Bikini Incision Modification of the Direct Anterior Approach.

Background: Although the direct anterior approach (DAA) represents an intermuscular and internervous approach to total hip arthroplasty (THA), it did not reach global acceptance until its adoption by large teaching centers. Today, >50% of primary THA procedures in Switzerland are performed via the DAA. Besides being truly minimally invasive, a key advantage of the DAA is the inherent stability that it provides.

Mid-term results of autologous matrix-induced chondrogenesis for large chondral defects in hips with femoroacetabular impingement syndrome.

Aims: The purpose of this study was to evaluate the mid-term outcomes of autologous matrix-induced chondrogenesis (AMIC) for the treatment of larger cartilage lesions and deformity correction in hips suffering from symptomatic femoroacetabular impingement (FAI).

Methods: This single-centre study focused on a cohort of 24 patients with cam- or pincer-type FAI, full-thickness femoral or acetabular chondral lesions, or osteochondral lesions ≥ 2 cm, who underwent surgical hip dislocation for FAI correction in combination with AMIC between March 2009 and February 2016. Baseline data were retrospectively obtained from patient files.

Isolating factors for the prediction of rebound after guided growth with tension band plating for the valgus deformity of the knee.

Purpose: The conditions leading to growth rebound after hemiepiphysiodesis are still poorly understood. This article analyzes the radiographical outcomes after guided growth with tension band plating, using plates in idiopathic genu valgum patients and attempts to generate a predictive model of growth rebound.

Methods: Patients with idiopathic genu valgum deformity who received tension band plating were selected for evaluation.

Impact of capsular preservation on patient-reported outcomes and complication rates in total hip arthroplasty using the direct anterior approach.

Aims: It is not known whether preservation of the capsule of the hip positively affects patient-reported outcome measures (PROMs) in total hip arthroplasty using the direct anterior approach (DAA-THA). A recent randomized controlled trial found no clinically significant difference at one year postoperatively. This study aimed to determine whether preservation of the anterolateral capsule and anatomical closure improve the outcome and revision rate, when compared with resection of the anterolateral capsule, at two years postoperatively.

FGF-2-dependent signaling activated in aged human skeletal muscle promotes intramuscular adipogenesis.

Aged skeletal muscle is markedly affected by fatty muscle infiltration, and strategies to reduce the occurrence of intramuscular adipocytes are urgently needed. Here, we show that fibroblast growth factor-2 (FGF-2) not only stimulates muscle growth but also promotes intramuscular adipogenesis. Using multiple screening assays upstream and downstream of microRNA (miR)-29a signaling, we located the secreted protein and adipogenic inhibitor SPARC to an FGF-2 signaling pathway that is conserved between skeletal muscle cells from mice and humans and that is activated in skeletal muscle of aged mice and humans.

Pelvic Chondrosarcoma Treated by En Bloc Resection with Patient-Specific Osteotomy Guides and Reimplantation of the Extracorporeally Irradiated Bone as an Osseocartilaginous Structural Orthotopic Autograft: A Report of Two Cases with Description of the Surgical Technique.

Primary tumors of the pelvis are considered difficult to treat due to the complex anatomy and the proximity of important neurovascular structures. The surgical armamentarium for the treatment of these tumors has evolved with the help of cutting-edge technology from debilitating hemipelvectomies to solutions such as precise resections guided by patient-specific instruments or computer navigation and reconstruction by modular prostheses, 3D-printed custom-made implants, or orthotopic autograft reimplantation after extracorporeal irradiation. Different combinations of these techniques have been described in the literature with various rates of success.

The trochanteric double contour is a valuable landmark for assessing femoral offset underestimation on standard radiographs: a retrospective study.

Background: Inaccurate projection on standard pelvic radiographs leads to the underestimation of femoral offset-a critical determinant of postoperative hip function-during total hip arthroplasty (THA) templating. We noted that the posteromedial facet of the greater trochanter and piriformis fossa form a double contour on radiographs, which may be valuable in determining the risk of underestimating femoral offset. We evaluate whether projection errors can be predicted based on the double contour width.

Ligamentum Teres Impingement in Valgus Impacted Femoral Neck Fracture: A Case for Hip Arthroscopy.

Case: Seven years after hip arthroscopy for cam impingement, a 47-year-old female patient suffered a valgus impacted femoral neck fracture of her left hip that was stabilized with cannulated screws. After fracture healing, she experienced persisting sharp groin pain that could be elicited in flexion/internal rotation and extension/adduction. We suspected a ligamentum teres impingement at the border of the acetabular fossa due to a post-traumatic fovea alta and performed an arthroscopic ligament resection.

Unrecognized Chondrosarcoma as a Cause of Total Hip Arthroplasty Failure.

Background: Total hip arthroplasty (THA) is one of the most successful procedures in orthopedic surgery. The most frequent THA indications are osteoarthritis and avascular necrosis, whereas symptomatic aseptic loosening is the most common indication to revision surgery. Chondrosarcoma (CS) is the most frequent bone sarcoma in adults, and proximal femur is the most prevalent location.

The Impact of Heterotopic Ossification on Self-Reported Outcomes After Total Hip Arthroplasty Using the Direct Anterior Approach.

Background: Heterotopic ossification (HO) is a known finding after total hip arthroplasty (THA) that potentially affects clinical outcomes. The incidence of HO is related to various factors, including soft-tissue trauma, postoperative medication, surgical approach, and the surgeon's experience. Because use of the direct anterior approach (DAA) is gaining popularity, we aimed (1) to determine the incidence of HO after DAA-THA and (2) to evaluate the impact of HO on patient-reported outcomes (PROs).

Oncological outcome, functional results and costs after unplanned excision of musculoskeletal soft tissue sarcoma.

Background: Treatment of soft tissue sarcomas (STS) should only be initiated once the diagnosis is fully established. Resection of tumors of unknown nature should be avoided. Nevertheless, specialized centers continue to face numbers of unplanned excisions (UPE) in STS.

MRI with state-of-the-art metal artifact reduction after total hip arthroplasty: periprosthetic findings in asymptomatic and symptomatic patients.

Objectives: To assess the spectrum of periprosthetic MRI findings after primary total hip arthroplasty (THA).

Methods: This multi-center cohort study analyzed 31 asymptomatic patients (65.7 ± 12.

Percutaneous image-guided cryoablation of painful bone metastases: A single institution experience.

Background: Bone metastases are frequently painful and may lead to various complications that can affect quality of life. While external beam radiation therapy is the standard first-line treatment, 20-30% of patients do not experience sufficient pain relief. Cryoablation is increasingly being used for the treatment of musculoskeletal metastases.

The external obturator footprint as a landmark in total hip arthroplasty through a direct anterior approach: a CT-based analysis.

Background:: Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known.

Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty.

Background: Anatomical reconstruction in total hip arthroplasty (THA) allows for physiological muscle function, good functional outcome and implant longevity. Quantitative data on the effect of a loss or gain of femoral offset (FO) are scarce. The aim of this study was to quantitatively describe the effect of FO changes on abductor moment arms, muscle and joint reactions forces.

[Sarcoma centres : a necessary tool in the management of patients and for research.].

Sarcomas are rare diseases, the treatment of which requires an appropriate technical plateform and a broad spectrum of multidisciplinary specialists. Many are initially treated by unplanned excision, and then referred to specialized centres. Secondary treatments may lead to higher complication rates and local recurrence, with lower functional outcome, life quality and possibly overall survival.

Effect of a collar on subsidence and local micromotion of cementless femoral stems: in vitro comparative study based on micro-computerised tomography.

Purpose: The aim of this study is to quantitatively compare the difference in primary stability between collarless and collared versions of the same femoral stem. Specifically, we tested differences in subsidence and micromotion.

Methods: Collarless and collared versions of the same cementless femoral stem were implanted in two groups of six fresh-frozen cadaveric femurs.

Impact of individual anatomy on the benefit of cup medialisation in total hip arthroplasty.

Introduction: In total hip arthroplasty, cup medialisation with compensatory increase of femoral offset has been proposed to increase the moment arms of abductor muscles. However, this technique is associated with a loss of acetabular bone stock. Previous data indicates that the potential benefit is not constant among patients and is likely related to patient anatomy.

Trans-foveal approach for curettage and bone grafting of a giant cell tumour in the femoral head.

Background: Surgical access to benign neoplastic lesions of the femoral head are associated with significant morbidity, including contamination of intra-osseous access tracks, articular cartilage lesions, avascular bone necrosis or tumour recurrence due to incomplete curettage.

Case Presentation: We present a case of a 20-year-old female with a giant cell tumour in the femoral head, which was treated with curettage through a trans-foveal approach and bone grafting. This technique includes a surgical dislocation of the hip with trochanteric osteotomy.

Systemic Metal Ion Levels in Patients With Modular-Neck Stems: A Prospective Cohort Study.

Background: Recent registry data reveal that modular-neck hip prostheses are associated with increased revision rates compared to fixed-neck stems. Poor implant survival has been associated to corrosion at the neck-stem junction, inducing metal ion release and subsequently adverse local tissue reactions. Data on metal ion release on the neck-stem junction of such stems are scarce.

Impact of the Femoral Head Position on Moment Arms in Total Hip Arthroplasty: A Parametric Finite Element Study.

Background: Although the importance of accurate femoral reconstruction to achieve a good functional outcome is well documented, quantitative data on the effects of a displacement of the femoral center of rotation on moment arms are scarce. The purpose of this study was to calculate moment arms after nonanatomical femoral reconstruction.

Methods: Finite element models of 15 patients including the pelvis, the femur, and the gluteal muscles were developed.