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Benjamin G. Domb - One of the best experts on this subject based on the ideXlab platform.

  • Modified Shelf Acetabuloplasty Endoscopic Procedure With Allograft for Developmental Hip Dysplasia Treatment.
    Arthroscopy techniques, 2018
    Co-Authors: David R. Maldonado, Victor Ortiz-declet, Austin W. Chen, Ajay C. Lall, Mitchell R. Mohr, Joseph R. Laseter, Benjamin G. Domb
    Abstract:

    Abstract Hip Dysplasia has been identified as one of the leading causes of osteoarthritis. However, Hip arthroscopy alone, in the setting of Hip Dysplasia, remains controversial. In borderline Hip Dysplasia, with lateral center-edge angle (LCEA) between 18° and 25°, good outcomes have been reported with appropriate capsular and labral management. However, in severe Hip Dysplasia, with LCEA below 18°, there is an acetabular bony structural deficiency that must be addressed. Even with the potential benefit of Hip arthroscopy in addressing intra-articular injuries related to the instability, it cannot be used for soft-tissue procedures. Periacetabular osteotomy remains the gold standard to address that matter; however, its invasive nature along with the long recovery time leaves some patients unwilling to undergo this procedure. New minimally invasive endoscopic procedures, derived from open techniques, describe acetabular autologous bone grafting as an alternative. Donor-side morbidity is always a concern when using autografts; we believe that the use of bone allograft will decrease this potential issue and make the procedure itself less invasive. This Technical Note will describe a type of endoscopic shelf acetabuloplasty using an allograft iliac bone graft.

  • open and arthroscopic treatment of adult Hip Dysplasia a systematic review
    Arthroscopy, 2016
    Co-Authors: Parth Lodhia, Sivashankar Chandrasekaran, Chengcheng Gui, Nader Darwish, Carlos Suarezahedo, Benjamin G. Domb
    Abstract:

    Purpose To compare patient-reported outcome (PRO) and rates of conversion to total Hip arthroplasty (THA) after Hip arthroscopy, Bernese periacetabular osteotomy (PAO), and a combined approach for the management of patients with different grades of Hip Dysplasia. Methods We searched MEDLINE and PubMed databases for articles published since 2000 using the following terms: (((("Hip Dysplasia") or "dysplastic") and "arthroscopy")) or ((("Hip Dysplasia") or "dysplastic") and "osteotomy"). Two authors independently reviewed the literature. Inclusion criteria were English language, relevance to Hip Dysplasia, surgical outcomes, and sample size of 10 patients or more. We excluded articles that were reviews or techniques; articles that included overlapping populations, patients with a mean age less than 18 years, patients with other Hip conditions, patients with genetic or neuromuscular causes of Hip Dysplasia, and patients with Tonnis grade 2 or greater arthritis; articles on femoral osteotomy, and articles on previous surgical intervention, except Hip arthroscopy. Articles were analyzed for PRO scores and rates of conversion to THA. Results Ten of 759 articles reviewed met the inclusion and exclusion criteria. Of 834 Hips treated for Dysplasia with a mean age of 31 years, 114 were treated with arthroscopy alone, 703 were treated with PAO alone, and 17 were treated with both procedures. Mean follow-up was 3.2 years, 6.5 years, and 5.6 years, respectively. Conversion rates to THA were 4.8%, 12.0%, and 17.7%, respectively. In studies reporting pre- and postoperative PRO scores, all but one reported improvement. Conclusions The management of Hip Dysplasia may entail Hip arthroscopy, PAO, or a combined approach. Arthroscopy has resulted in improved outcomes in borderline dysplastic cases (lateral center edge angle between 18° and 25°). PAO has primarily been used in true Dysplasia with continued success. There were too few combined procedures of arthroscopy with PAO to reach a reliable conclusion in this subgroup. Level of Evidence Systematic review of Level III and Level IV studies.

  • is intraarticular pathology common in patients with Hip Dysplasia undergoing periacetabular osteotomy
    Clinical Orthopaedics and Related Research, 2014
    Co-Authors: Benjamin G. Domb, Justin M Lareau, Hasan Baydoun, Itamar B Botser, Michael B Millis
    Abstract:

    Background Periacetabular osteotomy (PAO) enables correction of bony acetabular deficiency in the setting of Hip Dysplasia. Patients with insufficient acetabular coverage often have intraarticular pathology, but the degree of this pathology has been incompletely characterized. We have used arthroscopy as an adjunct to PAO to further delineate intraarticular pathology in patients with Hip Dysplasia with mechanical symptoms.

Bettina Gyr - One of the best experts on this subject based on the ideXlab platform.

  • Single-Stage, Single-Incision Correction of Neuromuscular Hip Dysplasia: Surgical Technique.
    Journal of surgical orthopaedic advances, 1
    Co-Authors: Fiesky A Nunez, Bettina Gyr
    Abstract:

    Surgical correction of neuromuscular Hip Dysplasia is a common orthopaedic procedure that carries significant risk of complications. Reducing time of surgery, limiting incisions, and minimizing unnecessary surgical exposure are paramount in reducing complications. This article describes the use of a single-stage, single-surgical approach operation for the correction of neuromuscular Hip Dysplasia. The operation consists of a modified anterolateral approach to the Hip joint (modified Watson-Jones approach) to perform a varus derotational proximal femur osteotomy, hinged acetabuloplasty, and soft tissue releases.

Fiesky A Nunez - One of the best experts on this subject based on the ideXlab platform.

  • Single-Stage, Single-Incision Correction of Neuromuscular Hip Dysplasia: Surgical Technique.
    Journal of surgical orthopaedic advances, 1
    Co-Authors: Fiesky A Nunez, Bettina Gyr
    Abstract:

    Surgical correction of neuromuscular Hip Dysplasia is a common orthopaedic procedure that carries significant risk of complications. Reducing time of surgery, limiting incisions, and minimizing unnecessary surgical exposure are paramount in reducing complications. This article describes the use of a single-stage, single-surgical approach operation for the correction of neuromuscular Hip Dysplasia. The operation consists of a modified anterolateral approach to the Hip joint (modified Watson-Jones approach) to perform a varus derotational proximal femur osteotomy, hinged acetabuloplasty, and soft tissue releases.

Anders Troelsen - One of the best experts on this subject based on the ideXlab platform.

  • The role of the acetabular labrum in Hip Dysplasia: A literature overview
    Acta orthopaedica, 2013
    Co-Authors: Charlotte Hartig-andreasen, Kjeld Søballe, Anders Troelsen
    Abstract:

    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic Hip Dysplasia and no osteoarthritis. In symptomatic Dysplasia of the Hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral anatomy and function, the etiology of labral tears in Hip Dysplasia, and diagnostic assessment of labral tears, and we discuss treatment strategies for coexisting labral tears and Hip Dysplasia.

  • Assessment of adult Hip Dysplasia and the outcome of surgical treatment.
    Danish medical journal, 2012
    Co-Authors: Anders Troelsen
    Abstract:

    Hip Dysplasia and Hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of Hip Dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist, and some of these were the focus of this doctoral thesis. Categorized into subjects, the major findings and their possible importance are listed below. DIAGNOSTIC ASSESSMENT OF Hip Dysplasia: A multi-observer study quantified the variability of different methods for diagnostic assessment of Hip Dysplasia and osteoarthritis and resulted in general recommendations regarding diagnostic assessment of Hip Dysplasia. Pelvic tilt was shown to differ significantly between the supine and weight-bearing positions in patients with dysplastic Hip joints. This is a finding that adds controversy to the application of neutral pelvic positioning during assessment of Hip deformities because pelvic tilt affects the appearance of acetabular version. Weight-bearing assessment of acetabular version showed the presence of retroversion in 33% of dysplastic Hips. The establishment of retroversion as a rather frequent entity in dysplastic Hips is contradictory to the historical finding that Hip Dysplasia is characterized by insufficient anterior and lateral coverage. In general, the findings have important implications for orthopedic surgeons and radiologists dealing with diagnostic assessment of painful Hips in young adults, and for surgeons planning and performing joint-preserving periacetabular osteotomies. ASSESSMENT OF ACETABULAR LABRAL TEARS IN Hip Dysplasia: The roles of ultrasound and clinical tests in acetabular labral tear diagnostics were established. After overcoming an initial learning curve, ultrasound investigation was highly reliable in diagnosing labral tears, whereas only a positive impingement or FABER test was reliable in identifying a labral tear. It seems that non-invasive and rapid ultrasound examination performed by an experienced examiner can potentially alter the traditional diagnostic algorithm in which magnetic resonance arthrography remains the gold standard. PERIACETABULAR OSTEOTOMY FOR SURGICAL TREATMENT OF Hip Dysplasia IN ADULTS: Encouraging Hip joint survival and clinical outcome were reported at medium-term follow-up after periacetabular osteotomy. The small number of studies reporting the outcome beyond a 5-year follow-up is in contrast to the wide application of the periacetabular osteotomy. The performed analysis of predictors of conversion to total Hip replacement following periacetabular osteotomy documented the importance of different biomechanical and degenerative factors. Knowledge about factors predicting early conversion to total Hip replacement has the potential to refine patient selection and to improve treatment by periacetabular osteotomy. Cartilage thickness was documented to be preserved up to 2,5 years after periacetabular osteotomy. All but 1 Hip joint had acetabular labral tears, thus indicating that the presence of labral tears does not accelerate cartilage degeneration after periacetabular osteotomy.

  • Assessment of Hip Dysplasia and osteoarthritis: variability of different methods
    Acta radiologica (Stockholm Sweden : 1987), 2010
    Co-Authors: Anders Troelsen, Lone Rømer, Søren Kring, Brian Elmengaard, Kjeld Søballe
    Abstract:

    Background: Reliable assessment of Hip Dysplasia and osteoarthritis is crucial in young adults who may benefit from joint-preserving surgery.Purpose: To investigate the variability of different methods for diagnostic assessment of Hip Dysplasia and osteoarthritis.Material and Methods: By each of four observers, two assessments were done by vision and two by angle construction. For both methods, the intra- and interobserver variability of center-edge and acetabular index angle assessment were analyzed. The observers’ ability to diagnose Hip Dysplasia and osteoarthritis were assessed. All measures were compared to those made on computed tomography scan.Results: Intra- and interobserver variability of angle assessment was less when angles were drawn compared with assessment by vision, and the observers’ ability to diagnose Hip Dysplasia improved when angles were drawn. Assessment of osteoarthritis in general showed poor agreement with findings on computed tomography scan.Conclusion: We recommend that angles ...

  • Hip Dysplasia: clinical assessment, radiologic evaluation and reference
    Ugeskrift for laeger, 2007
    Co-Authors: Anders Troelsen, Lone Rømer, Kjeld Søballe
    Abstract:

    Hip Dysplasia is a common congenital disorder, and identified as a source of pain, functional impairment and increased risk for development of osteoarthritis. Early diagnosis and reference is essential in symptomatic Hip Dysplasia, since patients may be candidates for joint preserving surgery. Assessment concentrates on history, physical examination and plain radiography. If radiography confirms the diagnosis (CE-angle < 25 degrees), the patient should be referred for expert evaluation. The assessment of Hip Dysplasia should be well-known to GPs, orthopaedics and radiologists.

Robert M. Kay - One of the best experts on this subject based on the ideXlab platform.

  • Hip Dysplasia Is Not More Common in W-Sitters.
    Clinical pediatrics, 2020
    Co-Authors: Susan A. Rethlefsen, Nicole M. Mueske, Alexander Nazareth, Oussama Abousamra, Tishya A. L. Wren, Robert M. Kay, Rachel Y. Goldstein
    Abstract:

    Parents are frequently cautioned by therapists, teachers, physicians, and online resources about potential negative effects of w-sitting in children (including Hip Dysplasia), despite lack of evidence. To examine relationsHips between w-sitting and Hip Dysplasia, a prospective cohort study was conducted of 104 patients (196 Hips), aged 9.9 (standard deviation = 5.7) years, who underwent Hip/pelvis radiography at a pediatric tertiary care center. Measures of Hip Dysplasia were taken from radiographs. Parents/patients completed a questionnaire regarding the patients' sitting habits. Associations between Hip Dysplasia and w-sitting were analyzed statistically. About 48/104 parents/patients (46%) reported current or past w-sitting: 11/104 (11%) current, preferred position; 23/104 (22%) current, nonpreferred position, 14/104 (13%) w-sat in past, and 56/104 (54%) never w-sat. There was no difference in measures of Hip Dysplasia (P > .12) or Hip Dysplasia frequency between w-sitters (9%) and non-w-sitters (10%; P = .81), or among w-sitting persistence groups (P = .26). W-sitting in children is not associated with Hip Dysplasia.

  • Hip Dysplasia is Not More Common in W-Sitters
    Pediatrics, 2019
    Co-Authors: Rachel Y. Goldstein, Susan A. Rethlefsen, Nicole M. Mueske, Alexander Nazareth, Parisa Ziarati, Robert M. Kay
    Abstract:

    PURPOSE Many anecdotes linking w-sitting to Hip Dysplasia and other musculoskeletal issues seem to be common place; however, there is a paucity of systematic investigation into the relationsHip between w-sitting and Hip Dysplasia. This discrepancy may lead to misconceptions and attempts to solve a problem that is not even an issue. The purpose of this study was to investigate the relationsHip between w-sitting and the incidence of abnormal Hip morphology in …