Imaging evaluation of hip capsule disorders: a comprehensive review.

The hip capsule and capsular ligaments play crucial roles in providing hip stability and mobility. Their role in hip pathologies is being increasingly recognized, underscoring the need for thorough imaging evaluation, which is better performed through MRI-arthrography. Various diseases affect the hip capsule directly or indirectly.

The Envelope of Function: Revisiting the Theory With New Concepts-A Narrative Review.

Musculoskeletal injuries are a complex multifactorial phenomenon, and several factors can contribute to their occurrence. This review aimed to discuss some relevant and often unexpected elements involved in musculoskeletal injuries and rehabilitation. One of the main factors discussed is the role of physiological adaptation to training in musculoskeletal injury susceptibility.

Robot-assisted knee arthroplasty: Analyzing the learning curve and initial institutional experience.

Robot-assisted total knee arthroplasty (rTKA) involves a learning curve for orthopedic surgeons. The aim of the present study was to assess the surgical times of rTKA procedures performed by initial stage and proficiency stage surgeons in comparison with times of conventional total knee arthroplasty (cTKA). The results reveal that the learning curve for rTKA varies considerable between surgeons, suggesting that the skill and aptitude of the individual to adapt to the robotic system play key roles in the learning process.

Proximal endoscopic repair of the hamstring tendons: a cadaveric anatomical study of posterior hip portals.

Arthroscopy and endoscopic hip surgery have attracted increasing attention in the orthopedic field. In the case of arthroscopy, portals and their relationships with neurovascular bundle structures at risk are well established. However, studies on endoscopic portals used for the repair of hamstring tendon injuries are insufficient.

Reproducibility of Digital Planning in Cementless Total Hip Arthroplasty Among Experienced and Novice Surgeons.

 The present study aims to assess the reproducibility of digital planning for cementless total hip arthroplasty (THA) among surgeons with different levels of experience. In addition, it attempts to determine the degree of planning reliability based on a contralateral THA or on a spherical marker positioned at the greater trochanter for calibration.  Two evaluators with different experience levels (A1 and A2) performed independently the retrospective digital surgical planning of 64 cementless THAs.

Mentorship in Medical Residency in Orthopedics: Evaluation of a Program by Mentors and Mentees.

 To demonstrate the degree of recommendation of mentors and mentees regarding a mentorship program, to assess the degree of satisfaction of the participants, and to describes the main characteristics of the meetings in pairs.  A primary, retrospective, analytical study based on answers to the annual evaluation questionnaires of the institutional mentorship program in pairs of the Orthopedics and Traumatology residency from December 2017 to February 2021.  We compiled 52 responses from 26 mentorship preceptors and 26 mentored residents.

ETHICAL AND LEGAL ASPECTS OF TELEMEDICINE APPLIED IN ORTHOPEDICS.

Due to the pandemic of COVID-19, many outpatient services were suspended, affecting hundreds of patients. As a result, several countries were forced to seek strategies to readapt their health systems, one of which was the expansion of telemedicine. Currently, telemedicine is used for several specialties, facilitating the treatment and follow-up of patients who have difficulty accessing it.

RADIOGRAPHIC EVALUATION OF OSSEOINTEGRATION OF UNCEMENTED TARGOS® STEMS. A 5-YEAR FOLLOW-UP.

Introduction: Total hip arthroplasty is a widespread treatment and is considered the gold standard in cases of hip osteoarthritis, with high rates of success in improving pain and function when well performed. After five years of follow-up, this study evaluates the osseointegration of uncemented Targos® collared stems in arthroplasties.

Methods: Observational study of 182 total hip arthroplasties performed in 2014 with Targos® cementless collared femoral stems (Lepine).

Cementless Total Hip Arthroplasty in Patients with Osteoarthrosis Secondary to Legg-Calvé-Perthes Disease Compared with Primary Osteoarthrosis: A Case-control Study.

 To perform a comparative clinical, functional and radiographic evaluation of total hip arthroplasty (THA) performed with a cementless prosthesis in cases of osteoarthrosis secondary to Legg-Calvé-Perthes Disease (LCPD) and in cases of primary osteoarthrosis.  In the present case-control study, we reviewed medical records of patients admitted to a university hospital between 2008 and 2015 to undergo THA due to LCPD sequelae and compared them with a control group of patients who underwent the same surgery due to primary hip osteoarthrosis. We recruited patients for clinical, functional, and radiographic analysis and we compared the evaluations in the immediate postoperative period and at the last follow-up visit, considering surgical time, size of prosthetic components, and complications.

FEMORAL HEAD DECOMPRESSION AND GRAFT: TECHNIQUE WITH NEW INSTRUMENTS.

Introduction: Osteonecrosis of the femoral head (ONFH) is a pathology that can be treated with many approaches by the hip surgeon. Advanced decompression is a technique that aims to prevent the collapse of the femoral head and the arthrosis process of the joint, a technique already widespread and used by hip surgeons. In this study, we performed the technique with a new retractable blade and a new bone substitute as graft for the femoral head.

Osteonecrosis of the Femoral Head: Update Article.

Among the pathologies that affect the hip joint, osteonecrosis of the femoral head (ONFH) is probably the most intriguing and challenging. It consists of a multifactorial disease with a highly-variable spectrum in its clinical presentation. It has a devastating effect, due to disabling painful conditions, both for usual activities and sports.

Inter and intra-observer agreement of the 3-dimensional CT based anterior inferior iliac spine classification system shows fair-to-moderate agreement among high volume hip surgeons.

Purpose: The purpose of this multicenter, multinational study is to evaluate the agreement level of the Hetsroni's classification system across high-volume hip surgeons who specialize in hip preservation surgeries.

Methods: Four surgeons from three countries reviewed a digital survey that included 93 3D CT images of the hip from 53 patients. The population was composed of individuals who had undergone a pelvis CT scan in a tertiary hospital between 2000 and 2016.

Effectiveness of Nonoperative Management of Hip Microinstability.

Background: Hip microinstability has recently gained acceptance as a cause of hip pain. In this condition, the femoral head demonstrates increased motion relative to the acetabulum, which may lead to chondrolabral damage. Even though patients are initially prescribed a trial of nonoperative treatment, the success rates of rehabilitation are unknown.

THREE-DIMENSIONAL PRINTING IN ORTHOPEDICS: WHERE WE STAND AND WHERE WE ARE HEADING.

Three-dimensional printing is a technology in expansion in the medical field. It also presents many applications in orthopedics. Our review article aims to describe 3D printing, types of 3D printers, and its use in the orthopedic field.

EPIDEMIOLOGY OF HIP PAIN IN BRAZILIAN BODYBUILDERS.

Objective: To determine the frequency of hip pain in competitive bodybuilders over three different bodybuilding competitions.

Methods: This study evaluated bodybuilders recruited from three competitions during the year of 2016. All participants provided their informed consent and the study received IRB approval.

Evidence-based Risk Stratification for Sport Medicine Procedures During the COVID-19 Pandemic.

Orthopaedic practices have been markedly affected by the emergence of the COVID-19 pandemic. Despite the ban on elective procedures, it is impossible to define the medical urgency of a case solely on whether a case is on an elective surgery schedule. Orthopaedic surgical procedures should consider COVID-19-associated risks and an assimilation of all available disease dependent, disease independent, and logistical information that is tailored to each patient, institution, and region.

Three-Dimensional Printing in Orthopedics: from the Basics to Surgical Applications.

Purpose Of Review: Additive manufacturing (AM) is a rapidly evolving field traditionally utilized in non-medical industries. Recently, the medical use of AM is expanding, especially in orthopedics. The goal of this article is presenting the principles of AM and its main applications in orthopedics.

Femoroacetabular Impingement and Acetabular Labral Tears - Part 3: Surgical Treatment.

In the last 15 years, the diagnosis of femoroacetabular impingement has become more frequent; with the advance of surgical indications, different techniques have been developed. Surgical treatment includes a wide variety of options, namely: periacetabular osteotomy, surgical hip dislocation, arthroscopy with osteochondroplasty via a small incision, modified anterior approach technique, and exclusively arthroscopic technique. The type of approach should be chosen according to the complexity of the morphology of the femoroacetabular impingement and to the surgeon's training.

Femoroacetabular Impingement and Acetabular Labral Tears - Part 1: Pathophysiology and Biomechanics.

Femoroacetabular impingement (FAI) is an important cause of hip pain, and the main etiology of hip osteoarthritis in the young population. Femoroacetabular impingement is characterized by subtle alterations in the anatomy of the acetabulum and proximal femur, which can lead to labrum tearing. The acetabular labrum is essential to the stability of the hip joint.

Nonoperative Treatment of Psoas Tendon Avulsion in a Professional Athlete: A Case Report and Evidence Based Review.

Case: A 36-year-old male professional soccer player sustained an acute left hip injury during a tournament game while defending the goal. Magnetic resonance imaging demonstrated a complete avulsion of the iliopsoas tendon from the left trochanter. The patient was treated nonoperatively, and after 10 weeks, he was able to return to full activity.

Multiple deep tissue cultures in primary total hip arthroplasty: prognostic value for periprosthetic infection.

Background: The risk of infection after total hip replacement (THR) is significant, with negative impact on quality of life and high costs. Bacteria can contaminate the surgical site despite aseptic techniques; however, there is debate regarding the benefit of identifying bacteria during the primary procedure. Although taking multiple samples for culture is a well-established practice in revision arthroplasty, doing so in primary cases remains controversial.

Contributions of the Capsule and Labrum to Hip Mechanics in the Context of Hip Microinstability.

Background: Hip microinstability and labral pathology are commonly treated conditions with increasing research emphasis. To date, there is limited understanding of the biomechanical effects of the hip capsule and labrum on controlling femoral head motion.

Purpose/hypothesis: The purpose of this study was to determine the relative role of anterior capsular laxity and labral insufficiency in atraumatic hip microinstability.

The Role of Anterior Capsular Laxity in Hip Microinstability: A Novel Biomechanical Model.

Background: Hip microinstability is an increasingly recognized source of hip pain and disability. Although the clinical entity has been well described, the pathomechanics of this disease remain poorly understood.

Purpose/hypothesis: The purpose of this study was to determine the role of capsular laxity in atraumatic hip microinstability.

Arthroscopic bullet removal from the hip joint and concurrent treatment of associated full-thickness chondral defects: A case report.

The diagnosis of a bullet inside the hip joint is a rare finding. The usual method to treat this condition has been open surgery, with its associated complications and morbidity. The arthroscopic approach has been increasingly utilized for the diagnosis and treatment of several hip conditions, and the number of indications for this technique has been steadily rising.

INCISIONAL NEGATIVE-PRESSURE WOUND THERAPY IN REVISION TOTAL HIP ARTHROPLASTY DUE TO INFECTION.

Objective: To present our institution's experience with negative-pressure wound therapy (NPWT) as an adjuvant in wound healing of patients who have undergone revision total hip arthroplasty (THA) due to septic loosening in the presence of active fistula.

Methods: We prospectively assessed patients presenting with THA infection, associated with the presence of fistula, treated with a PICO device for NPWT, in combination with the standard treatment for prosthesis infection in our institution. Resolution of the infectious process and healing of the surgical wound without complications were considered an initial favorable outcome.