Article

Osseous remodeling after femoral head-neck junction osteochondroplasty.

Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, Suite 11300 West Pavilion, St Louis, MO 63110, USA.
Clinical Orthopaedics and Related Research (Impact Factor: 2.79). 09/2009; 468(2):511-8. DOI: 10.1007/s11999-009-1098-x
Source: PubMed

ABSTRACT Femoral head-neck junction osteochondroplasty is commonly used to treat femoroacetabular impingement, yet remodeling of the osteochondroplasty site is not well described. We therefore describe bony remodeling at the osteochondroplasty site and analyze clinical outcomes and complications associated with femoral osteochondroplasty. We retrospectively reviewed 135 patients (150 hips) who underwent femoral head-neck osteochondroplasty combined with hip arthroscopy, surgical hip dislocation, periacetabular osteotomy, or proximal femoral osteotomy. The minimum clinical followup was 10 months (mean, 22.3 months; range, 10-65 months). We assessed the femoral-head neck offset, head-neck offset ratio, alpha angle, and cortical remodeling. We used the Harris hip score to determine hip function. We observed an increase in the head-neck offset, offset ratio, and decrease in the alpha angle postoperatively and at latest followup. Ninety-eight of 113 (87%) hips had partial or complete recorticalization at the osteochondroplasty site. The mean Harris hip score improved from 64 to 85. We excised heterotopic bone in one hip. There were no femoral neck fractures. The deformity correction achieved with femoral head-neck osteochondroplasty is maintained and recorticalization occurs in the majority of cases during the first two years. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

0 Bookmarks
 · 
119 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Since Dr Legg reported the paper entitled “An obscure affliction of the hip joint” in 1910, Legg-Calvé-Perthes disease (LCPD) has been recognized. In the intervening 100 years, our understanding of disease etiology, natural history, treatment options, and factors related to prognosis have expanded, and yet many opinions remain without consensus, especially in treatment decisions. During the past 30 years, containment of the femoral head within the acetabulum by conservative or surgical methods has been popularly accepted as a concept for treatments. Several large and multicenter retrospective studies have noted three factors related to outcome in children treated for LCPD: age at onset, severity of involved femoral head, and type of treatment. In patients with onset over the age of 8 years and greater than lateral pillar B or B/C class, surgical treatment was associated with improved Stulberg outcomes compared with conservative treatments. Moreover, the decision to apply appropriate surgical methods should consider the age at surgery, Waldenström stage, and whether the femoral head was containable in abduction. Relevant studies with evidence-based data regarding the results of different surgical methods for LCPD are reviewed here, and there are valid descriptions of surgical indications, characteristics, and associations with improved radiographic outcome.
    Formosan Journal of Musculoskeletal Disorders. 11/2012; 3(4):111–115.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to define the clinical and disease characteristics in patients who fail hip arthroscopy and require periacetabular osteotomy. Thirty patients (30 hips) who underwent a PAO, following a failed hip arthroscopy were identified from a multicenter database. Eighty-seven percent were female and the average age was 27.3 years. The average LCE angle was 14.7°, acetabular inclination 16.3°, and ACE angle 16.8°. Labral abnormalities and acetabular chondral disease were noted at PAO surgery in 60 and 56%, respectively. The average clinical scores prior to the PAO were mHHS 53.5, WOMAC 56.9, and UCLA 5.4. Failed hip arthroscopy and the need for PAO are most commonly observed in young female patients with mild to moderate dysplasia, major functional limitations and associated intra-articular abnormalities.
    The Journal of Arthroplasty 05/2014; · 2.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Over recent years hip arthroscopic surgery has evolved into one of the most rapidly expanding fields in orthopaedic surgery. Complications are largely transient and incidences between 0.5% and 6.4% have been reported. However, major complications can and do occur. This article analyses the reported complications and makes recommendations based on the literature review and personal experience on how to minimise them.
    Bone & joint research. 07/2012; 1(7):131-44.

Full-text (2 Sources)

Download
12 Downloads
Available from
May 30, 2014