HIP International最新文献

{"title":"The accuracy of a patient-specific femoral planning and delivery system for total hip arthroplasty.","authors":"Jason M Jennings, Tristan Jones, Chameka S Madurawe, Jim Pierrepont, Paula Abila, Douglas A Dennis","doi":"10.1177/11207000241307378","DOIUrl":"10.1177/11207000241307378","url":null,"abstract":"<p><strong>Introduction: </strong>A primary objective when performing a total hip arthroplasty (THA) is to restore hip biomechanics in accordance with a chosen surgical plan. The aim of this study was to assess the accuracy of a 3D-printed patient-specific guide for delivering a planned femoral osteotomy for both a posterior and an anterior approach.</p><p><strong>Methodology: </strong>40 patients (20 anterior and 20 posterior) scheduled for THA received a preoperative work-up allowing for patient-specific implant sizing and positioning. Following surgeon confirmation, a patient-specific guide was designed and printed, enabling the desired osteotomy to be executed. Achieved osteotomies were assessed using commercially available software platforms. Planning accuracy was also assessed using both the planning platform as well as more traditional 2D-templating techniques.</p><p><strong>Results: </strong>The mean deviation between the planned and achieved osteotomy level was -0.6 mm (range -4.1-6.4 mm). 95% of the achieved osteotomy levels were within 3 mm of the plan for both the posterior and anterior approach groups. 70% of the Optimized Positioning System (OPS) planned femoral components were the exact size as planned versus 25% of the 2D-planned components. 98% of the OPS planned femoral components were within 1 size of plan versus 58% for the 2D-planned components. No sizing accuracy difference was observed between planning approaches (<i>p</i> = 0.70).</p><p><strong>Conclusions: </strong>A patient-specific osteotomy guide can be a simple and accurate method to reproduce a planned femoral neck resection through an anterior or posterior approach. Further, 3D planning appears to more accurately predict femoral sizing in THA than more conventional 2D methods.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"124-129"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947823","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}

{"title":"Achieving cup target as per spinopelvic assessment is associated with improved THA outcome: a prospective, multicentre study.","authors":"Jeroen C F Verhaegen, Moritz Innmann, Camille Vorimore, Christian Merle, George Grammatopoulos","doi":"10.1177/11207000241312654","DOIUrl":"10.1177/11207000241312654","url":null,"abstract":"<p><strong>Background: </strong>Different methods can help to optimise sagittal cup orientation in total hip arthroplasty (THA) based on individual spinopelvic characteristics. This study aimed to: (1) assess how often combined sagittal index (CSI) and hip-spine-classification targets were achieved post THA; (2) compare anteversion/inclination between cups in-/outside optimal CSI zone; and (3) determine association with outcome.</p><p><strong>Methods: </strong>This is a multicentre, prospective, case-cohort study of 435 primary THA for osteoarthritis (53% females; age: 65 ± 12 years; follow-up: 2.4 ± 0.6 years) (58% lateral, 29% anterior, 13% posterior approach). No robotics or dual-mobility were used. Patients underwent spinopelvic radiographs to measure parameters including lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), pelvic femoral angle (PFA), and ante-inclination (AI) on lateral spinopelvic radiographs. Unbalanced spine was defined as PI - LL ⩾ 10° (PI: pelvic incidence; LL: lumbar lordosis), stiffness as ∆LL < 20°. Optimal cup orientation was based on CSI targets: 205-245° for balanced spine (<i>n =</i> 327), or 215-235° for unbalanced spine (<i>n =</i> 108), hip-spine classification targets (±5°), and conventional inclination/anteversion (40/20° ± 10°) target. Patient-reported outcome was measured using Oxford Hip Score (OHS).</p><p><strong>Results: </strong>CSI targets were achieved in 60% (<i>n =</i> 261/435), whilst 44% had cup position within hip-spine classification targets (<i>n =</i> 125/284). Anteversion was higher among cups within CSI targets (26° ± 8° vs. 22° ± 10°; <i>p <</i> 0.001). Overall dislocation rate was 0.9% (<i>n =</i> 4/435), without difference whether CSI targets were achieved (0.4% vs. 1.7%; <i>p =</i> 0.178). Postoperative OHS was better among those within CSI targets (42 ± 8 vs. 40 ± 9; <i>p =</i> 0.003) or within hip-spine-classification targets (<i>p =</i> 0.028), but not according to conventional orientation (<i>p =</i> 0.384).</p><p><strong>Conclusions: </strong>Awareness of adverse spinopelvic characteristics and using sagittal characteristics (especially CSI) can help surgeons to achieve optimal cup orientation, improving outcome and reducing dislocation risk post-THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"130-141"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046574","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}

{"title":"RM Pressfit vitamys: the 10-year follow-up.","authors":"Pascal C Haefeli, Zinedine M Zwahlen, Ralf Baumgärtner, Björn-Christian Link, Martin Beck","doi":"10.1177/11207000241304659","DOIUrl":"10.1177/11207000241304659","url":null,"abstract":"<p><strong>Introduction: </strong>The RM Pressfit vitamys is an uncemented, titanium particle-coated, isoelastic monoblock cup made of vitamin E blended highly cross-linked polyethylene. We addressed the following questions: (1) What are the clinical and (2) radiographic outcomes 10 years after implantation? (3) What is the revision rate?</p><p><strong>Methods: </strong>In this prospective observational study in a tertiary care centre we investigated all consecutive cases of total hip replacement with the RM Pressfit vitamys cup between September 2009 and November 2011. It was implanted in 162 hips, 49.4% in women. The mean age was 67.2 years (standard deviation [SD] 9.5), and the mean BMI was 27.3 kg/m² (SD 4.7). In 153 cases (94.4%), primary or secondary osteoarthritis was the diagnosis. We evaluated preoperative and follow-up data at 6 weeks, 1, 5, and 10 years. A modified Harris Hip Score (mHHS), pain and satisfaction on a visual analogue scale (VAS), radiographic evaluation, complications and revision rate were investigated.</p><p><strong>Results: </strong>At the 10-year follow-up (mean 120.5 months, SD 1.4, range 118-126), 99 hips were available for clinical and radiographic evaluation. (1) The mean mHHS was 94.8 (SD 9.9), rest pain 0.2 (SD 0.6), load pain 0.5 (SD 1.5), and satisfaction 9.5 (SD 1.1). The mean improvement as compared to preoperatively was +33.7 (SD 16.8), -3.3 (SD 2.7), -6.0 (SD 2.4) and +5.7 (SD 2.5), respectively. (2) In the radiographic evaluation, no loose cups, no acetabular lucent lines, or acetabular osteolysis were seen. (3) 2 cups were revised, both due to malpositioning. The 10-year cumulative revision rate was 2.0% (95%CI, 0.0-4.2%). The implant survival rate with aseptic loosening as endpoint was 100%. No adverse events were reported.</p><p><strong>Conclusions: </strong>At the 10-year follow-up, the RM Pressfit vitamys cup still had promising results with good clinical and radiographic outcomes and a low revision rate.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"142-149"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947820","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}

{"title":"Ilio-femoral impingement angle: a new radiographic measurement.","authors":"Jackson Ellis, Isaac Rhee, Sina Babazadeh, Dirk Van Bavel","doi":"10.1177/11207000241311530","DOIUrl":"10.1177/11207000241311530","url":null,"abstract":"<p><strong>Background: </strong>Hip dislocations after total hip arthroplasty (THA) are a debilitating complication, often occurring in deep flexion. Current 3D modelling allows for simulating the flexion angle at which bone-on-bone impingement occurs, but it is resource-intensive and not widely available for routine clinical use. Therefore, we propose the ilio-femoral impingement angle (IFIa) as a novel, simple radiographic measure to help identify patients at higher risk for dislocation using standard radiographs.</p><p><strong>Methods: </strong>A radiographic study was performed on 117 consecutive patients who underwent preoperative planning for THA with 3D remodelling from 2021 to 2022 at a single institution. The flexion angle was recorded at which the femur impingement on the pelvis was identified from the 3D model. This was compared to the angle subtended between a vertical line, the centre of the femoral head and a line rotated upwards to the first point of contact with the ipsilateral ilium. This angle was named the ilio-femoral impingement angle (IFIa).</p><p><strong>Results: </strong>The mean IFIa was 142.29° ± 11.49°, and it demonstrated a strong correlation with the 3D impingement angle (r = 0.69, <i>p <</i> 0.05). The inter-rater reliability of the IFIa measurement was high, with an ICC of 0.87, confirming the consistency of this novel radiographic measure.</p><p><strong>Conclusions: </strong>This study demonstrates that the novel radiographic measurement of the IFIa represented the deep flexion impingement angle of the femur on the ilium. The IFIa may be used as simple and cost-effective alternative measurement to model impingement during flexion.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"174-180"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947817","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}

{"title":"Postoperative delirium following total joint arthroplasty: epidemiology, risk factors, and associated complications.","authors":"Ashley Knebel, Manjot Singh, Rhea Rasquinha, Mohammad Daher, Joseph E Nassar, John Hanna, Eric M Cohen, Bassel G Diebo, Alan H Daniels","doi":"10.1177/11207000241305771","DOIUrl":"10.1177/11207000241305771","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium (POD) is a feared complication following major surgery in elderly patients. Further investigation of the risk factors and consequences of POD following total joint arthroplasty is warranted.</p><p><strong>Methods: </strong>Patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) were identified using PearlDiver. Patients were filtered into 2 cohorts based on the presence or absence of POD within 7 days of surgery. Epidemiological analyses were performed to examine trends in POD following TKA and THA by age group and year. Comparative analyses were performed on patient demographics and baseline cognitive status. After matching by age, sex, and comorbidities, electrolyte disturbances and 90-day postoperative complications were analysed.</p><p><strong>Results: </strong>Among 2,518,918 (99.7%) no POD and 7240 (0.3%) POD patients who underwent total knee or hip arthroplasty, mean age was 65.58 years, 60.2% were female, and mean CCI was 1.50 for the whole cohort. POD patients frequently had baseline cognitive impairment (<i>P</i> <i><</i> 0.001). Incidence of POD decreased from 0.54% in 2010 to 0.10% in 2022 (<i>P</i> <i><</i> 0.001) and increased with age (<i>P</i> <i><</i> 0.001). POD patients had higher 90-day costs (TKA = $19,572 vs. $10,397, <i>P</i> <i><</i> 0.001; THA = $18,496 vs. $9,877 <i>P</i> <i><</i> 0.001). After matching, POD TKA patients had higher rates of hypernatraemia (6.1% vs 4.5%, <i>P</i> <i>=</i> 0.001) and POD THA patients had higher rates of hyponatraemia (26.5% vs 23.1%, <i>P</i> <i>=</i> 0.008). POD patients had higher rates of 90-day postoperative medical and surgical complications (<i>P</i> <i><</i> 0.05) than no POD patients.</p><p><strong>Conclusions: </strong>Nearly 0.3% of patients who underwent either TKA or THA between 2010 and 2022 developed transient delirium. POD was most common in elderly patients with baseline cognitive impairment undergoing revision surgery. POD patients had higher rates of 90-day postoperative surgical and joint-related complications. While POD rates have decreased, continued initiative to prevent POD in total joint arthroplasty patients is imperative.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"150-158"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812924","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}

{"title":"Short-term outcomes of AVN CAGE implantation for early-stage osteonecrosis of the femoral head.","authors":"Shaoyi Guo, Wang Deng, Wenzhou Xiao, Yunfeng Zhang, Dejin Yang, Yixin Zhou","doi":"10.1177/11207000241304362","DOIUrl":"10.1177/11207000241304362","url":null,"abstract":"<p><strong>Purpose: </strong>Considering the low survival rate for the numerous hip-preserving procedures developed for treating early-stage osteonecrosis of the femoral head (ONFH), this study aimed to evaluate short-term clinical outcomes following avascular necrosis (AVN) CAGE implantation.</p><p><strong>Methods: </strong>58 hips with early-stage ONFH (44 with Association Research Circulation Osseous [ARCO] stage 2 and 14 with stage 3A) treated with the AVN CAGE between August 2018 and December 2021 were included. The survival rates were analysed using radiographic progression and conversion to subsequent total hip arthroplasty (THA) as endpoints.</p><p><strong>Results: </strong>The mean follow-up period was 22.2 ± 8.2 months. 11 hips progressed to ARCO stage 3B/4, and 6 underwent THA. The estimated 2-year radiographic survival rates were 89.1% and 59.0% for patients with ARCO stages 2 and 3A, respectively. The estimated 2-year radiographic survival rates were 92.9% and 76.3% for Japanese Investigation Committee type B/C1 and C2, respectively. The overall estimated 2-year THA-free survival rate was 88.9%. Advanced disease stage and a large necrotic area were independent risk factors for radiographic progression.</p><p><strong>Conclusions: </strong>AVN CAGE combined with standard core decompression was a promising hip-preserving option for patients with no signs of collapse, small necrotic areas, or medially located necrotic locations.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"181-189"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794196","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}

{"title":"Zuyderland Hip Inference for Survival and Lifetime Expectancy (ZHISLE) following hip fracture surgery: validation of the model that demonstrated good predictive power.","authors":"Maud A M Vesseur, Lars Quaedvlieg, Martijn G M Schotanus, Jasper Most, Lee H Bouwman, Raoul van Vugt, Bert Boonen","doi":"10.1177/11207000241312306","DOIUrl":"10.1177/11207000241312306","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal femoral fractures are common within the elderly population and are associated with a high risk of mortality and reduced quality of life. Hemiarthroplasty or osteosynthesis (extramedullary or intramedullary) is the primary treatment option for these fractures. However, within this fragile patient population many comorbidities, among others dementia, are seen. Therefore, predicting patients with a high mortality risk after surgery may lead to adopting alternative treatment options with less risks. This paper proposes a new model to distinguish patients with high postoperative mortality risk with adequate follow-up time in combination with a wide set of useful and available variables.</p><p><strong>Methods: </strong>Patients treated with hemiarthroplasty or osteosynthesis for proximal femoral fractures were studied, with a follow-up period of 6 months. Patients who died within this follow-up period were compared to survivors, and predicting variables were assessed in logistic regression: The Zuyderland Hip Inference for Survival and Lifetime Expectancy (ZHISLE). The model was validated internally against a held-out dataset. Furthermore, the model performance was compared against the Almelo Hip Fracture Score (AHFS) on the same sample.</p><p><strong>Results: </strong>Out of 2463 patients undergoing surgical treatment for proximal femoral fractures, 415 (16.8%) died within 183 days. Predictors for early mortality included old age, male sex, high heartbeat, KATZ-ADL and GFI scores, C-reactive protein and urea concentrations and low albumin concentration. Our model showed satisfactory predictive and discriminatory power (ROC curve = 0.81). Internal validation was good (ROC in validation dataset = 0.81), and better than the AHFS (ROC = 0.57).</p><p><strong>Conclusions: </strong>The ZHISLE model demonstrates good predictive power concerning mortality risk for old patients with a proximal femoral fracture. The model could benefit patients by indicating if a conservative, non-invasive policy might be a better option for those patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"214-219"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947845","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}

{"title":"Robotic-assistance and computer-navigation have similar rates of intraoperative fracture and return to the operating room within 1 year to fluoroscopy-only direct anterior total hip arthroplasty.","authors":"Ilya Bendich, Yu-Fen Chiu, Nana Sarpong, Alejandro Gonzalez Della Valle, Edwin Su, Alexander McLawhorn","doi":"10.1177/11207000241305977","DOIUrl":"10.1177/11207000241305977","url":null,"abstract":"<p><strong>Introduction: </strong>The use of technology in direct anterior approach (DAA) total hip arthroplasty (THA) is expanding. Although the use of computer-navigation (CN-THA) and robotics (RA-THA) has previously demonstrated improved component positioning, it is important to understand whether its use is associated with differences in intraoperative complications or early return to the operating room when compared to fluoroscopy-only (manual-THA) DAA THA.</p><p><strong>Methods: </strong>3433 DAA THAs (226 RA-THA, 1007 CN-THA, 2200 manual-THA) performed at a single institution were retrospectively reviewed. Cohorts were adjusted for age, sex, BMI, femoral fixation, history of spine fusion, and Charlson Co-morbidity Index (CCI) using Inverse Probability of Treatment Weight (IPTW). Operative times were identified. Intraoperative fractures and re-operations within 1 year were identified via chart review.</p><p><strong>Results: </strong>There were no statistically significant differences in intraoperative fracture among the cohorts (0.4% RA-THA, 0.4% CN-THA, 0.4% manual-THA; p > 0.529). There were also no statistically significant differences (<i>p</i> > 0.589) among the cohorts in rates of return to the operating room within 1 year for postoperative fracture (0.0% RA-THA, 0.4% CN-THA, 0.4% manual-THA), dislocation (0.0% RA-THA, 0.0% CN-THA, 0.1% manual-THA), infection (0.4% RA-THA, 0.7% CN-THA, 0.5% manual-THA), or other aetiologies (0.0% RA-THA, 0.2% CN-THA, 0.1% manual-THA).</p><p><strong>Conclusions: </strong>This study did not find a statistically significant difference in intraoperative fracture or re-operations within 1 year between DAA THA performed with RA, CN, or manual techniques. The introduction of technology to THA is not associated with increase in reoperations within one-year.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"116-123"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835353","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}

{"title":"Patients with multiple sclerosis have higher rates of worsening following total hip arthroplasty: a propensity-matched analysis.","authors":"Perry L Lim, Nicholas Sauder, Zain Sayeed, Michael Esantsi, Hany S Bedair, Christopher M Melnic","doi":"10.1177/11207000241297630","DOIUrl":"10.1177/11207000241297630","url":null,"abstract":"<p><strong>Introduction: </strong>The progressive nature of multiple sclerosis (MS) may adversely affect outcomes following total hip arthroplasty (THA). As patient-reported outcome measures (PROMs) in this specific group are not well defined, this study aimed to compare the clinical outcomes and the rates of achieving the minimal clinically important difference for improvement (MCID-I) and worsening (MCID-W) between patients with MS and those without MS undergoing THA.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 375 THAs, including 75 MS patients and 300 propensity-matched non-MS patients (4:1), performed between 2016 and 2022. Collected PROMs included Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Mental and Physical, PROMIS Physical Function short form 10-a (PF-10a), and Hip disability and Osteoarthritis Outcome Score-Physical Function Short-form (HOOS-PS). Preoperative and postoperative PROMs and MCID-I/MCID-W rates were compared.</p><p><strong>Results: </strong>A total of 375 THAs, including 75 MS and 300 matched non-MS patients, were analysed. MS patients had higher 90-day postoperative complication rates (9.3% vs. 2.3%, <i>p</i> = 0.012) and infection rates (4.0% vs. 0.3%, <i>p</i> = 0.006). The rates of achieving MCID-I and MCID-W were similar for PROMIS Global Mental, PROMIS Global Physical, and HOOS-PS, but MS patients had a higher rate of experiencing MCID-W for PROMIS PF-10a compared to non-MS patients (16.7% vs. 6.5%, <i>p</i> = 0.022). Additionally, MS patients had a longer mean hospital stay (2.4 vs. 1.9 days, <i>p</i> = 0.005) and lower rates of being discharged home (82.7% vs. 94.3%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The present study found that MS patients experience similar rates of MCID-I and MCID-W in most PROMs but have a higher rate of MCID-W for PROMIS PF-10a and increased postoperative complications. These findings highlight the need for careful consideration of postoperative risks despite potential improvements. Further research is needed to explore the impact of MS progression on PROMs and perioperative outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"167-173"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604348","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}

{"title":"The peri-articular muscle envelope of the hip (PAME) shows atrophy in patients with refractory groin pain after iliopsoas tenotomy.","authors":"Jonas Declercq, Frans-Jozef Vandeputte, Guillaume Clinckemaillie, Stijn Roose, Annick Timmermans, Kristoff Corten","doi":"10.1177/11207000241309600","DOIUrl":"10.1177/11207000241309600","url":null,"abstract":"<p><strong>Background: </strong>Iliopsoas tenotomy is commonly used to address refractory groin pain resulting from iliopsoas tendinopathy. However, consensus and high-level research on its effectiveness are lacking, with concerns about poor outcomes and complications. Little is known of the effects of iliopsoas tenotomy on the peri-articular muscle envelope of the hip. As the iliopsoas loses its function as the most important hip flexor, the rectus femoris takes over its function, which makes the rectus prone to tendinopathy.</p><p><strong>Methods: </strong>A retrospective review of patients (<i>n</i> <i>=</i> 17) undergoing iliopsoas tenotomy between January 2016 and January 2021 was conducted. Pelvic MRI scans were evaluated for muscle quality and volume using a Quartile classification system and cross-sectional area (CSA) measurements. Reliability tests determined the most consistent reference points. Statistical analyses assessed changes between ipsilateral and contralateral sides.</p><p><strong>Results: </strong>Following iliopsoas tenotomy, significant reduced cross sectional area was seen in the psoas, iliacus, gluteus minimus, gluteus maximus, rectus femoris, piriformis, obturator internus and obturator externus. Significant increased fatty degeneration was seen in the psoas, iliacus, gluteus minimus, tensor fascia latae, piriformis, obturator internus and obturator externus. The gluteus medius was the only muscle where no difference was seen in the cross sectional area or the fatty degeneration. 15 patients (88%) presented with rectus tendinopathy and 8 of these patients had a surgical debridement of the rectus femoris.</p><p><strong>Conclusions: </strong>Our findings reveal that patients with persistent groin pain following iliopsoas tenotomy exhibit changes in the peri-articular muscle envelope, displaying atrophy or fatty degeneration in all muscles except the gluteus medius. Awareness of potential risks is crucial when contemplating iliopsoas tenotomy. Persistent groin pain after iliopsoas tenotomy may be linked to secondary rectus femoris tendinopathy. Caution is recommended in the consideration of iliopsoas tenotomy for patients with pre-existing iliopsoas tendinopathy.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"190-197"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931586","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}