Pub Date : 2025-01-18eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae049
Ali Bajwa
The Journal of Hip Preservation Surgery (JHPS) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so JHPS has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what JHPS hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes ….
{"title":"What the papers say.","authors":"Ali Bajwa","doi":"10.1093/jhps/hnae049","DOIUrl":"10.1093/jhps/hnae049","url":null,"abstract":"<p><p>The <i>Journal of Hip Preservation Surgery</i> (<i>JHPS</i>) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so <i>JHPS</i> has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what <i>JHPS</i> hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes ….</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"323-325"},"PeriodicalIF":1.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-18eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae047
Richard E Field
{"title":"Levels of evidence.","authors":"Richard E Field","doi":"10.1093/jhps/hnae047","DOIUrl":"10.1093/jhps/hnae047","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"241-242"},"PeriodicalIF":1.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10eCollection Date: 2024-07-01DOI: 10.1093/jhps/hnae032
Ali Bajwa
The Journal of Hip Preservation Surgery (JHPS) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so JHPS has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what JHPS hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes….
{"title":"What The Papers Say.","authors":"Ali Bajwa","doi":"10.1093/jhps/hnae032","DOIUrl":"10.1093/jhps/hnae032","url":null,"abstract":"<p><p>The <i>Journal of Hip Preservation Surgery</i> (<i>JHPS</i>) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so <i>JHPS</i> has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what <i>JHPS</i> hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes….</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 3","pages":"236-239"},"PeriodicalIF":1.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10eCollection Date: 2024-07-01DOI: 10.1093/jhps/hnae030
Richard E Field
{"title":"A growing role for Registry data to guide discussions with patients on their treatment options.","authors":"Richard E Field","doi":"10.1093/jhps/hnae030","DOIUrl":"10.1093/jhps/hnae030","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 3","pages":"165-166"},"PeriodicalIF":1.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae037
Brian P Crowley, James M Helm, Omar G Stocks, Alexis H Aboulafia, Jacob J Siahaan, Alfred A Mansour
Periacetabular osteotomy (PAO) is a procedure used to treat patients with hip dysplasia. Current literature reports symptomatic hardware removal (HWR) rates of 13.6% following PAO. No reports have examined the incidence of or factors relating to screw breakage during HWR. This study reports the incidence of screw breakage in patients undergoing HWR following PAO and examines the associated clinical and surgical factors. Patients who underwent PAO by a single surgeon from 2012 to 2022 were retrospectively reviewed. Demographic, surgical, and implant information was collected. Constructs were stratified by number (three-screw and four-screw) and type (3.5 mm only, 4.5 mm only, and mixed). Incidence rates of HWR and screw breakage were calculated. Three hundred and two hips from 254 patients undergoing PAO were included. Seventy-one hips from 58 patients underwent HWR (23.5%). Eighteen of 259 screws (6.9%) were broken upon removal in 10/71 hips (14.1%). Significantly more 3.5-mm screws were removed (24.7% vs 21.2%; P = .05) and broken than 4.5-mm screws (10.5% vs 3.8%; P = .04). Time to removal was significantly longer in broken screws (16.8 ± 12.7 months vs 33 ± 18.2 months, P < .001). The use of 3.5-mm screws and increased time from implantation to removal are associated with higher rates of screw breakage during HWR following PAO. The use of 4.5-mm screws and earlier time to removal (less than 12 months) both decrease the probability of breakage.
髋臼周围截骨术(PAO)是一种用于治疗髋关节发育不良患者的手术。目前文献报道PAO术后症状性硬体去除(HWR)率为13.6%。目前还没有报道检查HWR期间螺钉断裂的发生率或相关因素。本研究报道PAO术后HWR患者螺钉断裂的发生率,并探讨相关的临床和手术因素。回顾性分析2012年至2022年由单一外科医生行PAO手术的患者。收集了人口统计、手术和种植体信息。结构按数量(三螺钉和四螺钉)和类型(仅3.5 mm、仅4.5 mm和混合)分层。计算HWR和螺钉断裂的发生率。纳入254例PAO患者的312髋。58例患者中71例髋关节行HWR(23.5%)。259枚螺钉中有18枚(6.9%)在10/71髋(14.1%)取出后断裂。3.5 mm螺钉移除率明显高于对照组(24.7% vs 21.2%;P = 0.05)和4.5 mm螺钉断裂(10.5% vs 3.8%;p = .04)。骨折组的螺钉取出时间明显延长(16.8±12.7个月vs 33±18.2个月)
{"title":"Clinical and surgical factors influencing screw breakage during hardware removal following periacetabular osteotomy.","authors":"Brian P Crowley, James M Helm, Omar G Stocks, Alexis H Aboulafia, Jacob J Siahaan, Alfred A Mansour","doi":"10.1093/jhps/hnae037","DOIUrl":"10.1093/jhps/hnae037","url":null,"abstract":"<p><p>Periacetabular osteotomy (PAO) is a procedure used to treat patients with hip dysplasia. Current literature reports symptomatic hardware removal (HWR) rates of 13.6% following PAO. No reports have examined the incidence of or factors relating to screw breakage during HWR. This study reports the incidence of screw breakage in patients undergoing HWR following PAO and examines the associated clinical and surgical factors. Patients who underwent PAO by a single surgeon from 2012 to 2022 were retrospectively reviewed. Demographic, surgical, and implant information was collected. Constructs were stratified by number (three-screw and four-screw) and type (3.5 mm only, 4.5 mm only, and mixed). Incidence rates of HWR and screw breakage were calculated. Three hundred and two hips from 254 patients undergoing PAO were included. Seventy-one hips from 58 patients underwent HWR (23.5%). Eighteen of 259 screws (6.9%) were broken upon removal in 10/71 hips (14.1%). Significantly more 3.5-mm screws were removed (24.7% vs 21.2%; <i>P</i> = .05) and broken than 4.5-mm screws (10.5% vs 3.8%; <i>P</i> = .04). Time to removal was significantly longer in broken screws (16.8 ± 12.7 months vs 33 ± 18.2 months, <i>P</i> < .001). The use of 3.5-mm screws and increased time from implantation to removal are associated with higher rates of screw breakage during HWR following PAO. The use of 4.5-mm screws and earlier time to removal (less than 12 months) both decrease the probability of breakage.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"298-303"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae035
Catherine C Alder, Trevor J Wait, Caleb J Wipf, Carson L Keeter, Adam Peszek, Stephanie W Mayer, Charles P Ho, Alexandra Orahovats, James W Genuario
Intraoperative assessment of labral quality determines arthroscopic repair versus reconstruction for hip labral tear treatment. T2 mapping technology discriminates between healthy and damaged cartilage. This study investigated if T2 mapping magnetic resonance imaging (MRI) can preoperatively predict labral repair versus reconstruction. This retrospective comparative study included patients with preoperative T2 mapping MRI who underwent hip labral repair or reconstruction at a single institution between March 2021 and February 2023. Three reviewers using Syngo.via recorded average T2 mapping values for the labrum, acetabular cartilage, and femoral cartilage on patients' sagittal cut. Intraclass correlation values estimated rater agreement of T2 values. T2 means were compared using t-tests. Three Bayesian regression models were created, separately analyzing the labrum, acetabular cartilage, and femoral cartilage mapping values. The 95% credible intervals determined the significance of regression coefficients. A total of 63 operations were included: 14 reconstructions and 49 repairs. Participants were 14- to 50-years-old, with 35 females and 28 males. There was excellent agreement among raters for T2 measurements. There was no significant difference in average T2 values between the repair and reconstruction groups. All three models showed that the odds of labral reconstruction were negatively associated with T2 mapping values, positively associated with age, and increased in males. Preoperative T2 mapping values from the labrum, acetabular, and femoral cartilage are negatively associated with the odds of needing a labral reconstruction. Increased age and being male are associated with increased odds of needing a labral reconstruction. This study will allow further evaluation into other variables that predict labral repair versus reconstruction.
{"title":"Preoperative quantitative imaging use in predicting intraoperative decision for hip labral repair versus reconstruction.","authors":"Catherine C Alder, Trevor J Wait, Caleb J Wipf, Carson L Keeter, Adam Peszek, Stephanie W Mayer, Charles P Ho, Alexandra Orahovats, James W Genuario","doi":"10.1093/jhps/hnae035","DOIUrl":"10.1093/jhps/hnae035","url":null,"abstract":"<p><p>Intraoperative assessment of labral quality determines arthroscopic repair versus reconstruction for hip labral tear treatment. T2 mapping technology discriminates between healthy and damaged cartilage. This study investigated if T2 mapping magnetic resonance imaging (MRI) can preoperatively predict labral repair versus reconstruction. This retrospective comparative study included patients with preoperative T2 mapping MRI who underwent hip labral repair or reconstruction at a single institution between March 2021 and February 2023. Three reviewers using Syngo.via recorded average T2 mapping values for the labrum, acetabular cartilage, and femoral cartilage on patients' sagittal cut. Intraclass correlation values estimated rater agreement of T2 values. T2 means were compared using <i>t</i>-tests. Three Bayesian regression models were created, separately analyzing the labrum, acetabular cartilage, and femoral cartilage mapping values. The 95% credible intervals determined the significance of regression coefficients. A total of 63 operations were included: 14 reconstructions and 49 repairs. Participants were 14- to 50-years-old, with 35 females and 28 males. There was excellent agreement among raters for T2 measurements. There was no significant difference in average T2 values between the repair and reconstruction groups. All three models showed that the odds of labral reconstruction were negatively associated with T2 mapping values, positively associated with age, and increased in males. Preoperative T2 mapping values from the labrum, acetabular, and femoral cartilage are negatively associated with the odds of needing a labral reconstruction. Increased age and being male are associated with increased odds of needing a labral reconstruction. This study will allow further evaluation into other variables that predict labral repair versus reconstruction.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"287-297"},"PeriodicalIF":1.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae027
Sajid Ansari, Kshitij Gupta, Parshwanath Bondarde, Ch Raja Bhaskar Venkatasai Madhusudan, R B Kalia
Osteonecrosis of femoral head (ONFH) can be a debilitating disease, for which numerous salvage surgeries have been popularized to halt its progression. The aim of this study was to assess the clinical and radiological outcomes of a single-incision core decompression (CD) technique using trochanteric autograft in ONFH and to determine the prognostic factors of treatment success. Sixty-six hips (41 patients) of Association Research Circulation (ARCO) 1 and 2 ONFH undergoing CD were included in the study with a mean follow-up of 58 months. Treatment failure was taken as radiographic collapse and/or conversion to total hip arthroplasty (THA). The following clinical and radiological factors impacting outcomes were evaluated-symptom duration, etiology, age, sex and body mass index, ARCO grade, Japanese Investigation Committee grade, modified Kerboul angle, and bone marrow edema (BME) on magnetic resonance imaging. Twenty-one of the 66 hips (31.8%) had a radiological collapse by the last follow-up, and 6 hips (9%) required THA. Overall, significant improvement in Harris hip scores (60.18 versus 80.81, P-value = .012) and visual analog scale scores (7.3 versus 1.2, P-value = .025) were noted postoperatively with no surgical complications. Late presentation (>3 months) (P-value = .001) and presence of BME (P = 0.0002) were significantly correlated with poor outcomes. The 5-year collapse-free rate was 68.2%, and 91% hips were arthroplasty free. Our single-incision CD technique using a trochanteric autograft yielded favorable outcomes for precollapse stages of nontraumatic ONFH at 5-year follow-up. Delayed presentation and presence of BME are poor prognostic factors. Adequate patient selection is for achieving a good survivorship and improvement in patient-reported outcomes.
{"title":"Outcomes of single-incision-augmented core decompression using trochanteric autograft in osteonecrosis of femoral head-a mean 5-year follow-up study.","authors":"Sajid Ansari, Kshitij Gupta, Parshwanath Bondarde, Ch Raja Bhaskar Venkatasai Madhusudan, R B Kalia","doi":"10.1093/jhps/hnae027","DOIUrl":"10.1093/jhps/hnae027","url":null,"abstract":"<p><p>Osteonecrosis of femoral head (ONFH) can be a debilitating disease, for which numerous salvage surgeries have been popularized to halt its progression. The aim of this study was to assess the clinical and radiological outcomes of a single-incision core decompression (CD) technique using trochanteric autograft in ONFH and to determine the prognostic factors of treatment success. Sixty-six hips (41 patients) of Association Research Circulation (ARCO) 1 and 2 ONFH undergoing CD were included in the study with a mean follow-up of 58 months. Treatment failure was taken as radiographic collapse and/or conversion to total hip arthroplasty (THA). The following clinical and radiological factors impacting outcomes were evaluated-symptom duration, etiology, age, sex and body mass index, ARCO grade, Japanese Investigation Committee grade, modified Kerboul angle, and bone marrow edema (BME) on magnetic resonance imaging. Twenty-one of the 66 hips (31.8%) had a radiological collapse by the last follow-up, and 6 hips (9%) required THA. Overall, significant improvement in Harris hip scores (60.18 versus 80.81, <i>P</i>-value = .012) and visual analog scale scores (7.3 versus 1.2, <i>P</i>-value = .025) were noted postoperatively with no surgical complications. Late presentation (>3 months) (<i>P</i>-value = .001) and presence of BME (<i>P</i> = 0.0002) were significantly correlated with poor outcomes. The 5-year collapse-free rate was 68.2%, and 91% hips were arthroplasty free. Our single-incision CD technique using a trochanteric autograft yielded favorable outcomes for precollapse stages of nontraumatic ONFH at 5-year follow-up. Delayed presentation and presence of BME are poor prognostic factors. Adequate patient selection is for achieving a good survivorship and improvement in patient-reported outcomes.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"280-286"},"PeriodicalIF":1.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae034
Fernando Gómez-Verdejo, Elsa Alvarado-Solorio, Carlos Suarez-Ahedo
Femoroacetabular impingement syndrome (FAIS) is a common condition of the hip that can cause significant damage to the joint, leading to degeneration and osteoarthritis. FAIS constitutes an abnormal and dynamic contact between the femoral head-neck junction and the acetabular rim, resulting from altered bone morphology at one or both sites. Repetitive trauma at the site of impingement generates progressive damage to the acetabular labrum, chondrolabral junction, and articular cartilage. Proper diagnosis based on patient symptoms, specific clinical signs, and imaging findings will guide treatment and ultimately allow preservation of the native hip joint. Common symptoms in patients with FAIS include pain, clicking, catching, buckling, stiffness, giving way, and a limited range of motion of the hip. Specific clinical maneuvers can aid diagnosis, such as flexion adduction internal rotation and flexion abduction external rotation tests. Imaging diagnosis includes orthogonal hip and pelvis X-ray views, as well as magnetic resonance imaging/magnetic resonance arthrogram imaging. Initial treatment of FAIS can be conservative and include physical therapy, intra-articular injections, and activity modification. Currently, the preferred surgical management consists of hip arthroscopy, which aims to correct bony abnormalities, repair or reconstruct labral lesions and address other intra-articular and extra-articular derangements as needed.
{"title":"Review of femoroacetabular impingement syndrome.","authors":"Fernando Gómez-Verdejo, Elsa Alvarado-Solorio, Carlos Suarez-Ahedo","doi":"10.1093/jhps/hnae034","DOIUrl":"10.1093/jhps/hnae034","url":null,"abstract":"<p><p>Femoroacetabular impingement syndrome (FAIS) is a common condition of the hip that can cause significant damage to the joint, leading to degeneration and osteoarthritis. FAIS constitutes an abnormal and dynamic contact between the femoral head-neck junction and the acetabular rim, resulting from altered bone morphology at one or both sites. Repetitive trauma at the site of impingement generates progressive damage to the acetabular labrum, chondrolabral junction, and articular cartilage. Proper diagnosis based on patient symptoms, specific clinical signs, and imaging findings will guide treatment and ultimately allow preservation of the native hip joint. Common symptoms in patients with FAIS include pain, clicking, catching, buckling, stiffness, giving way, and a limited range of motion of the hip. Specific clinical maneuvers can aid diagnosis, such as flexion adduction internal rotation and flexion abduction external rotation tests. Imaging diagnosis includes orthogonal hip and pelvis X-ray views, as well as magnetic resonance imaging/magnetic resonance arthrogram imaging. Initial treatment of FAIS can be conservative and include physical therapy, intra-articular injections, and activity modification. Currently, the preferred surgical management consists of hip arthroscopy, which aims to correct bony abnormalities, repair or reconstruct labral lesions and address other intra-articular and extra-articular derangements as needed.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"315-322"},"PeriodicalIF":1.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01eCollection Date: 2024-12-01DOI: 10.1093/jhps/hnae033
Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides
The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, P ≤ .001, d = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, P ≤ .001, d = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.
本研究的目的是验证翻修关节镜下环缘同种异体唇瓣重建术(CLR)在非关节炎髋关节中的成功,在罕见的失败情况下,以前曾由同一外科医生进行过唇瓣重建术。通过至少24个月的随访,分析了24个髋关节的翻修CLR数据,以确定患者报告的预后(PROs)的改善。所有纳入的病例完成了至少24个月的随访,成功率为96%。所有的PROs都有了显著的改善,效果非常明显。改良Harris髋关节评分平均提高26.68分,88%的患者达到最小临床重要差异(MCID) (+6.49, P≤)。001, d = 1.32)。下肢功能量表评分平均提高21.88分,78%的患者达到MCID (+7.79, P≤)。001, d = 1.32)。根据视觉模拟量表(Visual analogue Scale)评定的疼痛,包括休息、日常生活活动和运动时的疼痛,都得到了显著改善,效果显著,约75%的患者达到了MCID。本研究证实,失败的髋关节唇部重建可以安全有效地进行另一次髋关节唇部重建。虽然唇部重建已广泛显示出非常好的结果,但本研究表明,在极少数失败的情况下,翻修CLR不仅可行,而且可以改善疼痛和功能。
{"title":"Failed labral reconstruction of the hip can be successfully revised to another labral reconstruction: improved patient-reported outcomes at a minimum of 2-year follow-up.","authors":"Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides","doi":"10.1093/jhps/hnae033","DOIUrl":"10.1093/jhps/hnae033","url":null,"abstract":"<p><p>The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, <i>P</i> ≤ .001, <i>d</i> = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, <i>P</i> ≤ .001, <i>d</i> = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"271-279"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Cevolani, Marco Focaccia, Benedetta Spazzoli, Alessandro Bruschi, Eric Lodewijk Staals, Barbara Dozza, Roberta Laranga, Tommaso Frisoni, Andrea Sambri, Andrea Montanari, Giuseppe Bianchi, Davide Maria Donati
The aim of this article is to determine the safety and efficacy of core decompression (CD) combined with injection of autologous bone marrow concentrate (BMC), demineralized bone matrix (DBM), and platelet-rich fibrin (PRF) for treating femoral head osteonecrosis. Seventy-seven patients (53 males and 24 females) for a total of 87 hips were treated for hip osteonecrosis with CD combined with injection of autologous BMC, DBM, and PRF at Rizzoli Orthopedic Institute from September 2008 to December 2019. Patients were assessed at baseline, at 45 days, and at 3, 6, 12, 24, and 36 months postoperatively. The primary outcome was the survival rate of hips not converted to total hip arthroplasty (THA). The secondary outcomes were (I) radiographic positive evolution assessed by X-ray films and magnetic resonance imaging and (II) the clinical symptoms evaluated with the Harris Hip Score (HHS). Eighty-seven hips from 77 patients with femoral head osteonecrosis (FHON), 60 males and 27 females, with a median age of 34 years (range 15–55) were included. The cause of necrosis was steroid treatment in 30 patients (17 of these for hematological malignancies, 2 for lupus, 1 for Churg–Strauss syndrome, and the remaining for other causes), 1 was alcohol-related, 4 followed hip injury, while 15 patients had idiopathic causes. THA was carried out in 20 hips (40%). These patients had lesions classified as IIa on the Ficat stage in four cases, six were IIb, nine were III, and one was 4. No CD-related complications were found during THA surgery or at the last follow-up in these cohorts of patients. Radiographic progression of the FHON was found in 14 hips (28%), with a higher percentage on Ficat’s stage IIb. There were procedure-related complications in two hips, including one femoral neck fracture and one deep infection. Nineteen hips with successful treatment had good to excellent functional results at a 3-year follow-up or more (HHS ≥ 80). The long-term outcomes of treatment with CD and injection with BMC combined with DBM and PRF are promising to prevent femoral head collapse in patients with FHON. Moreover, CD does not influence the outcome in cases of THA.
{"title":"Is core decompression and bone marrow concentrate with demineralized bone matrix and platelet-rich fibrin suitable for treating femoral head osteonecrosis?","authors":"Luca Cevolani, Marco Focaccia, Benedetta Spazzoli, Alessandro Bruschi, Eric Lodewijk Staals, Barbara Dozza, Roberta Laranga, Tommaso Frisoni, Andrea Sambri, Andrea Montanari, Giuseppe Bianchi, Davide Maria Donati","doi":"10.1093/jhps/hnae031","DOIUrl":"https://doi.org/10.1093/jhps/hnae031","url":null,"abstract":"The aim of this article is to determine the safety and efficacy of core decompression (CD) combined with injection of autologous bone marrow concentrate (BMC), demineralized bone matrix (DBM), and platelet-rich fibrin (PRF) for treating femoral head osteonecrosis. Seventy-seven patients (53 males and 24 females) for a total of 87 hips were treated for hip osteonecrosis with CD combined with injection of autologous BMC, DBM, and PRF at Rizzoli Orthopedic Institute from September 2008 to December 2019. Patients were assessed at baseline, at 45 days, and at 3, 6, 12, 24, and 36 months postoperatively. The primary outcome was the survival rate of hips not converted to total hip arthroplasty (THA). The secondary outcomes were (I) radiographic positive evolution assessed by X-ray films and magnetic resonance imaging and (II) the clinical symptoms evaluated with the Harris Hip Score (HHS). Eighty-seven hips from 77 patients with femoral head osteonecrosis (FHON), 60 males and 27 females, with a median age of 34 years (range 15–55) were included. The cause of necrosis was steroid treatment in 30 patients (17 of these for hematological malignancies, 2 for lupus, 1 for Churg–Strauss syndrome, and the remaining for other causes), 1 was alcohol-related, 4 followed hip injury, while 15 patients had idiopathic causes. THA was carried out in 20 hips (40%). These patients had lesions classified as IIa on the Ficat stage in four cases, six were IIb, nine were III, and one was 4. No CD-related complications were found during THA surgery or at the last follow-up in these cohorts of patients. Radiographic progression of the FHON was found in 14 hips (28%), with a higher percentage on Ficat’s stage IIb. There were procedure-related complications in two hips, including one femoral neck fracture and one deep infection. Nineteen hips with successful treatment had good to excellent functional results at a 3-year follow-up or more (HHS ≥ 80). The long-term outcomes of treatment with CD and injection with BMC combined with DBM and PRF are promising to prevent femoral head collapse in patients with FHON. Moreover, CD does not influence the outcome in cases of THA.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"3 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}