We have reviewed a consecutive series of six professional footballers who presented with intractable hip pain which was attributed at arthroscopy, to an anterior acetabular labral tear with adjacent chondral damage. The location and type of labral tear were identical for each patient. There was no evidence of acetabular
The sagging rope sign is the term used to describe the radiographic appearances which sometimes occur after Perthes' disease. It is severe examples of that disease and indicates damage to the growth plate with a marked metaphysial reaction. The same appearance follows severe epiphysitis after forcible reduction of a congenitally dislocated hip, and certain rare epiphysial
Patient-specific instrumentation has been shown to increase a surgeon’s precision and accuracy in placing the glenoid component in shoulder arthroplasty. There is, however, little available information about the use of patient-specific planning (PSP) tools for this operation. It is not known how these tools alter the decision-making patterns of shoulder surgeons. The aim of this study was to investigate whether PSP, when compared with the use of plain radiographs or select static CT images, influences the understanding of glenoid pathology and surgical planning. A case-based survey presented surgeons with a patient’s history, physical examination, and, sequentially, radiographs, select static CT images, and PSP with a 3D imaging program. For each imaging modality, the surgeons were asked to identify the Walch classification of the glenoid and to propose the surgical treatment. The participating surgeons were grouped according to the annual volume of shoulder arthroplasties that they undertook, and responses were compared with the recommendations of two experts.Aims
Methods
Eleven patients with tears of the acetabular labrum are discussed and the syndrome of the torn labrum is defined. In all cases the lesion was associated with acetabular
We describe a method of intertrochanteric osteotomy with posterior rotation of the femoral head and neck. We analysed 45 hips in 44 children and adolescents aged from six to 18 years with residual
The occurrence of "windswept deformity" in the legs of otherwise healthy African children in the second or third year of life is illustrated by three typical case histories. The usual causes of epiphysial abnormality were absent in these and other similar patients seen recently in central Nigeria. It is suggested that an unrecognised hereditary
The transiliac method of leg lengthening uses a modification of Salter's innominate osteotomy. The bone graft increases the length of the hemipelvis distal to the sacro-iliac joint. Leg-length inequality in 23 patients was treated by this method with an average gain in length of 2.8 cm (2.0 to 3.5). Apart from one residual femoral nerve palsy there were no notable complications. The facility to redirect the acetabulum allowed by the technique, may be useful in cases of potential hip instability or acetabular
Two cases of malignant angioblastoma of tibia are described, one finally treated by amputation and the other by segmental resection and grafting. They have remained free from signs of local recurrence or distant metastasis for five and a half and ten and a half years respectively. Both showed prominent areas of neoplastic mesenchymal angioblastic tissue which closely imitates solitary fibrous
We report a rare case of Albright's syndrome associated with both a soft-tissue myxoma and hypophosphataemic osteomalacia. Renal tubular function was preserved, except for glycosuria. Serum levels of 1,25(OH)2 vitamin D3 were normal. Excision of the myxoma did not influence the biochemical abnormalities, nor did standard doses of vitamin D3 or 1 alpha-OH vitamin D3. The previously reported cases of hypophosphataemic osteomalacia associated with fibrous
1. Congenital dislocation of the hip can be diagnosed clinically immediately after birth and the diagnosis confirmed radiologically by a special technique. 2. If the affected joint is reduced during the first two or three days after birth and held reduced for a period not exceeding three months, the joint will remain stable. 3. This treatment probably leads to normal development of the hip joint. 4. The cause of congenital dislocation of the hip may be laxity of the soft tissues of the joint and not a primary
In the 1990s, a bioactive bone cement (BABC) containing apatite-wollastonite glass-ceramic (AW-GC) powder and bisphenol-a-glycidyl methacrylate resin was developed at our hospital. In 1996, we used BABC to fix the acetabular component in primary total hip arthroplasty (THA) in 20 patients as part of a clinical trial. The purpose of this study was to investigate the long-term results of primary THA using BABC. A total of 20 patients (three men and 17 women) with a mean age of 57.4 years (40 to 71), a mean body weight of 52.3 kg (39 to 64), and a mean body mass index (BMI) of 23.0 kg/m2 (19.8 to 28.6) were evaluated clinically and radiologically. Survival analyses were undertaken, and wear analyses were carried out using a computer-aided method.Aims
Patients and Methods
We have studied the natural history of spontaneous dislocation of the hip in cerebral palsy, with particular reference to the pattern of neurological involvement. In patients with bilateral hemiplegia and severe involvement of the upper limbs the incidence of dislocation was very high (59%), while in those with diplegia and little involvement of the upper limbs, only 6.5% were affected. There was no evidence of
The hips of twenty full-term African neonates have been examined in detail to determine any anatomical factors which might explain the difference in the incidence of congenital dislocation of the hip in the African and in the Caucasian. Measurements included the degree of anteversion of the femoral neck and the acetabulum and the diameter and depth of the acetabulum. The acetabulum tended to be deeper and to vary within a much narrower range than that reported for Caucasians, lending indirect support to the theoretical role of acetabular
We describe a little-known variety of hip dysplasia, termed ‘acetabular retroversion’, in which the alignment of the mouth of the acetabulum does not face the normal anterolateral direction, but inclines more posterolaterally. The condition may be part of a complex
We describe 95 patients with previously treated congenital dislocation of the hip who underwent femoral osteotomy after the age of five years. The commonest indication for surgery was progressive uncovering and subluxation of the femoral head; other reasons were coxa vara, long leg
1. The results of the by-pass grafting operation in eleven cases of pseudarthrosis of the tibia in childhood are presented. 2. The operation was successful in securing sound bone union in nine cases, and unsuccessful in two. 3. The causes of failure in the two unsuccessful cases are analysed. 4. The possible causes of occurrence and persistence of tibial pseudarthrosis in childhood are discussed. 5. It is suggested that the pseudarthrosis results from a fatigue fracture of a congenitally abnormal tibia, but that its persistence depends entirely on mechanical factors. 6. There is evidence to suggest that the underlying congenital abnormality may arise from
The anterior centre-edge (VCA) angle quantifies the anterior cover of the femoral head, and angles of less than 20° are considered abnormal. We have measured the VCA angles in hips without osteoarthritic changes. We took bilateral false-profile radiographs of nine female and 30 male cadavers without signs of osteoarthritis. The mean age at the time of death was 72 years (46 to 92). The mean VCA angle was 32.8° (17.7 to 53.6). The SD was 7.9°. Our findings suggest that the threshold of abnormality of the VCA angle may be slightly lower than previously thought. This information may be useful in counselling patients with asymptomatic acetabular
The long-term results following the correction of coxa vara by Pauwels' Y-shaped intertrochanteric osteotomy have been evaluated in 14 children. Ten of the children had unilateral hip disease and were otherwise normal while four had bilateral hip disease due to generalised skeletal