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Treu EA, Sato EH, Omotowa OM, Heaton TB, Erickson JA, Blackburn BE, Peters CL, Anderson LA. Dysplastic Hips That Are Too Late for Periacetabular Osteotomy Are Not Too Early for Total Hip Arthroplasty. J Arthroplasty 2024; 39:S131-S137. [PMID: 38677342 DOI: 10.1016/j.arth.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is often performed in symptomatic patients who have hip dysplasia and do not qualify for periacetabular osteotomy. The impact of osteoarthritis (OA) severity on postoperative outcomes in dysplasia patients who undergo THA is not well described. We hypothesized that dysplasia patients who have mild OA have slower initial recovery postoperatively but similar one-year patient-reported outcome measures (PROMs) compared to dysplasia patients who have severe OA. METHODS We performed a retrospective review at a single academic institution over a 6-year period of patients who have dysplasia who underwent THA compared to patients who have primary OA who underwent THA. There were 263 patients who had dysplasia, compared to 1,225 THA patients who did not have dysplasia. Within the dysplasia cohort, we compared PROMs stratified by dysplasia and OA severity. The diagnosis of dysplasia was verified using the radiographic lateral center edge angle. A minimum one-year follow-up was required. The PROMs were collected through one year postoperatively. Logistic and linear regression models were used, adjusting for age, sex, body mass index, and Charlson comorbidity index. RESULTS No significant differences were found in postoperative PROMs or revision rates (P = .58). When stratified by dysplasia severity, patients who had lower lateral center edge angle had more improvement in physical function scores from preoperative to 2 weeks (P < .01) and higher physical function scores at 2 weeks (P = .03). When stratified by OA severity, patients who had a worse Tönnis score had more improvement in physical function scores from preoperative to 2 weeks (P < .01). Recovery curves in dysplasia patients based on dysplasia and OA severity were not significantly different at 6 weeks, 1 year, and 2 years postoperative. CONCLUSIONS Patients who had hip dysplasia and mild OA had similar recovery curves compared to those who had severe OA or who did not have dysplasia. We believe that THA is a reasonable surgical intervention for symptomatic dysplasia patients who have mild arthritis and do not qualify for periacetabular osteotomy.
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Affiliation(s)
- Emily A Treu
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | - Eleanor H Sato
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | | | - Tanner B Heaton
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | - Jill A Erickson
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | | | | | - Lucas A Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
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Zhang Z, Ren N, Cheng H, Luo D, Li Y, Zhang H. Periacetabular osteotomy for Tönnis grade 2 osteoarthritis secondary to hip dysplasia. INTERNATIONAL ORTHOPAEDICS 2023:10.1007/s00264-023-05795-w. [PMID: 37010562 DOI: 10.1007/s00264-023-05795-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To investigate the clinical outcomes of periacetabular osteotomy (PAO) for Tönnis grade 2 osteoarthritis secondary to hip dysplasia. METHODS Forty-nine patients (51 hips) with Tönnis grade 2 osteoarthritis secondary to hip dysplasia, followed by a mean of 52.3 months (range: 24.1 to 95.2 months), were reviewed. As a control group, 51 patients (51 hips) with Tönnis grade 1 osteoarthritis were matched for age, surgery date, and follow-up period. All patients were evaluated clinically with the use of modified Harris hip score (mHHS) questionnaire, WOMAC score, and the 12-item International Hip Outcome Tool (iHot-12). Radiographic measurements included the lateral centre-edge angle (LCEA), Tönnis angle, and anterior centre-edge angle (ACEA). Kaplan-Meier survivorship analysis was performed to predict a five year survival rate of no osteoarthritis progression. RESULTS All functional scores and radiographic measurements of the two groups significantly improved at the final follow-up. There were no significant differences between the two groups either in functional scores or radiographic measurements. The five year survival rate of no osteoarthritis progression was 86.2% in Tönnis grade 2 group and 93.1% in Tönnis grade 1 group, respectively. In the Tönnis grade 2 group, the osteoarthritis progressed in six hips. Of which, four hips had an ACEA of < 25°. No osteoarthritis progression was found in hips with an ACEA > 40°. CONCLUSIONS PAO yielded similar results for patients with Tönnis grade 2 and grade 1 osteoarthritis secondary to hip dysplasia. The majority of hips can be preserved without progression of osteoarthritis at five years postoperatively. The slight overcorrection anteriorly may be helpful in preventing osteoarthritis progression.
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Affiliation(s)
- Zhendong Zhang
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China
| | - Ningtao Ren
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China
| | - Hui Cheng
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China
| | - Dianzhong Luo
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China
| | - Yong Li
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China
| | - Hong Zhang
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Beijing, China.
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Rogers MJ, Sato EH, LaBelle MW, Ou Z, Presson AP, Maak TG. Association of Cam Deformity on Anteroposterior Pelvic Radiographs and More Severe Chondral Damage in Femoroacetabular Impingement Syndrome. Am J Sports Med 2022; 50:2980-2988. [PMID: 35975987 DOI: 10.1177/03635465221111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Abnormal proximal femoral morphology in femoroacetabular impingement syndrome (FAIS) identifiable on the anteroposterior (AP) pelvic radiograph has been described as the "pistol grip" deformity. The effect of a superior cam deformity identified on this radiographic view remains unknown. PURPOSES To assess the relationship between AP cam deformity (AP alpha angle [AP AA] >55°) and cartilage injury; to assess the relationship between AP cam deformity and labral injury; and to determine if patient factors are correlated with cartilage and labral injury. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Patients undergoing osteochondroplasty and labral repair for FAIS with a single surgeon were identified retrospectively. Intraoperative size, location, and severity of cartilage and labral damage were prospectively collected. Chondrolabral and femoral/acetabular cartilage damage were graded with the Beck labral and cartilage injury criteria. Radiographic data included the AP AA, lateral center-edge angle (LCEA), and maximum femoral alpha angle (MF AA). Patients with hip dysplasia (LCEA <18°; LCEA 18°-25° with acetabular index >10°) were excluded. Outcomes were compared across cartilage and labral severity grades. We report odds ratios (ORs) with 95% confidence intervals and P values from multivariable logistic regressions. RESULTS Of the 158 included hips (154 patients), 69% were female and the mean (± standard deviation [SD]) age was 30.3 ± 9.7 years. Increase in age, increase in body mass index (BMI), and male sex were associated with increasing severity of cartilage and labral injury. More severe cartilage damage was associated with increasing AP AA (P < .001) and MF AA (P < .001). The odds of developing a higher category of cartilage injury severity (grade ≥3) were 119% higher (OR, 2.19 [95% CI, 1.36-3.64]; P = .002) for every SD increase (16.7°) in AP AA, adjusting for age, sex, and BMI. The odds of developing a severe labral injury (grade ≥3) were 118% higher (OR, 2.18 [95% CI 1.17-4.32]; P = .018) for every SD increase (10.5°) in MF AA, adjusting for age, sex, BMI, and AP AA. CONCLUSION Increasing age and BMI, and male sex are associated with increasing severity of cartilage and labral injury in FAIS. The odds of developing a cartilage injury are significantly higher with independent increases in AP AA and MF AA.
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Affiliation(s)
- Miranda J Rogers
- Department of Orthopaedic Surgery, University of Utah Orthopedic Center, University of Utah, Salt Lake City, Utah, USA
| | - Eleanor H Sato
- Department of Orthopaedic Surgery, University of Utah Orthopedic Center, University of Utah, Salt Lake City, Utah, USA
| | - Mark W LaBelle
- Department of Orthopaedic Surgery, University of Utah Orthopedic Center, University of Utah, Salt Lake City, Utah, USA
| | - Zhining Ou
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Travis G Maak
- Department of Orthopaedic Surgery, University of Utah Orthopedic Center, University of Utah, Salt Lake City, Utah, USA
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Falez F, Mavrogenis A, Scarlat MM. Outcome scores after hip surgery in young adults: an editorial approach. INTERNATIONAL ORTHOPAEDICS 2022; 46:1675-1679. [PMID: 35829745 DOI: 10.1007/s00264-022-05491-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Francesco Falez
- San Filippo Neri et Santo Hospital, University Sapienza, Rome, Italy
| | - Andreas Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Str, 15562, Athens, Greece
| | - Marius M Scarlat
- Clinique Chirurgicale St Michel, Avenue d'Orient, Groupe ELSAN, Toulon, France.
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Influence of shelf acetabuloplasty on the outcomes of total hip arthroplasty in hips with dysplasia: a case-control study. INTERNATIONAL ORTHOPAEDICS 2022; 46:989-997. [PMID: 35113185 DOI: 10.1007/s00264-022-05322-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Total hip arthroplasty (THA) in young adults, especially in those with hip dysplasia, is affected by wear and acetabular fixation problems. Shelf acetabuloplasty is performed to delay THA in patients with acetabular dysplasia. Thus, we conducted a retrospective, continuous case-control study at a single healthcare facility to analyze (1) the influence of prior shelf acetabuloplasty on the survival of a subsequent THA and (2) the functional outcomes. MATERIALS AND METHODS We evaluated 105 patients (124 THA) who underwent THA due to hip dysplasia: 54 patients (61 THA) were included in the THA post-shelf acetabuloplasty group (case group) and 51 patients (63 THA) in the THA for dysplasia group (control group). RESULTS At 15 years' follow-up, 89% of patients (95% CI: 84-91%) in the shelf group and 83% (95% CI: 81-90%) in the dysplasia group had not undergone surgical revision. This difference between groups was not statistically significant (p = 0.566). The functional outcomes were satisfactory in both groups; however, they were significantly better in the dysplasia group than in the shelf group based on the Merle d'Aubigne and Postel score (16.9 vs 16.0 min-max: 14-18 vs 3-18) (p = 0.01), Harris Hip score (90.0 vs 84.7, min-max: 62-100 vs 22-100) (p = 0.017), and the Oxford-12 (18/60 vs 21/60, min-max: 45-12 vs 51-12) (p = 0.04). CONCLUSION Shelf acetabuloplasty before THA does not negatively affect THA survivorship. The functional outcomes appear to be better in the hips that did not undergo shelf acetabuloplasty, although the results were good in both groups.
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Navas L, Faller J, Schmidt S, Streit M, Hauschild M, Zimmerer A. Sports Activity and Patient-Related Outcomes after Cementless Total Hip Arthroplasty in Patients Younger than 40 Years. J Clin Med 2021; 10:jcm10204644. [PMID: 34682767 PMCID: PMC8537021 DOI: 10.3390/jcm10204644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The management of degenerative hip diseases in young patients remains a challenge. Despite the improvement of hip-preserving procedures, total hip arthroplasty (THA) may be required in some instances. In addition, young patients undergoing THA have high expectations concerning their postoperative level of activity. PURPOSE (1) to define the sports activity level and the return to sports after THA, (2) to describe the modification or initiation of new sports disciplines, and (3) to report the clinically meaningful outcomes after THA in patients younger than 40 years. METHODS A total of 36 patients (40 hips) were prospectively analyzed at a midterm follow-up of 3.9 years. The modified Harris Hip Score (mHHS); the Visual Analog Scale (VAS) for pain; the University of California, Los Angeles (UCLA) activity scale; and sports and recreational activity levels were assessed via questionnaire. The minimal clinically important difference (MCID) was determined by calculating half of the standard deviation, and the substantial clinical benefit (SCB) as well as patient acceptable symptomatic state (PASS), were calculated by the anchor method for the mHHS. RESULTS At the final follow-up, there was a significant improvement in mHHS (34.1 to 92.6; p < 0.0001), UCLA (3.2 to 7.6; p < 0.0001), and VAS for pain (8 to 1; p < 0.0001). More patients were active in sports at follow-up than before surgery (44% to 92%, p < 0.0001). In addition, the duration and frequency of sports activities showed a significant increase (p < 0.0001). The MCID, SCB and PASS for mHHS were 89% and 58%, respectively. No revision surgery had to be performed. CONCLUSION This study showed that a large proportion of patients under 40 years of age who underwent THA increased their physical activity. Eighty-six percent of the patients were highly active, with a UCLA score ≥ 7. Furthermore, the reported MCID, SCB, and PASS for mHHS were achieved by more than 80% of patients.
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Affiliation(s)
- Luis Navas
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
| | - Jasmin Faller
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
| | - Sebastian Schmidt
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
| | - Marcus Streit
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
| | - Matthias Hauschild
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
| | - Alexander Zimmerer
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179 Pforzheim, Germany; (L.N.); (J.F.); (S.S.); (M.S.); (M.H.)
- Department of Orthopaedics, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- Correspondence:
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Cazzulino A, Wu W, Allahabadi S, Swarup I. Diagnosis and Management of Unstable Slipped Capital Femoral Epiphysis: A Critical Analysis Review. JBJS Rev 2021; 9:01874474-202107000-00007. [PMID: 34270502 DOI: 10.2106/jbjs.rvw.20.00268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» An unstable slipped capital femoral epiphysis (SCFE) is characterized by the inability to walk and is associated with a high risk of osteonecrosis. » An unstable SCFE is less common than a stable SCFE; however, the demographics are similar in both groups of patients with SCFE. » The diagnosis of an unstable SCFE is characterized by a history of antecedent pain and the inability to walk on examination, and it is confirmed by radiographic assessment. » Management of an unstable SCFE includes closed reduction, open reduction, and capital realignment, which have all been noted to have lower rates of osteonecrosis than reported in historic reports. » All management approaches have certain advantages and disadvantages, and comparative studies are needed to guide clinical decision-making.
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Affiliation(s)
- Alejandro Cazzulino
- Division of Pediatric Orthopaedic Surgery, UCSF Benioff Children's Hospital, University of California San Francisco, Oakland, California
| | - Wei Wu
- San Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, California
| | - Sachin Allahabadi
- Division of Pediatric Orthopaedic Surgery, UCSF Benioff Children's Hospital, University of California San Francisco, Oakland, California
| | - Ishaan Swarup
- Division of Pediatric Orthopaedic Surgery, UCSF Benioff Children's Hospital, University of California San Francisco, Oakland, California
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Makarewich CA, Anderson MB, Gililland JM, Pelt CE, Peters CL. Ten-year survivorship of primary total hip arthroplasty in patients 30 years of age or younger. Bone Joint J 2018; 100-B:867-874. [PMID: 29954212 DOI: 10.1302/0301-620x.100b7.bjj-2017-1603.r1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Aims For this retrospective cohort study, patients aged ≤ 30 years (very young) who underwent total hip arthroplasty (THA) were compared with patients aged ≥ 60 years (elderly) to evaluate the rate of revision arthroplasty, implant survival, the indications for revision, the complications, and the patient-reported outcomes. Patients and Methods We retrospectively reviewed all patients who underwent primary THA between January 2000 and May 2015 from our institutional database. A total of 145 very young and 1359 elderly patients were reviewed. The mean follow-up was 5.3 years (1 to 18). Logistic generalized estimating equations were used to compare characteristics and the revision rate. Survival was evaluated using Kaplan-Meier curves and hazard rates were created using Cox regression. Results The overall revision rate was 11% (16/145) in the very young and 3.83% (52/1359) in the elderly groups (odds ratio (OR) 2.58, 95% confidence interval (CI) 1.43 to 4.63). After adjusting for the American Society of Anesthesiologists (ASA) score, gender, and a history of previous surgery in a time-to-event model, the risk of revision remained greater in the very young (adjusted hazard ratio (HR) 2.48, 95% CI 1.34 to 4.58). Survival at ten years was 82% (95% CI, 71 to 89) in the very young and 96% (95% CI, 94 to 97) in the elderly group (p < 0.001). The very young had a higher rate of revision for complications related to metal-on-metal (MoM) bearing surfaces (p < 0.001). At last follow-up, the very young group had higher levels of physical function (p = 0.002), lower levels of mental health (p = 0.001), and similar levels of pain (p = 0.670) compared with their elderly counterparts. Conclusion The overall revision rate was greater in very young THA patients. This was largely explained by the use of MoM bearings. Young patients with non-MoM bearings had high survivorship with similar complication profiles to patients aged ≥ 60 years. Cite this article: Bone Joint J 2018;100-B:867-74.
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Affiliation(s)
- C A Makarewich
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - M B Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - J M Gililland
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - C E Pelt
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - C L Peters
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
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Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther 2016; 33:1921-1946. [PMID: 27671326 PMCID: PMC5083776 DOI: 10.1007/s12325-016-0409-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Indexed: 01/05/2023]
Abstract
Highly prevalent among the elderly, hip osteoarthritis (OA) carries a heavy burden of disease. Guidelines for the management of hip OA are often extrapolated from knee OA research, despite clear differences in the etiopathogenesis and response to treatments of OA at these sites. We propose that hip OA requires specific attention separate from other OA phenotypes. Our understanding of the etiopathogenesis of hip OA has seen significant advance over the last 15 years, since Ganz and colleagues proposed femoroacetabular impingement (FAI) as an important etiological factor. This narrative review summarizes the current understanding of the etiopathogenesis of hip OA and identifies areas requiring further research. Therapeutic approaches for hip OA are considered in light of the condition’s etiopathogenesis. The evidence for currently adopted management strategies is considered, especially those approaches that may have disease-modifying potential. We propose that shifting the focus of hip OA research and public health intervention to primary prevention and early detection may greatly improve the current management paradigm.
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Affiliation(s)
- Nicholas J Murphy
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - Jillian P Eyles
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
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Abstract
Slipped capital femoral epiphysis (SCFE) is a condition of the immature hip in which mechanical overload of the proximal femoral physis results in anterior and superior displacement of the femoral metaphysis relative to the epiphysis. The treatment of SCFE is surgical, as the natural history of nonsurgical treatment is slip progression and early arthritis. Despite advances in treatment, much controversy exists regarding the best treatment, and complication rates remain high. Complications include osteonecrosis, chondrolysis, SCFE-induced impingement, and related articular degeneration, fixation failure and deformity progression, growth disturbance of the proximal femur, and development of bilateral disease.
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Ramme AJ, Guss MS, Vira S, Vigdorchik JM, Newe A, Raithel E, Chang G. Evaluation of Automated Volumetric Cartilage Quantification for Hip Preservation Surgery. J Arthroplasty 2016; 31:64-9. [PMID: 26377376 DOI: 10.1016/j.arth.2015.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/24/2015] [Accepted: 08/10/2015] [Indexed: 02/01/2023] Open
Abstract
Automating the process of femoroacetabular cartilage identification from magnetic resonance imaging (MRI) images has important implications to guiding clinical care by providing a temporal metric that allows for optimizing the timing for joint preservation surgery. In this paper, we evaluate a new automated cartilage segmentation method using a time trial, segmented volume comparison, overlap metrics, and Euclidean distance mapping. We report interrater overlap metrics using the true fast imaging with steady-state precession MRI sequence of 0.874, 0.546, and 0.704 for the total overlap, union overlap, and mean overlap, respectively. This method was 3.28× faster than manual segmentation. This technique provides clinicians with volumetric cartilage information that is useful for optimizing the timing for joint preservation procedures.
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Affiliation(s)
- Austin J Ramme
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York
| | - Michael S Guss
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York
| | - Shaleen Vira
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York
| | - Jonathan M Vigdorchik
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York
| | - Axel Newe
- Methodpark Engineering GmbH, Erlangen, Germany; Chair of Medical Informatics, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany
| | | | - Gregory Chang
- Department of Radiology, Center for Musculoskeletal Care, NYU Langone Medical Center, New York, New York
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Beck JJ, Giordano BD, Yen YM. Arthroscopic Treatments of Residual Pediatric Deformities. OPER TECHN SPORT MED 2015. [DOI: 10.1053/j.otsm.2015.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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