Overall, the 7-year hip survival rate in hip dysplasia appears inferior compared with that reported in femoroacetabular impingement (78%). Hip arthroscopic surgery is associated with an excellent chance of hip preservation in mild dysplasia (green zone: AI = 0°-15°, LCEA = 15°-25°) and no articular wear. The authors advise that the greatest caution should be used when considering arthroscopic options in cases of severe dysplasia (red zone: AI >20° and/or LCEA <10°).
In his fascinating review of fallstreak holes or 'hole-punch ' clouds, David Pedgley (2008) remarked that there were no measurements into the microphysics and dynamics of holepunch clouds from ground-based remote sensors because the probability of a hole drifting into the instrument sample volume is so small. Here we present some remarkable measurements of exactly that, which we were lucky enough to make at the Chilbolton Observatory in Hampshire.
We aimed to identify factors such as pre-arthroscopy and intra-operative variables that were associated with failure of hip arthroscopy as a joint preserving operation. We performed a retrospective analysis of a database containing 344 consecutive hip arthroscopies performed at our institution. Forty-four hips were identified that underwent a subsequent arthroplasty procedure following their hip arthroscopy (cases). Sixty-six control hips (hip arthroscopy with no subsequent arthroplasty) were randomly selected from the same database. Cases and controls were matched for age, sex and follow-up (P = 0.59, 0.48, 0.10, respectively). Pre-operative radiographs/MRI scans plus intra-operative findings were analysed to identify factors associated with failure. Both a lower centre edge angle and higher acetabular index on pre-operative radiographs were associated with higher rates of failure (P < 0.001). The presence of any acetabular wear at operation was also associated with failure (P < 0.001). Highest rates of failure were seen in hips with both features of dysplasia on pre-operative radiographs and any intra-operative acetabular wear (relative risk: 5, odds ratio: 9.13, P < 0.001). Dysplastic features on pre-operative radiographs and the finding of acetabular wear at hip arthroscopy increase the risk of subsequent arthroplasty. Identification of these features pre-operatively with evolving imaging techniques would improve the results of hip arthroscopy as joint preserving surgery.
We present a case of recurrent vago-glossopharyngeal neuralgia after previous surgery, treated successfully with microvascular decompression using intra-operative neurophysiology monitoring.
Description of ocular infection with Onchocerca lupi in the United Kingdom METHODS Reports of infection with Onchocerca lupi nematodes generally originate from areas of Greece and Portugal. The increasing importation of rescued stray animals from these areas may result in an increase in cases seen in the UK. Here we document one such case.
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