Database : MEDLINE
Search on : Hip and Dislocation [Words]
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[PMID]: 29204597
[Au] Autor:Ravi B; Pincus D; Wasserstein D; Govindarajan A; Huang A; Austin PC; Jenkinson R; Henry PDG; Paterson JM; Kreder HJ
[Ad] Address:Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
[Ti] Title:Association of Overlapping Surgery With Increased Risk for Complications Following Hip Surgery: A Population-Based, Matched Cohort Study.
[So] Source:JAMA Intern Med;178(1):75-83, 2018 Jan 01.
[Is] ISSN:2168-6114
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Overlapping surgery, also known as double-booking, refers to a controversial practice in which a single attending surgeon supervises 2 or more operations, in different operating rooms, at the same time. Objective: To determine if overlapping surgery is associated with greater risk for complications following surgical treatment for hip fracture and arthritis. Design, Setting, and Participants: This was a retrospective population-based cohort study in Ontario, Canada (population, 13.6 million), for the years 2009 to 2014. There was 1 year of follow-up. This study encompassed 2 large cohorts. The "hip fracture" cohort captured all persons older than 60 years who underwent surgery for a hip fracture during the study period. The "total hip arthroplasty" (THA) cohort captured all primary elective THA recipients for arthritis during the study period. We matched overlapping and nonoverlapping hip fractures by patient age, patient sex, surgical procedure (for the hip fracture cohort), primary surgeon, and hospital. Exposures: Procedures were identified as overlapping if they overlapped with another surgical procedure performed by the same primary attending surgeon by more than 30 minutes. Main Outcomes and Measures: Complication (infection, revision, dislocation) within 1 year. Results: There were 38 008 hip fractures, and of those, 960 (2.5%) were overlapping (mean age of patients, 66 years [interquartile range, 57-74 years]; 503 [52.4%] were female). There were 52 869 THAs and of those, 1560 (3.0%) overlapping (mean age, 84 years [interquartile range, 77-89 years]; 1293 [82.9%] were female). After matching, overlapping hip fracture procedures had a greater risk for a complication (hazard ratio [HR], 1.85; 95% CI, 1.27-2.71; P = .001), as did overlapping THA procedures (HR, 1.79; 95% CI, 1.02-3.14; P = .04). Among overlapping hip fracture operations, increasing duration of operative overlap was associated with increasing risk for complications (adjusted odds ratio, 1.07 per 10-minute increase in overlap; P = .009). Conclusions and Relevance: Overlapping surgery was relatively rare but was associated with an increased risk for surgical complications. Furthermore, increasing duration of operative overlap was associated with an increasing risk for complications. These findings support the notion that overlapping provision of surgery should be part of the informed consent process.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1001/jamainternmed.2017.6835

  2 / 14999 MEDLINE  
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[PMID]: 29523974
[Au] Autor:Kanda A; Kaneko K; Obayashi O; Mogami A; Morohashi I
[Ad] Address:Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Izunagaoka 1129, Izunokuni-Country, Shizuoka, 410-2295, Japan. tetsutakan@aol.com.
[Ti] Title:Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty.
[So] Source:Eur J Orthop Surg Traumatol;, 2018 Mar 09.
[Is] ISSN:1633-8065
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:INTRODUCTION: In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate. METHODS: We evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery. RESULTS: The width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study. CONCLUSIONS: We cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate. LEVEL OF EVIDENCE: Therapeutic, Level IV.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s00590-018-2166-2

  3 / 14999 MEDLINE  
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[PMID]: 29523442
[Au] Autor:Meneghini RM
[Ad] Address:Department of Orthopaedic Surgery, Indiana University Health Physicians Orthopedics and Sports Medicine, Indiana University School of Medicine, Fishers, IN.
[Ti] Title:Investigation of the Unstable Total Hip Arthroplasty.
[So] Source:J Arthroplasty;, 2018 Mar 06.
[Is] ISSN:1532-8406
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity. A classification system, based on etiology of recurrent instability, is available and helpful to guide treatment strategy. Finally, emerging research has debunked the previous characterization of an acetabular "safe zone" and further identified lumbar spine disease and surgical fusion as a significant risk factor for recurrent instability. Current and future research efforts target radiographic assessment of lumbopelvic alignment in diagnosis, treatment, and prevention of recurrent total hip arthroplasty instability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  4 / 14999 MEDLINE  
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[PMID]: 29523346
[Au] Autor:Alí-Morell OJ; Zurita-Ortega F; Davó-Jiménez I; Segura-Biedma S
[Ad] Address:Servicio de Fisioterapia, Fundación Purísima Concepción, Granada, España. Electronic address: fisiopurisima@gmail.com.
[Ti] Title:Ángulo acetábulo-epifisario y luxación de cadera en la parálisis cerebral: Estudio preliminar. Acetabular-epiphyseal angle and hip dislocation in cerebral palsy: a preliminary study.
[So] Source:Radiologia;, 2018 Mar 06.
[Is] ISSN:1578-178X
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:OBJECTIVE: To relate, in non-ambulatory subjects with palsy, Reimers' migration percentage with standardized radiological measurements, including the acetabular-epiphyseal angle. METHOD: Descriptive, observational and transversal study of 15 individuals with cerebral palsy at levels IV and V of the Gross Motor Function Classification System, aged between 3 and 9 years. Radiological measurements of the acetabular index, Hilgenreiner's epiphyseal angle, acetabular-epiphyseal angle, neck-shaft angle and Reimers' migration percentage of each of the hips were performed. RESULTS: Correlations between acetabular index, epiphyseal angle and acetabular-epiphyseal angle were obtained with respect to the Reimers migration percentage. For hips with a migration rate of 15% or less, a positive correlation was observed between acetabular and epiphyseal angles. CONCLUSIONS: In our population, the measurement between acetabular and epiphyseal inclination represents the highest association with the hip migration percentage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  5 / 14999 MEDLINE  
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[PMID]: 29404667
[Au] Autor:Li D; Xie L; Guo W; Tang X; Ji T; Yang R
[Ad] Address:Musculoskeletal Tumour Centre, Peking University People's Hospital, Beijing, 100044, China.
[Ti] Title:Extra-articular resection is a limb-salvage option for sarcoma involving the hip joint.
[So] Source:Int Orthop;42(3):695-703, 2018 Mar.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: With the development of surgical techniques and improvements in hemi-pelvic prosthesis systems, extra-articular resection can be performed as a limb-salvage procedure in selected patients whose hip joint is invaded by a sarcoma. The aim of this study was to describe the indications for and the technical details, post-operative complications, and oncologic and functional outcomes of this procedure. METHODS: Eighteen patients with Enneking IIB or IB sarcoma who underwent extra-articular resection of the hip joint were enrolled. A modular pelvic endoprosthesis combined with a femoral endoprosthesis was used to reconstruct the bone and joint defect. Pathological diagnoses included osteosarcoma (7 patients), chondrosarcoma (7), undifferentiated high-grade pleomorphic sarcoma (3), and malignant peripheral nerve-sheath tumour (1). RESULTS: Wide, marginal and intralesional surgical margin was achieved in 13, four and one patients, respectively. There was one peri-operative death and the other 17 patients were followed up for 35.0 months (range, 10-75 months). Three patients had early-stage dislocations. One had a traumatic dislocation three years later. Two patients had wound complications. The average MSTS 93 score was 63.5% ± 10.8%. Four patients had local recurrence. The estimated three-year disease-free survival and overall survival for the 18 patients were both 50.0%. CONCLUSION: Although technically demanding, extra-articular resection of hip is a limb-salvage procedure that is worth considering for carefully selected patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1007/s00264-018-3771-8

  6 / 14999 MEDLINE  
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[PMID]: 29356794
[Au] Autor:Cai Z; Zhao Q; Li L; Zhang L; Ji S
[Ad] Address:Department of Orthopaedics, Central Hospital of Shenyang Medical College.
[Ti] Title:Can Computed Tomography Accurately Measure Acetabular Anterversion in Developmental Dysplasia of the Hip? Verification and Characterization Using 3D Printing Technology.
[So] Source:J Pediatr Orthop;38(4):e180-e185, 2018 Apr.
[Is] ISSN:1539-2570
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: One of the important pathologic changes in developmental dysplasia of the hip (DDH) is increased acetabular version angle (AA). Reasonable correction for excessive AA is an important step in the treatment of DDH, making accurate AA measurement very crucial. However, the results of different AA measurement methods vary. Thus, this study aimed to compare the difference in AA measurements between 2-dimensional computed tomography (2D-CT) and 3-dimensional computed tomography (3D-CT) in children with DDH and to identify the AA degree in children with DDH to guide treatment. METHODS: AA was measured by 2D-CT and 3D-CT in 186 children with DDH, and the measurement results were compared with the physical measurement result in the 3D-printed pelvis (3D-PP) model. The 3D-PP was a 1:1 model identical to the human pelvis. All patients were unilaterally affected. RESULTS: The results of AA measurement through 2D-CT, 3D-CT, and 3D-PP of normal hips were 14.0±6.6, 11.9±5.3, and 11.9±3.4 degrees, respectively, whereas those of the dislocated hips were 24.9±8.9, 19.8±5.2, and 19.5±4.3 degrees, respectively. In both the normal and dislocated hip groups, the results between 2D-CT and 3D-CT was significantly different (P<0.05), but there was no difference between the results of 3D-CT and 3D-PP (P>0.05). The AA of the normal and dislocated hips as measured by 3D-PP was 11.9±3.6 and 19.6±4.3 degrees, respectively, with statistically significant difference (P<0.05). In the dislocated hips, a significant positive correlation was found between age and AA (r=0.756, P<0.05) and between AA and degree of dislocation (r=0.837, P<0.05). CONCLUSIONS: 3D-CT is more accurate than 2D-CT for AA measurement, and compared with normal hips, AA in dislocated hips increased by ∼7.7 degrees on average. AA increases as age and degree of dislocation increase. LEVEL OF EVIDENCE: Level II.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1097/BPO.0000000000001141

  7 / 14999 MEDLINE  
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[PMID]: 29205969
[Au] Autor:Zhang W
[Ad] Address:Department of Forensic Medicine, National Police University of China, Shenyang 110035, China.
[Ti] Title:[Forensic Analysis of the Characteristics of Pelvic Fracture in 65 Road Traffic Accident Death Cases].
[So] Source:Fa Yi Xue Za Zhi;32(6):428-430, 2016 Dec.
[Is] ISSN:1004-5619
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVES: To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. METHODS: Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. RESULTS: Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. CONCLUSIONS: Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury.
[Mh] MeSH terms primary: Accidents, Traffic
Fractures, Bone/diagnosis
Pelvic Bones/injuries
[Mh] MeSH terms secundary: Acetabulum/injuries
Death
Forensic Pathology
Fractures, Comminuted/diagnosis
Humans
Ischium/injuries
Soft Tissue Injuries/diagnosis
Spinal Fractures/diagnosis
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.06.008

  8 / 14999 MEDLINE  
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[PMID]: 29509616
[Au] Autor:Zhang Z; Luo D; Cheng H; Xiao K; Zhang H
[Ad] Address:Division of Joint Surgery, Department of Orthopaedic Surgery, First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, China.
[Ti] Title:Unexpected Long Lower Limb in Patients with Unilateral Hip Dislocation.
[So] Source:J Bone Joint Surg Am;100(5):388-395, 2018 Mar 07.
[Is] ISSN:1535-1386
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Several methods are commonly used to predict lower-limb-length discrepancy (LLD) on pelvic radiographs. It is not clear how the lower-limb length of patients with unilateral developmental dislocation of the hip (DDH) changes and whether a pelvic radiograph is reliable to predict LLD. In this study, we analyzed the characteristics of LLD in patients with unilateral DDH by measuring full-length standing anteroposterior radiographs. METHODS: The radiographic data of all patients with unilateral DDH who met the inclusion criteria from March 2011 to May 2016 were retrospectively reviewed. These data included femoral length, tibial length, skeletal limb length, and distance from the lesser trochanter to the tibial plafond. We also compared LLD between patients with Hartofilakidis type-II DDH and those with type III. RESULTS: Sixty-seven patients (12 male and 55 female) were included. The tibial length, skeletal limb length, and lesser trochanter-tibial plafond distance were significantly greater (p < 0.001, p = 0.040, and p < 0.001, respectively) on the ipsilateral (DDH) side, compared with the contralateral side, in 51 patients (76%), 43 patients (64%), and 52 patients (78%), respectively, with the values on the ipsilateral side exceeding those on the contralateral side by an average of 4.6 mm (range, 0.4 to 17.5 mm), 7.0 mm (range, 0.3 to 21.1 mm), and 10.0 mm (range, 1.1 to 28.8 mm), respectively. The femoral length did not differ significantly between the 2 sides (p = 0.562). There was also no significant difference in LLD, femoral length, tibial length, skeletal limb length, or lesser trochanter-tibial plafond distance between patients with Hartofilakidis type II and those with type III (p > 0.05). CONCLUSIONS: Patients with unilateral DDH, regardless of whether the hip dislocation is low or high, may present with LLD derived from both the femur and the tibia. This LLD includes a greater ipsilateral tibial length, skeletal limb length, and lesser trochanter-tibial plafond distance in most patients and an unpredictable femoral length. Using the lesser trochanter on pelvic radiographs to predict LLD is not reliable. The use of full-length standing anteroposterior radiographs for preoperative templating is advisable for this special group of patients. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review
[do] DOI:10.2106/JBJS.17.00187

  9 / 14999 MEDLINE  
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[PMID]: 29240467
[Au] Autor:Schultz K; Ewbank ML; Pandit HG
[Ad] Address:Medical Student, Indiana University School of Medicine, Indianapolis, USA.
[Ti] Title:Changing practice for hip arthroplasty and its implications.
[So] Source:Br J Nurs;26(22):1238-1244, 2017 Dec 14.
[Is] ISSN:0966-0461
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:This overview provides insight into changes in clinical practice and the implications for nursing staff and clinicians who are involved in the management of patients undergoing primary total hip arthroplasty. The review highlights commonly used surgical approaches, their advantages, their associated risks and how to manage complications if they occur.
[Mh] MeSH terms primary: Arthroplasty, Replacement, Hip/methods
Practice Patterns, Physicians´/trends
[Mh] MeSH terms secundary: Arthroplasty, Replacement, Hip/adverse effects
Humans
Orthopedic Nursing
Postoperative Complications/etiology
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Js] Journal subset:N
[Da] Date of entry for processing:171215
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.22.1238

  10 / 14999 MEDLINE  
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[PMID]: 29240611
[Au] Autor:Schirwani S; Smith K; Balasubramanian M
[Ad] Address:Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds.
[Ti] Title:Clinical and molecular characterization of the first familial report of 1p32 microdeletion.
[So] Source:Clin Dysmorphol;27(2):36-41, 2018 Apr.
[Is] ISSN:1473-5717
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Structural rearrangements of chromosome band 1p31p32 are rare, and their phenotypic consequences remain poorly delineated. Up to 12 patients with learning difficulties, developmental delay, multiple congenital anomalies and microdeletion of the chromosome band 1p31p32 have been described. Inheritance of this deletion has not been reported previously. We describe the inheritance of the 1p32 deletion and discuss the relevance of this deletion to the described phenotype. The differences in clinical and molecular characteristics between the proband and other published reports are reviewed. Patients were evaluated in Genetics Clinic with history, examination and investigation. The existing literature on interstitial deletions of 1p was reviewed. Here, we report on a three-generation family, where the index patient was an adult female with learning difficulty, dysmorphic features, microcephaly, ambiguous genitalia, congenital hip dislocation and brachydactyly in whom a maternally inherited 1.45 Mbp interstitial deletion was detected at 1p32.3. Both her mother and maternal grandmother have learning difficulties and dysmorphic features. There are 14 OMIM genes in the deleted region including LRP8 and DMRTB1. The NFIA gene is not deleted in this family. The first report of a familial 1p32 microdeletion in three generations of a family carrying the smallest reported a deletion involving this region and brachydactyly as a previously unreported feature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.1097/MCD.0000000000000209


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