Background: The annual rate of primary THA has been increasing with new designs promoting THA in the younger population, therefore increasing rates and complexity of hip revision surgeries. Different types of acetabular defects in hip revisions, usually make the use of primary cementless cups quite difficult. In complex defects, using cages with cemented cups or combining cementless cups with metal augments, are possible reconstruction solutions. The Delta TT acetabular revision system provides a solution to complex defects combining the advantages of both cage construct and primary implants, with modularity that helps restore anatomical hip centre and biomechanics. The aim of this study is to evaluate the short-term results of the use of the Delta TT revision system in acetabular revision surgeries. Type of the study: A retrospective case series. Methods: 24 patients underwent acetabular revision using (Delta TT) revision system, from 2018 to 2021. The mean follow-up was 20.75 months. Clinical and functional outcomes were assessed using Harris Hip Score. Results: The use of the Delta TT revision system in acetabular revision surgery provided adequate pain relief, and early patient mobilization. The preoperative HHS mean of 29.88 improved to a mean of 85.21, at the last, follow-up. None of the patients developed periprosthetic infection or loosening or nerve palsy during the follow-up period. Conclusion: Short-term clinical outcomes for the use of the Delta TT revision cup system in acetabular revision are encouraging with good functional outcomes and patient satisfaction.
Developmental hip dysplasia is a common cause for secondary osteoarthritis and in the past it was considered impossible to do hip arthroplasty surgery for this group of patients. We aim at introducing our results and arthroplasty technique in management of such technically demanding and challenging cases. 22 patients with 25 hips suffer from hip dysplasia Crowe type IV were operated by total cementless unconstrained hip arthroplasty with subtrochentric derotation osteotomy without fixation of osteotomy site, The mean age group was 37.9. All patients were operated through lateral approach. The acetabular component is located in the true acetabulum. Postoperatively the patient can weight bear fully unaided within 3 months. The preoperative limb length discrepancy improved from a mean 46.36 mm to 7.3 mm. One case of stem subsidence occurred and underwent revision to cemented stem 1years later. The Harris hip score improved to 85.9 at end of follow up in comparison to38.09 preoperatively. The osteotomy site healed within 5.1months in average .No cases of osteotomy non union occurred. The mean follow up was 28.3 months. We concluded that hip arthroplasty in patients with hip dysplasia Crowe type IV is technically demanding surgery. Recreation of normal biomechanics and anatomy through implantation of acetabular component in the true acetabulum and femoral shortening and derotation offers the patient painless and adequately functioning hip
Purpose: To evaluate the effect of the coracoclavicular distance widening in athletes after arthroscopic acromioclavicular (AC) stabilization using a suspensory button fixation device in terms of function, athletic performance, or isokinetic assessment. Methods: Sixty-eight athletes with a minimum 6-month follow-up after AC stabilization using suspensory button fixation were allocated in 2 groups, the widening group and non-widening group, according to the measured coracoclavicular distance after 6 months from the operation. The assessment was done every 6 months by Subjective Patient Outcome for Return to Sports (SPORTS) score, Athletic Shoulder Outcome Scoring System (ASOSS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, ConstanteMurley score (CMS), and the coracoclavicular distance. Isokinetic testing was performed at 24 months postoperatively to evaluate shoulder abduction and external rotation strength. Results: No statistically significant differences were found between the 2 groups in terms of the DASH, ASOSS, SPORTS, and the CMS, in addition to the isokinetic testing (P > .05). A statistically significant improvement in both groups over the follow-up stage was identified in the DASH, ASOSS, SPORTS, and the CMS (P < .05). Conclusions: Coracoclavicular distance widening following arthroscopic suspensory button fixation for AC joint dislocation did not affect function, athletic performance, or isokinetic evaluation in athletes. Level of Evidence: III; nonrandomized, comparative trial.A cromioclavicular (AC) joint dislocations are a common injury that account for almost 50% of sports-related shoulder injuries. [1][2][3] The Rockwood classification is the most commonly used classification system. Conservative management is widely used for type I and II dislocations, whereas surgical treatment the intervention of choice for type IV to VI dislocations. 1,[4][5][6] Many surgical options have been reported in the literature, all of which aim for full recovery with the return to the preinjury level of activity and sport participation. [6][7][8] The suspensory button fixation was reported initially for the fixation of syndesmotic ankle injuries. The use of these devices in the treatment of AC dislocations has been described in open and arthroscopic techniques. 7,[9][10][11] The loss of AC joint reduction, as evident by coracoclavicular (CC) distance widening, is commonly reported after AC stabilization using suspensory button fixation devices. The effect of such findings on the athletic performance of patients is not yet fully understood. 7,9,[11][12][13][14][15] The purpose of this study is to evaluate the effect of CC distance widening in athletes after arthroscopic AC joint stabilization using a suspensory bottom fixation device in terms of function, athletic performance, and/or isokinetic assessment. We hypothesized that the CC distance rewidening after AC joint stabilization using a suspensory button fixation might affect the function and athletic performance of the shoulder joint. Methods
Background:The all-aperture fixation technique for anatomical medial patellofemoral ligament (MPFL) reconstruction using a doubleloop semitendinosus autograft has been proposed as a strong and biomechanically sound surgical procedure. The aim of the study was to describe the surgical procedure and report the early and mid-term results of MPFL reconstruction using patellar knotless anchors and femoral interference screws. These procedures were performed in the same institution. Methods:This is a retrospective case series studying 10 patients with chronic patellofemoral instability who underwent anatomical MPFL reconstruction by means of patellar knotless anchors and femoral interference screws. The Tegner-Lysholm score with clinical data such as apprehension test and knee range of motion (ROM) were assessed preoperatively and postoperatively. Results:After a mean follow-up of 19.4 mo, all the cases had good clinical outcomes, and none of the cases had any recurrence. The mean Lysholm score and knee ROM significantly improved from 59 and 101 preoperatively to 80.2 and 125, respectively (P < 0.001). Conclusions:The technique of anatomical double-bundle MPFL reconstruction by patellar knotless anchors and femoral interference screws is an effective, reproducible, and easy technique for restoring stability and function of the patellofemoral joint.
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