The hip arthroscopy develops quickly in the past 20 years. Its use in the diagnosis and treatment of the hip injury get more notably. Many of pathologic conditions previously unrecognized through X-ray, CT or MRI have been diagnosed correctly under hip arthroscopy. The technology has become gradually a golden standard to confirm the hip discords. In the present, the examining path of the hip arthroscopy contains mainly the outside path, the anterior path, the outside-posterior path. The application range of the hip arthroscopy includes the management of labral tears, the femoroacetabular impingement, the ligamentum tear injuries, the chondral lesions, the synovical abnormalities, the intra-articular infection, the loose bodies in the joint etc. The hip arthroscopy is a comprehensive technology. Its superiority can be reflect well if the doctors are familiar with the indication, the contraindication and the operation procedure. And also the thorough physical examination and imaging examination should be made before operation, as well as reasonable and effective postoperative function training should be conducted.
Arthroscopy ; methods ; Hip Injuries ; surgery ; Hip Joint ; surgery ; Humans

Femoral head fractures without dislocation or subluxation are extremely rare injuries. We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident. He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39. He received cementless total hip replacement. At latest follow-up of 2.3 years, functional outcome was excellent with Harris hip score of 95. Such isolated injuries have been described only once in the literature and have not been classified till now. The purpose of this report is to highlight the extreme rarity, possible mechanism involved and a novel classification system to classify such injuries.
Adult ; Arthroplasty, Replacement, Hip ; Femur Head ; injuries ; Fractures, Comminuted ; surgery ; Hip Fractures ; surgery ; Humans ; Male

We report the surgical technique used to perform posterior-stabilized total knee arthroplasty (TKA) in two patients with a well positioned and functional hip arthrodesis. Intraoperatively, the operating table was placed in an increased Trendelenburg position. Episodically, we flexed the foot of the table by 90degrees to allow maximal knee flexion to facilitate exposure and bone cuts. We opted to resect the patella and tibia first to enable exposure, given the stiffness of the arthritic knee. One patient's medical condition prohibited complex conversion total hip arthroplasty (THA) prior to the TKA. The other patient's scarred soft tissues around the hip, due to chronic infection and multiple operations, made THA risky. The final outcome provided satisfactory results at a minimum of 2 years postoperatively. TKA can be successfully performed with adjustments of table position and modification of the sequence of surgical steps in patients with ipsilateral hip fusion.
Acetabulum/injuries/surgery ; Aged, 80 and over ; *Arthrodesis ; Arthroplasty, Replacement, Knee/*methods ; Fractures, Bone/surgery ; Hip Fractures/*surgery ; Hip Injuries/surgery ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee/*surgery ; War

BACKGROUND: Acetabular labral tear is a main cause of hip pain and disability, often requiring surgical treatment. Improvements of hip arthroscopic technique have produced positive outcomes after labral repair with arthroscopy. The purpose of this study was to determine clinical outcomes and patient satisfaction after arthroscopic repair of acetabular labral tear. METHODS: We interviewed 21 patients (10 men and 11 women; mean age, 36 years [range, 22 to 57 years]) with acetabular labral tears that had been repaired arthroscopically in terms of satisfaction of the procedure. In addition, clinical outcome was assessed using visual analog scale (VAS) score, University of California, Los Angeles (UCLA) activity, Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, and Harris hip score, and radiologic outcome was assessed using serial radiography. The patients were followed for 24-50 months. RESULTS: The mean Harris hip score was 73 points (range, 64 to 84 points) preoperatively and 83 points (range, 66 to 95 points) postoperatively. Fifteen hips (71%) were rated excellent and good. The mean WOMAC osteoarthritis index and VAS scores were improved at final follow-up. UCLA activity at the latest follow-up improved in 16 patients. The Tonnis grade of osteoarthritis at the latest follow-up did not change in all patients. Eighteen of the patients (86%) were satisfied with the procedure. CONCLUSIONS: High rate of satisfaction after arthroscopic repair of acetabular labral tears is an encouraging outcome. Arthroscopic treatment of labral tears might be a useful technique in patients with hip pathologies, such as femoroacetabular impingement with labral tears.
Acetabulum/*surgery ; Adult ; Arthroscopy ; Asian Continental Ancestry Group ; Female ; Fibrocartilage/injuries/surgery ; Hip Injuries/*surgery ; Hip Joint/*surgery ; Humans ; Male ; Middle Aged ; *Patient Satisfaction ; Young Adult

Acetabulum ; injuries ; surgery ; Adult ; Female ; Fractures, Bone ; surgery ; Hip Injuries ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Spinal Fractures ; surgery ; Young Adult

Total hip arthroplasty (THA) for an untreated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old female patient with untreated column and comminuted posterior wall fracture of the acetabulum was treated in our institution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior column with cancellous grafting and cementless THA in a single stage. At 3 years?follow-up, the patient was independently mobile without limb length discrepancy. Radiological evaluation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular reconstruction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision.
Acetabulum ; injuries ; Arthroplasty, Replacement, Hip ; methods ; Autografts ; Bone Transplantation ; Female ; Fractures, Comminuted ; surgery ; Hip Fractures ; surgery ; Humans ; Middle Aged

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture-dislocations of the left hip (Pipkin's type IV) and knee (Moore II) joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.
Adult ; Fractures, Open ; surgery ; Hip Dislocation ; surgery ; Humans ; Knee Dislocation ; surgery ; Leg Injuries ; surgery ; Male ; Tomography, X-Ray Computed

Hip arthroscopy has been reported to be useful and promising for the treatment of hip pathologies. However, it is not known whether the utilization of hip arthroscopy has increased in Korea. The purpose of this study was to evaluate national trends regarding the utilization of hip arthroscopy in Korea. We retrospectively reviewed nationwide data obtained from the Health Insurance Review and Assessment Service (HIRA). All new admissions for hip arthroscopy are recorded nationwide by HIRA using the ICD-10 code and the code for arthroscopic devices. Using archived data, we determined the trends in utilization of hip arthroscopy between 2007 and 2010. The number of hip arthroscopies increased more than twofold over the study period, from 596 to 1,262. A third of cases were performed in hospitals. Furthermore, a bimodal distribution was observed for men (20 to 24 yr and 45 to 49 yr) and an unimodal distribution for women (50 to 54 yr). Our results show an increasing trends in the utilization of hip arthroscopy from 2007 to 2010, which is in-line with recent findings of increased utilization with the rest of the world.
Adult ; Arthroscopy/*trends ; Databases, Factual ; Female ; Hip Injuries/*surgery ; Hip Joint ; Humans ; Male ; Middle Aged ; Republic of Korea ; Retrospective Studies

OBJECTIVETo evaluate middle and long-term results of total hip arthroplasties (THA) for the treatment of secondary hip traumatic osteoarthritis and femoral head necrosis after acetabular fractures.

METHODSFrom January 2000 to December 2005, 33 patients with secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures were treated with THA. There were 21 males and 12 females, ranging in age from 27 to 69 years old, with an average of 52 years old. Twenty-three patients were performed with open reduction and internal fixation: 5 patients were treated with anterior approach; 12 patients, posterior approach; 6 patients, combined approaches; other 10 patients, conservative treatment in the early stage. All THA were performed with posterior-lateral approach. Bone union was achieved in the all acetabular fractures. Removal of all implants was necessary in 5 patients, and partial removal in 3 patients. Cemented cup was implanted in 6 patients and uncommented cup in 27 patients. Intraoperative and postoperative complications were observed, and Harris hip scores before surgery and 10 years after operation were compared. The prosthetic loosening, osteolysis or revision were used to evaluate 10 years survival rate of prosthesis.

RESULTSAll the patients were followed up,and the duration ranged from 10 to 15 years, with a mean of 12 years. One patient died at the 10th year after operation. The Harris score at the 10th year was higher than the preoperative one. One and two patients were performed with revision total hip arthroplasty caused by aseptic loosening alone and aseptic loosening combined with osteolysis respectively. Osteolysis occurred in 1 patient; deep venous thrombosis in 4 patients; dislocation of prosthesis in 2 patients. One patient had infection of incision and one patient had infection around the prosthesis. Ten years survival rate of implant was 84.8% (28/133).

CONCLUSIONTHA is an effective method to treat secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures in improving hip joint functions with high implant survival rate and good middle and long-term results.

Acetabulum ; injuries ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur Head Necrosis ; surgery ; Fractures, Bone ; complications ; Hip Injuries ; complications ; Humans ; Male ; Middle Aged ; Osteoarthritis, Hip ; surgery ; Postoperative Complications ; surgery

OBJECTIVETo analyze the early clinical effects of total hip arthroplasty(THA) for the treatment of old acetabular fractures.

METHODSFrom January 2007 to June 2010, thirteen patients with old acetabular fractures were reviewed, including 10 males and 3 females. Ten patients were treated with internal fixation and conservative treatment had been used in three patients. The average Harris Hip Score was used to evaluate therapeutic effects.

RESULTSAfter operation, all thirteen patients were followed up for one year. Hip X-ray films were taken and prosthesis loosening was not seen on any of the films at the 1st year after operation. The Harris Hip Score improved from preoperative (37.19 +/- 20.12) to postoperative (83.38 +/- 3.33), there was statistically significant difference.

CONCLUSIONFor reasons of malunion or failure of internal fixation, large and various bone defect, it's difficult to reach the anatomical reduction. THA is a good treatment method, but it needs rich skills and experience compared with ordinary operation.

Acetabulum ; injuries ; Arthroplasty, Replacement, Hip ; methods ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies