Is There Any Difference Between a Spherical Marker and a Simple Coin for Hip Replacement Digital Planning?

 To evaluate the accuracy and differences between 2 types of metallic markers, sphere, and coin, for radiographic calibration in the preoperative planning of hip arthroplasty.  Four spherical metallic markers and four coins, both 25 mm in diameter, were placed on the greater trochanter, pubic symphysis, between the thighs, and on the table of the exam, for radiographic examination of the hip in 33 patients with hip prosthesis. The prosthesis head was used for calibration and two examiners measured the markers' image diameters, and the results were analyzed statistically.

The impact of sonication cultures when the diagnosis of prosthetic joint infection is inconclusive.

Background: In the absence of a gold standard criterion for diagnosing prosthetic joint infections (PJI), sonication of the removed implant may provide superior microbiological identification to synovial fluid and peri-implant tissue cultures. The aim of this retrospective study was to assess the role of sonication culture compared to tissue cultures for diagnosing PJI, using different consensus and international guidelines for PJI definition.

Methods: Data of 146 patients undergoing removal of hip or knee arthroplasties between 2010 and 2018 were retrospectively reviewed.

Comparative Study of the Osteointegration of Irradiated and Non-irradiated Bone Grafts Used in Patients with Revision Hip Arthroplasty.

 To evaluate and compare the osteointegration of irradiated and non-irradiated frozen bone grafts used in 21 patients undergoing revision hip arthroplasty procedures with the Exeter technique.  A retrospective study of 21 patients undergoing revision hip arthroplasty with the Exeter technique using bone tissues treated or not with gamma radiation between 2013 and 2014. The patients were divided into two groups according to the use of grafts treated or not with ionizing radiation (gamma rays); as such, these groups were classified as irradiated or non-irradiated.

Analysis of potential contamination factors in musculoskeletal tissues.

Tissue Banks have become the main source for bone grafts, due to preference for homologous tissues. Notwithstanding the use of aseptic techniques for procurement of tissues and judicious selection of donors, microorganisms are frequently found in procured bones. Purpose of this study is to evaluate the factors that increase safety of procurement and minimize discard of procured tissues.

Effects of ionizing radiation on proteins in lyophilized or frozen demineralized human bone.

Objective: The aim was to study the effects of application of ionizing radiation (gamma and electrons) as sterilizing agents at doses of 15 kGy, 25 kGy and 50 kGy, on lyophilized or frozen demineralized bone tissue for use in transplants.

Methods: Five human femoral diaphyses from different donors of musculoskeletal tissue were demineralized and preserved as lyophilized or frozen at -80 °C. The samples were divided into two groups: non-irradiated (control) and irradiated by means of gamma rays or an electron beam.

TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY.

Objectives: To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores.

Methods: We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1(st), 2008 to December 31(st), 2010.

Results: In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure.

Epidemiology of fractures of the proximal third of the femur in elderly patients.

Objective: This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo.

Methods: The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up.

Prevalence and risk factors for intra-operative periprosthetic fractures in one thousand eight hundred and seventy two patients undergoing total hip arthroplasty: a cross-sectional study.

Purpose: The purpose of this study was to identify the frequency and type of intra-operative periprosthetic fractures and to describe risk factors in a single tertiary, public hospital, so that these events could be prevented, even among less experienced surgeons.

Methods: This is a cross-sectional study, based on medical records and imaging exams from the archives of a public, tertiary hospital, from April 1998 to October 2013. All consecutive patients submitted to total hip arthroplasty (THA) in the study period were evaluated, excluding unipolar or bipolar arthroplasty, surgery for the osteosynthesis of periprosthetic fractures, surgical procedure to clean infection site without component substitution and not arthroplastic surgery.

Surgical technique: Endoscopic gluteus maximus tendon release for external snapping hip syndrome.

Background: While many authors have recommended surgery for patients with persistent symptoms of external snapping hip, it is unclear which one best relieves symptoms. Concerns with iliotibial band (ITB)-modifying techniques include altering the shape of the lateral thigh and overload of the contralateral abduction mechanism. We describe a new endoscopic technique that decreases the tension of the ITB complex by releasing the femoral insertion of the gluteus maximus tendon (GMT).

SURGICAL TREATMENT FOR FEMOROACETABULAR IMPINGEMENT IN A GROUP THAT PERFORMS SQUATS.

Objective: Describe the results from arthroscopic surgical treatment on a group of patients who developed symptoms after repetitive physical activity of moving their hips in a position of hyperflexion, as in leg presses and squats.

Methods: The study group comprised 47 individuals (48 hips) who developed the onset of painful symptoms associated with hip hyperflexion exercises (leg presses or squats) and underwent arthroscopic treatment. The patients were evaluated radiographically and clinically according to the "Harris Hip Score", as modified by Byrd (MHHS), pre and postoperatively, and were asked about their return to sports activities and the surgical findings.

Evaluation of the reliability of the modified Merle d'Aubigné and Postel Method.

Objective: To assess the inter-evaluator reproducibility of the Modified Merle d'Aubigné and Postel Method.

Method: Forty-five patients took part in the study, with a mean age of 57.93 (±13.

Comprehension and reproducibility of the Judet and Letournel classification.

Objective: To evaluate the effectiveness of the method of radiographic interpretation of acetabular fractures, according to the classification of Judet and Letournel, used by a group of residents of Orthopedics at a university hospital.

Methods: We selected ten orthopedic residents, who were divided into two groups; one group received training in a methodology for the classification of acetabular fractures, which involves transposing the radiographic images to a graphic two-dimensional representation. We classified fifty cases of acetabular fracture on two separate occasions, and determined the intraobserver and interobserver agreement.

PROPOSAL FOR STANDARDIZATION OF RADIOGRAPHIC STUDIES ON THE HIP AND PELVIS.

Diagnoses of hip and pelvis disorders are based on the detailed medical history, physical examination and laboratory tests, as appropriate for each condition. Plain radiography is still the initial examination of choice and, because of its importance, there is a need to standardize radiographic studies, both in relation to execution and in radiographic series, according to the different pathological conditions. The aim of this paper was to propose standardization for the main radiographic views of the hip and pelvis, and with regard to performing specific series for different pathological conditions, and to provide technical guidance for achieving these aims.

Do complications in hip arthroscopy change with experience?

Purpose: The aim of this study was to evaluate the type and incidence of complications during the development of hip arthroscopic techniques.

Methods: A retrospective series of 194 files of patients treated with hip arthroscopy in a tertiary hospital from December 1999 to March 2008 was reviewed for complications. The incidence of complications was recorded consecutively for each group of 30 patients and in intervals of 2 years.

HEMIARTHROPLASTY IN THE TREATMENT FRACTURES OF THE FEMORAL NECK.

Objective: To epidemiologically and clinically evaluate patients with displaced femoral neck fractures that were surgically treatment with cemented hip hemiarthroplasty.

Methods: All patients with displaced femoral neck fractures (Garden III and IV) who underwent cemented hip hemiarthroplasty using a unipolar prosthesis (Thompson), by means of a posterolateral access between June 2005 and September 2008 were retrospectively evaluated.

Results: Seventy patients were initially evaluated.

STUDY OF THE TREATMENT OF FEMORAL HEAD FRACTURES.

Objective: To establish guidelines for the treatment of femoral head fractures and to determine the best form of access in cases treated surgically.

Methods: We evaluated the clinical and radiological results from 13 patients (13 fractures) treated surgically, between May 1986 and July 1996, at the Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de Sao Paulo (SCMSP), Fernandinho Simonsen Wing.

Results: Out of six cases of Pipkin 1 fractures, five underwent resection of the fragment, resulting in four excellent and one good result.

ARTHROSCOPIC TREATMENT OF SYNOVIAL OSTEOCHONDROMATOSIS OF THE HIP.

Objective: The objective of this study is to show the results achieved in the treatment of hip osteochondromatosis by arthroscopy.

Methods: Six patients submitted to hip arthroscopy for synovial osteochondromatosis have been assessed for pre- and postoperative function and pain. The time of preoperative complaint ranged from nine to 48 months, in an average of 28.

ANALYSIS OF THE SEGMENTAL IMPACTION OF FEMORAL HEAD FOLLOWING AN ACETABULAR FRACTURE SURGICALLY MANAGED.

Objective: Correlate the postoperative radiographic evaluation with variables accompanying acetabular fractures in order to determine the predictive factors for segmental impaction of femoral head.

Methods: Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation. Within approximately 35 years, 596 patients were treated for acetabular fractures; 267 were followed up for at least two years.

ARTHROSCOPIC TREATMENT OF FEMOROACETABULAR IMPINGEMENT.

Objective: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable.

Methods: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy.

THE IMPORTANCE OF THE DIAGNOSIS OF SUBCHONDRAL FRACTURE OF THE FEMORAL HEAD, HOW TO DIFFERENTIATE IT FROM AVASCULAR NECROSIS AND HOW TO TREAT IT.

Subchondral fracture of the femoral head is an uncommon and underdiagnosed affection. The abrupt or gradual onset of groin pain with functional disability on weight-bearing that improves with a resting period should alert the orthopedic surgeon to the possibility of this diagnosis. The differential diagnosis from osteonecrosis of the femoral head can be provided by assessing the different patterns of bone edema on MRI studies of the hip, thus avoiding unnecessary invasive operations on the hip.

HIP ARTHROSCOPY IN ATHLETES.

Unlabelled: To confirm the therapeutic importance of hip arthroplasty in athletes whose pain precludes sportive function of the hip joint, being able to minimize it to the extent of helping on the return of sports practice at satisfactory levels.

Methods: 49 athlete patients (51 hips) submitted to hip arthroscopy complaining of pain and inability to practice sports were assessed. Follow-up time ranged from 12 to 74 months (mean: 39.

Sugioka's Modified Hungria-Kramer intertrochanteric osteotomy in the treatment of severe slipped capital femoral epiphysis.

From May 1990 to November 1997, 24 cases of severe slipped capital femoral epiphysis were treated by an osteotomy that is a modification of the Hungria-Kramer intertrochanteric osteotomy proposed by Sugioka (Hungria-Kramer-Sugioka osteotomy or HKS osteotomy). The degree of displacement as seen on the frog-leg lateral radiograph of the proximal femur was measured according to the deviation of the longitudinal axis of the epiphysis from the center line of the neck (Fish classification). All hips were considered as grade III and underwent HKS osteotomy.