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

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

Bacillus cereus is a widespread organism in nature and a member of the B. cereus group of catalasepositive, aerobic, spore-forming, Gram-positive bacilli. B. cereus found in blood is often dismissed as a contaminant in the absence of repeated isolation from multiple cultures. Soft tissue and bone infection due to B. cereus have been associated with trauma, intravenous drug use, and an immunocompromised state. We report a very late prosthetic joint infection of the hip joint and consequent bacteremia caused by B. cereus, which occurred 13 years after total hip replacement surgery in the absence of recent trauma or intervention.
Arthritis ; Arthroplasty, Replacement, Hip ; Bacillus cereus* ; Bacillus* ; Bacteremia* ; Hip Joint* ; Hip* ; Joints* ; Pathology* ; Prostheses and Implants

Arthroplasty, Replacement, Hip ; adverse effects ; Hemangiosarcoma ; diagnosis ; Hip Joint ; pathology ; surgery ; Hip Prosthesis ; Humans

In 1941, Jaffe and coworkers studied a lesion with histologic appearance of fibrous stroma, pigmented deposition and histiocytic infiltration as well as giant cell, for which they named pigmented villonodullar synovitis, bursitis and tenosynovitis. Thereafter many authors have disscussed etiology, clinical and radiological features, pathology and treatment regarding the disease. Recently we experienced a case of pigmented villonodular synovitis involving an hip joint which was treated by synovectomy and total hip replacement with good result.
Arthroplasty, Replacement, Hip ; Bursitis ; Giant Cells ; Hip Joint ; Hip ; Pathology ; Synovitis ; Synovitis, Pigmented Villonodular ; Tenosynovitis

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

BACKGROUND: Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion. METHODS: Sixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated. RESULTS: The average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed. CONCLUSIONS: Using cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established.
Acetabulum/*pathology/radiography/*surgery ; Adult ; Arthritis, Infectious/complications/pathology ; *Arthroplasty, Replacement, Hip ; Female ; Hip Dislocation, Congenital/pathology/surgery ; Hip Joint/radiography ; *Hip Prosthesis ; Humans ; Male ; Middle Aged

Adult ; Female ; Femoracetabular Impingement ; pathology ; Hip Joint ; pathology ; Humans ; Male ; Synovial Membrane ; pathology

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

OBJECTIVETo investigate clinical characteristics and pathological changes of tissue surrounding prosthesis after hip and knee arthroplasty.

METHODSA total of 67 patients receiving hip and knee arthroplasty were included in the study and pathological changes of the revision specimens were evaluated by microscopic examination.

RESULTSOf 67 patients, there were 25 males and 42 females (ratio of 0.6) with a mean age of 64 years. There were 42 cases of revision hip prosthesis and 25 cases of knee prosthesis. The primary causes for the revision varied, including 20 cases of infection (29.9%, within 3 months in 9 cases,3 to 24 months in 3 cases and over 24 months in 8 cases), 14 cases of pain (20.9%), 13 cases of loosening of the prosthesis (19:4%), 9 cases of joint stiffness (13.4%), 8 cases of prosthetic dislocation (11.9%), and 3 cases of prosthesis fracture (4.5%). Pathological findings in the tissue surrounding the prostheses included debris reaction, histiocytes, acute inflammatory, chronic non-specific inflammation, pigmented villonodular synovitis (PVNS), "pseudomembranous", calcification, necrosis, sequestrum, etc. These histological changes were frequently admixed.

CONCLUSIONSVarious reasons may lead to hip and knee revision arthroplasty. The main pathological findings include infection, debris granulomas, chronic non-specific inflammatory changes, PVNS. The surgical pathology of the prosthesis provids guidances for clinical treatment and basic research.

Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Female ; Hip Joint ; pathology ; Humans ; Knee Joint ; pathology ; Knee Prosthesis ; Male ; Middle Aged ; Reoperation ; Synovitis, Pigmented Villonodular ; pathology