Valgus intertrochanteric osteotomy is an effective treatment for osteoarthritis of the hip in younger patients. However, the disadvantage of this osteotomy is the difficult stem insertion at the time of subsequent total hip arthroplasty. Sugioka designed transtrochanteric valgus osteotomy to overcome this disadvantage. The purpose of the present study was to report the short-term results after operateion. The results of the first 10 hips in patients were prospectively studied with a minimum of 6-months follow-up. All patients had a long history of hip pain. The average age at the time of operation was 45.7 years. All patients had a flexion arc of at least 80 degrees and at least 20 degrees of passive adducion. Preoperative radiographs of the patients showed an elliptical deformity of the femoral head associated with a well-developed infermedial osteophyte and improved congruence of the articular surfaces was demonstrated in full adduction. Operatve corrections averaged 19 degrees of valgus and 6 degrees of extension. Bone union of both the femoral and trochanteric osteotomies was obtained in all hips. Hip pain was relieved in all except one hip.
To evaluate the relationship between posterolateral reconstruction, abductor muscle strength, and femoral offset following total hip arthroplasty.Of 28 patients (56 limbs) we assessed, 12 underwent posterolateral reconstruction (reconstruction group) and 16 did not (non-reconstruction group). Isometric abductor muscle strength was measured with a handheld dynamometer. Each patient's muscle strength was converted into a force to body weight ratio, and this ratio was used in the comparisons.The reconstruction group showed a higher value in abductor muscle strength than the non-reconstruction group (p<0.05). Significant correlation between abductor muscle strength and femoral offset was found in the reconstruction group (p=0.016; r=0.674).Posterolateral reconstruction and appropriate reconstruction of femoral offset following total hip arthroplasty are important to improve the abductor muscle strength.
Dislodgement of the polyethylene liner is an increasingly common complication following total hip arthroplasty. We present three cases of dislodgement of the polyethylene liner after total hip arthroplasty using the Harris-Galante porous acetabular component.At the revision surgery, some tines of the metal shell were broken and the grasping points of the polyethylene liner were severely damaged. Metallosis around the joint was also observed. These dislodgements are considered to have been caused by the failure of the liner-locking mechanism. In each case, postoperative course was good.These results indicate the need to recognize the importance of early treatment for postoperative mechanical failure.
We investigate the short-term results of immediate weight bearing after cementless THA. One hundred and seven hips of 102 patients were included in this study. Three different types of prosthesis were used. Patients were allowed full weight bearing three days after THA. Clinical and radiographical findings were observed for six months after surgery. Subsidence of the femoral prosthesis was observed in three hips. Two did not sustain injury. No other complications were observed. These three types of prosthesis had good initial stability for postoperative immediate weight bearing, and bone ingrowth may lead to the prosthesis.
The tensile properties of the human acetabular labrum were investigated using a uniaxial tension testing apparatus. The superior quadrant of the acetabular labrum was harvested from patients who underwent hip surgery. The obtained labra were sliced and shaped into rectangles for measuring uniaxial tension. We hypothesized that several characteristics such as gender, age, degeneration due to primary ailment, and the severity of the acetabular dysplasia would influence the tensile properties of the labrum. Antero-posterior radiographs of the pelvis have been used to evaluate the severity of the acetabular dysplasia and to diagnose the developmental dysplasia of the hip joint (DDH) clinically. Thus, we investigated the correlation between each of two representative radiological measurements—the CE angle and the Sharp angle—and tensile properties to assess the influence of the severity of the acetabular dysplasia. The tensile stress–strain curves for the labrum assumed a sigmoid shape. The mean tensile stress at failure for all specimens was 8.8 ± 4.1 MPa. The mean strain at failure for all specimens was 48.5 ± 10.4%. The mean tensile modulus was 66.4 ± 42.2 MPa. Mean tensile stress at failure for specimens from males was greater than that of specimens from females. A significant difference was found in the maximum stress at failure among the three diagnosis-based groups: the other group withstood the highest stress before failure, whereas the osteoarthritis (OA) group withstood the lowest. No significant correlations with age or radiological characteristics were found for tensile stress, strain at failure, or tensile modulus. Our results suggest that labra obtained from male patients have stronger tensile stress than those from female patients, and that degenerative changes may influence the properties of the acetabular labrum.
The flexor carpi radialis brevis (FCRB) is a rare, anomalous musculotendinous structure of the wrist. Here, we report five cases of FCRB in a consecutive series of 123 distal radius fractures that were repaired by using volar locking plates.
The purpose of the present study is to report the mid-term results of modified Sugioka transtrochanteric valgus ostetomy (TVO) for the treatment of secondary osteoarthritis. The lateral displacement of the greater trochanter was simultaneously performed. Fourteen TVOs were performed in 14 patients with unilateral osteoarthritis of the hip from 1993. We assessed 8 hips in 8 patients in this study. The mean age of the patients at the time of surgery was 46.4 years (41 to 55 years). The average follow-up was 3.9 years (2.4-7.2years). The patients were evaluated for radiographic changes of the joint space, roof osteophyte, weight bearing surface of acetabulum, AHI, abductor lever arm, capital drop, bone cyst in the acetabulum or femoral head as well as clinical results using JOA score. The mean JOA score improved from 57.4 to 76.3. The widening of joint space, lengthening of weight bearing surface of acetabulum were seen in seven hips. The length of the abductor lever arm after surgery was not proportional to the JOA score at the latest follow-up. In one patient, total hip arthroplasty was required after 2.2 years. This procedure is considered useful for the treatment of osteoarthritis in dysplastic hips.
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