Ricardo Ramón, Esteban Holguín, Manuel Ribas, Nihad Al Hussin, Marco Ezechieli
{"title":"Modified Ludloff’s medial approach for resection of heterotopic ossification of the hip following severe SARS-CoV-2 infection: a case report","authors":"Ricardo Ramón, Esteban Holguín, Manuel Ribas, Nihad Al Hussin, Marco Ezechieli","doi":"10.1093/jhps/hnad048","DOIUrl":"https://doi.org/10.1093/jhps/hnad048","url":null,"abstract":"The coronavirus disease 2019 pandemic has significantly affected people worldwide. Herein, we present a case of massive heterotopic ossification (HO) of the right hip following severe SARS-CoV-2 infection. The exact origin of HO development is still unknown, but a critical illness, chronic immobilization and hypoxia are important risk factors. Considering the location and size of the HOs in this case, modified Ludloff’s medial approach of the hip was used. This approach allows for good exposure and access to the medial and inferior part of the hip joint and the successful extirpation of the pathologic tissue.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139373662","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}
Morgan W Rice, Robert B Browning, Thomas W Fenn, Mario Hevesi, Shane J Nho
{"title":"Defining the Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) at 2 years following open gluteus medius and/or minimus repair","authors":"Morgan W Rice, Robert B Browning, Thomas W Fenn, Mario Hevesi, Shane J Nho","doi":"10.1093/jhps/hnad019","DOIUrl":"https://doi.org/10.1093/jhps/hnad019","url":null,"abstract":"To define Minimally Clinically Important Difference (MCID) and Patient Acceptable Symptomatic State (PASS) threshold scores after open gluteus medius and/or minimus repair. Primary open gluteus medius and/or minimus repair patients from November 2013 to March 2020 were identified. Patient reported outcomes (PROs) were assessed preoperatively, 1- and 2-year follow-up, including the Hip Outcome Score Activities of Daily Living (HOS-ADL), modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12) and Visual Analog Scale (VAS) Pain. Thresholds for achieving a MCID and PASS postoperatively were calculated using the distribution method and receiver operator curve analysis; 25 patients (24 females, 1 male, age: 69 ± 6.8 years, body mass index: 26.9 ± 5.0 kg/m2) were included in final analyses. MCID threshold scores for HOS-ADL, mHHS, iHOT-12 and VAS Pain were calculated as 11.1, 6.2, 15.3 and 14.0, respectively. PASS threshold scores for each of the PROs were as follows: HOS-ADL (71.9), mHHS (60.0), iHOT-12 (49.2) and VAS Pain (36.8). MCID thresholds for HOS-ADL, mHHS, iHOT-12 and VAS Pain were achieved by 58.3%, 83.3%, 66.7% and 57.1% of patients, respectively. PASS thresholds for HOS-ADL, mHHS, iHOT-12 and VAS Pain were achieved by 52.4%, 44.8%, 65% and 59.1% of patients, respectively. Open gluteus medius and/or minimus repair results in a high rate of achievement of clinically significant outcomes at a minimum of 2 years postoperatively. MCID threshold values for HOS-ADL, mHHS, iHOT-12 and VAS Pain were 11.1, 6.2, 15.3 and 14.0, respectively. PASS threshold values for HOS-ADL, mHHS, iHOT-12 and VAS Pain were 71.9, 60.0, 49.2 and 36.8, respectively. The majority of patients achieved clinically significant outcomes with 81.3% and 77.3% achieving MCID and PASS for at least one PRO, respectively.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139101841","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}
Phillip Wyatt, Sarah Cole, James Satalich, Brady S Ernst, John Cyrus, Alexander Vap, Robert O’Connell
{"title":"Periacetabular osteotomy with and without concomitant arthroscopy: a systematic review of evidence on post-operative activity levels and return to sport","authors":"Phillip Wyatt, Sarah Cole, James Satalich, Brady S Ernst, John Cyrus, Alexander Vap, Robert O’Connell","doi":"10.1093/jhps/hnad043","DOIUrl":"https://doi.org/10.1093/jhps/hnad043","url":null,"abstract":"The purpose of this systematic review is to (i) compare post-operative activity levels after periacetabular osteotomy (PAO) versus PAO + HA (concomitant PAO and hip arthroscopy) using patient-reported outcomes that specifically assess activity and sports participation [Hip Disability and Osteoarthritis Outcome Score—Sport and Recreation subscale (HOOS-SR), University of California Los Angeles (UCLA) activity score, Hip Outcome Score—Sport-Specific Subscale (HOS-SSS)] and (ii) compare post-operative return to sport (RTS) data between PAO and PAO + HA groups. A systematic review of literature was conducted on 1 June 2023, utilizing PubMed, Cochrane and Embase (OVID). Articles were screened for inclusion using specific inclusion and exclusion criteria. Twenty-six out of 1610 articles met all inclusion criteria, without meeting any exclusion criteria. In the 12 studies containing only subjects who underwent PAO alone, 11 demonstrated an average score improvement in UCLA, HOOS-SR or HOS-SSS post-operatively (P < 0.05). In the three studies containing subjects who underwent PAO with concomitant HA, significant improvements were seen in the HOS-SS and UCLA scores (P < 0.05). In the five studies that directly compared UCLA, HOS-SSS and HOOS-SSS scores between PAO groups and PAO + HA groups, all demonstrated statistically significant improvement post-operatively (P < 0.05). The rate of RTS ranged from 63% to 90.8% among PAO studies and was found to be 81% in the single PAO + HA study that assessed RTS. When performed in patients with intra-articular pathology, concomitant PAO + HA may provide similar sport-related outcomes to PAO alone in patients without intra-articular pathology.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"9 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139101881","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}
Till D Lerch, Malin K Meier, Markus S Hanke, Adam Boschung, Florian Schmaranzer, Klaus A Siebenrock, Moritz Tannast, Simon D Steppacher
{"title":"Rotational femoral osteotomies and cam resection improve hip function and internal rotation for patients with anterior hip impingement and decreased femoral version","authors":"Till D Lerch, Malin K Meier, Markus S Hanke, Adam Boschung, Florian Schmaranzer, Klaus A Siebenrock, Moritz Tannast, Simon D Steppacher","doi":"10.1093/jhps/hnad018","DOIUrl":"https://doi.org/10.1093/jhps/hnad018","url":null,"abstract":"Femoroacetabular impingement (FAI) patients with reduced femoral version (FV) are poorly understood. The aim of this study is to assess (i) hip pain and range of motion, (ii) subjective satisfaction and (iii) subsequent surgeries of symptomatic patients who underwent rotational femoral osteotomies. A retrospective case series involving 18 patients (23 hips, 2014–2018) with anterior hip pain that underwent rotational femoral osteotomies for treatment of decreased FV was performed. The mean preoperative age was 25 ± 6 years (57% male), and all patients had decreased FV < 10° and minimum 1-year follow-up (mean follow-up 2 ± 1 years). Surgical indication was the positive anterior impingement test, limited internal rotation (IR) in 90° of flexion (mean 10 ± 8°) and IR in extension (mean 24 ± 11°), anterosuperior chondrolabral damage in Magnet resonance (MR) arthrography, CT-based measurement of decreased FV (mean 5 ± 3°, Murphy method) and no osteoarthritis (Tönnis Grade 0). Most patients had intra- and extra-articular subspine FAI (patient-specific 3D impingement simulation). Subtrochanteric rotational femoral osteotomies to increase FV (correction 20 ± 4°) were combined with cam resection (78%) and surgical hip dislocation (91%). (i) The positive anterior impingement test decreased significantly (P < 0.001) from pre- to postoperatively (100% to 9%). IR in 90° of flexion increased significantly (P < 0.001, 10 ± 8° to 31 ± 10°). (ii) Subjective satisfaction increased significantly (P < 0.001) from pre- to postoperatively (33% 77%). The mean Merle d’Aubigné and Postel score increased significantly (P < 0.001) from 14 ± 2 (8–15) points to 17 ± 1 (13–18, P < 0.001) points. Most patients (85%) reported at follow-up that they would undergo surgery again. (iii) At follow-up, all 23 hips were preserved (no conversion to total hip arthroplasty). One hip (4%) underwent revision osteosynthesis. Proximal rotational femoral osteotomies combined with cam resection improve hip pain and IR in most FAI patients with decreased FV at short-term follow-up. Rotational femoral osteotomies to increase FV are safe and effective.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"135 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139101954","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":"In search of excellence.","authors":"Richard E Field","doi":"10.1093/jhps/hnad045","DOIUrl":"10.1093/jhps/hnad045","url":null,"abstract":"<p><p>A little while ago, I had the opportunity to spend some time in the operating room (theatre) of one of the world's most experienced and technically skilful hip arthroscopists. How I wish I had made the effort to visit this surgeon earlier in my career and how I regret that there are still so many surgeons I have failed to visit. Every surgeon who has allowed me into their operating room has shown me something that has enhanced my practice and learning to execute their manoeuvres always adds to the pleasure of surgical practice.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"10 3-4","pages":"133-134"},"PeriodicalIF":1.4,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075602","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}
{"title":"What the papers say (Issue 10.3)","authors":"A. Bajwa","doi":"10.1093/jhps/hnad047","DOIUrl":"https://doi.org/10.1093/jhps/hnad047","url":null,"abstract":"\u0000 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 …","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"45 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949823","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 non-arthroplasty hip registry of the UK: a decade on","authors":"Christian Smith, V. Khanduja, A. Malviya","doi":"10.1093/jhps/hnad046","DOIUrl":"https://doi.org/10.1093/jhps/hnad046","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"62 18","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950474","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}
Alexander Volpi, Kristin Twomey Hopkins, Malachy McHugh, Gregory Galano
{"title":"Physician reported outcomes of hip arthroscopy without a perineal post: an international survey","authors":"Alexander Volpi, Kristin Twomey Hopkins, Malachy McHugh, Gregory Galano","doi":"10.1093/jhps/hnac038","DOIUrl":"https://doi.org/10.1093/jhps/hnac038","url":null,"abstract":"Although the current literature reports an acceptable rate of complications with the use of a perineal post in hip arthroscopy, they are still possible and preventable. The purpose of this study was to survey International Society for Hip Arthroscopy (ISHA) members on their use of postless distraction in hip arthroscopy. A 19-question survey was emailed to hip preservation surgeons that are members of ISHA. The questions examined surgeons’ location, experience, utilization of a perineal post or postless distraction and any complications they may have encountered. In all, 145 respondents completed the survey. Regarding complications encountered when using a perineal post, the most frequent responses were temporary nerve damage (115, 80.6%), temporary genitourinary complications (39, 27%), temporary genital skin injury (35, 24%) and permanent nerve injury (12, 8%). Regarding the postless technique, of the 60 respondents who noted they have utilized postless distraction, 9 (15%) reported complications, with 7 (12%) reporting temporary nerve damage being the most common and 0 reporting cases of permanent nerve injury. These were statistically significantly less than those reported with a perineal post. Ninety-seven percent reported that after utilizing postless distraction, their patients were recovering better than or the same as when using a perineal post. This survey had excellent international participation by experienced hip arthroscopists. There were a statistically significantly decreased number of complications reported by the surgeons utilizing postless distraction. This survey highlights that postless distraction is being done successfully with lower reported complications and excellent patient recovery.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"54 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138562203","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}
Joaquín Lara, Alan Garín, Selim Abara, Javier del Río, Javier Besomi, Cristhián Herrera, Jaime Cancino, Diego Villegas, Carlos Tobar
{"title":"Prevention of motor ascending branch of the rectus femoris injuries in Bernese periacetabular osteotomy: a cadaveric study","authors":"Joaquín Lara, Alan Garín, Selim Abara, Javier del Río, Javier Besomi, Cristhián Herrera, Jaime Cancino, Diego Villegas, Carlos Tobar","doi":"10.1093/jhps/hnad036","DOIUrl":"https://doi.org/10.1093/jhps/hnad036","url":null,"abstract":"The Bernese periacetabular osteotomy (PAO) is a surgical procedure used to treat hip dysplasia in young adults, but it carries the risk of neurological complications, including injury to the motor ascending branch of the rectus femoris (MABRF). This study aimed to describe anatomical considerations to prevent MABRF injuries during PAO. A cadaveric study was conducted on seven specimens. The original and modified PAO approaches were used, with and without disinsertion of the rectus femoris muscle origin. The femoral nerve was dissected in all specimens from the endopelvic position to the MABRF origin (T-point). The average distance from the anterosuperior iliac spine to the T-point was 10.2 ± 0.4 cm. To protect the MABRF, a safety zone was identified for the osteotome placement during the ischial cut. The osteotome was slid over the joint capsule, deflecting the iliocapsularis muscle medially and distally. This manoeuvre shields the MABRF with the iliocapsularis muscle, reducing the risk of neurological injury. Both the original and modified PAO approaches were considered safe techniques with low risk to the rectus femoris innervation. These findings offer valuable insights for surgeons performing PAO, emphasizing the significance of understanding anatomical relationships and implementing protective measures to enhance patient outcomes and minimize complications. In conclusion, implementing these anatomical considerations can help prevent MABRF injuries during PAO, contributing to safer and more successful surgical interventions for hip dysplasia in young adults.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"9 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138533388","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}
Zhi Li, Reva Y Qiu, Abdulaziz Khurshed, Dana Alomran, Dale S Williams, Olufemi R Ayeni, Waleed Kishta
{"title":"The McMaster osteotomy—a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study","authors":"Zhi Li, Reva Y Qiu, Abdulaziz Khurshed, Dana Alomran, Dale S Williams, Olufemi R Ayeni, Waleed Kishta","doi":"10.1093/jhps/hnad042","DOIUrl":"https://doi.org/10.1093/jhps/hnad042","url":null,"abstract":"Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder that can lead to complex proximal femur deformities and devastating consequences such as avascular necrosis, femoroacetabular impingement syndrome and early-onset osteoarthritis. Existing surgical techniques are often insufficient to fully address the constellation of multiplanar deformities in patients with severe SCFE. Therefore, the McMaster Osteotomy, a novel intertrochanteric proximal femur osteotomy, was developed to improve anatomic correction and hip mechanics in patients with chronic SCFE. The McMaster Osteotomy was implemented in two patients (A: 16-year-old male, B: 17-year-old female) with proximal femur deformities due to chronic SCFE. Surgical planning was facilitated with a 3D-printed pelvic model generated from a CT scan of a patient with the SCFE deformity. Patient B also underwent concurrent arthroscopic osteochondroplasty and labral repair. Pre- and post-operative function and radiographic measurements were recorded. Post-operatively, patient A’s neck-shaft angle improved from 125° to 136°, Southwick angle from 52° to 33°, neck length from 66 mm to 80 mm and hip internal rotation from 5° to 25°. Patient B’s post-operative neck-shaft angle improved from 122° to 136°, Southwick angle from 25° to 15°, neck length from 76 mm to 84 mm, hip internal rotation from 5° to 20° and alpha angle from 87.6° to 44.3°. Both patients are pain-free and have obtained full union of their osteotomies. The McMaster Osteotomy is a versatile technique that can produce a more anatomic reconstruction of hip anatomy and restoration of abductor mechanics. As an extracapsular technique, the risk of femoral head avascular necrosis is minimized.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"8 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138533397","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}