Incidence of avascular necrosis of native femur following hip transposition surgery for periacetabular malignancies: a single-centre experience. | LitMetric
Background: Hip transposition surgery after surgical resection of large pelvic tumours is a well-established alternate to endoprosthetic reconstruction. The major goals of surgery are to ensure adequate resection margins with limb salvation, albeit with acceptable levels of morbidity. While surveillance is aimed at diagnosing local recurrence or distant metastasis primarily, other complications may occasionally be seen.The aim of this study was to assess incidence of avascular necrosis (AVN) in the preserved native femoral heads after hip transposition surgery for periacetabular malignancies, also known as hanging hip surgery.
Patients And Methods: Patient records and follow-up imaging of 22 patients who had undergone hanging hip surgery from 1999 to 2020 were retrospectively analysed to assess for any probable causes of AVN.
Results: Of the 22 patients, 5 (22.7%) had developed AVN on follow-up with a mean time of onset of about 10.5 months from surgery (5 months-2 years). A review of the patient demographics, surgical notes, preoperative management did not offer any clues as to the cause of AVN in these patients. Osteopenia was the most common radiological finding (59%) in most patients, but this also did not herald AVN onset.
Conclusions: The theory that loss of major vascular supply to the femoral head from capsular disruption during hip transposition surgery would lead to AVN in most patients did not hold true as AVN occurred in a small number of patients.
Aims: This study aimed to determine clinical outcomes; relationships between postoperative anterior, lateral, and posterior acetabular coverage and joint survival; and prognostic factors for joint survival after transposition osteotomy of the acetabulum (TOA).
Methods: Data from 616 patients (800 hips) with hip dysplasia who underwent TOA between November 1998 and December 2019 were reviewed. The median follow-up period was 8.
The study aimed to find the best acetabular position for hip biomechanics after a specific surgical procedure called transposition osteotomy of the acetabulum (TOA) in patients with hip dysplasia.
Researchers used patient-specific models to simulate various acetabular positions, focusing on joint contact pressure and hip range of motion during daily activities to determine optimal positions.
Results indicated that a lateral center-edge angle of 30° with 15° of anterior rotation was most effective for a significant majority of patients, while a specific preoperative measurement (head-neck offset ratio) could predict the risk of hip impingement post-surgery.
Pelvic bone sarcoma surgery is challenging due to complex anatomy, proximity to major neurovascular structures, and, more importantly, the potential for complications. Decision-making is vital in offering patients the best oncological and functional outcomes after surgery. Multidisciplinary teams involved from the stage of diagnosis and treatment planning, followed by surgery by experienced teams have proven to be beneficial.
Objective: The principles of limb reconstruction are crucial for treatment success, but there is no unified standard for complex limb deformities. The aim of this study was to analyze the characteristics of the cases of post-traumatic lower limb deformity and explore the new principle of limb reconstruction.
Method: A retrospective analysis was conducted of 148 patients with post-traumatic lower limb deformity who underwent surgery from May 1978 to December 2023; 85 were males (57.
* The reconstruction goals focus on restoring skeletal continuity, maintaining limb length, and ensuring a functional hip joint, while soft-tissue reconstruction aims to securely cover structures and prevent complications.
* Pelvic resections are classified into four types, each requiring specific reconstruction strategies, with type II and IV often needing more complex approaches due to associated functional and stability challenges.
