scholarly journals Dysplastic Hip Joint Configuration After Bernese Periacetabular Osteotomy

2021 ◽  
Author(s):  
Kamil Kołodziejczyk ◽  
Adam Czwojdziński ◽  
Andrzej Sionek ◽  
Jarosław Czubak
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Normal Distribution ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Hip Joints ◽  
Radiological Parameters ◽  
Significant Difference ◽  
Dysplastic Hip

Abstract Background: Residual hip dysplasia is one of the factors contributing to early hip joint osteoarthritis. The main problems caused by residual dysplasia are pain and instability of the hip joint caused by the lack of sufficient bony covering of the femoral head. The aim of this work was to radiologically assess the configuration change of a dysplastic hip joint after surgical treatment using the Bernese periacetabular osteotomy procedure.Methods: We assessed the radiological parameters of patients with hip dysplasia treated by Bernense periacetabular osteotomy by performing a digital antero-posterior pelvis X-ray: central edge angle and femoral head coverage, medialization, distalization and ilio-ischial angle parameters. For normally distributed parameters, we used Student’s t-test; for parameters without a normal distribution, we used the Wilcoxon signed-rank test. Correlations were assessed according to a normal distribution using the Pearson and Spearman method.Results: For all parameters, we observed statistically significant differences in the measurements of dysplastic hip joints before and after the surgery. We also observed a statistically significant difference between the structure of dysplastic hip joints prior to the surgery and healthy hip joints from the control group based on all radiological parameters. The resulting medialization was 2.68 mm, distalization was 3.65 mm, and the ilio-ischial angle was changed by 2.62°. There was also an improvement in the femoral head bony covering: CEA by 17.61° and FHC by 16.46%.Conclusions: Based on all the radiological parameters, we presented the difference between healthy and dysplastic hip joints. Learning the parameter values that are used to describe dysplastic hip joints will allow us to improve the imaging of the condition and will also allow for better planning and proper qualification of patients for surgical treatment of hip joint dysplasia.Trial registration: Consent of the bioethics commission Medical Centre of Postgraduate Education 83/PB/2015 18.11.2015 Warsaw

scholarly journals Juvenile pubic symphysiodesis associated with pectineus myectomy for treatment of hip dysplasia in dog

2021 ◽  
Vol 49 ◽  
Author(s):  
Daniel Munhoz Garcia Perez Neto ◽  
Leonardo Augusto Lopes Muzzi ◽  
Fernando Yoiti Kitamura Kawamoto ◽  
Caio Afonso dos Santos Malta ◽  
Laura Lourenço Freitas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Clinical Signs ◽  
Radiographic Examination ◽  
Acetabular Coverage ◽  
Hip Joints ◽  
Limb Muscles

Background: Hip dysplasia (HD) is the most common non-traumatic orthopedic disease in large breed dogs. Treatment is chosen according to the severity of the condition, the age of the dog and the involvement of osteoarthritis (OA). For puppies up to 20-weeks-old, surgical treatment by the juvenile pubic symphysiodesis (JPS) technique can be performed. This procedure promotes the ventrolateral rotation of the acetabulum over the femoral head, which improves hip joint congruence and stability. The objective of this study is to report the case of a young dog with HD treated with JPS and pectineus myectomy. Clinical and radiographic outcomes were assessed for up to one year after surgery.Case: A 17-week-old Saint Bernard puppy was attended at the University Veterinary Hospital showing abnormal weight bearing and lameness in pelvic limbs, without history of previous trauma. On orthopedic examination, there was a marked hypotrophy of the pelvic limb muscles, severe pain and laxity in the hip joints, and positive feature in the Ortolani test. The hip joint subluxation angle (SA) and reduction angle (RA) were measured. A radiographic study was carried out to evaluate the hip joints and measure the Norberg angle (NA), distraction index (DI), acetabular angle (AA) and dorsal acetabular rim angle (DARA). The 20-week-old dog underwent surgical treatment by JPS technique. A ventral surgical approach to the pubis was performed and the pubic symphysis was cauterized with electrocautery. Partial pectineus myectomy technique was also performed. Drug therapy and restriction of physical activities were indicated in the early postoperative. The dog was evaluated by clinical and radiographic examinations at 4 months and 1 year after the surgical procedure. In the reassessment after 4 months of surgical treatment, the patient showed improvement in clinical signs, with mild lameness and absence of painful sensitivity in the movement of the hip joints. Radiographically, hip joint incongruity was observed, but with progressive improvement in the values of the measured variables. In the clinical examination 1 year after the procedure, the dog showed satisfactory weight bearing with slight lameness in pelvic limbs in the running gait. There was improvement in the thigh muscles and no painful signs were observed in the hip joints, but a positive result was detected in the Ortolani test. In the radiographic examination, bilateral articular incongruity was still observed, however, there was a mild improvement in the coverage of the acetabulum over the femoral head. The measured angles and indices showed favorable results regarding the recovery of hip joint stability and proper development.Discussion: Studies evaluating the JPS technique for the treatment of HD have shown to be a relatively simple and effective procedure, which allows altering the acetabular coverage, reducing the development of HD and the progression of OA. The need for an early diagnosis of this condition is essential, so that the JPS technique can be used in young dogs and offer effective results. In the present report, in the late postoperative period, the dog showed improvement in clinical signs, with favorable weight bearing and ambulation in pelvic limbs, recovery of limb muscles, absence of pain in the hip joints and decrease in RA and SA. Radiographically, the reduction in joint subluxation, improvement in acetabular coverage over femoral heads, increase in NA and AA, reduction in DI and DARA are evidence of the favorable outcome of ventrolateral rotation of the acetabulum after surgical treatment. The surgical technique used was effective, which enabled the dog to recover the functional use of the pelvic limbs and improve the quality of life.Keywords: hip dysplasia, juvenile pubic symphysiodesis, hip joint, osteoarthritis, dog.Título: Sinfisiodese púbica juvenil associada à miectomia do pectíneopara tratamento de displasia coxofemoral em cãoDescritores: displasia coxofemoral, sinfisiodese púbica juvenil, coxofemoral, osteoartrite.

Asymmetrical lumbosacral transitional vertebrae in dogs may promote asymmetrical hip joint development

2017 ◽  
Vol 30 (02) ◽  
pp. 137-142 ◽  
Author(s):  
Frank Steffen ◽  
Michael Hässig ◽  
Joseph Morgan ◽  
Mark Flückiger
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Transverse Process ◽  
Hip Joints ◽  
Secondary Osteoarthritis ◽  
Pelvic Rotation ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae ◽  
Canine Hip Dysplasia

Summary Objectives: This study examines the relationship between the morphology of the lumbosacral transitional vertebra (LTV) and asymmetrical development of the hip joints in dogs. Methods: A total of 4000 dogs which had been consecutively scored for canine hip dysplasia were checked for the presence of a LTV. A LTV was noted in 138 dogs and classified depending on the morphology of the transverse processes and the degree of contact with the ilium. Results: In dogs with an asymmetrical LTV, the hip joint was significantly more predis-posed to subluxation and malformation on the side of the intermediate or sacral-like transverse process (p <0.01), on the side of the elevated pelvis (p <0.01), or when an asymmetrical LTV resulted in pelvic rotation on its long axis (p <0.01), whereas hip joint conformation was less affected on the side featuring a free transverse process (p <0.01). Clinical significance: The results support our hypothesis that an asymmetrical LTV favours pelvic rotation over its long axis, resulting in inadequate femoral head coverage by the acetabulum on one side. Inadequate coverage of the femoral head favours subluxation, malformation of the hip joint, and secondary osteoarthritis. Asymmetrical hip conformation may therefore be the sequela of a LTV and mask or aggravate genetically induced canine hip dysplasia.

The Dysplastic Hip Joint: Radiologic and Histologic Development

1975 ◽  
Vol 12 (4) ◽  
pp. 279-305 ◽  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Growth And Development ◽  
Hip Dysplasia ◽  
Normal Rate ◽  
Mild Dysplasia ◽  
Pelvic Bones ◽  
Dysplastic Hip

The pelvic growth in dogs that developed hip dysplasia was followed radiographically, grossly, and histologically from birth to maturity to obtain clues to the earliest signs of the disease. The growth and development in the length and diameter of the pelvic bones and femurs were at a normal rate in the dysplastic dog. The bony malformations were confined to the hip joint, except for minor adjustments in shape. In the dogs described, hip dysplasia became severe. There was no recognizable evidence of the disease until the 7th week, at which time the femoral head became unstable and subluxated from the cavity of the acetabulum. In other less severe instances (mild dysplasia), the femoral head subluxation usually was not evident until the 5th–6th month of age. In even milder cases, the dogs were 12–14 months of age before hip dysplasia was apparent radiographically. The degree of the maldevelopment depended on the extent of femoral head and acetabular separation and the age of the dog when congruity was interrupted by subluxation.

Relationship of peroxidation indicators and hemograms in children with hip joint pathology

2021 ◽  
Vol 66 (2) ◽  
pp. 104-109
Author(s):  
M. P. Teplen’kiy ◽  
E. L. Matveeva ◽  
E. S. Spirkina ◽  
A. G. Gasanova
Keyword(s):  
Lipid Peroxidation ◽  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Stage Ii ◽  
Perthes Disease ◽  
Antioxidant Protection ◽  
Aseptic Necrosis ◽  
Joint Pathology ◽  
Group I

The increase in the number of patients with hip pathologies among children of different ages makes the diagnosis and treatment of these diseases one of the most actually existing problems in modern orthopedics. The aim of the work was to determine the features of the lipid peroxidation system - antioxidant protection and hemogram indices in children with various forms of hip joint pathology. The results of a preoperative examination of 47 patients aged 6-15 years (average age 10.3 years) who were treated at the clinic “FSBI NICC“ TO ”named after academician G. A. Ilizarova, Ministry of Health of the Russian Federation. There were 25 boys and 20 girls. Given nosology, patients were divided into five groups. The diagnosis was established on the basis of a clinical and radiological examination. Group I consisted of 8 male patients with stage II Perthes disease (mean age 8.75 + 1.63). Group II includes 16 patients (8 boys, 7 girls) with stage III Perthes disease. (average age 11.80 + 0.89). Group III included 12 patients (6 boys, 6 girls) with aseptic necrosis of the femoral head (average age 14.7 + 2.35). Group IV consisted of 4 patients (1 boy, 3 girls) with epiphyseal dysplasia. (average age 10.25 + 1.36). Group V includes 7 patients with hip dysplasia complicated by aseptic necrosis of the femoral head (mean age 8.33 + 2.11). The norm is the data that was obtained after examining 10 healthy male adolescents (age 13-14) and 5 female adolescents (age 8-14 years). Changes in lipid peroxidation rates and antioxidant activity are unidirectional in different forms of pathology of the hip joints in children, and the content of peroxidation products reliably correlates with hemogram values in stage II osteochondropathy and complicated hip dysplasia. In the complex of diagnostic measures for children with dystrophic lesions of the hip joint, to clarify the nature and stage of the pathological process, as additional criteria, hemogram indicators and lipid peroxidation systems - antioxidant protection can be used.

Periacetabular Osteotomy in Hip Dysplasia with Deformed Femoral Head

2008 ◽  
Vol 43 (6) ◽  
pp. 718 ◽  
Author(s):  
Jae Suk Chang ◽  
Hyoung Keun Oh ◽  
Ji Wan Kim ◽  
Soo Heon Hong
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

2018 ◽  
Vol 02 (04) ◽  
pp. 156-166
Author(s):  
Tai Holland ◽  
Holly Thomas-Aitken ◽  
Jessica Goetz ◽  
Michael Willey
Keyword(s):  
Surgical Treatment ◽  
Hip Dysplasia ◽  
Groin Pain ◽  
Periacetabular Osteotomy ◽  
Hip Pain ◽  
Acetabular Retroversion ◽  
Short Term ◽  
Radiographic Findings ◽  
Lateral Hip Pain

AbstractBorderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

scholarly journals Differences of the Curvature Radius and the Curvature Center between Acetabulum and Femoral Head in Dysplastic Hip Joint

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Hironobu Hoshino ◽  
Shoichi Nishikino ◽  
Hiroshi Koyama ◽  
Hiroki Furuhashi ◽  
Yukihiro Matsuyama
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Curvature Radius ◽  
Dysplastic Hip

scholarly journals Transposition of the great trochanter: A look at the problem

2021 ◽  
Vol 9 (2) ◽  
pp. 195-202
Author(s):  
Ivan Y. Pozdnikin ◽  
Pavel I. Bortulev ◽  
Dmitry B. Barsukov ◽  
Vladimir E. Baskov
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Range Of Motion ◽  
Hip Joint ◽  
Proximal Femur ◽  
Great Trochanter ◽  
Clinical Parameters ◽  
Greater Trochanter ◽  
Hip Joints ◽  
High Position

BACKGROUND: Multiplanar deformity of the proximal femur with a high position of the greater trochanter is one of the most common residual deformities of the hip joint. The VeauLamy transposition of the greater trochanter does not fully treat the mutual trauma of the components of the hip joint, as it only brings down the greater trochanter to provide tension for the gluteal muscles. AIM: This study aimed to share the experience of performing transposition of the greater trochanter according to our proposed technique. MATERIALS AND METHODS: The study included 15 patients (15 hip joints) aged 916 years with a high position of the greater trochanter of the femur, who underwent surgical treatment in the period from 2018 to 2019. In addition to the actual transposition of the greater trochanter, the intervention provided a modeling resection of the base (bed) of the greater trochanter and the formation of an offset of the femoral neck. RESULTS: Patients were followed up for period of up to 30 months. All patients showed positive changes after surgical treatment with improvement of radiological and clinical parameters. CONCLUSIONS: The proposed intervention allows restoration of the function of the gluteal muscles, improves the range of motion in the hip joint, and prevents and treats extra-articular impingement syndrome.

scholarly journals Orthopaedic and Neurologic Aspects of Early Coxarthrosis Development in Children with Hip Dysplasia

2016 ◽  
Vol 23 (1) ◽  
pp. 55-61
Author(s):  
N. Kh Bakhteeva ◽  
G. A Korshunova ◽  
V. V Zotkin ◽  
I. A Norkin
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Motor Neurons ◽  
Functional Activity ◽  
Peripheral Nerves ◽  
Hip Dysplasia ◽  
Clinical Course ◽  
Healthy Children ◽  
Hip Joints ◽  
Conservative And Surgical Treatment

Comparison of clinical-roentgenologic and electroneuromyographic data was performed for 29 patients, aged 3 - 16 years, at different stages of conservative and surgical treatment for hip joints dysplasia. First group included 18 patients with complicated clinical course; second - 11 patients with favorable process of joint formation. Functional activity of motor neurons, spinal cord and peripheral nerves conductivity was assessed. It was shown that in patients from the 1st group the ENMG indices were statistically significantly lower than in healthy children ( р

scholarly journals Diagnosis and correction of somatic dysfunction in young infants with congenital defects of hip joints

2019 ◽  
pp. 56-63
Author(s):  
Yu. N. Gavrik ◽  
Yu. Yu. Markelova ◽  
Yu. O. Kuzmina
Keyword(s):  
Hip Joint ◽  
Hip Dysplasia ◽  
Acetabular Index ◽  
Congenital Defects ◽  
Control Group ◽  
Hip Joints ◽  
Functional Connection ◽  
Young Infants ◽  
Orthopaedic Treatment ◽  
Comprehensive Therapy

Introduction. Hip dysplasia in infants is one of the most common congenital defects of connective tissue. It is assumed that correction of somatic dysfunctions, which are formed in this orthopaedic pathology, will affect the timing of treatment and rehabilitation.Goal of research — to explore the opportunities of osteopathic correction for somatic dysfunctions in comprehensive conservative treatment of hip joint congenital orthopaedic pathology in young infants.Materials and methods. There were 40 infants under 6 month with diagnosis of hip joint dysplasia under observation, divided into two groups of 20 infants each. Functional orthopaedic treatment (massage, physiotherapy, exercise therapy, orthopaedic splint) and osteopathic correction were performed for infants of the main group. Infants of the control group received the orthopaedic treatment only. Osteopathic status was rated in addition to provided treatment in both groups. Treatment results were evaluated by using hip joints radiography, namely, by the acetabular index.Results. It was found that global somatic dysfunctions are not typical in infants with hip joint congenital defects. The most frequently identifi ed somatic dysfunctions were regional, in a region of head, neck, pelvis, as well as thoracic region. Somatic dysfunctions of head and pelvis region are the most signifi cant. It proves the functional connection between these dysfunctions and hip joint congenital defexts. X-ray examination data analysis let us suggest a direct effect of somatic dysfunctions correction on the acetabular index in infants with congenital orthopaedic pathology, and thus on rehabilitation periods reduction.Conclusion. The study showed that osteopathic correction of somatic dysfunctions is effective in combination with orthopaedic treatment of hip dysplasia performed from the fi rst months of infant′s life. It should be recommended as a part of comprehensive therapy of this orthopaedic pathology.

Sign in / Sign up

Export Citation Format

Share Document