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Oleg Safir - One of the best experts on this subject based on the ideXlab platform.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Guy Raz, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
Yona Kosashvili - One of the best experts on this subject based on the ideXlab platform.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Guy Raz, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
V. Mounasamy - One of the best experts on this subject based on the ideXlab platform.
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Pipkin type IV Femoral Head Fractures: a case series and review of literature
European Journal of Orthopaedic Surgery & Traumatology, 2020Co-Authors: J. L. Engel, P. Johnsen, N. K. Patel, J. Satpathy, V. MounasamyAbstract:Introduction Femoral Head Fractures with associated acetabular Fractures are uncommon injuries usually resulting from high-energy mechanisms such as motor vehicle collisions. Outcomes of Pipkin type IV Fractures have been historically poor, with high rates of osteonecrosis, post-traumatic arthritis, and heterotopic ossification. The objective of this study was to define the outcomes of operatively treated Pipkin type IV Fractures In addition, we reviewed the available literature of this uncommon injury pattern. Methods A retrospective chart review at a single level 1 trauma center from 2007 to 2016 identified 10 patients with Pipkin IV Femoral Head Fractures. Demographic information, Fracture type, associated injuries, operative details, and complications were evaluated. Clinical and radiological outcomes were assessed at latest follow-up including conversion to total hip arthroplasty. Results Six of the seven patients were treated with open reduction and internal fixation of the Femoral Head Fracture and acetabular Fracture through a Kocher–Langenbeck approach aided by a trochanteric flip and one had fragment excision. Six patients (87.5%) developed post-traumatic arthritis. Four (57.1%) later underwent conversion to total hip arthroplasty (THA) a mean of 20.5 months after index procedure. Conclusion Our study shows a rate of osteonecrosis and osteoarthritis that is even higher than the previously reported studies. The former may relate to longer-term follow-up and the latter possibly due to associated comminuted posterior wall Fracture.
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Pipkin type IV Femoral Head Fractures: a case series and review of literature.
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020Co-Authors: J. L. Engel, P. Johnsen, N. K. Patel, J. Satpathy, V. MounasamyAbstract:Femoral Head Fractures with associated acetabular Fractures are uncommon injuries usually resulting from high-energy mechanisms such as motor vehicle collisions. Outcomes of Pipkin type IV Fractures have been historically poor, with high rates of osteonecrosis, post-traumatic arthritis, and heterotopic ossification. The objective of this study was to define the outcomes of operatively treated Pipkin type IV Fractures In addition, we reviewed the available literature of this uncommon injury pattern. A retrospective chart review at a single level 1 trauma center from 2007 to 2016 identified 10 patients with Pipkin IV Femoral Head Fractures. Demographic information, Fracture type, associated injuries, operative details, and complications were evaluated. Clinical and radiological outcomes were assessed at latest follow-up including conversion to total hip arthroplasty. Six of the seven patients were treated with open reduction and internal fixation of the Femoral Head Fracture and acetabular Fracture through a Kocher-Langenbeck approach aided by a trochanteric flip and one had fragment excision. Six patients (87.5%) developed post-traumatic arthritis. Four (57.1%) later underwent conversion to total hip arthroplasty (THA) a mean of 20.5 months after index procedure. Our study shows a rate of osteonecrosis and osteoarthritis that is even higher than the previously reported studies. The former may relate to longer-term follow-up and the latter possibly due to associated comminuted posterior wall Fracture.
Ai Yoshida - One of the best experts on this subject based on the ideXlab platform.
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dislocated intra articular Femoral Head Fracture associated with Fracture dislocation of the hip and acetabulum report of 12 cases and technical notes on surgical intervention
European Journal of Orthopaedic Surgery and Traumatology, 2013Co-Authors: Yasuo Kokubo, Kenzo Uchida, Kenichi Takeno, Takafumi Yayama, Tsuyoshi Miyazaki, Kohei Negoro, Hideaki Nakajima, Daisuke Sugita, Naoto Takeura, Ai YoshidaAbstract:This report describes case series of the Femoral Head Fractures associated with Fracture-dislocation of the hip joint to evaluate the mid- and long-term outcomes and to highlight the surgical technique of fixation of the Femoral Head from the posterior trochanteric flip osteotomy approach. Twelve patients (6 men and 6 women) with dislocated Femoral Head Fractures (mean age at the time of injury, 56 years; range, 23–80) were followed up for mean period of 9.7 years (range, 5–20). All dislocations were reduced within less than 6 h after the injury. The type of Femoral Head Fracture was classified according to the Pipkin classification on radiographs and CT. Five patients were classified as type I, 2 as type II, 2 as type III, and 3 as type IV. The clinical and radiological outcomes were assessed by Thompson and Epstein’s regimen. Excluding 2 patients with Pipkin type III, the outcome of 9 patients was excellent/good, and poor in 1. The latter patient sustained Pipkin type IV and developed osteoarthritis 1 year after surgery and consequently required total hip arthroplasty. We conclude that small fragment of the Femoral Head less than 1 cm can be removed, while larger fragments should be fixed by bioabsorbable screws or pins in all types of Femoral Head Fractures. In Pipkin type IV Fractures, surgeons should always take anatomical reduction in the acetabulum into consideration during surgery.
Oren Ben Lulu - One of the best experts on this subject based on the ideXlab platform.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
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Fresh-stored osteochondral allografts for the treatment of Femoral Head defects: surgical technique and preliminary results
International Orthopaedics, 2013Co-Authors: Yona Kosashvili, David Backstein, Oren Ben Lulu, Allan E. Gross, Guy Raz, Oleg SafirAbstract:Purpose The purpose of this study was to present the preliminary clinical and radiographic outcomes of the treatment of Femoral Head osteochondral defects in eight consecutive symptomatic patients with fresh-stored osteochondral allografts via a trochanteric osteotomy. Methods This study included all consecutive patients treated in our department between 2008 and 2010 for worsening pain and mechanical symptoms of Femoral Head osteochondral defects. Each patient had preoperative routine hip radiographs and a preoperative magnetic resonance imaging study that determined and recorded the defect size and Femoral Head diameters. Allograft donors were identified through the Multiple Organ Retrieval and Exchange program (Ontario, Canada). Results The osteochondral defects were secondary to osteochondritis dissecans in four patients, avascular necrosis in three and Femoral Head Fracture without dislocation in one. The patients’ average age at surgery was 23.7 (range 17–42), and the average follow-up was 41 months (range 24–54). Follow-up included clinical and radiographic examinations at standard intervals. The average Harris hip scores improved from 57.7 (range 50–65) points preoperatively to 83.9 (range 72–94) points at latest follow-up. Five patients had good-to-excellent clinical outcomes, and one had a fair outcome. One patient was converted to a total hip arthroplasty due to progression of arthritis. Another patient’s graft subsided and he underwent a successful repeat transplantation. An additional patient required the removal of the screws transfixing her trochanter due to persistent irritation. Conclusions These findings indicate that fresh-stored osteochondral allograft transplantation using a trochanteric slide and surgical dislocation is a viable treatment option for Femoral Head defects in young patients.
