In the revisions of total hip replacement, the classification of the bone deficiency includes both the acetabular and the femur. That classification of the acetabular bone deficiency includes the classification of Paprosky, Engh, Gross, Gustilo and Pasternak, Chongqing, and so on. That classification of the femoral bone deficiency includes AAOS, Paprosky, Mallory, and modified Mallory. All of the classification is not consistent for peroperative evaluation. As to the confusion, it is necessity to do more researches.
Acetabulum ; pathology ; Arthroplasty, Replacement, Hip ; Femur ; pathology ; Humans

Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation.
Acetabulum* ; Arthroscopy* ; Head ; Hip Dislocation* ; Hip Joint ; Hip* ; Osteoarthritis ; Pathology

Acetabulum ; pathology ; Aged ; Femur Head ; pathology ; Hip Joint ; pathology ; Humans ; Male

There is much confusion in orthopedic literature regarding the nature and significance of the so-called acetabular labrum in congenital dislocation of the hip. This experiment describes an animal model in which the relationship between eversion of the acetabular labrum and acetabular dysplasia with degeneration of the articular cartilage was studied. The acetabulum gradually become shallower and more vertically oriented and the femoral head gradually subluxed, but never dislocated. The radiographic appearance of the hip dysplasia was very similar to that seen in human beings. The animals remained asymptomatic without clinically visible signs of hip abnormality throughout the study. It was clearly demonstrated that there was substantial amounts of degenerative change in the articular cartilages of the subluxed hip with no evidence of degenerative change radiologically. It could be concluded that excision of the acetabular labrum should be avoided during open reduction of congenital dislocation of the hip.
Acetabulum/pathology* ; Animal ; Bone Diseases, Developmental/etiology* ; Dogs ; Hip Dislocation/complications* ; Osteoarthritis/etiology*

Plgmented villonodular synovitis is a benigh lesion that develops in joint lining and is characterized by an exuberant inflammation. Many authors have discussed etiology, clinical and radiological features, pathology and treatment regarding the disease. This occurs most commonly in the knee joint as a monoarticular proliferative process, but rarely in the hip joint. It is a nonneoplastic disease but may develop as an aggressive local process with bone and joint destruction. Sometimes clinician can not detect it in early time because of its nonspecific clinical findings and misdiagnose it as sarcomatous process. So, early diagnosis of hip joint involvement is necessary because destruction of the femoral head and acetabulum is the ultimate outcome if treatment is not intiated. We report two cases of pigmented villonodular synovitis involving the hip joint, which were diagnosed and treated in our department.
Acetabulum ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Inflammation ; Joints ; Knee Joint ; Pathology ; Synovitis ; Synovitis, Pigmented Villonodular

The aim of investigation is to calculate the mean value of the acetabular anteversion of normal Korean adult after closure of growth according to different gender and sex age group, to find out any significant difference of the value of acetabular anteversion to some other variables such as age, height, weight and radiographic inclination(abduction angle) of acetabulum. Transverse pelvic computed tomography(CT) scans of 360 right hips with no known pathology were examined. The study population consisted of 12 groups by gender (male and female) and age(from third to eighth decade). The number of each group was thirty. The scanning slice nearest the middle region of the acetabulum (nearest through the center of the femoral head) on the scout film was chosen. A measuring point was assigned at the anterior edge of the acetabulum and second at the posterior edge. The line connecting these points was drawn. The angle formed by this line and the plane sagittal to the pelvis was determined as acetabular anteversion. The data analysis was run on a statistical analysis system(SAS). The mean value of acetabular anteversion 19.8±5.4 degrees(17.1±5.6 in males, 22.2±5.4 in females), it was greater significantly in females than in males (p=0.0001). The mean value of acetabular anteversion in third decade male group than the third, fourth and fifth decade group significantly(p < 0.05). The mean value of acetabular anteversion of Koreans was similar to Caucasians value. The value of acetabular anteversion was relatively releated to age. In conclusion, the acetabular anteversion of Korean females was larger than the Korean males. It was increased with aging. When we perform the total hip arthroplasty and pelvic osteotomy or reorientation procedure, we must consider the acetabular anteversion by different gender and age group.
Acetabulum ; Adult ; Aging ; Arthroplasty, Replacement, Hip ; Female ; Hip ; Humans ; Male ; Osteotomy ; Pathology ; Pelvis ; Statistics as Topic

Hip arthroscopy has been useful for resolving unexplained pains of the hip joint, despite its clinical applicability came after many other joints. Surgical indications have been increasing recently. Moreover, additional surgical techniques allow both the anatomy and function to return to its normal state. Recently, the concepts and treatments for extra-articular pathologies, such as deep gluteal syndrome, ischiofemoral impingement, subspinal impingement and iliopsoas impingement as well as classic indication, such as femoroacetabular impingement, acetabular labral tear, loose bodies, and synovial osteochondromatosis have been introduced. We present a diagnosis and treatment for diverse indications of hip arthroscopy, preoperative considerations, surgical technique and postoperative rehabilitation.
Acetabulum ; Arthroscopy* ; Chondromatosis, Synovial ; Diagnosis ; Femoracetabular Impingement ; Hip Joint ; Hip* ; Joints ; Pathology ; Rehabilitation ; Tears

The pelvis and the spine form a system balancing human skeleton. Within this system, the pelvis adapts to age-related changes in the spine. Previous studies were predominantly focused on changes of pelvic parameters in the sagittal plane. The aim of this study was to reveal age-related changes of lesser pelvic dimensions at different levels of the pelvic cavity in the sagittal and coronal planes and to explore sexual dimorphism in age-related tendencies. The computed tomography pelvimetry was performed on the three-dimensional workstation. The research sample included 211 females aged 18 to 84 years and 181 males aged 18 to 82 years, who underwent an examination at the Riga East University Hospital, Clinical Center “Gailezers,” Latvia. Three pelvic angles and transverse and sagittal diameters of the lesser pelvis were measured at four levels: the inlet, two axial planes in the mid-cavity, and the outlet. The results demonstrated that more pronounced age-related changes occurred in the inlet and the outlet of the lesser pelvis. The mid-cavity was less changing. The transverse diameter between acetabular centers and the sagittal diameter at the level of ischial spines were independent of age. In general, the common age-related trends were observed for pelvic parameters in females and males. A single exception was the proportion of diameters at the level of ischial spines, which decreased in males only. For parameters associated with pelvic floor diseases, age-related changes occurred in the direction of pathology.
Acetabulum ; Aging ; Bays ; Female* ; Humans ; Latvia ; Lesser Pelvis ; Male* ; Pathology ; Pelvic Floor Disorders ; Pelvimetry* ; Pelvis ; Skeleton ; Spine

For the diagnosis and treatment of the labral pathology, the cross sectional morphology of the labrum is needed. Fifty-four labra (male: female=44: 10) from 32 adult Korean cadavers were cut in radial and perpendicular fashions to their longitudinal axis. Each labrum was divided into 8 segments, resulting 8 equally distanced points. To analyze the 432 cut surfaces, which consisted of 378 labra and 54 transverse acetabular ligaments cut surfaces, all dimensions of the cut surfaces were measured, and the attachment patterns, including the sublabral slit, observed. The shapes of the cut surfaces were classified into four types (3 subtypes of triangle and 1 quadrangle) and the attachment patterns into five types. At the anterior portion of the labrum, which other studies reported as the predilection area for labral tears, there were several common findings: 1) Tall triangular shapes were dominant (61.1%) or relatively common type (25.9%). 2) The average heights of the labrum were longer (7.4 and 7.0 mm) than at the other sites (4.0 - 6.8 mm). 3) The attachment types with no extra-extended portion (68.5%) and sublabral slits (39.0%) were most commonly observed. It was concluded that there were different types of cut surface and attachment patterns of the acetabular labrum, and these findings had a tendency to be distributed with some labral tears. These anatomical data are believed could be useful in the management of an acetabular labral pathology.
Acetabulum/*anatomy & histology/pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Magnetic Resonance Imaging ; Male ; Middle Aged

OBJECTIVETo retrospectively review the experience with different surgical procedures for periacetabular metastasis.

METHODSThe data of 43 patients with periacetabular metastasis between July 2000 and July 2007 was reviewed. There were 21 patients with primary malignant tumors at the beginning, and 10 patients diagnosed metastasis by preoperative biopsy. The other 12 patients presented skeletal involved as initial manifestations of metastasis prior to the pathological diagnosis of the primary tumor. Twelve patients had solitary metastasis, and the others had multiple bone metastasis. The surgical procedure included curettage (35 cases) and en-blot excision (8 cases). The techniques of reconstruction of acetabular defect included total hip replacement (THR) with cemented components or titanium acetabular reconstruction cup (12 cases), THR with partial pelvis replacement with Candal Hook (16 cases), THR with Steinmann pins and cement augmented or titanium cup reconstruction (7 cases), and modular hemipelvic prosthesis reconstruction (8 cases).

RESULTSAll the patients received successful operations. The average score for preoperative pain of 7.2 was assessed. Forty-one patients (95.4%) were evaluated for relief of pain and resumption of walking, and the pain score improved to 3.5 after surgery. The average functional score was 24.5 postoperatively. Six of 32 patients had local recurrence. Fourteen patients died of diseases. The average blood loss during the operation was 1600 ml in 43 patients and the bleeding exceeded 3000 ml was in 3 patients with renal carcinomas. Major complications included two superficial wound infections, one multiple organ failure and two dislocations.

CONCLUSIONSAlthough surgery will not typically cure patients of their metastatic disease, surgery that is well planned and well executed can help many people by relieving their suffering and improving their quality of life.

Acetabulum ; pathology ; Adult ; Aged ; Bone Neoplasms ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies