PURPOSE: We wanted to report the clinical results of arthroscopic resection of osseous abnormality that caused femoroacetabular impingement MATERIALS AND METHODS: Among 38 cases of patients who had their causes diagnosed as femoroacetabular impingement and who were treated by arthroscopy from April 2000 to August 2005, 21 cases of the patients who were operated on for resection of the acetabular labrum before August 2004 are categorized as group 1; after that, 17 cases of patients who were operated on for bumpectomy or acetabuloplasty were categorized as group 2. RESULTS: The pain scores for all the patients during the preoperative phase, the 2nd week, the 6th week, the 3rd month, the 6th month and the 1st year were 0.57, 1.57, 2.10, 2.19, 2.38 and 2.33, respectively, for group 1 and 0.65, 0.59, 1.41, 1.65, 2.12 and 2.47, respectively, for group 2, which showed improvement from the medical view. The differences between the pain scores of the preoperative phase and the 2nd week postoperatively were an average of 1.00 and -0.06, respectively, in group 1 and group 2, which showed aggravation of the clinical condition of group 1 compared to that of group 2. The differences between the pain scores of the preoperative phase and the 1st year of the postoperative phase were an average of 1.76 and 1.82 in group 1 and group 2, respectively, which presents the better improvement in the medical condition of group 2. 15 out of 21 people in group 1 (71%) and 14 out of 17 people in group in group 2 (82%) were satisfied after the operation. CONCLUSION: Removal of osseous deformity through arthroscopy, compared with the aspects of the clinical conditions as based on the result of partial labrectomy, causes pain in the early days of the postoperative phase. However, the results of the 1 year progression of postoperative phase present a favorable turn of the patients' clinical condition.
Acetabulum ; Arthroscopy ; Congenital Abnormalities ; Femoracetabular Impingement* ; Humans

Hip joint preserving osteotomy surgery is the treatment of choice for young patients with early symptomatic structural abnormalities of the acetabulum and proximal femur. This is true even in the absence of severe secondary degenerative changes. These disorders can include hip instability from classic developmental dysplasia, post-traumatic acetabular dysplasia, hip impingement from retrotorsional acetabular deformities, or, rarely, post-traumatic problems. During the past 20 years, various techniques of acetabular and proximal femoral reorientation have evolved, making the procedure reliable, reproducible, and durable. In this report, the current indications and results of acetabular and proximal femoral osteotomies in patients with symptomatic acetabular structural problems will be discussed.
Acetabulum ; Congenital Abnormalities ; Femur ; Hip ; Hip Joint ; Humans ; Osteotomy

An evaluation of the acetabular cartilage was performed grossly and histologically in a patient who had a bipolar hemiarthroploasty, which had served satisfactorily for 2 years until the femoral prosthetic head had been separated from the acetabular assembly due to creep deformation of the inner bearing polyethylene cup. This study indicates that the double-bearing bipolar prosthesis dose not necessarily have an advantage over the classical single-piece prosthesis in the prevention of acetabular cartilage wear.
Acetabulum/abnormalities* ; Cartilage, Articular/abnormalities* ; Hip Joint/abnormalities ; Hip Prosthesis* ; Human ; Male ; Middle Age ; Postoperative Complications/etiology* ; Prosthesis Failure

Acetabulum ; abnormalities ; diagnostic imaging ; Adolescent ; Adult ; Cartilage ; abnormalities ; Female ; Hip Dislocation, Congenital ; diagnosis ; surgery ; Hip Joint ; abnormalities ; surgery ; Humans ; Ligaments ; abnormalities ; Male ; Orthopedic Procedures ; Young Adult

PURPOSE: To evaluate the usefulness of navigated acetabular cup fixation for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty. MATERIALS AND METHODS: This study enrolled 28 patients with at least 12 months' follow-up. The safe zone of the acetabular cup was defined as 40degrees+/-10degreesin inclination and 15degrees+/-10degreesin anteversion. The authors used the navigation and radiographic data to determine whether the acetabular cup was located within the safe zone or not. To evaluate the clinical outcomes, preoperative and last follow-up Harris hip scores were checked, and the occurrence of complications was evaluated. RESULTS: According to the navigation data, the mean inclination and anteversion were 38.5degrees+/-4.7degrees(range, 32degrees-50degrees) and 16.6degrees+/-4.0degrees(range, 8degrees-23degrees), respectively. According to the radiographic data the mean inclination and anteversion were 40.5degrees+/-4.6degrees(range, 32degrees-50degrees) and 19.4degrees+/-4.2degrees(range, 8degrees-25degrees), respectively. In both cases, all values were within the safe zone. Harris hip score was improved in all patients from preoperative 52.3+/-14.4 points (range, 29-87 points) to 88.0+/-9.0 points (range, 65-99 points) at the last follow-up. There was no dislocation or loosening of both cases. CONCLUSION: Navigated acetabular cup fixation is a useful technique for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty because it prevents the malposition and related complications.
Acetabulum* ; Arthroplasty, Replacement, Hip* ; Congenital Abnormalities* ; Dislocations ; Follow-Up Studies ; Hip ; Humans

Pelvic osteotomy is a surgery for correcting acetabular deformity, which causes incomplete coverage of the femoral head or biomechanically abnormal load to the hip joint. Pelvic osteotomy can be divided into two categories: reconstructive or realignment osteotomy and salvage osteotomy. Reconstructive osteotomy can be performed to correct the dysplastic hip with good congruency, and include most pelvic osteotomies, except Chiari osteotomy. Among these, Bernese osteotomy, rotational acetabular osteotomy, and periacetabular rotational osteotomy are commonly being used. Salvage osteotomy, which include Chiari osteotomy only, can be performed to increase the coverage of the femoral head of hip joint with joint incongruency due to the severely deformed femoral head and acetabulum or advanced osteoarthritis. Chiari osteotomy is a kind of arthroplasty reducing the pressure applied to the head, and increasing the bone coverage on the upper part of the femoral head. It is effective in reducing hip pain and slowing degenerative changes; however, as the surface is covered by fibrous cartilage, it is vulnerable to degenerative changes. The pelvic osteotomy is a very important and useful surgical technique to preserve joints, despite being a difficult procedure that is technically demanding.
Acetabulum ; Adult* ; Arthroplasty ; Cartilage ; Congenital Abnormalities ; Head ; Hip ; Hip Joint ; Humans ; Joints ; Osteoarthritis ; Osteotomy*

OBJECTIVE: Hip deformity is one of the common problems in children with cerebral palsy. And it is important to detect hip subluxation or dislocation as early as possible. The purpose of this study is to find the incidence of hip subluxation in early childhood in patients with cerebral palsy. METHOD: We reviewed clinical and radiological records of children with cerebral palsy under 36 months of age. We measured migration index, acetabular index, center edge angle and neck shaft angle from hip X-ray of patients. RESULTS: Total 76 patients were included in this study. The mean of migration index was 4.5+/-7.5% at 8~12 months, 10.9+/-11.9% at 13~24 months, and 18.2+/-13.0% at 25~36 months (p<0.05). Twenty one patients (27.6%) were above 25% on the migration index. The neuromotor type of cerebral palsy in 21 patients with hip subluxation, were spastic in 20 (95.2%) except one child. The incidence of hip subluxation was 25.0% (8/32) for quadriplegia, 29.6% (8/27) for diplegia and 50.0% (4/8) for hemiplegia. The acetabular index was significantly higher and the center edge angle was lower in the subluxated hip group than in the non-subluxated hip group, though no significant difference in the neck shaft angle. CONCLUSION: We concluded that the hip subluxation in cerebral palsy can occur under 36 months of age with a relatively high incidence. Therefore, it is recommended to evaluate the hip of cerebral palsy with radiological as well as clinical examination in early childhood.
Acetabulum ; Cerebral Palsy* ; Child* ; Congenital Abnormalities ; Dislocations ; Hemiplegia ; Hip* ; Humans ; Incidence ; Muscle Spasticity ; Neck ; Quadriplegia

Congenital coxa vara is a rare congenital deformity, seen in infancy and childhood and the ratio of unilateral to bilateral is 3:1. The deformity does not become manifest until after birth and usually not until the age of walking. Pathologically, it consists of a progressively increasing acuteness of the neck-shaft angle;shortnees of the neck; a vertical direction of the epiphyseal plate; an oblique defect of the neck; a greater trochanter extending upward toward the ilium as a besk; a shortened femur; a secondary degenerative changese in the acetabulum due to malposition. We have experienced a case of bilateral congenital coxa vara treated with valgue osteotomy and the case review is presented.
Acetabulum ; Congenital Abnormalities ; Coxa Vara ; Femur ; Growth Plate ; Ilium ; Neck ; Osteotomy ; Parturition ; Walking

Comminuted fracture of the acetabulum in association with dislocation of the hip has aiways been a serious injury because of its protracted convalescent period and the permanent disability. Conventional open reduction, however, has contained much technical difficulties and its end result has usually been disappointing to both the patient and the surgeon. Recent concept is that total hip replacemet can be the primary choice of treatment in the management of such complicated injuries. In contemplating THR in this occasion, however, the acetabular defect secondary to its fracture-dislocation stands out as a primary source af cup loosening atter operation. A special consideration has been given in this respect and in five clinical cases the TMR with our modification was carried out with the following results. 1. In three cases of comminuted central fracture-dislocation of the hip, the gap and deformity of the fractured acetabulum was successfully corrected by inserting two pieces of T-shaped bone graft taken from the removed femoral head. 2. In another two cases of comminuted posterior fracture-dislocation of the hip, the posterior wall defect of the acetabulum was prepared by reduction of the fragments displaced and then temporary fixation with two Steinmann pins during the operative step of cup insertion. The pins could easily be removed after setting of the bone cement. 3. By applying this new modification, the THR surgery was successful and uneventful in all five cases with smooth postoperative courses.
Acetabulum ; Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Dislocations ; Fractures, Comminuted ; Head ; Hip ; Humans ; Transplants

It is well known that early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip joint to provide a favorable function in the whole life. The goal of treatment, which is either conservative or operative, is to replace the dislocated hip into the socketand restore its anatomical position. If the head is reduced lately, it may subluxate or redislocate. As a result, secondary osteoarthritis will be complicated in such hips at a laterdate The most cases of congenital dislocation of hip have a increased anteversion and vaglus deformity. It is known that these deformity are cause of redislocation or subluxation, and should be corrected by varus or derotational varus osteotomy to restore for normal cephalocotyloid relationship. We analized 18 residual subluxation of hips which had been treated by derotational varus osteotomy. The results obtained are as follows. 1. Regardless of the age at the time of osteotomy and the amount of varization, the neck-shaft angle corrected to nearly normal in all cases within 3 years after the osteotomy. 2. Acetabular development, indicated by acetabular index, was satisfactory when the osteotomy was done before 4 years, but unsatisfactory in the cases after 4 years of age. 3. Coxa valga epiphysialis of the subluxated head corrected spontaenously after osteotomy in all cases. 4. Subluxated head, indicated by C-E angle and migration percentage, reduced in the cases who had by the derotational varus osteotomy in patients below age of 4 years, but it persisted without further luxation in the cases over 4 years of age.
Acetabulum ; Congenital Abnormalities ; Coxa Valga ; Dislocations ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Humans ; Osteoarthritis ; Osteotomy