Internal hip rotation in cerebral palsy (CP) is typically treated with a femoral derotation osteotomy. This has been shown to be largely a successful procedure but recurrence rates up to 41% have been reported. Reported risk factors include younger age, reduced hip joint impulse and ankle plantar-flexion. We report on two patients with bilateral CP demonstrating recurrent unilateral internal hip rotation despite surgical intervention(s). Both demonstrate a number of the reported risk factors for recurrence. In addition, this case report specifically compared gait kinematic patterns pre and post recurrence. On comparing both patient's hip rotation and ankle dorsi/plantarflexion kinematics they are seen to be almost identical both pre-operatively and post-operatively. Both patients appear to revert to approximately 30 of internal hip rotation which has been shown to maximise hip abductor function. Therefore, this case report suggests that surgical derotation in isolation is unlikely to be successful in this group and we suggest that this hip and ankle pattern may help predict recurrence in unilateral internal hip rotation.
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http://dx.doi.org/10.12688/hrbopenres.12893.2 | DOI Listing |
Clin Orthop Relat Res
December 2024
Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.
Background: Patients with transfemoral amputation experience socket-related problems and musculoskeletal overuse injuries, both of which are exacerbated by asymmetric joint loading and alignment. Bone-anchored limbs are a promising alternative to treat chronic socket-related problems by directly attaching the prosthesis to the residual limb through an osseointegrated implant; however, it remains unknown how changes in alignment facilitated through a bone-anchored limb relate to loading asymmetry.
Questions/purposes: What is the association between femur-pelvis alignment and hip loading asymmetry during walking before and 12 months after transfemoral bone-anchored limb implantation?
Methods: Between 2019 and 2022, we performed 66 bone-anchored limb implantation surgeries on 63 individuals with chronic socket-related problems.
World J Orthop
December 2024
Department for Science, Dubai College, Dubai 00000, Dubayy, United Arab Emirates.
Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons. These patients are typically younger and have greater functional demands. Therefore, achieving optimal biomechanical conditions is crucial, involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length.
View Article and Find Full Text PDFJ Exp Orthop
January 2025
Purpose: Non-contact anterior cruciate ligament (ACL) injuries are influenced by the anatomic and biomechanical characteristics of the lower limb. The combination of knee valgus, hip internal rotation and tibial external rotation are important contributors to non-contact ACL injuries. In this study, we aimed to evaluate the effect of femoral anteversion on the incidence of ACL injuries among athletes.
View Article and Find Full Text PDFBone Jt Open
January 2025
Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Toon, Japan.
Aims: Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system.
Methods: We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan.
J Biomech
December 2024
Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan; Human Performance Laboratory, Waseda University, Saitama, Japan.
A muscle's mechanical action is affected by its architecture. However, less is known about the architecture of muscles with broad attachments: "end-divergent" muscles. Potential regional variation of fascicle orientation in end-divergent muscles suggests that their mechanical action varies by region.
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