Total hip arthroplasty in osteonecrosis secondary to sickle cell disease.

Background: Sickle cell disease (SCD) is a multisystem disease, and the predominant articular manifestation is osteonecrosis (ON). Total hip arthroplasty (THA) is technically challenging, and the complication rates are high. In this retrospective study, we have analysed the outcome of THA in a cohort of patients with SCD at our institution.

Predicting the underestimation of the femoral offset in anteroposterior radiographs of the pelvis using 'lesser trochanter index': a 3D CT derived simulated radiographic analysis.

We developed 'lesser trochanter index' (LTI) and estimated its accuracy in predicting the underestimation of offset in the anteroposterior (AP) pelvic radiographs. We reconstructed 320 simulated radiographs from the CT scans of 40 adult hips at different rotational projections of 10° increments from 30° internal rotation to 40° external rotation. Underestimation of femoral offset as a percentage was derived from the neck profile angle for all radiographs.

The prevalence of cam-type femoroacetabular morphology in young adults and its effect on functional hip scores.

Pelvic computed tomography (CT) scans of forty five young adults were reviewed and the alpha angle was calculated. The patients were selected on the basis of an age of less than 40 years and the absence of any CT evidence of previous hip pathology. An alpha angle of >55º was considered positive for cam morphology.

Morphologic features of congenital acetabular dysplasia: one in six is retroverted.

It generally is thought that in congenital hip dysplasia, the opening of the acetabulum lies in excessive anteversion from the sagittal plane. Although this is true for the majority of patients, we found that one in six patients with acetabular dysplasia has retroversion in which the superior 1/3 of the acetabulum faces posterolaterally. Our method of analysis depends mainly on one true orthograde view of the pelvis.