Prognostic radiographic factors in developmental dysplasia of the hip following Salter osteotomy.

Radiographic parameters for evaluating hip development are altered by Salter osteotomy, and their prognostic value require further validation. A total of 63 patients who underwent open reduction and Salter osteotomy for unilateral hip dysplasia were evaluated with Severin classification 10.8 years later.

Two-incision versus modified Watson-Jones total hip arthroplasty in the same patients-- a prospective study of clinical outcomes and patient preferences.

Background: The two-incision technique and the modified Watson-Jones technique use muscular intervals and avoid muscle cutting in total hip arthroplasty (THA). However these two techniques have not been compared.

Methods: A prospective randomized study of clinical outcomes and patient preferences was performed in 20 patients who had a two-incision THA in one hip and a modified Watson-Jones THA in the other between January 2004 and August 2007.

Predictive value for femoral head sphericity from early radiographic signs in surgery for developmental dysplasia of the hip.

Background: Avascular necrosis after treatment for late developmental dysplasia of the hip can result in deformity of the femoral head and long-term morbidity. This study aims to analyze the clinical and radiographic factors that are associated with femoral head deformity in the early stage of avascular necrosis.

Methods: Thirty patients with unilateral developmental dysplasia of the hip treated by the same operation before 3 years of age and who developed early signs of avascular necrosis, were studied.

Surgical results and complications of developmental dysplasia of the hip--one stage open reduction and Salter's osteotomy for patients between 1 and 3 years old.

Background: Reports of the efficacy of Salter's osteotomy have often been based on groups of patients with complex disease conditions and treatment. The purposes of this study were to document the results of patients with well-defined conditions, focusing on the onset and sequelae of osteonecrosis.

Methods: The study participants consisted of 63 patients with unilateral hip dislocation who had undergone one-stage open reduction and Salter's innominate osteotomy between the ages of 1 and 3 years.

Non-traumatic osteonecrosis of the femoral head - from clinical to bench.

Non-traumatic osteonecrosis of the femoral head commonly affects young adults between the third and fifth decade of life. It is the leading cause of hip joint replacements in many Asian countries including Taiwan. The ultimate goal is the preservation of the involved hip.

Uncemented total hip arthroplasty in chronic hemodialysis patients.

Background And Purpose: Whether or not uncemented total hip arthroplasty (THA) can achieve durable fixation of implants to bone in patients on chronic hemodialysis is unknown. We analyzed the 2-13-year clinical outcomes of cementless THA in patients with end-stage renal diseases who were maintained on long-term hemodialysis.

Patients And Methods: We reviewed the outcome of 23 consecutive uncemented THAs undertaken between 1993 and 2004, in patients with chronic renal failure who had been on long-term hemodialysis (2-18 years).

Local cancellous bone grafting for osteonecrosis of the femoral head.

Objective: This study reports a novel local bone graft technique for the treatment of osteonecrosis of femoral head (ONFH).

Materials And Methods: From 1998 to 2005, a procedure using local bone grafting was performed for the treatment of ONFH in 11 patients. The local bone grafts were obtained from the intertrochanteric region and then impacted into the necrotic lesion.

Anatomic reduction of old displaced lateral condylar fractures of the humerus in children via a posterior approach with olecranon osteotomy.

Background/purpose: We questioned the principle of treatment of late lateral condylar fracture of a pediatric elbow. We report the results of treating this condition using a different approach.

Methods: We treated six children with type 3 late lateral condylar fractures.

The position of the bipolar cup reflects the direction of the hip contact force acting on it.

We radiographically measured the bipolar cup position to analyze the direction of joint force acting on the bipolar cup. The abduction angle of the bipolar cup was measured in each radiograph taken immediately and at six 12 weeks and yearly after the operation. Radiographs in patients with weight bearing were also investigated.

Extension splint for trigger thumb in children.

Sixty-two reducible trigger thumbs in 50 children with age from 0 to 4 years (mean, 1 year 11 months) were reviewed to study the effect of splinting. Thirty-one thumbs in 24 children received splinting for a mean of 11.7 weeks.

Image-guided periacetabular osteotomy: computer-assisted navigation compared with the conventional technique: a randomized study of 36 patients followed for 2 years.

Background: Periacetabular osteotomy (PAO) is an effective but technically demanding surgical procedure. We evaluated the efficiency of computer-assisted navigation in PAO and compared it with the traditional approach.

Patients And Methods: We performed a randomized study of 36 patients undergoing PAO using either the CT-based, computer-assisted navigation technique or the conventional approach.

Precooling of the femoral canal enhances shear strength at the cement-prosthesis interface and reduces the polymerization temperature.

Preheating of the femoral stem in total hip arthroplasty improves the cement-prosthesis bond by decreasing the interfacial porosity. The main concern, however, is the potential thermal osteonecrosis because of an increased polymerization temperature. In this study, the effects of femoral canal precooling on the characteristics of the cement-stem interface were evaluated in an experimental model for three test conditions: precooling of the femoral canal, preheating of the stem (44 degrees C), and a control in which stems were inserted at room temperature without thermal manipulation of the implant, cement, or bone.

Arthroscopic posterior cruciate ligament reconstruction with hamstring tendon autograft: results with a minimum 4-year follow-up.

This study prospectively evaluates the outcomes at a minimum 4-year follow-up after PCL reconstruction using quadruple hamstring tendon autograft with an arthroscopic double fixation technique. During 1996-1999, hamstring tendon autograft graft has been used in 57 patients. Data from 52 patients who had been followed up completely were analyzed.

The effect of necrotic lesion size and rotational degree on the stress reduction in transtrochanteric rotational osteotomy for femoral head osteonecrosis--a three-dimensional finite-element simulation.

Background: The prospect for success in the efficacy of osteotomy for precollapse stage of femoral head osteonecrosis depends on the ability to predict reliably the stress changes derived from specific osteotomies. A three-dimensional finite-element analysis was thus designed to compute necrotic femoral head stress changes with different extent of necrocrosis that accompany anterior or posterior rotational osteotomies.

Method: Computed tomography images of a standard composite femur were used to create the three-dimensional finite-element intact femur model.

Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft: clinical outcome in 4-7 years.

Surgical reconstruction of the anterior cruciate ligament (ACL) is indicated in the ACL-deficient knee with symptomatic instability and multiple ligaments injuries. In the present study, we describe the clinical results of quadriceps tendon-patellar bone autograft for ACL reconstruction. From 1996 to 1998, the graft has been used in 38 patients.

High concentration and bioactivity of vancomycin and aztreonam eluted from Simplex cement spacers in two-stage revision of infected hip implants: a study of 46 patients at an average follow-up of 107 days.

This study investigated the release of antibiotics in vivo, from an articulating polymethylmethacrylate (PMMA) spacer used in two-stage revision arthroplasty of infected hip implants. Forty-six patients who underwent two-stage revision hip arthroplasty for infections were managed with an interim PMMA spacer loaded with a high dose of vancomycin and aztreonam. Serum and aliquots of drainage collected after the first-stage surgery, and joint fluid obtained at the time of the second-stage surgery were analyzed for antibiotic concentrations by high performance liquid chromatography and bioactivity by tube dilution bioassay.

Staged arthroplasty as salvage procedure for deep hip infection following intertrochanteric fracture.

Deep hip infection is a rare complication of intertrochanteric fractures and an optimal treatment has not yet been reported. Twenty-seven patients who contracted deep hip sepsis following the failed primary treatment of an intertrochanteric fracture were treated with two-stage hip arthroplasty. Antibiotic-impregnated cement beads were implanted following resection arthroplasty in the first 15 patients, and a temporary cement spacer prosthesis was used in the other 12 hips.

Complications of hip arthroscopy: analysis of seventy three cases.

Background: Hip arthroscopy is recognized as a highly effective means of treating joint disorders. Complications in hip arthroscopy, including neurovascular traction injury, compression injury to the perineum and scope trauma, have been reported. We report our experience with 73 hip arthroscopy procedures and complications at Chang Gung Memorial Hospital.

Evaluating hip labral tears using magnetic resonance arthrography: a prospective study comparing hip arthroscopy and magnetic resonance arthrography diagnosis.

Purpose: To evaluate the sensitivity and accuracy of magnetic resonance arthrography (MRA) with true sagittal scout image mapped radial reformation in localizing hip labral tears.

Type Of Study: Case series.

Methods: Thirty patients were examined with hip MRA because of suspected labral tears.

Periprosthetic fractures of the greater trochanter through osteolytic cysts with uncemented MicroStructured Omnifit prosthesis: retrospective analyses pf 23 fractures in 887 hips after 5-14 years.

Background: Periprosthetic fractures of the greater trochanter through osteolytic cysts are rare. The proper treatment and its influence on the prosthetic survival remains unknown.

Patients And Methods: We retrospectively evaluated 887 hips with uncemented MicroStructured Omnifit total hip prostheses at a mean follow-up time of 11 (5-14) years.

Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears.

Background: Biceps long head tendon lesion is commonly associated with rotator cuff tendon pathology. This study is to determine the pathologic spectrum of biceps long head tendon in surgical cases with complete full thickness rotator cuff tear.

Methods: Between 1993 and 2002, 122 complete rotator cuff tears with surgery were included for the analysis.

Biomechanical comparison of newly designed stemless prosthesis and conventional hip prosthesis--an experimental study.

Local bone loss after implantation of traditional stem-type prostheses remains an unsolved problem during the long-term application of total hip replacement. The stress shielding effect and osteolysis were thought to be the two main factors that result in local bone loss after prosthesis implantation. A newly designed stemless cervico-trochanteric (C-T) prosthesis was thus developed to reduce stress shielding and osteolysis caused by the implantation of conventional stem-type prosthesis.

The degrees to which transtrochanteric rotational osteotomy moves the region of osteonecrotic femoral head out of the weight-bearing area as evaluated by computer simulation.

Background: Transtrochanteric rotational osteotomy is a technical demanding procedure. Currently, the pre-operative planning of the transtrochanteric rotational osteotomy is mostly based on X-ray images. The surgeons would need to reconstruct the three-dimensional structure of the femoral head and the necrosis in their mind.

Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis.

Background: A two-stage revision is a well-accepted method for the treatment of a deep infection of a hip with a joint implant. In the present study, the results associated with the interim use of antibiotic-loaded cement beads were compared with those associated with the interim use of an antibiotic-loaded cement prosthesis.

Methods: One hundred and twenty-eight consecutive patients who were managed with a two-stage revision hip arthroplasty for the treatment of an infection were followed clinically and radiographically for an average of 4.

Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer.

Background: Two-stage reconstruction is a well-recognized treatment for deep infection of hip joint implants. The purpose of the study was to report the results of our treatment using a standardized protocol.

Methods: Forty-two consecutive patients with deep infection of the hip prosthesis were treated according to a prospective, two-stage resection/reimplantation protocol.