Background
Femoral and sciatic nerves could be damaged during various stages of the periacetabular osteotomy. Changing the position of the hip could be the most effective way of preventing nerve injuries. The purpose of the present study was to investigate the distances of the nerves to various bony landmarks with different hip positions in computerized pelvic scanograms of healthy adults.
Materials and methods
Fifteen healthy male adults (30 hips) (age 30 ± 6) were included. Scans were performed at three different hip positions measured by goniometer (neutral “N,” flexion (30–45°) + abduction (30–45°) + external rotation (20°) “F” and neutral+ abduction (30–45°) + external rotation (20°) (Nabext) at three different levels (sourcil “1,” the middle of the femoral head “2,” and lower border of triradiate cartilage “3.”
Results
At the sourcil level, the femoral nerve was found to be the furthest distance from the anterior acetabulum in the neutral position compared to flexion or neutral plus abduction, external rotation (p < 0.001). For the sciatic nerve, at level 2, hip flexion resulted in a greater distance than in the neutral position (p = 0.001). For level 3, hip flexion caused a decrease in the distance of the sciatic nerve to the acetabulum compared to both neutral positions (N or Nabex) (p = 0.001).
Conclusions
During a pubic cut of the osteotomy, the femoral nerve moves closer to the anterior acetabulum wall with hip flexion or abduction plus external rotation. During an ischial cut, the sciatic nerve gets closer to the ischium with hip flexion while it moves away from the bone during retroacetabular cut.
Level-III Study
Background: Postoperative pain and edema are the most common problems associated with arthroscopic rotator cuff repair. The purpose of the present study was to compare ice wrap and subacromial injection (SI) as treatments for early postop pain and edema control and to contrast them with a control group. Materials and methods: 59 patients treated with arthroscopic rotator cuff repair were randomized into three groups: 23 patients who received an ice wrap, 20 patients who received a SI, and a control group of 16 patients. Results: Patient demographics, comorbidities, tear retraction, degree of fatty muscle degeneration, surgical procedures, and amount of irrigation fluid were similar for the three groups, which also showed similar results regarding postoperative pain and edema control as well as analgesic consumption. Conclusions: The present study failed to show any difference in effectiveness between the two most common pain management modalities, or between those modalities and the control group.
Gluteus medius and minimus tears have recently been reported to be very common and the main etiology of lateral sided hip pain. The purpose of this study was to determine whether there is any correlation between the dimensions of the tendon insertions and bare areas (BA) and various bony landmarks. Twenty-seven hemipelvises from adult male hips were included. The bony landmarks [anterior tip (Ta), posterior tip of trochanter, vastus tubercle (VT) and center of BA] were marked. The longitudinal lengths and widths (maximum) of posterosuperior (PS), lateral facets (LF), minimus insertion (Min) and BA and the distance between posterior (Tp) and Ta and between anterior/posterior tips and the VT or center of BA were measured using a digital caliper. A correlation analysis was performed between variables. There was a correlation between LFlength and Minlength (r = 0.4, P = 0.01) and between Ta–BA and PS + LF (r = 0.5, P = 0.003) or Minlength (r = 0.4, P = 0.016). LFwidth was negatively correlated with BAwidth (r = −0.4, P = 0.002). Tp–BA was negatively correlated with BAwidth (r = −0.4, P = 0.01). LFwidth was correlated with Tp–BA, and this nearly reached statistical significance (r = 0.3, P = 0.05). BA can be used intraoperatively as landmarks to estimate the width of the LF and also to determine the length of the longitudinal insertion of the gluteus medius and minimus tendons.
Objective: Coexistence of lumbar spine disorder with hip diseases is defined as Hip-Spine syndrome, there might be a relation between torsional deformities of the hip and lumbar disc disease. Purpose of the present study was to find whether hip torsional parameters (femur, acetabular anteversion) and clinical findings (hip range of motion, hip score) differ in patients with lumbar disc disease. Method: Patients with lomber disc herniation (n: 20) and control subjects (n: 20) without any lumbar spine or hip disease were enrolled in the study. Femoral anteversion (FeAv), acetabular anteversion (AA), center of edge angle (CE), degree of hip flexion, extension, Harris Hip scores (HHS) were evaluated bilaterally. Results: HHS score, degree of extension plus flexion was lower at diseased side when it is compared to the control subjects (p < 0.001). Unilaterally affected patients had lower AA than control subjects (AA: 13 ± 40 vs16 ± 20 p: 0.01). Conclusion: As there is a link between hip and spine disorders, present study aims to find whether there is a causal relation between hip torsional deviations and lumbar disc disease. Partially supporting the hypothesis, diseased side had lower degrees of acetabular anteversion compared to control subjects at unilaterally affected patients. Mechanical and /or hip torsional parameters especially the acetabular retroversion may have an etiopathogenetic role in unilateral lumbar disc disease.
Background
Presence of lumbar spine disorder with hip diseases is defined as Hip-Spine syndrome, there might be a relation between hip torsional deformities and lumbar disc disease which has not clarified previously. Purpose of the present study was to find whether hip torsional parameters (femur, acetabular anteversion) and clinical findings (hip range of motion, hip score) differ at patients with lumbar disc disease.
Methods
Patients with lomber disc herniation (n: 20) and control subjects (n: 20) without any lumbar spine or hip disease were enrolled. Femoral anteversion (FeAv), acetabular anteversion (AA), center of edge angle (CE), degree of hip flexion, extension, Harris Hip scores (HHS) were evaluated bilaterally.
Results
HHS score, degree of extension plus flexion was lower at diseased side when it is compared to the control subjects (p < 0.001). Unilaterally affected patients had lower AA than control subjects (AA: 13 ± 40 vs16 ± 20 p:0.01). Mechanic and /or hip torsional parameters especially the acetabular retroversion may have an etiopathogenetic role at unilateral lumbar disc disease.
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