Clohisy, John C. MD; Carlisle, Beaulé, Paul E. Kim, Young-Jo Trousdale, Robert T. Sierra, Rafael J. Leunig, Michael Schoenecker, Perry L. Millis, B. MD Author Information

Untreated femoro-acetabular impingement is a common cause of osteoarthrosis the hip. Surgical debridement adult hip with recently has been advocated aim relieving symptoms and slowing or halting progression arthrosis. At surgery, femoral sources are relieved by debriding aspheric peripheral portion head adjacent neck. Acetabular can be anterior rim. The most fundamental questions concerning these procedures relate to preoperative postoperative function, survivorship hips incidence...

Radiographic evaluation provides essential information regarding the diagnosis and treatment of musculoskeletal disorders. We evaluated ability hip specialists to reliably identify important radiographic features make a based on plain radiographs alone. Five one fellow performed blinded review 25 control hips, hips with developmental dysplasia (DDH), 27 femoroacetabular impingement (FAI). On two separate occasions, readers assessed acetabular version, inclination depth, position femoral head...

The Bernese periacetabular osteotomy is a commonly used non-arthroplasty option to treat developmental hip dysplasia in symptomatic younger patients. Predicting which hips will remain preserved and go on require arthroplasty following major challenge. In the present study, we assessed intermediate long-term results demonstrate clinical outcomes for patients with varying amounts of arthritis. From these results, probability-of-failure analysis was conducted predict likelihood preservation...

Background: Symptomatic femoroacetabular impingement (FAI) is associated with hip pain, functional limitations, and secondary osteoarthritis. There limited information from large patient cohorts defining the specific population affected by FAI. Establishing a cohort will facilitate identification of “at-risk” patients provide for ongoing clinical research initiatives. The authors have therefore established multicenter, prospective, longitudinal undergoing surgery symptomatic Purpose: To...

Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed provide better clinical evidence regarding this procedure. The goals of current study were (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality life), (2) investigate preoperative disease characteristics as predictors outcomes, (3) rate early failures reoperations in...

Background: The efficacy of surgical and medical treatment osteoarthritis is difficult to assess because the lack a noninvasive, sensitive measure cartilage integrity. Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) was designed specifically examine glycosaminoglycan changes in articular that occur during development osteoarthritis. Our primary goal compare this technique with measurement joint space width on conventional radiographs patients hip dysplasia. We performed...

To retrospectively analyze magnetic resonance (MR) arthrographic findings in patients with clinical cam-type femoroacetabular impingement.This study was approved by the institutional review board, and informed consent waived. Study compliant Health Insurance Portability Accountability Act. Forty-two MR arthrograms obtained 40 impingement were analyzed two radiologists. Quantitative analysis using alpha angle measurement performed to assess anterosuperior femoral head-neck morphology....

Hip dysplasia is a major cause of osteoarthrosis in adults. Early aggressive osteotomy has the potential preventing development arthritis, but carries with it significant risks. The problem further complicated because surgeon no means quantifying dysplastic deformity or predicting what particular combination osteotomies would do to correct deformity. This study describes methods hip-joint geometry three dimensions based on computed tomography and magnetic resonance studies, simulating pelvic...

From July 1987 to January 1991, 59 consecutive type III supracondylar humerus fractures in children were identified at Children's Hospital, Boston. Twenty-nine patients (49%) had evidence of neurovascular compromise. The median nerve was involved 15 (52%) these and associated with posterolateral displacement 87% cases. radial eight (28%) posteromedial every case. Injuries the brachial artery occurred 11 (38%) 64% 36% We conclude that is strongly injuries. Posteromedial responsible for...

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Background: Hip dysplasia leads to abnormal loading of articular cartilage, which results in osteoarthritis. Pelvic osteotomies such as the Bernese periacetabular osteotomy can improve mechanics joint, but are variable and appear depend on amount preexisting arthritis. Delayed gadolinium-enhanced magnetic resonance imaging cartilage (dGEMRIC) is a technique designed measure early arthritis, it potentially could be used select hips with too severe arthritis benefit from joint-preserving...

Surgical hip dislocation enables complete exposure of the joint for treatment various disorders.There is limited information regarding complications associated with this procedure. Our purpose to report incidence surgical in a large, multicenter patient cohort.A retrospective, analysis patients who had undergone was performed.Patients simultaneous osteotomy were excluded. Complications recorded, specific assessment osteonecrosis, trochanteric nonunion, femoral neck fracture, nerve injury,...

The Bernese periacetabular osteotomy (PAO) continues to be a commonly performed nonarthroplasty option treat symptomatic developmental hip dysplasia, but there are few long-term followup studies evaluating results after PAO.(1) What is the survivorship of PAO? (2) were validated outcomes scores among patients who had PAO more than 14 years ago? (3) factors associated with failure?One hundred fifty-eight dysplastic hips (133 patients) underwent between May 1991 and September 1998 by single...

Background: The purpose of this prospective multicenter study was to determine and categorize all complications associated with the periacetabular osteotomy performed by experienced surgeons. Methods: We prospectively analyzed perioperative in 205 consecutive unilateral osteotomies at seven institutions ten All were recorded an average weeks one year after surgery standardized fashion using a validated complication grading scheme applied hip preservation procedures. mean patient age 25.4...

Modified Dunn osteotomy has gained popularity over the past decade in treatment of moderate to severe adolescent slipped capital femoral epiphysis. The purpose this study was retrospectively evaluate a consecutive series epiphysis patients treated with modified procedure at single institution. We analyze indications for as well complications after surgical treatment.Forty-three (18 boys and 25 girls) were our institution between September 2001 August 2012. average follow-up cohort 2.6 years...

Objective. Delay in diagnosis of slipped capital femoral epiphysis (SCFE) has important implications terms slip severity and long-term hip outcome. The purpose this study was to identify predictors delay the SCFE. Methods. A review 196 patients with SCFE performed. primary outcome measure from onset symptoms diagnosis. Covariates included age, gender, side, weight, pain location, insurance status, family income, severity, stability. not normal distribution; therefore, nonparametric...

Background: Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures humerus in children, although controversy persists regarding optimal pin-fixation technique. The purpose this study was to compare efficacy lateral entry with that medial operative children. Methods: This prospective, randomized clinical trial had sufficient power detect a 10% difference rate loss between two groups. techniques were...

Pistol grip deformity of the femoral head-neck junction and slipped capital epiphysis can cause anterior impingement leading to pain, cartilage damage eventual osteoarthritis.1-3 Osteoplasty this metaphyseal prominence, with or without concomitant intertrochanteric osteotomy, using a surgical dislocation approach, effectively treat problem.4,5 Clinical radiographic outcomes were assessed in 19 patients who underwent osteoplasty osteoplasty/intertrochanteric osteotomy via Ganz-type average...

The Bernese periacetabular osteotomy is a commonly used non-arthroplasty option to treat developmental hip dysplasia in symptomatic younger patients. Predicting which hips will remain preserved and go on require arthroplasty following major challenge. In the present study, we assessed intermediate long-term results demonstrate clinical outcomes for patients with varying amounts of arthritis. From these results, probability-of-failure analysis was conducted predict likelihood preservation...

Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients slipped capital femoral epiphysis (SCFE), but it unclear whether changes metaphysis morphology are range of motion (ROM) or type impingement. We asked head-neck junction influences ROM analysis and addition slip angle acetabular version. analyzed 31 SCFE relationship between proximal limitation based on simulated preoperative CT data. The was relation degree slippage, morphology, version,...