Soft Tissue Cam Impingement in Adolescents: MRI Reveals Impingement Lesions Underappreciated on Radiographs.

Background: Femoroacetabular impingement (FAI) has been described as repetitive and abnormal contact between a structurally abnormal proximal femur (cam) and/or acetabulum (pincer), occurring during the terminal range of motion of the hip. While cam and pincer lesions have traditionally been defined as osseous abnormalities, there may be a subset of adolescent patients whose impingement is primarily soft tissue (nonosseous). The existence of a nonosseous cam lesion in adolescents with FAI has not been well described.

Excellent 20-Year Results of Total Hip Arthroplasty With Highly Cross-Linked Polyethylene on Cobalt-Chromium Femoral Heads in Patients ≤50 Years.

Background: Highly cross-linked polyethylene (HXLPE) acetabular bearing surfaces have appeared to offer excellent wear resistance, low incidence of wear-related osteolysis, and high implant survivorship at 10-year to 15-year follow-up. However, concerns over potential performance deterioration at longer-term follow-up remain - particularly in younger patients - and outcome data into the third decade have not been available.

Methods: We retrospectively assessed 62 patients (68 hips) who underwent primary total hip arthroplasty (THA) at age ≤50 years with a single manufacturer's cementless components, remelted HXLPE liner, and small diameter (26 and 28 millimeter) cobalt-chromium (CoCr) femoral heads at minimum 18-year follow-up.

Total Hip Arthroplasty in Patients with Bilateral Upper-Limb Amelia: A Report of 2 Cases.

Case: We report two patients, a 43-year-old man and a 26-year-old woman, with bilateral absence of the upper extremity and severe hip osteoarthritis. The involved hip was the dominant extremity for both patients. Total hip arthroplasty (THA) was performed using a posterior approach with dual-mobility implants.

Ankylosing spondylitis substantially increases health-care costs and length of hospital stay following total hip arthroplasty - National in-patient database study.

Introduction: The outcome following major arthroplasty surgeries in patients with ankylosing spondylitis (AS) has tremendously improved over the past decades, due to substantial amelioration in the medical therapies and sophistication of available surgical modalities. Although various studies have already demonstrated the complication rates and challenges faced in AS patients undergoing THA, there is a substantial paucity of data on the actual healthcare burden associated with this disease, and the diverse factors which may affect it.

Methods: Using the National Inpatient Sample (NIS) database (on the basis of ICD-10 CMP codes), patients undergoing THA between the years 2016 and 2019 were identified.

Mean 16-Year Results of Total Hip Arthroplasty With Alumina Ceramic Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50 Years or Less.

Background: Highly cross-linked polyethylene (HXLPE) is a widely used bearing surface in total hip arthroplasty (THA); long-term results in young patients are limited. We previously demonstrated excellent results in HXPLE on cobalt-chrome femoral heads at 15-year mean follow-up. The purpose of the present study was to investigate polyethylene wear rates, implant survivorships, wear-related revisions, and patient-reported outcomes (PROs) in a young patient cohort who had alumina ceramic on HXPLE coupling at an average 16-year follow-up.

Radiographic Predictors of Reoperation in Adolescents Undergoing Hip Preservation Surgery for Femoroacetabular Impingement.

Background: Femoroacetabular impingement (FAI) is a condition caused by repetitive abutment of a morphologically abnormal proximal femur and/or acetabulum that may result in chondral and labral pathology. An understanding of radiographic parameters associated with successful primary surgery has not been well established.

Purpose: To determine preoperative radiographic parameters that predict reoperation for FAI and correlate radiographic measurements with outcomes in these patients.

Review of patient-reported outcomes in periprosthetic distal femur fractures after total knee arthroplasty: a plate or intramedullary nail?

Purpose: This study reviewed the literature regarding the patient-reported treatment outcomes of using either open reduction and internal fixation (ORIF) with a plate and screw system or intramedullary nail (IMN) fixation for periprosthetic distal femur fractures around a total knee arthroplasty.

Methods: A total of 13 studies published in the last 20 years met the inclusion criteria. The studies included 347 patients who were allocated to ORIF (n = 249) and IMN (n = 98) groups according to the implants used.

Complications of primary total hip arthroplasty in human immunodeficiency virus-positive patients with femoral head osteonecrosis.

Background: Femoral head osteonecrosis (FHON) is a well-recognised complication in patients with human immunodeficiency virus (HIV) infection. Total hip arthroplasty (THA) is a reliable solution to FHON and has provided functional improvement and pain relief in these patients. Higher complication rates, in particular infections, have been reported in the series of THAs done in the HIV-positive patients.

The Association of α Angle on Disease Severity in Adolescent Femoroacetabular Impingement.

Background: Femoroacetabular Impingement (FAI) is a common cause of hip pain in adolescent patients. Clinical exam and radiographic markers, such as α angle and lateral center edge angle (LCEA), are commonly used to aid in the diagnosis of this condition. The purpose of this study was to correlate preoperative α angle and LCEA with preoperative symptoms, intraoperative findings, and preoperative and postoperative patient reported outcomes (PROs) in the adolescent patient.

Patient-Related Risk Factors Associated With Surgical Site Complications After Elective Hand Surgery.

Background: The purpose of this study was to identify independent risk factors associated with an increased rate of surgical site complications after elective hand surgery.

Methods: This study is a retrospective review of all patients who underwent elective hand, wrist, forearm, and elbow surgery over a 10-year period at a single institution. Electronic medical records were reviewed, and information regarding patient demographics, past medical and social history, perioperative laboratory values, procedures performed, and surgical complications was collected.

Use of an Extensile Posterior Approach to the Elbow Joint: Early Results of the Anconeus Approach.

Commonly used surgical approaches to the elbow typically limit the surgeon to either medial or lateral exposure, can provide visualization limited by an intact radial head, and may not be extensile. We describe the use of a well recognized, but uncommonly used, extensile approach to the medial and lateral compartments of the elbow joint. This approach provides access to address pathology of the proximal radius, ulna, and the distal humerus and can be made extensile both proximally and distally.