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Gersh MP, Mendelson BZ, Judice A, Aboulafia AJ. Use of a Cannulated, Percutaneous Expandable Reamer for Physeal Sparing Excision of a Femoral Head Chondroblastoma. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202309000-00007. [PMID: 37703503 PMCID: PMC10499101 DOI: 10.5435/jaaosglobal-d-23-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/20/2023] [Accepted: 07/06/2023] [Indexed: 09/15/2023]
Abstract
The treatment of chondroblastoma in the epiphysis of the femoral head in skeletally immature individuals is challenging and often requires surgical hip dislocation. We present a unique method of percutaneous use of an expandable reamer (X-REAM, Wright Medical) to treat a chondroblastoma of the femoral head in a 9-year-old boy without requiring surgical hip dislocation. The described technique provides access to the tumor in the proximal femoral epiphysis and local tumor control. However, the approach involves placing a cannula through the epiphyseal plate, resulting in partial premature epiphyseal closure. At 5 years after surgery, the patient has an asymptomatic leg-length discrepancy and radiographic evidence of premature physeal closure, but no restrictions on activity or evidence of local recurrence. A percutaneous expandable reamer can be used to treat chondroblastoma of the femoral head while avoiding surgical hip dislocation.
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Affiliation(s)
- Mallory P Gersh
- From the Wake Forest University, Winston-Salem, NC (Ms. Gersh); the West Virginia University School of Medicine, Morgantown, WV (Mr. Mendelson); the Vanderbilt University Medical Center, Nashville, TN (Dr. Judice); the Georgetown University School of Medicine, Washington, DC (Dr. Aboulafia); and the MedStar Georgetown/MedStar Franklin Square, and Sinai Hospital, University of Maryland School of Medicine, Baltimore, MD (Dr. Aboulafia)
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Peng P, Wei T, Fang W, Xiao F, He X, He W, Wei Q, He M. A bibliometric analysis and visualization of research trends on surgical hip dislocation. J Hip Preserv Surg 2023; 10:8-16. [PMID: 37275829 PMCID: PMC10234387 DOI: 10.1093/jhps/hnac049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/14/2022] [Accepted: 12/07/2022] [Indexed: 01/29/2024] Open
Abstract
Surgical hip dislocation (SHD) is a powerful and safe approach used to address pathologic lesions around the hip joint, and therefore, many studies have been conducted in this field. However, no bibliometric studies regarding the global research trend concerning SHD have been studied yet. This study aims to determine the research status in the field of SHD research between 2001 and 2021. The publications related to SHD from 2001 to 2021 were retrieved from the Web of Science Core Collection. Three bibliometric tools were used for this study. The main analyses include publication counts, contributions of countries, institutions, authors, journals and funding agencies, as well as analyses on clustering of references and keywords. In total, 498 articles were identified. The annual publication counts of SHD showed an ascending tendency as a whole. The United States has the most prominent contributions, with the most number of publications and the highest value of H-index. The University of Bern was the organization that produced the most literature. Professors Ganz R, Siebenrock KA, Tannast M, Steppacher SD and Leunig M were the core authors in this field. The most productive journal was Clinical Orthopaedics and Related Research. Burst keyword detection suggested that the following research directions, including 'surgical hip dislocation', 'outcome', 'fixation' and 'pain', are considered the research hotspots and deserve more attention. In conclusion, this is the first bibliometric analysis that provides a comprehensive overview of SHD research, which may assist investigators in exploring new directions for this technique.
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Affiliation(s)
- Peng Peng
- Guangzhou University of Chinese Medicine, No. 16, Jichang Road, Baiyun District, Guangzhou 510407, P.R. China
| | - Tengfei Wei
- Guangzhou University of Chinese Medicine, No. 16, Jichang Road, Baiyun District, Guangzhou 510407, P.R. China
| | - Weihua Fang
- Guangzhou University of Chinese Medicine, No. 16, Jichang Road, Baiyun District, Guangzhou 510407, P.R. China
| | - Fangjun Xiao
- Guangzhou University of Chinese Medicine, No. 16, Jichang Road, Baiyun District, Guangzhou 510407, P.R. China
| | - Xiaoming He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
- Joint Center, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
| | - Wei He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
- Joint Center, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
| | - Qiushi Wei
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
- Joint Center, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
| | - Mincong He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
- Joint Center, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou 510378, P.R. China
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Chen W, Li J, Guo W, Gao S, Wei Q, Li Z, He W. Outcomes of surgical hip dislocation combined with bone graft for adolescents and younger adults with osteonecrosis of the femoral head: a case series and literature review. BMC Musculoskelet Disord 2022; 23:499. [PMID: 35619082 PMCID: PMC9134689 DOI: 10.1186/s12891-022-05456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Osteonecrosis of the femoral head (ONFH) may occur in the adolescent and younger adults (AYAs). Total hip arthroplasty (THA) is not the best treatment option for younger patients. Surgical hip dislocation (SHD) combined with bone graft can be used in patients at different stages to reconstruct the bone structure in the head and delay the replacement time. The purpose of this study was to evaluate the effect and potential influencing factors of this surgery for ONFH in AYA patients. Methods We conducted a literature review and a retrospective research of our own cases. The Pubmed, Cochrane Library, EMBASE and CNKI databases were searched from 1 January 2001 to 1 October 2021, for clinical studies. A retrospective case series study of 34 patients (38 hips) treated with SHD combined with bone graft was performed. Results A total of 13 studies were included and the results showed that SHD combined with bone grafts had better clinical results for patients with pre- or early post-collapse. In the case series study, we retrospectively analyzed 34 patients (38 hips), and the mean follow-up time was 40.77 ± 15.87 months. One patient died and three patients were converted to THA finally. The post-collapse degree and post-lesion size were better than those before the operation (P < 0.05). The iHOT-12 at the last follow-up was significantly higher than that before the operation (P < 0.05). There were significant differences in the results of hip Harris score (HHS), visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before the operation, 2 years after the operation and at the last follow-up, but the difference was not related to the follow-up time (P < 0.05). There were no significant differences in the final clinical score and arthritic changes among different Japanese Investigation Committee (JIC) classification, the degree of collapse and the size of the necrotic (P > 0.05). Conclusions In AYA patients, SHD combined with bone grafting is a potentially good option for hip preservation in ONFH. The differences in JIC classification, collapse degree and lesion size did not affect the final clinical function and the risk of osteoarthritis. Even for very severe cases at collapsed stage, good short-term clinical effects can still be achieved by SHD combined with bone graft. Trial registration ChiCTR2100055079.retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05456-w.
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Affiliation(s)
- Wenhuan Chen
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Jianxiong Li
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Wenxuan Guo
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shihua Gao
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Qiushi Wei
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ziqi Li
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wei He
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Aprato A, Conti A, Bertolo F, Massè A. Slipped capital femoral epiphysis: current management strategies. Orthop Res Rev 2019; 11:47-54. [PMID: 31040725 PMCID: PMC6460813 DOI: 10.2147/orr.s166735] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
In orthopedic literature, there is little consensus regarding the best management of slipped capital femoral epiphysis (SCFE). Controversies and disparate trends derive from differences in clinical presentation, various classifications, and a variety of surgical procedures that have been described. Currently, there are no evidence-based recommendations. Surgical procedures vary, and they can be divided into fixation in situ, compensatory osteotomies, and direct corrections of the deformity at the head–neck junction. The first and second group of procedures have so far not gained optimal control over the risk of avascular necrosis or cannot achieve an anatomically aligned epiphysis with normal blood supply. On the other hand, the third technique can achieve this target and prevent residual deformity and the development of early hip arthritis, but it is not widely accepted, because of its surgical complexity. The purpose of this work is to present an overview of current knowledge and provide an orientation on clinical and surgical management of the patient suffering from SCFE.
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Affiliation(s)
- Alessandro Aprato
- Department of Orthopaedics and Traumatology, AOU Città della Salute e della Scienza di Torino - Ospedale CTO, Torino, Italy,
| | - Andrea Conti
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - Federico Bertolo
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - Alessandro Massè
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
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Abstract
PURPOSE OF REVIEW Femoroacetabular impingement (FAI) post slipped capital femoral epiphysis (SCFE) may lead to degenerative changes on the hip. We have reviewed the current procedures in the literature, aiming to correct the SCFE to prevent FAI and the ones that treat FAI post SCFE. RECENT FINDINGS The trends of managing moderated or severe SCFE is to correct the displacement by reduction and fixation with articular hematoma decompression in unstable hips and Dunn modified procedure even for unstable and stable situations. However, after FAI is settled, the options are osteochondroplasty by arthroscopy or surgical hip dislocation, associated or not to subtrocanteric osteotomy. SUMMARY Femoroacetabular impingement may occur in mild slips and certainly occur in cases of moderate and severe slips. The initial management depends on the severity and the stability of the slip.The modified Dunn procedure is a good option for the treatment of unstable SCFEs. Gentle closed reduction with capsulotomy (Parsch) may be considered whenever the surgeon is not comfortable with the modified Dunn procedure.Hips with open physis and stable moderate or severe SCFE, the modified Dunn procedure can be indicated. Cases with closed physis are managed with intertrochanteric osteotomy combined with osteoplasty.In the presence of symptomatic FAI secondary to SCFE, one should consider arthroscopic osteoplasty or surgical hip dislocation (with or without osteotomies) as treatment options.
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