Regional difference of tensile properties of the human acetabular labrum in various hip disorders

Kumano, Takafumi; Naito, Masatoshi; Ishiko, Toshiyuki; Moriyama, Shigeaki; Tanaka, Jun

doi:10.1097/bco.0b013e328313a982

Cited by 1 publication

(1 citation statement)

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“…A negative correlation was found in dysplastic hips between the tensile stress at failure of the anterosuperior labrum and age, while the degeneration of the anterosuperior labrum was more severe than that of the posteroinferior labrum. 17) We propose that degeneration of the fibers of the anterosuperior labrum due to OA may influence the stress and strain it can withstand.…”

Section: Development Of Oa In Dysplastic Hipmentioning

confidence: 99%

Curved Periacetabular Osteotomy for the Treatment of Dysplastic Hips

Naito

Nakamura

2014

Clin Orthop Surg

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Curved periacetabular osteotomy (CPO) was developed for the treatment of dysplastic hips in 1995. In CPO, the exposure of osteotomy sites and osteotomy of the ischium are made in the same manner as Bernese periacetabular osteotomy, and iliac and pubic osteotomies are performed in the same manner as rotational acetabular osteotomy. We studied the dynamic instabilities of 25 dysplastic hips before and after CPO using triaxial accelerometry. Overall magnitude of acceleration was significantly decreased from 2.30 ± 0.57 m/sec2 preoperatively to 1.55 ± 0.31 m/sec2 postoperatively. Pain relief and improvement of acetabular coverage resulting from acetabular reorientation seem to be related with reduction of dynamic instabilities of dysplastic hips. Isokinetic muscle strengths of 24 hips in 22 patients were measured preoperatively and after CPO. At 12 months postoperatively, the mean muscle strength exceeded the preoperative values. These results seem to be obtained due to no dissection of abductor muscles in CPO. The preoperative presence of acetabular cysts did not influence the results of CPO. An adequate rotation of the acetabular fragment induced cyst remodeling. Satisfactory results were obtained clinically and radiographically after CPO in patients aged 50 years or older. CPO alone for the treatment of severe dysplastic hips classified as subluxated hips of Severin group IV-b with preoperative CE angles of up to -20° could restore the acetabular coverage, weight-bearing area and medialization of the hip joint. CPO without any other combined procedure, as a treatment for 17 hips in 16 patients with Perthes-like deformities, produced good mid-term clinical and radiographic results. We have been performing CPO in conjunction with osteochondroplasty for the treatment of acatabular dysplasia associated with femoroacetabular impingement since 2006. The combined procedure has been providing effective correction of both acetabular dysplasia and associated femoral head-neck deformities without any increased complication rate. We have encountered an obturator artery injury in one case and two intraoperative comminuted fractures. Although serious complications such as motor nerve palsy, deep infection, necrosis of the femoral head or acetabulum, and delayed union or nonunion of the ilium were reported, such complications have never occurred in our 700 cases so far.

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Section: Development Of Oa In Dysplastic Hipmentioning

confidence: 99%