Change of joint line convergence angle and other coronal alignments after total hip arthroplasty.

Background: The purpose of this study was to determine the unloading effect of total hip arthroplasty (THA) on the ipsilateral knee joint through the joint line convergence angle (JLCA) change and determine the changes in other coronal radiographic parameters after THA, and evaluate the sensitivity of JLCA.

Patients And Methods: We retrospectively assessed 70 patients who underwent unilateral THA. Hip parameters such as neck shaft angle (NSA), neck length, and femoral offset and coronal alignment parameters of the lower extremity such as hip-knee-ankle angle (HKA), femur length, mechanical lateral distal femoral angle (mLDFA), JLCA, medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), and plafond talus angle (PTA) were measured in the operative and non-operative sides.

Periprosthetic occult acetabular fracture: an unknown side effect of press-fit techniques in primary cementless total hip arthroplasty.

Background: This study sought to investigate the prevalence and risk factors of periprosthetic occult acetabular fracture occurring during cementless acetabular cup insertion in patients undergoing primary total hip arthroplasty (THA) and to assess the clinical consequences of these fractures.

Methods: A total of 232 hips (n = 205 patients) were included in this study. A periprosthetic occult acetabular fracture was defined as that which was unrecognised intraoperatively and was undetectable on post-operative radiographs yet was successfully diagnosed on post-operative computed tomography (CT) images.

Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved?

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA.

Occult periprosthetic femoral fractures occur frequently during a long, trapezoidal, double-tapered cementless femoral stem fixation in primary THA.

The present study aimed to investigate the prevalence and clinical consequences of occult intra-operative periprosthetic femoral fractures in total hip arthroplasty (THA). Between 2012 and 2017, a total of 113 primary THAs were enrolled. The mean age of the patients was 66.

Differentiating Nutrient Artery Canals of the Femur versus Fracture Lines in Patients with Total Hip Arthroplasty on Plain Radiographs.

Background: Nutrient artery canals of the femur are often visible on plain radiographs as radiolucent lines which may mimic fracture lines. The purpose of this study was to distinguish nutrient artery canals from fracture lines on plain radiographs.

Materials And Methods: Ninety-three patients (102 hips) with an average age of 65.

Effect of pelvic tilt and rotation on cup orientation in standing anteroposterior radiographs.

Background: Individual pelvic tilt and rotation have wide variability that can affect the measurement of cup orientation in anteroposterior (AP) radiographs. The purpose of this study was to analyse the effect of pelvic tilt and rotation on radiographic measurements of cup orientation.

Methods: A total of 53 patients (63 hips) were included in this study.

The Safe Zone Range for Cup Anteversion Is Narrower Than for Inclination in THA.

Background: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA.

Changes in coronal alignment of the ankle joint after high tibial osteotomy.

Purpose: The purpose of this study was to investigate changes in coronal alignment of the ankle joint after HTO. Our hypothesis was that ankle joint orientation may become more parallel or less parallel to the ground after HTO, and this change may affect ankle symptoms.

Methods: Eighty-six knees were retrospectively analysed after HTO for varus osteoarthritis.

Use of auxiliary locking plates for the treatment of unstable pertrochanteric femur fractures.

Pertrochanteric femur fractures are successfully treated by orthopedic surgeons worldwide, but maintaining the reduction status or fixation of the greater trochanter is sometimes difficult in unstable cases in elderly patients. Several biomechanical advantages have been reported in locking plates when compared with conventional plates; locking plates provide angular and axial stability, better rigidity, and no toggling, and they preserve periosteal blood supply. The authors describe the use of auxiliary locking plates in unstable pertrochanteric femur fractures in elderly patients.

Navigated Acetabular Cup Fixation for Acetabular Deformity or Revision Total Hip Arthroplasty.

Purpose: To evaluate the usefulness of navigated acetabular cup fixation for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty.

Materials And Methods: This study enrolled 28 patients with at least 12 months' follow-up. The safe zone of the acetabular cup was defined as 40°±10°in inclination and 15°±10°in anteversion.

Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment.

Characterization of progression of pelvic osteolysis after cementless total hip arthroplasty: computed tomographic study.

A retrospective analysis of 63 primary total hip arthroplasty cases was done using repeated computed tomography scans to evaluate the pelvic osteolytic lesions in early stage. The progression rate of osteolysis of hips with small osteolytic volume less than 766.97 mm(3) in initial CT was 85.

Fifteen-year results of precoated femoral stem in primary hybrid total hip arthroplasty.

Background: There has been controversy whether methylmethacrylate precoating of the cemented femoral stem is a solution for aseptic loosening or rather contributes to increased failure rates in cemented total hip arthroplasties.

Methods: On a retrospective basis, we analyzed 76 primary hybrid total hip arthroplasties from 63 patients with precoated, cemented femoral stems between October 1990 and December 1995. The mean age of the patients was 46.

A validation study for estimation of femoral anteversion using the posterior lesser trochanter line: an analysis of computed tomography measurement.

The aim of this study was to introduce a simple and reliable intraoperative reference guide to reproduce the normal femoral anteversion during total hip arthroplasty (THA). We hypothesized that the posterior lesser trochanter line (PLTL) could be a useful guide for estimating femoral anteversion during THA. We conducted a study of 56 men (112 hips) to evaluate the relationship between the PLTL and the femoral anteversion using computed tomography scans.

Rapidly destructive arthropathy of the hip joint in patients with rheumatoid arthritis.

This article describes 3 patients with rheumatoid arthritis in which hip joint conditions were similar to rapidly destructive arthropathy of the hip joint. The patients had the following additional characteristics: (1) age at diagnosis was comparatively older; (2) rheumatoid arthritis had an onset after age 40 years; (3) severe rheumatoid arthritis was present in >4 major joints; (4) long-term steroids and disease-modifying antirheumatic drugs were taken due to the high activity of rheumatoid arthritis; and (5) patients were underweight, with body mass indexes <20 kg/m(2).Rapidly destructive arthropathy of the hip joint rarely occurs in osteoarthritis, avascular necrosis of the femoral head, and rheumatoid arthritis.

The use of the posterior lesser trochanter line to estimate femoral neck version: an analysis of computed tomography measurements.

We hypothesized that the lesser trochanter could be a useful guide for estimating femoral component version during total hip arthroplasty. We conducted a study of 88 patients to evaluate the relationship between the posterior lesser trochanter line (PLTL) and the femoral neck axis (FNA) using computed tomographic scans. The mean angle between the PLTL and the FNA was 17.

Reliability of a PowerPoint method for wear measurement after total hip arthroplasty: a retrieval study using 3-dimensional laser scanning.

The purpose of this study was to evaluate the reliability of the PowerPoint (PP) (2007 Version; Microsoft, Redmond, Wash) method for measuring polyethylene liner wear after total hip arthroplasty. Seventeen retrieved polyethylene liners were included in this study. Wear volumes were calculated using the PP, the Dorr and Wan, and 3-dimensional (3D) laser scanning methods.

Importance of independent measurement of width and length of lateral meniscus during preoperative sizing for meniscal allograft transplantation.

Background: Successful meniscus transplantation depends on an accurate sizing of the meniscal allograft. Although accurate sizing of the meniscal allograft is crucial during meniscus transplantation, the accuracy of meniscal measurement methods is still in debate.

Purpose: This study was undertaken to evaluate the relationship between the width and length of the lateral meniscus.

Relationship between the pelvic osteolytic volume on computed tomography and clinical outcome in patients with cementless acetabular components.

The purpose of this study was to evaluate the relationship between the pelvic osteolytic volume on computed tomography (CT) and clinical outcome in patients with cementless acetabular components. We reviewed 87 patients (104 hips) who met the following inclusion criteria: (1) there was evidence of pelvic osteolysis on CT at a minium of five years postoperatively, (2) all cups and stems were radiographically stable at the time of CT, (3) the follow-up period after CT was a minimum of two years clinically. The mean pelvic osteolytic volume was 2.

Femoral stem displacement during closed reduction of a dislocated bipolar hemiarthroplasty of the hip.

This article describes a case of femoral stem displacement during closed reduction of a redislocated bipolar hemiarthroplasty of the hip in a 72-year-old woman who had undergone bipolar hemiarthroplasty using a polished, tapered cemented femoral stem. The polished, tapered cemented femoral stem is vulnerable to displacement when exposed to traction forces. Six days after bipolar hemiarthroplasty, the patient experienced her first dislocation, and immediate reduction of the dislocated hip was easily achieved.

Use of slide presentation software as a tool to measure hip arthroplasty wear.

The authors propose a manual measurement method for wear in total hip arthroplasty (PowerPoint method) based on the well-known Microsoft PowerPoint software (Microsoft Corporation, Redmond, Wash). In addition, the accuracy and reproducibility of the devised method were quantified and compared with two methods previously described by Livermore and Dorr, and accuracies were determined at different degrees of wear. The 57 hips recruited were allocated to: class 1 (retrieval series), class 2 (clinical series), and class 3 (a repeat film analysis series).

Treatment of femoroacetabular impingement with surgical dislocation.

Background: The authors report the results of femoroacetabular impingement (FAI) treated with a surgical dislocation.

Methods: From April 2005 to May 2007, 15 FAI hips were treated with a surgical dislocation. The male/female ratio, mean age and mean symptom duration was 12/2, 35.