Modern Surgical Treatment of Recurrent Posterior Dislocation of the Native Hip

Carlson, Bayard C.; Desy, Nicholas M.; Johnson, James L.; Trousdale, Robert T.; Leunig, Michael; Ganz, Reinhold; Sierra, Rafael J.

doi:10.2106/jbjs.17.01170

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…Two independent investigations of different patterns of dysplasia reported the importance of judging anterior and posterior wall coverage of the femoral head [17,21]. Intraoperative evaluation of the wall indices is especially important when a PAO is used to correct posterolateral instability [5].…”

Section: Discussionmentioning

confidence: 99%

What Is the Reliability and Accuracy of Intraoperative Fluoroscopy in Evaluating Anterior, Lateral, and Posterior Coverage During Periacetabular Osteotomy?

Wylie

Ferrer

McClincy

et al. 2019

Clin Orthop Relat Res

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Background Periacetabular osteotomy (PAO) is an established treatment for acetabular dysplasia in the skeletally mature individual. Fluoroscopy is used intraoperatively for osteotomy completion and to judge fragment correction. However, a comprehensive study validating fluoroscopy to judge anterior, lateral, and posterior coverage in PAO has not been reported. Questions/purposes (1) Are radiographic and fluoroscopic measures of anterior, lateral, and posterior acetabular coverage reliable? (2) Do fluoroscopic measures of fragment correction accurately measure anterior, lateral, and posterior coverage when compared with postoperative radiographs? Methods We performed a retrospective study of patients undergoing PAO with a primary diagnosis of acetabular dysplasia. Between 2012 and 2014 two surgeons performed 287 PAOs with fluoroscopy. To be included in this retrospective study, patients had to be younger than 35 years old, have a primary diagnosis of dysplasia (not retroversion, Perthes, or skeletal dysplasia), have adequate radiographic and fluoroscopic imaging, be a primary PAO (not revision), and in the case of bilateral patients, only the first hip operated on in the study period was included. Based on these criteria, 46% of the PAOs performed were included here (133 of 287). A total of 109 (82%) of the patients were females (109 of 133), and the mean age of the patients represented was 24 years (SD, 7 years). Pre-and postoperative standing radiographs as well as intraoperative fluoroscopic images were reviewed and lateral center-edge angle (LCEA), Tönnis angle (TA), anterior center-edge angle (ACEA), anterior wall index (AWI), and posterior wall index (PWI) were measured. Two fellowship-trained hip preservation surgeons completed all measurements with one reader performing a randomized sample of 49 repeat measurements 4 weeks after the initial reading for purposes of calculating intraobserver reliability. Intra-and interrater reliability was assessed using an intraclass correlation coefficient (ICC) model. Agreement between intraoperative fluoroscopic and

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Section: Discussionmentioning

confidence: 99%

What Is the Reliability and Accuracy of Intraoperative Fluoroscopy in Evaluating Anterior, Lateral, and Posterior Coverage During Periacetabular Osteotomy?

Wylie

Ferrer

McClincy

et al. 2019

Clin Orthop Relat Res

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“…FAI can occur because of a CAM deformity, femoral retroversion, or acetabular retroversion. Anteverting periacetabular osteotomies (PAO), femoral derotational osteotomies, and osteochondroplasties through a surgical hip dislocation or hip arthroscopy have all been used for the treatment of recurrent hip instability secondary to FAI [12][13][14] (Table I). Anteroposterior x-ray of the right hip (Fig.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Post-traumatic Posterior Hip Dislocation Treated Using a Bone Block Technique

Amer

Dunlop

2022

JBJS Case Connector

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Case: A 26-year-old man presented with recurrent native hip dislocation after an initially traumatic posterior right hip dislocation. The combined soft-tissue and bony deficiency was addressed using an autologous bone block technique, as previously popularized for shoulder instability. Thirteen years postoperatively, no subsequent dislocations occurred, and the patient has an excellent functional outcome. Conclusion: The bone block technique for hip stabilization can be used to address focal acetabular deficiencies with promising long-term follow-up.

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“…Recurrent posterior native hip instability is considered extremely uncommon. Carlson et al, (2018) compiled 9 cases of recurrent hip dislocations from 2 different institutions and advocated to seek for low femoral anteversion or acetabular retroversion and address them by treating the cause of the impingement or performing a periacetabular osteotomy. If that is not detected, then posterior capsular reconstruction should carry out.…”

Section: Discussionmentioning

confidence: 99%

Luxación traumática recurrente de cadera asociada a fractura de cabeza femoral reconstruida con autoinjerto de cresta ilíaca

Rubio-Saez

Merino-Rueda

Pallares-Sanmartin

et al. 2021

IJMSS

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Las fracturas de la cabeza femoral de la cadera son extremadamente infrecuentes, pero probablemente se relacionen con luxaciones traumáticas de la cadera. Ambas lesiones requieren un tratamiento urgente para evitar más complicaciones. Paciente varón de 19 años que fue recibido tras un accidente automovilístico de alta energía con traumatismo craneoencefálico y toracoabdominal severo y fractura de cabeza femoral desplazada con luxación posterior de cadera sin fractura acetabular. Se realizó una reducción abierta emergente y fijación interna con 2 tornillos sin cabeza, así como reparación de la cápsula posterior. Tras 1 mes de internación en Unidad de Cuidados Intensivos, sufrió un nuevo episodio de luxación posterior de cadera. En consecuencia, se obtuvo una segunda reducción quirúrgica exitosa y la estabilidad de la cadera se logró mediante la reconstrucción posterior con autoinjerto de cresta ilíaca fijado con tornillo canulado y reparación de la estructura posterior. Dos años después, pudo caminar de forma independiente y no presenta ningún signo de enfermedad degenerativa articular ni necrosis avascular.

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Modern Surgical Treatment of Recurrent Posterior Dislocation of the Native Hip

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 9 publications

References 27 publications

What Is the Reliability and Accuracy of Intraoperative Fluoroscopy in Evaluating Anterior, Lateral, and Posterior Coverage During Periacetabular Osteotomy?

What Is the Reliability and Accuracy of Intraoperative Fluoroscopy in Evaluating Anterior, Lateral, and Posterior Coverage During Periacetabular Osteotomy?

Recurrent Post-traumatic Posterior Hip Dislocation Treated Using a Bone Block Technique

Luxación traumática recurrente de cadera asociada a fractura de cabeza femoral reconstruida con autoinjerto de cresta ilíaca

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