation as to the cause of the deformity has been proposed. We have also observed this deformity and the objective of this investigation was to determine the cause. METHODS: In 1987, a review of hip disease in JRA was carried out at the Wellesley Hospital. Nine hips in 5 patients were identified as having a mismatch in size between the femoral head and acetabulum. Six of these hips came to surgery during the growth phase. RESULTS: The 6 hips undergoing surgery between the ages of 16-19 showed an identical picture at the time of surgery. The pattern of pathology consisted of a femoral head devoid of articular cartilage and an acetabulum that showed an intact triradiate cartilage. Each of the 6 hips was treated with a resurfacing arthroplasty. CONCLUSION: The femoral head grows in circumference by endochondral ossification of the articular cartilage. If the rheumatoid process destroys that articular cartilage, growth of the femoral head ceases. The intact triradiate cartilage permits continuing acetabular growth and the deformity of a small femoral head in a large capacious acetabulum results.

Adolescent↗
PubMedDate not supplied

Treatment outcome of pelvic sarcomas in young children: orthopaedic and oncologic analysis.

Five children with pelvic Ewing's sarcoma whose age was 6-10 years underwent reconstruction after resection of the tumor. One child with a tumor of the ilium underwent an iliosacral arthrodesis with allograft. Three patients underwent a hip transposition after the resection of the ilium and the upper part of the acetabulum. One patient underwent no skeletal reconstruction after the resection of the acetabulum and the ilium. Two children are alive 96 and 60 months after surgery; however, two died 12 and 21 months after surgery of metastasis, and one is alive with metastasis 15 months after surgery. Functional evaluation was possible in four patients: one is excellent, and three are fair. After resection of the ilium, including the upper part of the acetabulum, a hip transposition can be selected. If all the acetabulum is resected, it will be optimal not to do a bony reconstruction.

Bone Neoplasms↗
PubMed1995

The effect of physeal traction applied to the triradiate cartilage on acetabular growth.

Physeal distraction was applied with an external fixator to the triradiate cartilage of dogs with the aim of increasing the capacity of the acetabulum. The force was continued for from 2 to 6 weeks and the consequent changes were evaluated with regard to function and structure by radiography and microscopy. The distraction, without producing epiphysiolysis and destruction of the cartilage, resulted in expansion of the pelvic bones. The depth and volume of the acetabulum were increased, but the acetabular angle was decreased. Distraction also caused proliferation of the lacunar cells and the number of mammillary processes in the cartilage columns increased. Distraction can therefore be applied to the triradiate cartilage to enlarge the capacity of the acetabulum without producing epiphysiolysis.

Acetabulum↗
PubMed1985

Changes in the pelvis after the Chiari and Salter osteotomies.

Pelvic osteotomies were simulated on a macerated female pelvis using the techniques of Chiari and Salter. The effect of varying amounts of medial or angular displacement upon the actual and radiological displacement of the acetabulum were then measured and compared. With the Chiari osteotomy, increasing medial displacement in the range 0.5-2.5 cm appeared to give a wider acetabular roof but at the expense of rotating the true acetabulum to face more laterally, thereby reducing the width of articular cartilage in the weight-bearing area from that present originally. However no disturbance of the symphysis was detected. In the Salter osteotomy it was found that the radiologically determined angle was up to 50% greater than the true angle. With an increasing true osteotomy angle up to 30 degrees steady improvement in the CE angle developed, but beyond 30% significant lateral displacement of the acetabulum, lengthening of the leg and disturbance of the symphysis pubis occurred. It is concluded that the osteotomy opening should not exceed 30 degrees in the Salter procedure.

Acetabulum↗
PubMed1978

[A new technique for socket implantation into dysplastic acetabula (author's transl)].

This report presents a new technique of socket implantation into the dysplastic acetabulum. A major part of the resected femoral head serves as the so-called intra acetabular femoral head graft and is screwed into the lateral part of the original acetabulum. By this technique it is possible to achieve a complete bony reconstruction of the dysplastic acetabulum into which a square shaped small ceramic socket can be easily implanted using few especially designed instruments. After the description of the operative technique this report presents the clinical results of this procedure based on 11 personal cases. Finally the technical, biomechanical and biological advantages of this implantation technique are discussed in view of other similar methods described recently.

Acetabulum↗
PubMed1985

Residual deformities related to arthrotic change after Perthes' disease. A long-term follow-up of fifty-one cases.

In order to clarify the long-term results of Perthes' disease and to elucidate the residual deformities, including those of the acetabulum, related to coxarthrosis, 51 patients who had had Perthes' disease were studied clinically and radiologically. Altogether there were 56 affected hips and radiographs taken from onset of disease to maturity were available in all cases. They were followed up for an average of 18 years. Thirteen hips (23%) revealed coxarthrosis. Head deformity, steepness of the lateral edge of the acetabulum, and insufficient acetabular coverage of the femoral head were noted in them both in adulthood and in the active phase of disease. Among these deformities, steepness of the lateral edge of the acetabulum was found to be the most significant prognostic factor and led to coxarthrosis of the affected hip even in the younger adult. Acetabular roof angle, which is a newly designed radiographic measurement, is a good indicator of the prognosis in Perthes' disease.

Acetabulum↗
PubMed2000

[Acetabular component implantation in coxarthrosis due to dysplasia after high congenital hip dislocation].

A total of 71 (25-110) months after primary total hip replacement, 17 patients with high congenital hip dislocation and false iliac acetabulum were clinically and radiologically assessed. Twenty-one threaded cups were placed, 16 at the site of the true acetabulum, one at the site of the acetabular rim and four at the site of the false acetabulum. The Harris hip score increased from 37.1 (20.2-55.5) points preoperatively to 84.7 (67.4-97.7) points postoperatively. Radiologically there were no signs of cup migration. It can be concluded that even complicated dysplastic hips can be treated successfully by total hip replacement, without prior ileofemoral distraction or additional acetabular augmentation.

Acetabulum↗
PubMed1997

[Contact surface and pressure load at implant-bone interface in press-fit cups compared to natural hip joints].

The implantation of an endoprosthetic socket into the acetabulum alters the mechanical stresses in the periacetabular region in a significant manner compared with the natural hip joint. In this way, a remodelling process is initiated. Primary stability to achieve osseointegration and a loading of the acetabulum owing to the biomechanical interaction between cup and bone that is similar to the natural joint, are important prerequisites for a long-term bony integration of the implant. Therefore, the intra-articular pressure distribution in eight hip joints of fresh-frozen human pelvic cadavers and in the bone/implant interface of two press-fit cups was investigated using pressure-sensitive Prescale films. A modular cup with a pure hemispherical shape (PCA cup) and a monoblock cup with a biradial surface and flattening of the pole (press-fit cup) were tested. Loads of up to twice body weight were introduced into the sacrum, simulating a single-leg stance with the hip in neutral flexion. The results were extracted from the pressure prints applying digital image processing methods. It was demonstrated that intra-articular contact occurs over the whole articular surface of the joint, with contact areas between 39.0% and 56.9% of the hemisphere, showing zones of higher pressures where the acetabulum is supported by the iliac, ischial and pubic bone. The biradial press-fit cup showed mean contact areas of 44.7% of its surface when inserted under press-fit only. This area was enlarged to 53.0% and to 64.2% with increasing load. The corresponding figures for the PCA cup are 45.1%, 48.9% and 57.1%. The low-profile PCA cup produces a small band of high pressure near the periphery, and with increasing load its pole area comes into contact with the acetabular fossa. Occasionally, irregular gaps do occur. The press-fit cup enlarges the contact area from the periphery to the pole within its optimised biradial contact zone until the lunar surface is loaded. The acetabular fossa remains unloaded owing to the flattening of the pole. This load distribution is close to that of the natural hip joint. The pressure distribution of both cups is also characterised by three zones at the iliac, ischial and pubic bones showing a higher load transmission.

Acetabulum↗
PubMed2002

MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children.

Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone. We present two cases of pediatric traumatic hip dislocation associated with posterior wall fractures of the acetabulum. In both cases, obvious postreduction instability was noted without conclusive findings of etiology on plain X-rays or CT scans. Magnetic resonance imaging (MRI) disclosed an extensive posterior wall traumatic involvement in both cases and helped to decide in favor of open reduction of the hip and internal fixation of the posterior wall fragment.

Acetabulum↗
PubMed1996

Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology.

OBJECTIVE: To show that absence or interruption of the supra-acetabular line is a subtle plain film indicator of pathology in the acetabulum. DESIGN: Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. RESULTS AND CONCLUSIONS: The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported.

Acetabulum↗
PubMed2005

Hip arthroscopy after previous acetabular osteotomy for developmental dysplasia of the hip.

PURPOSE: The purpose of this study was to examine the arthroscopic findings in the hips of patients with long-term follow-up of Chiari osteotomies. TYPE OF STUDY: Prospective consecutive series of patients. METHODS: Seven consecutive patients (1 male, 6 female; average age, 23 years) having a Chiari osteotomy performed in 1 hip during childhood or adolescence for developmental dysplasia of the hip were studied. They presented mechanical hip symptoms and had adequate head coverage as a result of the osteotomy with preservation of joint space. Hip arthroscopy was performed in all cases. RESULTS: A massive labral tear dislocated in the midportion of the joint was found in all cases with varying degrees of cartilage damage in the acetabulum or femoral head. The labral tear was resected, cartilage lesions were repaired, and microfracturing of the exposed subchondral bone was performed. Mechanical symptoms improved after surgery and all of the patients were able to go back to activities of daily living. CONCLUSIONS: In the Chiari osteotomy, medial displacement of the acetabulum leaves the labrum in the center of the load-bearing area of the resulting acetabulum. Over time this can produce a tear of the labrum, which may be the cause of the mechanical symptoms in our series. It has been documented that labral tears can lead to early degenerative hip disease and, combined with the cartilage lesions, may explain in part the long-term bad results of the Chiari osteotomy. LEVEL OF EVIDENCE: Level IV.

Acetabulum↗
PubMed2006

Towards a better understanding of the aetiology of Legg-Calvé-Perthes' disease: acetabular retroversion may cause abnormal loading of dorsal femoral head-neck junction with restricted blood supply to the femoral epiphysis.

The most accepted part of the aetiology of Perthes' disease is an intermittent arterial occlusion. Many different reports now also suggest that some mechanical factor plays a role. In search of mechanical differences between normal hips and Perthes hips, many secondary morphologic differences of the proximal femur and the acetabulum are known. Recent research by the author has shown morphological changes of the acetabulum, independent of Perthes' disease in a large part of patients. In particular, retroversion of the acetabulum was found in a large part of adults who suffered from Perthes' disease as a child, and even in children who just developed Perthes' disease. The author suggest a relation of the two entities and hypotheses that due to the acetabular retroversion, there may be an intermittent, movement depending abnormal loading pressure on the dorsal femoral head-neck junction and the local blood vessels, which can lead to insufficient blood supply of the femoral epiphysis and to local necrosis, as these vessels are the only blood supply to the femoral epihysis in children.

Acetabulum↗