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At least 1,495 records · Page 83Linked to original sources
PubMed1989

A long-term follow-up study of total hip replacement with bone graft. Correlations between roentgenographic measurement and hip mobility.

Fifty total hip replacement treating the acetabular deficiency with autologous bone graft from the femoral head were performed on 44 patients with congenital dislocation of the hip. The average age was 55 years. The average follow-up period was 5 years and 2 months, ranging from 3 years, 8 months to 6 years, 11 months. Solid union was demonstrated in all acetabular grafting. No loosening of either acetabular or femoral components occurred. Roentgenological measurements used as a parameter of good results showed that better results were obtained using the true acetabulum (ideal position) with appropriate bony coverage.

Acetabulum↗
PubMed1982

Hip CT in congenital dislocation: appearance of tight iliopsoas tendon and pulvinar hypertrophy.

The iliopsoas tendon can interpose between the femoral head and the acetabulum, preventing reduction or stability of reduction of a dislocated hip by a closed method. The tendon produces an infolding of the capsule and labrum. This infolding of the capsule and labrum creates an "isthmus" between the capital and the acetabular parts of the capsule. This deformity of the capsule was recognizable on computed tomography (CT) in 10 patients, all of whom had surgical confirmation of the findings. The presence of hypertrophied pulvinar can also be recognized by CT.

Child, Preschool↗
PubMed1982

[Congenital dysplasia and dislocation of the hip. Pathological anatomy in the newborn and infant (author's transl)].

The authors have had the opportunity of making a complete and precise dissection of newborns with congenital dislocation of the hip. They have also made a dynamic study of the hip joints in the specimens. The findings have been compared with other studies published in the literature. It is concluded that the dislocation is posterior or postero-superior and that acetabular dysplasia is consistent in unstable hips in the newborn. The acetabular plasia is secondary to the dislocation and lies postero-superiorly. It cannot be detected radiologically. The existence of primary acetabular dysplasia is doubtful. The main responsibility for congenital dislocation of the hip is a faulty position of the foetus in utero. The disease therefore cannot be prevented. It is of importance to diagnose the disease as soon as possible.

Acetabulum↗
PubMed1995

Femoral head bone grafting for reconstruction of the acetabular wall in dysplastic hip replacement.

From 1980 through 1991 we screwed a preshaped cortico-cancellous bone graft onto the ileum wall to compensate acetabular deficiency in 94 consecutive total hip replacements. We report the results of 87 hips (79 patients) with an average follow-up of 30 months (12-75 months) postoperatively. Pain in dysplasia-coxarthrosis and congenital dislocation of the hip, destructive coxitis in rheumatoid arthritis and cup loosening was the main indication for surgery. According to the Merle d'Aubigné score the postoperative clinical evaluation demonstrated 77% very good and 18% good results. Due to component loosening the results had to be classified as unsatisfactory in 4 hips (2 cups and 2 stems). At the time of evaluation 90% of the arthroplasties was osseously consolidated as evidenced by trabecular bridging and structural integrity with host bone. Resorptions of the graft were noted in 32 hips. One cup was removed because of complete resorption and consecutive loosening, a further one was considered clinically and radiologically loose because of partial graft resorption. Two further complete resorptions and 28 partial lateral resorptions had no influence on the secondary stability of the implant. We are aware that these are short-term results. Nevertheless, we recommend the described method as a valuable addition to arthroplasties for acetabular rim defects both in osteoarthritis and in revision surgery.

Acetabulum↗
PubMed1977

[The osteomyelitis of the hip in newborns and its functional treatment with "extensionsreposition" and "Hanausek-Retention" (author's transl)].

Since 1969 all our patients below the age of three years with congenital dislocation of the hip are treated by a modified overhead-traction (Extensionsreposition) and the "Hanausek-Apparat" for retention. Because of good results of careful reduction and retention in a mitigated Lorenz-position we also treated osteomyelitis of the hip-joint in newborns and following dislocation by this method. It is reported of 3 cases, different types of osteomyelitis of the hip and the method are described.

Bone Development↗
PubMed1995

Varus derotation osteotomy for persistent dysplasia in congenital dislocation of the hip. Proximal femoral growth and alignment changes in the leg.

We studied the morphological changes in the proximal femur in 42 patients (42 hips) who had had varus derotation osteotomy of the upper femur for residual acetabular dysplasia and congenital subluxation of the hip and who did not show deformity of the head of the femur. In 19 patients the alignment of the whole leg was examined. The femoral neck-shaft angle (FNSA) at the final examination was unrelated to that immediately after operation or to the state of the acetabulum at that time. The postoperative FNSA was not related to the final result but the CE angle obtained at surgery influenced the outcome. The femoral length did not differ significantly between the unaffected and affected sides. Significant differences were found in the femorotibial angle (176.6 degrees v 174.5 degrees) and in the point of intersection between the mechanical axis and knee (65.0% v 57.2%).

Acetabulum↗
PubMed1990

Dermatoglyphic patterns in congenital dislocation of the hip.

In this study, dermatoglyphic patterns of 100 children (15 boys and 85 girls) with CDH who were treated with conservative management or surgical reduction are presented. 200 pairs of fingerprints and palm patterns and their combinations were evaluated and classified according to Galton's system, compared with a control group of 100 normal children. Keeping in mind the possibility that most of the dermatoglyphic pathologies might be in keeping with CDH due to embryologic developing coincidence, specifically head-presentation deliveries were selected for the study. None of them had other congenital anomalies and no medicines were received during pregnancies which would cause a teratogenic effect in development of dermal patterns. Printer's-ink method was used to take the dermal patterns. There was an increased frequency of patterns in the fingerprints of the girls' and boys left hands. There were no other significant dermal patterns to use as a diagnostic feature in CDH. Literature was reviewed and discussed.

Child↗
PubMed1986

[Value of ultrasonic diagnosis in the evaluation of hip dislocation in neonates and infants. Apropos of 340 cases].

Ultrasound imaging of hip (UIH) was performed in 170 children (340 hips) with normal (193) and dysplasic (147) hips and findings compared with results of clinical and radiologic examinations. Ultrasound demonstrated 100% sensitivity in cases with abnormal clinical and radiologic finding, and 94% specificity for UIH when clinical and radiologic examinations were negative. Sensitivity and specificity of ultrasound screening (respectively 96 and 81%) were comparatively superior to those of radiography of the pelvis (83 and 78%) in relation to the clinical examinations. These findings predict further development of UIH for screening of congenital dislocation of the hips and for follow up surveillance of treated children.

Evaluation Studies as Topic↗
PubMed1984

A dynamic canine model of experimental hip dysplasia. Gross and histological pathology, and the effect of position of immobilization on capital femoral epiphyseal blood flow.

We produced a dynamic model of experimental hip dysplasia in growing puppies by cast immobilization of a single hind leg with the knee in extension. Serial roentgenographic studies demonstrated a progressive acetabular dysplasia with subluxation and eventually dislocation of the femoral head. A consistent finding in the dysplastic hip was significant hypertrophy of the ligamentum capitum femoris, both in length and in cross-sectional area. Quantitative studies of blood flow in the femoral head by the hydrogen-washout technique in normal and dysplastic hips demonstrated a significant decrease in blood flow to the dysplastic femoral heads. The dysplastic hips were then placed in various positions of immobilization and blood-flow determinations were repeated. The position of forced abduction significantly reduced circulation in the femoral head, whereas immobilization in flexion consistently resulted in the highest rate of blood flow in the femoral head. These experimental data indicate the potential ischemic hazards of immobilization in the forced abducted position in the treatment of congenital dislocation of the hip. Progressive degenerative changes developed in the articular cartilage of the dislocated joint, with severe reduction of safranin-O staining, fibrocartilaginous metaplasia, and hypocellularity. The degenerative changes in the acetabular cartilage were more severe than those in the femoral head. These findings further emphasize the importance of reducing the dislocated hip at the earliest opportunity in order to prevent irreversible degenerative changes.

Animals↗
PubMed1998

Total hip reconstruction in the anatomically distorted hip. Cemented versus hybrid total hip arthroplasty.

Recent reports in the literature strongly support the idea that cement is the optimum form of fixation of the femoral component in total hip replacement. For hybrid total hip arthroplasty, we used a cemented cup instead of an uncemented cup since this was inevitable in cases of poorly developed acetabulum. The uncemented cone femoral component is also beneficial in cases of extremely narrow and cylindrical configuration of the medullary cavity of untreated congenital dislocation of the hips (CDH) and tuberculosis or septic arthritis in childhood. We reviewed the clinical result of a consecutive series of patients with cemented total hip arthroplasty (THA) compared with recent studies on hybrid reconstruction using survivorship analysis. This subsequent study involved a hybrid uncemented Wagner cone femoral component and a cemented acetabular component with roof reinforcement by additional impacted cancellous allograft with hydroxyapatite (HA). We believe that early failure of the cemented components was due to an adverse effect of thin cement mantles around cemented femoral stems as well as the cemented cup in THA. In addition, 8 patients who received our modification of the Charnley CDH component had poor results even though we reduced the stem geometry and thickness. Furthermore, intraoperative fracture and splitting of the proximal femur was a major complication during implantation. Contrary to expectations, the results of these hybrid reconstructions were extremely encouraging (average follow-up period of 2-4.5 years). In addition to our experience of the cemented versus hybrid THA involving the uncemented Wagner femoral component, we have determined positive indications for the untreated and severely distorted anatomy of bilateral CDH for which surgical interventions for reconstruction were not recommended before.

Adult↗
PubMedDate not supplied

[Acetabular convexity--a specific addition to total endoprosthetic hip replacement].

Between 1. 1. 1977 and 30. 6. 1988, 1470 total hip prostheses were implanted at the 1st Orthopedic Clinic in Bad Abbach/Regensburg. In 101 cases (82 patients, average age 54.8 years) the acetabular convexity was built up at the same time. This is considered indicated if the acetabulum is too shallow and thus provides insufficient lateral or dorsolateral countersupport. The main area of indication is dysplasia-coxarthrosis and congenital dislocation of the hip, destructive coxitis in chronic polyarthritis or juvenile chronic arthritis, and loosened prostheses. The material used for building up the convexity is a block of corticocancellous bone, which is fixed ventrolaterally to dorsolaterally to the ilium by osteosynthesis. Autologous material was used in 88 cases and homologous material in 13. Sixty-one patients with a total of 77 built-up convexities were followed up. In 92.2% a bony bridge between the corticocancellous block and the rising branch of the ilium was fund. The method described is a valuable addition to replacements in case of extreme hip joint changes and replacement operations. In the authors' opinion it has considerable advantages over supporting shells and similar materials.

Acetabulum↗
PubMed1992

Congenital anomalies concomitant with persistent primary congenital hypothyroidism.

The Israeli national neonatal screening program for congenital hypothyroidism (CH) was initiated in May 1978. The overall incidence of persistent primary congenital hypothyroidism (PPCH) during the first 10 years of screening was 1:2,950 live births. The purpose of this study was to ascertain the incidence of congenital extrathyroid anomalies (ETAs) among the infants with PPCH and to compare it with the Israeli Birth Defect Monitoring System data. Among 243 PPCH infants on whom adequate data were available, 38 infants (15.6%) had associated congenital anomalies. Fourteen infants had congenital cardiac anomalies (5.8%): VSD (n = 7), PDA (n = 3), PS (n = 2), one mitral insufficiency, and one congenital atrial flutter. Eight children (3.3%) had congenital dislocation of the hip; their M:F ratio was 3:5 similar to the M:F ratio in CH (unlike the ratio in the general population). Some additional anomalies were considerably more common than in the general population. It is reasonable to assume that teratogenic effects active during organogenesis may affect simultaneously many organs, including the developing thyroid, causing a relatively high percentage of CH infants with congenital ETA.

Congenital Abnormalities↗
PubMed1979

The management of late diagnosed congenital dislocation and subluxation of the hip-with special reference to femoral shortening.

Thirty hips affected by congenital dislocation or subluxation underwent surgical treatment between the ages of five and fifteen years, and the results are presented. Reduction was aided by concurrent femoral shortening in seventeen. An aggressive approach in older children not only relieves the presenting symptoms in most, but also, by improving the anatomical relationships, increases the prospect of success should total replacement become indicated in the future.

Adolescent↗
PubMed1992

Early and late loosening of the acetabular cup after low-friction arthroplasty.

Between 1971 and 1979, 680 low-friction arthroplasties of the hip were performed in 598 patients. The average duration of follow-up was twelve years and eight months. Sixty-one acetabular cups had loosening as seen on roentgenograms eighteen years postoperatively, resulting in a total cumulative probability of loosening of 19 per cent, according to survivorship analysis. In twenty-nine cups, the loosening appeared within ten years after the operation (early loosening) and in thirty-two, more than ten years after the operation (late loosening). Early loosening was associated with deficient structure of the bone of the acetabulum, a previous congenital dislocation of the hip, acetabular fracture, or acetabular protrusion in all instances (p < 0.01). Late loosening was associated with the depth of acetabular wear. Of the thirty-two cups that had more than two millimeters of wear, eighteen (56 per cent) had loosening on the roentgenograms (p < 0.001). In hips that had early loosening, migration was the most frequent finding, and its rate of progression was higher than in hips that had late loosening (p < 0.001). In late loosening, a complete bone-cement radiolucency of more than two millimeters was the most frequent finding. Clinical failure was seen in twenty-two (76 per cent) of the twenty-nine cups that loosened early and in nine (28 per cent) of the thirty-two cups that loosened late. The probability of extensive resorption of bone necessitates close observation of patients who have early loosening, while a reasonable period of observation is possible for those who have late loosening.

Acetabulum↗