After disastrous outcomes due to wear-induced osteolysis in the 1980s, hip resurfacing arthroplasty has undergone a renaissance, mainly because of the introduction of metal-on-metal bearings. However, there are still problems associated with this technique, such as femoral neck fractures, neck thinning, and aseptic loosening, and their causes are still being investigated. During the last years, increasing evidence has shown that both the frequently used posterior approach to the hip as well as preparation of the femoral epiphysis can impair blood supply to the femoral head. In the presence of mechanical stresses (impaction, heat development during cement polymerization) during the implantation, the epiphysis might not be able to compensate for this. This paper summarizes the current understanding of the blood supply to the femoral head and proposes a way to preserve the viability after hip resurfacing.
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http://dx.doi.org/10.1007/s00132-008-1300-y | DOI Listing |
J Orthop Surg Res
January 2025
Department of Hand-Foot Microsurgery, Shenzhen Nanshan People's Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.
Background: Steroid-induced osteonecrosis of the femoral head (SIONFH) is a universal hip articular disease and is very hard to perceive at an early stage. The understanding of the pathogenesis of SIONFH is still limited, and the identification of efficient diagnostic biomarkers is insufficient. This research aims to recognize and validate the latent exosome-related molecular signature in SIONFH diagnosis by employing bioinformatics to investigate exosome-related mechanisms in SIONFH.
View Article and Find Full Text PDFCalcif Tissue Int
January 2025
Department of Pharmacology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan.
Hypophosphatasia (HPP) is a congenital bone disease caused by tissue-nonspecific mutations in the alkaline phosphatase gene. It is classified into six types: severe perinatal, benign prenatal, infantile, pediatric, adult, and odonto. HPP with femoral hypoplasia on fetal ultrasonography, seizures, or early loss of primary teeth can be easily diagnosed.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan.
Case: We present 3 cases demonstrating radiographic posterior subluxation in lateral functional radiographs taken in the flexed-seated position. Two of the patients were asymptomatic, and 2 showed the posterior translation of the femoral head, which is almost a dislocation, with spontaneous reduction. The subluxation can occur not only in patients after lumbar fusion surgery but also in patients with relatively normal lumbar spine due to excessive hip flexion.
View Article and Find Full Text PDFActa Orthop
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
Background And Purpose: Computed tomography radiostereometric analysis (CT-RSA) assesses implant micromovements using low-dose CT scans. We aimed to investigate whether CT-RSA is comparable to marker-based radiostereometric analysis (RSA) measuring early femoral head migration in cemented stems. We hypothesized that CT-RSA is comparable to marker-based RSA in evaluating femoral head subsidence.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Department of Orthopaedic Surgery, University of California Irvine, Orange, California, U.S.A.
Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN.
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