Invasive cervical carcinomas frequently reveal additional copies of the long arm of chromosome 3. The detection of this genetic aberration in diagnostic samples could therefore complement the morphological interpretation. We have developed a triple-color DNA probe set for the visualization of chromosomal copy number changes directly in thin-layer cervical cytology slides by fluorescence in situ hybridization. The probe set consists of a BAC contig that contains sequences for the RNA component of the human telomerase gene (TERC) on chromosome band 3q26, and repeat sequences specific for the centromeres of chromosomes 3 and 7 as controls. In a blinded study, we analyzed 57 thin-layer slides that had been rigorously screened and classified as normal (n ‫؍‬ 13), atypical squamous cells (ASC, n ‫؍‬ 5), low-grade squamous intraepithelial lesions (LSIL, n ‫؍‬ 14), and highgrade squamous intraepithelial lesions ( Cytologic screening 1 has greatly reduced incidence and mortality of cervical cancer in industrialized nations.2 In developing countries, however, cervical cancer remains a health problem of tremendous proportions. If detected in a timely manner, cervical cancer precursors, especially high-grade squamous intraepithelial lesions (HSILs) can be effectively treated, sparing patients the morbidity and mortality resulting from invasive cancer. Despite its success as a public health measure, a single cytologic examination is relatively insensitive, poorly reproducible and frequently yields equivocal results. Inadequate sampling, the scarcity of aberrant cells in some samples and the subjectivity of morphological interpretation are recognized limitations of cytology. 2,3 In addition, equivocal and mild cytologic abnormalities are extremely common in young women, but most of these lesions regress spontaneously, even when caused by oncogenic types of human papillomaviruses, 4,5 which play a crucial role in the pathogenesis of cervical cancer. 6,7 This has prompted efforts to discover other biomarkers and other screening techniques with the potential to supplement cytologic screening. 8 -13

Diagnosis of acetabular retroversion is essential in femoroacetabular impingement (FAI), but its assessment from radiographs is complicated by pelvic tilt and the two-dimensional nature of plain films. We performed a study to validate the diagnostic accuracy of the cross-over sign (COS) and the posterior wall sign (PWS) in identifying acetabular retroversion. COS and PWS were evaluated from radiographs and computed tomography (CT) scans as the standard of reference in 50 hips of subjects with symptoms of FAI. A CT-based method using three-dimensional (3D) models was developed to measure the COS, PWS, true acetabular version, and pelvic tilt relative to the anterior pelvic plane. The new CT-based method aimed to eliminate errors resulting from variations in the position and orientation of the pelvis during imaging. A low level of agreement for COS and PWS was found between radiographs and CT scans. A positive COS strongly correlated with pelvic tilt. These results suggest that COS and PWS determined from anteroposterior radiographs are considerably limited by pelvic tilt and inherent limitations of radiographs. Their use as the sole basis for deciding whether or not surgical intervention is indicated seems questionable. Keywords: hip; femoroacetabular impingement; cross-over sign; posterior wall sign; three-dimensional analysis Femoroacetabular impingement (FAI) has been shown to be one of the primary risk factors predisposing to the early development of osteoarthritis (OA) of the hip.1 Therefore, reliable and accurate diagnosis of the anatomical features resulting in FAI is critical to initiate timely and effective treatment in early disease. There are two main forms of FAI: cam impingement, which is characterized by a reduced femoral neck/head offset, and pincer impingement, a condition in which the osseous pathologies occur mainly on the acetabular side.2 Pincer type FAI can be caused by acetabular retroversion resulting from excessive anterior coverage of the femoral head or a deficient posterior acetabular rim.3 These anatomical deformities of the anterior and posterior acetabular wall can occur in isolation or in combination, but both of these osseous pathologies influence the resulting version of the acetabulum. Reduced anteversion results in the acetabulum acting as an obstacle to joint motion at high degrees of flexion and internal rotation, predisposing to impingement and leading, over time, to lesions of the anterior labrum and adjacent cartilage.2,4 Since the identification of acetabular retroversion has important therapeutic consequences for the preservation of the natural joint, 5-7 the reliability with which acetabular anteversion can be diagnosed is critical for the clinical decision process and the success of surgical intervention. 89Numerous methods for identifying acetabular anteversion have been described, but its diagnosis in clinical practice often exclusively relies on anteroposterior (AP) radiographs of the pelvis and measurement of anteversion in two-dimensional axial computed t...

Aims The use of trabecular metal (TM) shells supported by augments has provided good mid-term results after revision total hip arthroplasty (THA) in patients with a bony defect of the acetabulum. The aim of this study was to assess the long-term implant survivorship and radiological and clinical outcomes after acetabular revision using this technique. Patients and Methods Between 2006 and 2010, 60 patients (62 hips) underwent acetabular revision using a combination of a TM shell and augment. A total of 51 patients (53 hips) had complete follow-up at a minimum of seven years and were included in the study. Of these patients, 15 were men (29.4%) and 36 were women (70.6%). Their mean age at the time of revision THA was 64.6 years (28 to 85). Three patients (5.2%) had a Paprosky IIA defect, 13 (24.5%) had a type IIB defect, six (11.3%) had a type IIC defect, 22 (41.5%) had a type IIIA defect, and nine (17%) had a type IIIB defect. Five patients (9.4%) also had pelvic discontinuity. Results The overall survival of the acetabular component at a mean of ten years postoperatively was 92.5%. Three hips (5.6%) required further revision due to aseptic loosening, and one (1.9%) required revision for infection. Three hips with aseptic loosening failed, due to insufficient screw fixation of the shell in two and pelvic discontinuity in one. The mean Harris Hip Score improved significantly from 55 (35 to 68) preoperatively to 81 points (68 to 99) at the latest follow-up (p < 0.001). Conclusion The reconstruction of acetabular defects with TM shells and augments showed excellent long-term results. Supplementary screw fixation of the shell should be performed in every patient. Alternative techniques should be considered to address pelvic disconinuity. Cite this article: Bone Joint J 2019;101-B:311–316.