Operative findings and complications associated with adjunctive hip arthroscopy in 95 hips undergoing periacetabular osteotomy.

Purpose: to report our initial experience with adjunctive hip arthroscopy and periacetabular osteotomy (PAO).

Methods: Retrospective review of patients who underwent PAO and ipsilateral hip arthroscopy between 2003 and 2013. Indications for arthroscopy were mechanical symptoms and/or positive magnetic resonance imaging to suggest intra-articular pathology including chondrolabral lesions, ligamentum teres tears and hypertrophy, and synovitis.

Economic Impact of Orthopedic Adult Reconstruction Office Practice: The Implications of Hospital Employment Models on Local Economies.

The purpose of this study was to evaluate the economic attributes of private practice adult reconstruction (AR) offices. 458 AAHKS surgeons responded; 65% were in private practice (fee-for-service, non-salaried, non-employed AR surgeons). 54% had considered hospital employment in the past two years.

Combined arthroscopic and modified open approach for cam femoroacetabular impingement: a preliminary experience.

Purpose: We report our case series of patients undergoing surgical treatment (femoral osteoplasty) for symptomatic cam femoroacetabular impingement (FAI). Clinical results using a modified Heuter anterior approach combined with adjunctive hip arthroscopy are presented.

Methods: A chart review of 16 hips (14 consecutive patients) was conducted.

Pelvic and femoral osteotomy in the treatment of hip disease in the young adult.

Osteotomies of the pelvis and upper femur play a useful and enduring role in the overall management of posttraumatic and developmental conditions of the hip. Rotational osteotomies of the pelvis have supplanted intertrochanteric osteotomies for treatment of most dysplasia-related conditions. In particular, the Bernese (Ganz) periacetabular osteotomy with lateral muscle sparing has emerged as the most effective and widely used pelvic osteotomy.

Does neck/liner impingement increase wear of ultrahigh-molecular-weight polyethylene liners?

We explore the hypothesis that repetitive impingement increases wear of ultrahigh-molecular-weight polyethylene inserts. During revision total hip arthroplasty, 113 acetabular components were retrieved and examined for impingement, backside wear, and articular wear. Sixty percent of acetabular liners showed evidence of prosthetic impingement, with moderate or severe damage to the rim in 32%.

The role of acetabular and femoral osteotomies in reconstructive surgery of the hip: 2005 and beyond.

Femoral and acetabular osteotomies have enduring and useful roles in the ongoing surgical treatment of patients with various hip conditions. The classic indication for intertrochanteric valgus osteotomy is to induce healing of femoral neck nonunions. Additional indications include posttraumatic deformity, limb-length inequality, certain cases of osteonecrosis, and adult sequelae of Legg-Calve-Perthes disease, and slipped capital femoral epiphysis.

Intertrochanteric femoral osteotomies for developmental and posttraumatic conditions.

Despite the numerous advances in technology and techniques for total hip arthroplasty, this surgery is often not the procedure of choice for all patients or for all hip conditions. Originally described as a treatment for femoral neck nonunions, the intertrochanteric femoral osteotomy retains an enduring role in the treatment of various posttraumatic and developmental hip conditions including femoral neck nonunions, iatrogenic or postsurgical deformities, leg-length inequality, osteonecrosis, slipped capital femoral epiphysis, deformities occurring after Legg-Calvé-Perthes desease, and for certain patients with dysplasia and secondary arthritis. By correcting deformity (either acquired or developmental), the intertrochanteric osteotomy can restore a more normal biomechanical geometry to the hip joint, which can increase the likelihood of improved longevity of the articulation.

An analysis of orthopaedic liability in the acute care setting.

The risk of litigation in the emergency room is not directly proportional to the severity of injury. In fact, the risk of initiation of legal action is greater in cases of relatively modest permanent and partial disability. In these cases, failure to obtain and document informed consent, failure to effectively communicate with the patient and family, and failure to assure followup and prompt assessment of complications are the factors that have most frequently led to litigation.