The purpose of this study was to compare pre-operative acetabular cup parameters using this novel dynamic imaging sequence to the Lewinnek safe zone We retrospectively reviewed 350 consecutive primary THAs that underwent dynamic pre-operative acetabular cup planning utilizing a pre-operative CT scan to capture the individual's hip anatomy, followed by standing (posterior pelvic tilt), sitting (anterior pelvic tilt), and supine X-rays. Using these inputs, we modeled an optimal cup position for each patient. Radiographic parameters including inclination, anteversion, pelvic tilt, pelvic incidence, and lumbar flexion were analyzed.Introduction
Methods
Morton’s syndrome is an entrapment of a digital nerve between the metatarsal heads in the foot causing pain between the metatarsal heads. 41 subjects with signs and symptoms of Morton’s syndrome were prospectively examined with an ultrasound scan and the size of the bifurcation of the interdigital nerve was recorded if it was visible. Each subject completed a Visual Analogue Scale and short form McGill Pain Questionaire before an injection of local anaesthetic and corticosteroid was administered. The subjects were reviewed after 6 weeks and the pain scores repeated. 26 subjects had positive ultrasounds with a mean width of 5.1 mm, range 2.7–9.8 mm and 15 subjects had negative ultrasounds. Differences in mean ranks of VAS scores between the two groups were borderline statistically significant for scores before injection (p=0.064). Difference in mean rank of VAS score was significant after injection (p=0.013). Differences in mean ranks of MPQ scores were borderline statistically significant for changes in scores (p=0.062). Difference in mean rank of MPQ score was significant after injection (p=0.007). None of the correlations between nerve width and any of VAS or MPQ outcome measures were statistically significant. This study demonstrates that the larger the neuroma on the ultrasound, the more painful it is for the patient. This study suggests that patients who have a small or absent neuroma demonstrated on the ultrasound scan are more likely to have their pain reduced to an acceptable level with an injection of local anaesthetic and corticosteroid than those patients with a large neuroma. Ultrasound examination is a useful tool in the management of patients with Morton’s syndrome.
The epidemiological data and intra-operative findings from 260 consecutive arthroscopically-diagnosed acetabular labral tears seen over a ten-year period were analysed. Radiographs of 128 of these patients were assessed for dysplasia using established radiological parameters. Patients with acetabular dysplasia were then compared against those without in order to identify any differences in gender, age, the side of the tear, the pattern of the tear, the number of quadrants involved, the quadrant preference and the prevalence of intra-articular comorbidity. Dysplasia was found in 46% (59 of 128) of the hips. No significant differences existed between the dysplastic and non-dysplastic subgroups as regards gender distribution, the side of the lesion, the number of quadrants involved or the distribution of tears among the quadrants. However, tears associated with dysplasia were diagnosed in an older age group, had a different pattern and were associated with a much higher prevalence of osteoarthritis.
