Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 2017
What MRI Findings Predict Failure 10 Years After Surgery for Femoroacetabular Impingement?
Magnetic resonance arthrogram (MRA) with radial cuts is presently the best available preoperative imaging study to evaluate chondrolabral lesions in the setting of femoroacetabular impingement (FAI). Existing followup studies for surgical treatment of FAI have evaluated predictors of treatment failure based on preoperative clinical examination, intraoperative findings, and conventional radiography. However, to our knowledge, no study has examined whether any preoperative findings on MRA images might be associated with failure of surgical treatment of FAI in the long term. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Apr 2017
Does Surgeon Experience Impact the Risk of Complications After Bernese Periacetabular Osteotomy?
Bernese periacetabular osteotomy (PAO) is a technically challenging procedure with potential risk for major complications and a previously reported steep learning curve. However, the impact of contemporary hip preservation fellowships on the learning curve of PAO has not been established. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Apr 2017
Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations With CT.
Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. ⋯ Level IV, prognostic study.
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Clin. Orthop. Relat. Res. · Apr 2017
Comparative StudyPeriacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion.
Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d'Aubigné scores in a midterm followup compared with rim trimming. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Apr 2017
Comparative StudyLabral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection.
Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years. ⋯ Level III, therapeutic study.