Paulo Rego

• PhD Medicine
• Professor (Assistant) at University of Lisbon

The indication for upper intertrochanteric (ITO) and subtrochanteric (STO) femoral osteotomies is becoming less frequent due to the favourable results of total hip replacements even when implanted in rather young adults. In contrast to total hip arthroplasty (THA), the outcome of hip osteotomies can be unpredictable, especially when performed for e...

Executing an extended retinacular flap containing the blood supply for the femoral head, reduction osteotomy (FHO) can be performed, increasing the potential of correction of complex hip morphologies. The aim of this study was to analyse the safety of the procedure and report the clinical and radiographic results in skeletally mature patients with...

Background The modified Dunn procedure, which is based on the development of an extended retinacular flap containing the blood supply for the femoral head, allows anatomic reestablishment in patients with moderate to severe slipped capital femoral epiphysis (SCFE). Some controversy exists regarding the short-term to midterm risk of avascular necros...

Purpose The objectives of this study were to develop recommendations for clinical and radiographic criteria to help define the “acceptable” surgical correction of femoroacetabular impingement syndrome (FAIS) and identify/define complications postoperatively. Methods A three-phase modified Delphi study was conducted involving a case-based survey; a...

Background: Multiple surgical techniques have been described for the treatment of unstable acromioclavicular (AC) dislocation injuries. However, consensus on the most adequate procedure is yet to be established. This study aimed to evaluate the clinical and radiological results of a single cohort of patients treated with an arthroscopically assiste...

Introduction: The indications for proximal femoral inter-trochanteric osteotomy are becoming less frequent due to unpredictable results, when performed for established osteoarthritis but also due to undesired side effects: Limb shortening, abductor weakness, extra-articular impingement, local pain from hardware, more complicated conversion to total...

Objectives: Total Hip Arthroplasty (THA) is among the most common surgical orthopaedical procedures. Although there are numerous described approaches, there is no evidence of superiority of one over another in THA. The objective of this study was to compare the clinical and component positioning short-term results after THA, performed either by the...

Resumo Objetivo O objetivo do presente trabalho foi comparar a medição da versão do componente acetabular em radiografias em incidência anteroposterior (AP) e cross-table após artroplastia total do quadril (ATQ). Métodos Foram selecionadas radiografias de 60 quadris com ATQ primário. A versão foi calculada na radiografia AP usando o método de Lewin...

Objectives Imaging assessment for the clinical management of femoroacetabular impingement (FAI) is controversial because of a paucity of evidence-based guidance and notable variability among practitioners. Hence, expert consensus is needed because standardised imaging assessment is critical for clinical practice and research. We aimed to establish...

Objectives Imaging diagnosis of femoroacetabular impingement (FAI) remains controversial due to a lack of high-level evidence, leading to significant variability in patient management. Optimizing protocols and technical details is essential in FAI imaging, although challenging in clinical practice. The purpose of this agreement is to establish expe...

Purpose of review: Femoroacetabular impingement (FAI) is one of the main causes of hip pain in young adults and poses clinical challenges which have placed it at the forefront of imaging and orthopedics. Diagnostic hip imaging has dramatically changed in the past years, with the arrival of new imaging techniques and the development of magnetic res...

Purpose: Using an extended retinacular flap containing the blood supply for the femoral head, proximal femur osteotomies can be performed at the neck level increasing the potential of correction of complex morphologies. The aim of this study was to analyze the safety, clinical, and radiographic results of this intra-articular surgical technique pe...

The original version of this article, published on 14 May 2020, unfortunately contained a mistake.

Objectives Imaging assessment for the clinical management of femoroacetabular impingement (FAI) syndrome remains controversial because of a paucity of evidence-based guidance and notable variability in clinical practice, ultimately requiring expert consensus. The purpose of this agreement is to establish expert-based statements on FAI imaging, usin...

Background Hemiarthroplasty has been associated with inferior and unpredictable outcomes when used in the treatment of complex proximal humeral fractures in elderly patients. In this age-group, reverse shoulder arthroplasty is gaining popularity due to the promising results presented in recent evidence. Our aim is to analyze the cases of complex pr...

Introdução: O tratamento das fraturas proximais do úmero mantém-se controverso, em particular no que se refere à interpretação, classificação e respetivo prognóstico. Alguns aspetos em que a história natural possa ser modificada pela cirurgia têm sido apontados na literatura, nomeadamente o ângulo cervico diafisário (ACD) do úmero. Recentemente foi...

Femoroacetabular impingement (FAI) is increasingly recognized as a risk factor for early hip degeneration in young active patients. The diagnosis depends on clinical examination and proper imaging that should be able to identify abnormal and sometimes subtle morphological changes. Labral tears and cartilage lesions rarely occur without underlying b...

Background:: Given the high prevalence of patients with hip deformities and no ongoing hip dysfunction, understanding the anatomic factors predicting the symptomatic state is critical. One such variable is how the spinopelvic parameters (SPPs) may interplay with hip anatomic factors. Hypothesis/purpose:: SPPs and femoral- and acetabular-specific...

Objectives: The purpose of this study was to report (1) a different but specific pattern of impingement in hips involved with valgus slipped capital femoral epiphysis (valgus SCFE) and (2) the results of surgical treatment using intracapsular realignment techniques. Design: Case series. Setting: Multiple academic centers. Patients: Six patie...

Purpose: The purpose of this study was to determine if there were significant differences between patients submitted to hip arthroscopy (HA) and surgical hip dislocation (SHD) to treat femoro-acetabular impingement (FAI), which variables were significantly associated with hip function before surgery and those predictive of the applied functional o...

Objective: To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. Methods: We prospectively included 590 patients and evaluated 1111 hips with semi-automa...

The Bernese periacetabular osteotomy (PAO) is a widely used procedure to reorient a dysplastic acetabulum resulting from developmental dysplasia of the hip, retroversion, protrusio, or some deformities with a traumatic etiology. Throughout the execution, the lateral femoral cutaneous nerve (LFCN) as well as the obturator, femoral, and sciatic nerve...

Background: Knowledge of the vascular supply of the femoral head is crucial for hip-preserving surgical procedures. The critical area for reshaping cam deformity is at the retinacular vessel penetration, an area with ill-defined topographic anatomy. We performed a cadaver study of the extension of the lateral retinaculum near the head-neck junctio...

Objective Our objectives were to use 3D computed tomography (CT) to define head–neck morphologic gender-specific and normative parameters in asymptomatic individuals and use the omega angle (Ω°) to provide quantification data on the location and radial extension of a cam deformity. Methods We prospectively included 350 individuals and evaluated 188...

La anatomía de la cadera presenta una serie de peculiaridades que condicionan el tratamiento artroscópico de su patología. El objetivo de la presente publicación es describir los hallazgos anatómicos y biomecánicos más destacados para la aplicación clínica y terapéutica.

Background: There is a wide discrepancy in reported prevalence rates for cam, pincer, and mixed femoroacetabular impingement (FAI), particularly among distinct populations, namely asymptomatic or symptomatic subjects and athletes. No systematic analysis to date has yet compared studies among these groups to determine differences in radiographic si...

In this study, three-dimensional finite element models based on the specific anatomy of a patient presenting a femoroacetabular impingement of the "cam" type were developed. The finite element meshes were obtained from arthrographic magnetic resonance images captured before and after hip arthroscopy. All soft tissues were considered linear elastic...

Purpose: The alpha angle is used to quantify in a single plane the head-neck junction deformity of cam femoro-acetabular impingement (FAI). When the deformity overlaps the superior retinaculum, femoral head osteoplasty in this area can jeopardise intra-articular vascular structures. This study proposes a new angular measure of the linear radial ex...

Traumatic hip dislocations are rare injuries resulting from high-energy road-traffic collisions. These injuries have a high incidence of associated injuries, which requires a thorough trauma assessment and immediate reduction, preferably in the first six hours after trauma. The reduction and surgical reconstruction of acetabulum and femoral head ar...

Deep infection after total hip arthroplasty is a serious complication. Despite recent progress in diagnosis and treatment it is still a major source of morbidity and mortality and prevention is therefore of the utmost importance. Unfortunately, among the many measures advocated to prevent infection, only some are based on strong scientific evidence...

Several microsurgical techniques have been described for the treatment of osteonecrosis of the talus (ONT). Recently reported in children, vascularized periosteal grafts showed promising revascularizing properties. We report a novel technique using a pedicled periosteal graft from the first metatarsal bone to treat steroid-induced early Ficat-Arlet...

In this study, a three-dimensional finite element (FE) model based on the specific anatomy of a patient presenting a femoroacetabular impingement of the 'cam'-type is developed. The FE meshes of the structures of interest are obtained from arthrographic magnetic resonance images. All soft tissues are considered linear elastic and isotropic, and the...

Literature on the reconstruction of the proximal femur in skeletally immature patients with the use of an epiphyseal transplant is scarce and with variable results depending on the indication. We report successful outcomes using a modified vascularized fibular epiphyseal transplant in a 4-year-old boy with an oncologic lesion. We discuss the advant...

The core aim of this study was to investigate zinc (Zn)- and zinc and strontium (ZnSr)-containing brushite-forming beta-tricalcium phosphate (TCP) cements for their effects on proliferation and differentiation of osteoblastic-like cells (MC3T3-E1 cell line) as well as for their in vivo behaviour in trabecular bone cylindrical defects in a pilot stu...

Rheumatoid arthritis (RA) is associated with an increased risk of fragility fractures. In RA patients, the direct effect of inflammation on bone is difficult to study because their skeleton is also affected by medication with corticosteroids and other drugs as well as aging and menopause, which contribute to bone fragility. This study used an anima...

Magnetic resonance arthrography (MRa) is an imaging modality designed to diagnose problems within a diathrodial joint of the human body such as the knee or the hip with the aid of a contrast agent. In fact, magnetic resonance imaging (MRI) without arthrography is of limited value when the detection of abnormalities is sought. The arthrography invol...

Endothelium-derived vasoactive factors are produced by the endothelium activated by effective stimulus, and with paracrine regulatory activity of the tone/proliferation of the vascular smooth muscle and platelet function. They are divided in two groups: endothelium-derived relaxing and contracting factors. Among the endothelium-derived relaxing fac...

The conflict known as femoro-acetabular impingement depends on an abnormal morphological relation between the femoral head and the acetabular cavity. The "Cam" type impingement is due to the presence of a non-spherical portion of the femoral head, usually located at the antero-superior quadrant of the region of transition with the anatomical neck....