Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Acetabulum”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,405 records · Page 78Linked to original sources
PubMed2002

Prosthetic replacement in treatment of subcapital femoral neck fractures in the elderly.

OBJECTIVE: To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF). METHODS: Between May 1987 and July 1998, 56 elderly patients (6 5-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement. RESULTS: There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that i n Group THR. CONCLUSIONS: Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bi polar THR installed with cement is indicated for most elderly patients. Since th e femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.

Aged↗
PubMed2002

[Physical diagnosis--Ortolani's manoeuvre].

Ortolani's manoeuvre is used to detect hip instability. It is intended to be used to establish the mobility of a dislocated femoral head with respect to the acetabulum in newly-born infants. Barlow's modification attempts to dislocate a reduced but unstable hip out of the acetabulum. Ortolani's manoeuvre is a primarily tactile, proprioceptive sensation and has nothing to do with the usually inconsequential audible and palpable clicks in infant hips. It has been found that widespread use of Ortolani's manoeuvre cannot prevent all late diagnoses of hip dysplasia. This is because neonatal hip instability is only part of the total spectrum of hip dysplasia, and because the examination requires a relaxed newly-born infant and an experienced examiner. In the Dutch situation, general screening with Ortolani's manoeuvre is not advisable as this will lead to many false-positive and false-negative outcomes due to this neonatal examination being carried out by various physicians and midwives with insufficient experience. Better results may be expected from ultrasound screening at child welfare clinics. This is presently being investigated in a large population study.

False Negative Reactions↗
PubMedDate not supplied

Habitual dislocation of the hip in children: report of eight additional cases and literature review.

The purpose of this study was to report eight additional cases of habitual dislocation of the hip (HDH) and to combine the authors' data with a compilation of the cases from the literature. The authors attempted to investigate the various causative factors, outcomes, and indications for conservative and operative treatments. The results suggest that an unusual ability to dislocate the hip voluntarily at a young age constitutes a specific pediatric entity, and no single factor can be determined to be the definite cause of HDH. Multiple triggering factors (generalized ligamentous laxity, excessive anteversion of the femur and acetabulum, osteocartilaginous defect of acetabulum, coxa valga, psychiatric immaturity) appear to be associated with HDH. Treatment should be conservative in the first instance; it includes simple observation with or without psychiatric counseling and immobilization with cast or brace. Hip stabilization by surgical means is selectively indicated when the episodes of hip dislocation do not fade away in due time despite conservative treatment and when primary or secondary capsular laxity or osteocartilaginous deformation or defect of the hip is severe enough to cause repeated dislocation or residual subluxation, which may cause persistent pain or discomfort.

Child, Preschool↗
PubMed1998

Factors affecting stability of press fit acetubular cups.

Press fitting cementless porous coated acetabular components without screw fixation is desirable to minimize debris-related problems. Compression between the bone and periphery of an acetabular component which is slightly larger than the reamed acetabulum provides implant fixation while oversizing at the dome may adversely affect stability. In most primary total hip arthroplasties, the acetabulum can be reamed to a hemispherical cavity and assessed using acetabular sizing trials prior to implanting the cup. Use of an implant with a hemispherical dome and gradual transition to a wider peripheral dimension maximizes peripheral bone strains and implant stability with less impaction force and overall deformation than a larger oversized hemispherical cup.

Journal Article↗
PubMedDate not supplied

Pelvic osteomyelitis in children: a comparison of decades from 1980-1989 with 1990-2001.

Since 1980, 64 children with pelvic osteomyelitis (40 boys) were treated at a major pediatric referral center. The average age was 11 years and 6 months. The presenting complaints included pain in 61 children, fever in 30, and altered weight-bearing in 31. The erythrocyte sedimentation rate was elevated in 56 and there was leukocytosis in 19. The most commonly affected sites were the ilium in 21 and the acetabulum in 20, followed by the pubis in 11 and the ischium in 10. Culture results were negative in 32 and positive for Staphylococcus aureus in 26. Treatment consisted of intravenous antibiotics in 62 and irrigation and debridement in five children, all of whom presented since 1990. The infection resolved in 62 children and persisted in two. Three developed complications, including fusion of the sacroiliac joint in one, deformity of the acetabulum in one, and one child with an underlying protein C deficiency developed thromboembolism. Recent patients have demonstrated increased severity, likely due to increased virulence of the organism.

Adolescent↗
PubMed1991

[The value of Sowinski coracoid-plasty for recurrent dislocation of the shoulder].

The value of Sowiński coracoplasty for recurrent, trauma related dislocation of the shoulder was evaluated on the basis of multidirectional clinical, Xray, CT and ultrasound examinations in 15 patients operated on between 18 and 40 years of age. Good results were achieved in 14 cases after 2-14 years follow up. In one case of epileptic patient 4.5 years after surgery traumatic dislocation of the shoulder occurred with a fracture of incorporated bony graft. The authors have proved the coracoplasty performed to be efficient in preventing recurrent dislocation of the shoulder by means of creating new biomedical conditions around the joint. The bony graft by elongation of the coracoid process of ca 35 mm and change in its alignment imposes strong mechanical support for the head of the humerus and indirectly makes the acetabulum deeper. The graft located above anterior rim of the acetabulum increases the tension of subscapular muscle and stabilizes the capsule thus aiding to the stability of the joint. In 4 cases some adhesions between the graft and subscapularis muscle have slightly restricted external sotation of the shoulder.

Adolescent↗
PubMed2003

[Effects of unilateral mandibular distraction osteogenesis on temporomandibular joint].

OBJECTIVE: To study the effects of unilateral mandibular distraction osteogenesis(MDO) on the temporomandibular joint(TMJ). METHODS: Ten rhesus monkeys were used to perform right MDO. After 5 days, latency period, the distractor was initiated at the rate of 0.5 mmx2/day, totally 15 days. When MDO completed, and 2,4,6,and 12 weeks after MDO, X-ray films of bilateral TMJ were taken and one group of animals was sacrificed. Bilateral TMJ were obtained and paraffin slices were made HE and immunohistochemistry stains of TGF-beta1 were done on the slices. RESULTS: After MDO, the monkeys' mandible midline obviously deflected to the left side. The front teeth had open bite and reverse bite. The right molars were severely open bite and the left molars were reverse bite. From the X-ray film, we can see that the right condylar process moved backward and upward in the acetabulum, while the left condylar process moved forward and downward. On the slices, both sides of the TMJ showed different degrees of degeneration and proliferation, but the changes on the right side were more severe and obvious than the left side, and had involved all the cartilage's layers and the bone tissues under the cartilage. In some animals, there even appeared cartilage erosion and light histological changes of acetabulum. During the consolidation period, the open bite gradually closed, and the condylar process gradually moved to normal position. Twelve weeks after MDO, the open bite at the right side disappeared, but the front teeth open bite and reverse bite still existed. The right condylar process still lay a little backward and had some degree of degeneration. The left TMJ had the normal position and histology except for cartilage hypertrophy layer thickness. At different times during consolidation period, the positive stains of TGF-beta1 in condylar process on both sides were all more obvious than that of the control group. CONCLUSION: MDO can cause TMJ position change and light histological degeneration, but these changes can gradually rehabilitate in the future. TGF-beta1 may play a role in the reconstructive process of TMJ degeneration.

Animals↗
PubMed2004

[A cannulated articulating spacer--a functional implant for treatment of infected hip joint prostheses].

PURPOSE OF THE STUDY: Two-stage revision arthroplasty with the use of a spacer is generally accepted as a reliable method for treating infected hip replacements. Spacers made from antibiotic-loaded bone cement give good results in treatment of deep infections, but this technique is demanding in terms of spacer shaping. In addition, the conventional spacer may dislocate or fracture during patient mobilization. We attempted to avoid the disadvantages of conventional spacers by the construction of a cannulated articulating spacer. This is a special implant consisting of a polyethylene acetabulum, a stem, a modular neck and a head. Both the acetabulum and stem are covered with antibiotic-impregnated bone cement. They are subsequently pressed into the bone bed to make impression in the cement. The union of the bone bed with cement, which occurs in conventional implantation, must be avoided. This is achieved by making movements with the implant attached to an insertion handle, and by irrigating the operative field with large volumes of saline. A drain inserted in the canal running along the stem long axis facilitates continuous lavage of the medullary cavity. MATERIAL AND METHODS: A total of 11 patients with deep infection of a hip replacement were treated with the use of a cannulated articulating spacer in the years 2002 and 2003. Seven patients had late hematogenous infections and four had chronic delayed infections. The drains providing lavage stayed in place for about 10 to 12 days or less when three consecutive cultivations of drainage discharge were negative. Antibiotics were administered for at least 6 weeks according to the results of CRP and FW assessment. The reimplantation was planned on the basis of laboratory and clinical findings. The outcome was evaluated using the Harris hip score. RESULTS: Infection was successfully eradicated in all cases. The average time during which the cannulated articulating spacer was in place was 9.4 weeks. The results, as rated by the Harris hip score, were very good; after reimplantation, the average score was 95.1 points (range, 92 to 99). Even better evidence of the advantages of this method was provided by the increase in the average Harris hip score, which was 35.3 points (range, 26 to 69). No spacer dislocation or any other mechanical complication associated with the implant were recorded. DISCUSSION: Our results achieved with the cannulated articulating spacers developed in our department, as compared with conventional ones, show that the articulating spacer provides the patient with greater comfort and, therefore, improved quality of life for the period between the removal of a loose prosthesis and reimplantation of a definitive one. This method markedly reduces the risk of failure or dislocation of the temporary implant. In comparison with the PROSTALAC system, which is difficult to obtain and which requires complicated instrumentation, our method is simpler and less expensive. Our results show that the presence of an articulating spacer as a foreign body has no effect on the efficacy of treatment for deep infection. CONCLUSIONS: The procedure for preparing a cannulated articulating spacer described here is a modification of the method used to treat deep infection at the site of a total hip arthroplasty; it is inexpensive and provides markedly greater comfort for the patient. The technique combines the advantages of a two-stage revision involving spacer insertion with the use of lavage. Because patient have no major complaint and there is low risk of implant failure, the method allows us to adjust the reimplantation timing to the course of infection eradication and patients' overall health status.

Anti-Bacterial Agents↗
PubMed2004

An anatomical study of corona mortis and its clinical significance.

OBJECTIVE: To provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis. METHODS: The course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues. RESULTS: During the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm (range, 38-68 mm). CONCLUSIONS: Vascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.

Adult↗
PubMed1992

The hip joint in Down's syndrome. A study of its structure and associated disease.

Clinical and roentgenographic examination of the hip was performed in 114 patients with Down's syndrome to study range of motion, roentgenographic anatomy, and incidence of hip pathology. The study found increased external rotation of the hip. Roentgenographic studies demonstrate that, in comparison with a normal acetabulum, the acetabulum of a patient with Down's syndrome is deep, more horizontally placed, and has increased anteversion. The proximal femur of a patient with Down's syndrome has a normal neck-shaft angle and a moderate increase in anteversion. Of the patients, 7.9% had some hip abnormality, including dysplasia, dislocation, avascular necrosis, or slipped capital femoral epiphysis.

Adolescent↗
PubMed1992

Bipolar hip arthroplasty for recurrent dislocation after total hip arthroplasty. A report of three cases.

Recurrent dislocation after total hip arthroplasty is often a difficult complication to manage. Bipolar prostheses may be useful in these cases because motion can occur at two bearing surfaces and thus permit the greater range of motion necessary to dislodge the head from the acetabulum. The bipolar head is also larger than a conventional total hip femoral component, so a greater volume must be displaced from the acetabulum for dislocation to occur. Three patients with recurrent dislocation of a total hip prosthesis were successfully treated by conversion to bipolar devices after failure of multiple surgical procedures and treatment even with braces.

Adult↗
PubMed2006

[Hip joint development after closed reduction, complicated by growth disturbance of the capital femoral epiphysis].

The purpose of the study was to assess hip joint development after the treatment of DDH with overhead traction and closed reduction complicated by growth disturbances of the proximal femoral epiphysis. Comparison was also made between joints affected by AVN and other treated joints. Antero-posterior radiographs of 107 hip joints (81 children) done during treatment and follow-up were retrospectively reviewed. The average age was 14.2 months (from 5 to 33 months) and age at the final follow up 20.7 years (minimum 14 years). AVN was detected in 31 (29%) of the hip joints. Type II necrosis according to Bucholz and Ogden classification system was the most common one. In the hips affected by growth disturbances of proximal femoral epiphysis there were worse final clinical and radiological results, osteoarthrosis and elongation of acetabulum were more often seen in comparison to other treated joints. There was no difference in terms of other parameters describing acetabulum. In 19 out of 31 cases deformity of femoral head was noted. AVN may present as a wide spectrum of pathology from mild, probably not significant growth disturbances of physis to severe deformity and lateralisation of femoral head. Statistically hips with AVN had worse final results and in cases with good congruity prognosis is often uncertain due to aspherical femoral head and secondary osteoarthrosis. Acetabular development is most often unaffected by AVN.

Adolescent↗
PubMed2007

Morel-Lavallee lesion. Results of surgical drainage with the use of synthetic glue.

OBJECTIVE: To evaluate the results of surgical drainage and use of synthetic glue in Morel-Lavallee lesions. METHODS: We treated 7 Morel-Lavallee lesions in Ankara Bayindir Hospital, Ankara, Turkey between April 2003 and June 2004. These lesions developed in 5 male patients due to crush under a vehicle or a traffic accident. The mean age was 32.8 years; range 16-55. All lesions were localized in thigh. One patient had surgery due to acetabulum fracture and one had an urological operation for urethral rupture. All patients were operated 6-48 hours after the injury. After surgical drainage, soft tissues were attached with the use of synthetic glue and compressive bandage was applied. We defined healing as the loss of fluctuation and elicitation of the normal mobility of the injured skin on manual examination. The mean follow-up was 11.6 months (range 8-20 months). RESULTS: One patient was operated for acetabulum fracture and had a bilateral Morel-Lavallee lesion 2 days after the operation. This patient was reoperated for drainage. All lesions were healed with a mean of 5 weeks (range 3-8 weeks). No infection, necrosis or recurrences were detected during the follow-up. CONCLUSION: Results of the treatment with the use of synthetic glue and surgical drainage in Morel-Lavallee lesion are satisfactory with early healing time without recurrence.

Adolescent↗
PubMed2006

[Total hip arthroplasty for Crowe type-IV development dysplasia of hip in adults].

OBJECTIVE: To determine the operation procedure of total hip arthroplasty (THA) for Crowe type-IV developmental dysplasia of hip and its relationship with nerve injury. METHODS: A consecutive series of 39 THAs was performed for Crowe type-IV developmental dysplasia of hip in 35 patients (all female). The mean age of the patients at the time of surgery was 46 years (range 36 - 56 years). Thirty-five hips in 31 patients were followed up. The average follow-up period of the whole series was 4 years (range 1 - 8 years). All procedures were carried out through a lateral-posterior approach. In 33 of 35 hips, the cup was inserted in the "true" acetabulum. All the prostheses used were cementless, except for 5 cemented femoral stems in 5 patients. Each patient was evaluated clinically and by radiographs before the operation and during the follow-up period, according to the Harris hip score (HHS). RESULTS: None of the cups and stems were revised for aseptic loosening, dislocation or infection during the follow-up period. The mean preoperative HHS was 43 compared with the postoperative HHS of 87. The mean amount of postoperative leg lengthening was 5 cm (range 4 - 6 cm). CONCLUSIONS: The reconstruction of the hip at the level of the "true" acetabulum through a lateral-posterior approach is a safe and effective procedure of THA for Crowe type-IV developmental dysplasia of hip in adults. Acute leg lengthening of less than 6 cm could not cause nerve injury.

Adult↗
PubMed2006

[Evaluation of pediatric patients with traumatic hip dislocation].

OBJECTIVES: We evaluated pediatric patients who were treated for traumatic dislocation of the hip. METHODS: Traumatic dislocation of the hip was detected in five children (all boys; mean age 9 years; range 7 to 13 years) between 1991 and 2005. Dislocations occurred in the right hip in four cases, and in the left hip in one, all of which had posterior localization. Etiology was fall during play in two children, and fall from height or car crash in three. One patient had posterior wall avulsion fracture of the acetabulum. Early radiologic follow-ups included conventional radiographs and computed tomography. Functional results were assessed with the Harris hip scoring system. Four patients had a sufficient follow-up period with a mean of 44 months (range 19 to 64 months). RESULTS: All the patients were treated with closed reduction under general anesthesia after a mean of 6.4 hours (range 2 to 16 hours) following trauma. Functional results were excellent in all the patients, with a mean Harris hip score of 92 (range 84 to 96). Based on early postoperative radiologic control with computed tomography, no surgical intervention was considered for posterior wall avulsion fracture of the acetabulum in one patient. At 40-month follow-up, he had no complaints, had a full range of motion and a hip score of 92. While no complications were observed in patients undergoing early reduction, one patient whose dislocation was reduced 16 hours after trauma developed avascular necrosis of the femur head 18 months after treatment, at which time his hip score was 84. CONCLUSION: Early reduction is of particular importance for the follow-up course of traumatic hip dislocations in childhood.

Adolescent↗
PubMed1992

Use of computed tomographic reconstruction in planning osteotomies of the hip.

Certain deformities of the hip joint seem to predispose the hip to the development of osteoarthrosis. Successful surgical correction of these deformities before the onset of osteoarthrosis requires accurate characterization of the anatomic deviations from normal as the first step in planning corrective osteotomy. Three-dimensional computed tomography (CT) reconstruction in planning reconstructive hip osteotomy has most often been employed in developmental dysplasia of the hip. Computed tomography scanning with three-dimensional reconstruction can characterize the often complex deviations from normal in shape and attitude of acetabulum and femoral head in cases with residual hip dysplasia. Three-dimensional reconstruction also allows simulation of redirectional femoral or pelvic osteotomies to facilitate precise application of newer powerful surgical techniques for reorienting the acetabulum.

Adolescent↗
PubMed1991

[Conflict between psoas and total hip prosthesis].

This conflict leads to a chronic irritation of the psoas by the antero-medial part of the cup, but it has been poorly described in the past. A study of six patients suffering from this trauma, and who were re-operated revealed that the muscle was worn thin in front of the prominent cup. In the case of 4 of the 6 patients pain had started to occur shortly after total hip replacement. The following symptoms were noted among all 6 patients: pain was suffered during flexion--extension movements--walking up stairs--arising from a chair. Pressure on the medial part of the groin was painful, especially during active elevation of the lower limb. Passive mobility was normal and painless. Psoas bursitis was observed in three cases. The main cause of this conflict is the protrusion of the cup beyond the antero-medial edge of the acetabulum; this protrusion may be either due to a bone graft or a bit of cement, but most often an acetabular insufficiency (congenital dysplasia) favors the formation of this anterior overhang. The spiral cup screwed into the bone can be especially aggressive when it protrudes. Treatment includes the resection of the overhang, but post-operative results will be uncertain unless the resection is really complete. In the case of 4 patients the results of such an intervention were only mild to poor. This problem can be avoided by proper care and preventive measures in the original replacement avoiding all projections beyond the anterior edge of the acetabulum--cup, bone graft, cement, especially if dysplasic.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Shelf arthroplasty in patients who have Legg-Calvé-Perthes disease. A study of long-term results.

We reviewed the long-term functional and roentgenographic outcomes of severe Legg-Calvé-Perthes disease in two similar groups of patients, one of which was managed with a shelf arthroplasty and the other, by a variety of non-operative means. Twenty hips in nineteen patients were treated with traction and, when necessary, adductor tenotomy to attempt reduction of the subluxation; this was followed by a shelf arthroplasty to increase the arc of the acetabulum and result in coverage of the femoral head. The average duration of follow-up was nineteen years (range, two to forty-seven years). The initial center-edge angle and the anteroposterior Mose sphericity measurement were significantly improved at the most recent follow-up (p greater than or equal to 0.05), and the average Iowa hip score was 91 points. Hinge abduction, which was producing incongruity, was eliminated in eleven of fourteen hips after the operation. The outcomes for the second group, consisting of eighteen hips in seventeen patients who were managed non-operatively, were also reviewed, at an average duration of follow-up of twenty-eight years (range, seven to forty-five years). No significant improvement in the center-edge angle or the anteroposterior Mose sphericity measurement was observed at the most recent follow-up, and the average Iowa hip score was 81 points. There was no significant difference in the range of motion of the hip between the groups. We believe that shelf arthroplasty is a favorable option in the treatment of Legg-Calvé-Perthes disease when additional bone is needed at the lateral aspect of the acetabulum to cover the extruded portion of the femoral head, to prevent additional incongruity and thereby delay the early onset of degenerative changes.

Adolescent↗