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Journal of Hip Preservation Surgery最新文献

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What the papers say. 报纸上说的。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2025-01-18 eCollection Date: 2024-12-01 DOI: 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 ….

《髋关节保存外科杂志》(JHPS)并不是唯一可以发表髋关节保存领域研究成果的杂志。虽然我们的目标是提供最好的,但我们一直被工作所吸引,这些工作在我们自己以外的期刊上找到了自己的方式。有很多东西可以从中学习,所以JHPS为那些寻求总结在我们迷人的髋关节保护世界中正在发生的事情的人选择了六个最近和热门的主题。您在这里看到的是原始文章的稍微编辑的摘要,以给JHPS希望的更可读的感觉。如果你时间紧迫,下面的内容应该不超过10分钟。这是....
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引用次数: 0
Levels of evidence. 证据水平。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2025-01-18 eCollection Date: 2024-12-01 DOI: 10.1093/jhps/hnae047
Richard E Field
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引用次数: 0
What The Papers Say. 报纸怎么说?
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-12-10 eCollection Date: 2024-07-01 DOI: 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….

《髋关节保存外科杂志》(JHPS)并不是唯一可以发表髋关节保存领域研究成果的杂志。虽然我们的目标是提供最好的,但我们一直被工作所吸引,这些工作在我们自己以外的期刊上找到了自己的方式。有很多东西可以从中学习,所以JHPS为那些寻求总结在我们迷人的髋关节保护世界中正在发生的事情的人选择了六个最近和热门的主题。您在这里看到的是原始文章的稍微编辑的摘要,以给JHPS希望的更可读的感觉。如果你时间紧迫,下面的内容应该不超过10分钟。这是....
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引用次数: 0
A growing role for Registry data to guide discussions with patients on their treatment options. 注册数据在指导与患者讨论治疗方案方面的作用越来越大。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-12-10 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae030
Richard E Field
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引用次数: 0
Clinical and surgical factors influencing screw breakage during hardware removal following periacetabular osteotomy. 影响髋臼周围截骨术后内固定物取出螺钉断裂的临床及手术因素。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-11-21 eCollection Date: 2024-12-01 DOI: 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)
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引用次数: 0
Preoperative quantitative imaging use in predicting intraoperative decision for hip labral repair versus reconstruction. 术前定量影像学应用于预测术中髋关节唇部修复与重建的决策。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-11-15 eCollection Date: 2024-12-01 DOI: 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.

术中对唇部质量的评估决定了髋关节唇部撕裂治疗的关节镜修复与重建。T2定位技术可以区分健康软骨和受损软骨。本研究探讨了T2定位磁共振成像(MRI)是否可以术前预测唇部修复与重建。这项回顾性比较研究纳入了2021年3月至2023年2月在同一家机构接受髋关节唇部修复或重建的术前T2定位MRI患者。三个评论者使用Syngo。通过记录患者矢状面切口上唇、髋臼软骨和股软骨的平均T2定位值。类内相关值估计T2值的一致性更高。T2均值比较采用t检验。建立3个贝叶斯回归模型,分别分析唇状软骨、髋臼软骨和股软骨的映射值。95%可信区间确定回归系数的显著性。总共包括63次手术:14次重建和49次修复。参与者年龄在14到50岁之间,其中女性35人,男性28人。评分者对T2的测量结果非常一致。修复组与重建组平均T2值差异无统计学意义。所有三种模型均显示,唇部重建的几率与T2测绘值负相关,与年龄正相关,且在男性中增加。术前唇部、髋臼和股软骨的T2定位值与需要唇部重建的几率呈负相关。年龄的增长和男性需要进行唇部重建的几率增加有关。这项研究将允许进一步评估预测唇部修复与重建的其他变量。
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引用次数: 0
Outcomes of single-incision-augmented core decompression using trochanteric autograft in osteonecrosis of femoral head-a mean 5-year follow-up study. 自体转子单切口增强股骨头减压治疗股骨头坏死的疗效——平均5年随访研究。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-11-08 eCollection Date: 2024-12-01 DOI: 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.

股骨头坏死(ONFH)是一种使人衰弱的疾病,许多抢救手术已经普及,以阻止其进展。本研究的目的是评估使用自体转子移植术治疗ONFH的单切口核心减压(CD)技术的临床和影像学结果,并确定治疗成功的预后因素。协会研究循环(ARCO) 1和2 ONFH接受CD的66髋(41例)纳入研究,平均随访58个月。治疗失败被视为影像学塌陷和/或转为全髋关节置换术(THA)。评估影响预后的临床和影像学因素:症状持续时间、病因、年龄、性别和体重指数、ARCO分级、日本调查委员会分级、改良Kerboul角和磁共振成像骨髓水肿(BME)。66个髋关节中有21个(31.8%)在最后一次随访时出现放射塌陷,6个髋关节(9%)需要THA。总体而言,术后Harris髋关节评分(60.18比80.81,p值= 0.012)和视觉模拟评分(7.3比1.2,p值= 0.025)均有显著改善,无手术并发症。就诊晚(0 ~ 3个月)(P值= 0.001)和BME的存在(P = 0.0002)与不良预后显著相关。5年无塌陷率为68.2%,91%髋部无置换术。在5年的随访中,我们采用自体转子移植的单切口CD技术对非外伤性ONFH塌陷前阶段取得了良好的结果。延迟的表现和BME的存在是不良的预后因素。充分的患者选择是为了获得良好的生存和改善患者报告的结果。
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引用次数: 0
Review of femoroacetabular impingement syndrome. 股髋臼撞击综合征综述。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-10-15 eCollection Date: 2024-12-01 DOI: 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.

股髋臼撞击综合征(FAIS)是髋关节的一种常见疾病,可对关节造成严重损害,导致退变和骨关节炎。FAIS是股骨头颈交界处与髋臼缘之间的异常动态接触,由一个或两个部位的骨形态改变引起。撞击部位的重复性创伤会对髋臼唇、软骨唇交界处和关节软骨造成进行性损伤。基于患者症状、特定临床体征和影像学表现的正确诊断将指导治疗并最终保留原有髋关节。FAIS患者的常见症状包括疼痛、咔嗒声、卡住、屈曲、僵硬、让位和髋关节活动范围有限。具体的临床操作可以帮助诊断,如屈曲内收内旋和屈曲外展外旋试验。影像学诊断包括髋关节和骨盆的正交x线片,以及磁共振成像/磁共振关节成像。FAIS的初始治疗可以是保守治疗,包括物理治疗、关节内注射和活动调节。目前,首选的手术治疗包括髋关节镜检查,其目的是纠正骨骼异常,修复或重建唇部病变,并根据需要处理其他关节内和关节外的紊乱。
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引用次数: 0
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. 失败的髋关节唇部重建可以成功地修正为另一个唇部重建:在至少2年的随访中改善了患者报告的结果。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-10-01 eCollection Date: 2024-12-01 DOI: 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。
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引用次数: 0
Is core decompression and bone marrow concentrate with demineralized bone matrix and platelet-rich fibrin suitable for treating femoral head osteonecrosis? 核心减压术和含有脱矿物质骨基质和富血小板纤维蛋白的骨髓浓缩物是否适合治疗股骨头坏死?
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1093/jhps/hnae031
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.
本文旨在确定核心减压(CD)联合注射自体骨髓浓缩物(BMC)、去矿物质骨基质(DBM)和富血小板纤维蛋白(PRF)治疗股骨头坏死的安全性和有效性。2008年9月至2019年12月,瑞佐利骨科研究所对77名患者(53名男性和24名女性)共87个髋关节进行了CD联合注射自体骨髓浓缩物、去矿物质骨基质和富血小板纤维蛋白治疗髋关节骨坏死的治疗。对患者进行了基线、45 天、术后 3、6、12、24 和 36 个月的评估。主要结果是未转为全髋关节置换术(THA)的髋关节存活率。次要结果是:(I) 通过X光片和磁共振成像评估的放射学阳性进展;(II) 通过哈里斯髋关节评分(HHS)评估的临床症状。77例股骨头坏死(FHON)患者的87个髋关节被纳入研究,其中男性60例,女性27例,中位年龄34岁(15-55岁)。30例患者的坏死原因为类固醇治疗(其中17例为血液恶性肿瘤,2例为狼疮,1例为丘格-斯特劳斯综合征,其余为其他原因),1例与酒精有关,4例为髋关节损伤,15例为特发性原因。20例(40%)髋关节接受了全髋关节置换术。在这些患者中,4 例患者的病变在 Ficat 分期中被归类为 IIa,6 例为 IIb,9 例为 III,1 例为 4。有14个髋关节(28%)的FHON出现放射学进展,其中Ficat分期为IIb的比例较高。有两个髋关节出现了手术相关并发症,包括一个股骨颈骨折和一个深部感染。19个治疗成功的髋关节在3年或更长时间的随访中获得了良好至卓越的功能效果(HHS≥80)。CD和注射BMC联合DBM和PRF治疗的长期疗效对预防FHON患者的股骨头塌陷很有帮助。此外,CD不会影响THA的疗效。
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引用次数: 0
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