Objective: To evaluate the prevalence, morphology, and clinical significance of a repeatedly observed yet not examined circumscript osseous defect at the anteroinferior aspect of the femoral head, termed femoral head defect.
Materials And Methods: Retrospective study with approval of the institutional review board. There was informed consent by all individuals. Magnetic resonance imaging (MRI) hip examinations of 970 individuals (age 15 to 55) were analyzed for femoral head defect. Patients with femoral head defect were matched for age and gender with patients without defect. Two readers independently assessed MRI images regarding presence, location, and morphology of the defect. MR images and radiographs were analyzed for findings of femoroacetabular impingement (FAI). Femoral torsion was measured. Independent t test and chi-square test were used for statistics.
Results: Sixty-eight (7%) of 970 MRI examinations exhibited a femoral head defect in an anteroinferior location of the femoral head (29/400 men, 7.3%; 39/570 women, 6.8%; p = 0.8). The most frequent morphology of femoral head defect was type I, dent-like (34; 50%), followed by type II, crater-like (27; 40%), and III, cystic (7; 10%). Femoral head defect was slightly more common on the right hip (39 individuals; 57%) compared to left (29 individuals; 43%), non-significantly (p = 0.115). There was no association between FAI or its subtypes and the presence of femoral head defect (p = 0.890). Femoral antetorsion was reduced in patients with femoral head defect (12.9° ± 8.6) compared to patients without defect (15.2° ± 8.5), without statistical significance (p = 0.121).
Conclusion: The femoral head defect is a common finding in MRI examinations of the hip and is situated in the anteroinferior location. There was no association with FAI yet a non-significant trend towards lower femoral antetorsion in patients with femoral head defects.
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http://dx.doi.org/10.1007/s00256-021-03730-x | DOI Listing |
The current study aimed to objectively evaluate the fit of a rectangular, tapered stem to the severely dysplastic hips on the basis of the proximal femoral anatomy and the dimensional properties of the stem. It was hypothesized that the stem size planned with accordance to the diaphyseal canal width alone can accommodate the distal femur successfully with no sizing mismatch. Forty-six patients (53 hips) suffering from secondary osteoarthritis due to hip dysplasia scheduled for total hip arthroplasty (THA) with a subtrochanteric transverse shortening osteotomy were included.
View Article and Find Full Text PDFFoot Ankle Int
January 2025
Royal National Orthopaedic Hospital NHS Trust, Foot & Ankle Unit, Stanmore, United Kingdom.
Background: Ankle and hindfoot fusion in the presence of large bony defects represents a challenging problem. The purpose of this study was to evaluate outcomes of patients who underwent ankle-hindfoot fusions with impaction bone grafting (IBG) with morselized femoral head allograft to fill large bony void defects.
Methods: This was a 3-center, retrospective review of a consecutive series of 49 patients undergoing ankle or hindfoot fusions with femoral head IBG for filling large bony defects.
Pak J Med Sci
January 2025
Muhammad Ashfaq, MCPS, FCPS, CHPE (JSMU) Pediatric Medicine, National Institute of Child Health Karachi, Pakistan.
Objectives: To determine gender and ethnic distribution of developmental dysplasia of hip in newborns using Graf method for ultrasound. To determine the significance of association between developmental dysplasia of hip with ethnicity in newborns using Graf's method ultrasound.
Method: This analytical cross-sectional observational study was conducted in Karachi from January through June 2022 .
J Clin Orthop Trauma
March 2025
Department of Orthopaedic Surgery, Mercy St. Vincent Medical Center, 2213 Cherry St., Toledo, OH, 43608, USA.
Background: Gravid females with pelvic fractures are rarely encountered by the orthopaedic trauma surgeon. The initial injury can be detrimental to the pregnant patient, but an unnecessary "second hit" from surgery could also contribute to the outcome of the fetus. Understanding the surgical risks for this unique patient population requires knowledge about the negative effects of anesthesia, surgical exposures, and radiation.
View Article and Find Full Text PDFJ Tissue Eng
January 2025
Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China.
Osteonecrosis of the femoral head (ONFH) is a prevalent orthopedic disorder characterized primarily by compromised blood supply. This vascular deficit results in cell apoptosis, trabecular bone loss, and structural collapse of the femoral head at late stage, significantly impairing joint function. While MRI is a highly effective tool for diagnosing ONFH in its early stages, challenges remain due to the limited availability and high cost of MRI, as well as the absence of routine MRI screening in asymptomatic patients.
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