BACKGROUND Optimal treatment for iliopsoas tendinitis after total hip arthroplasty(THA)with cup malposition,iliopsoas release alone or with cup revision,is controversial,particularly in young,active patients.Moreover,...BACKGROUND Optimal treatment for iliopsoas tendinitis after total hip arthroplasty(THA)with cup malposition,iliopsoas release alone or with cup revision,is controversial,particularly in young,active patients.Moreover,arthroscopic iliopsoas tendon(IPT)release in these patients has been rarely described,and midterm effects of this procedure on THA longevity and groin pain recurrence remain unclear.We performed arthroscopic IPT release after THA and report midterm outcomes in two young patients with acetabular cup malposition.CASE SUMMARY In the two patients,groin pain started early after THA.Physical examination revealed nonspecific findings,and laboratory tests showed no evidence of infection.Radiography and computed tomography showed reduced acetabular component anteversion angle and anterior cup prominence of more than 16 mm.For therapeutic diagnosis,ultrasonography-guided lidocaine with steroid was injected into the IPT sheath.In both patients,groin pain improved initially but worsened after a few months.Therefore,the patients underwent arthroscopic IPT release under spinal anesthesia.Arthroscopy revealed synovitis with fibrous tissues around the IPT and various lesions related to the implants after THA.IPT tenotomy and debridement with biopsy were performed;histopathologic studies showed chronic inflammation with synovial hyperplasia.Both patients were encouraged to start walking immediately after surgery,and they returned to complete daily function early after surgery.They experienced no recurrence of groin pain or any implant-related problems 5 years postoperatively.CONCLUSION Arthroscopic IPT release for cup malposition produced excellent midterm outcomes without recurrence of groin pain and implant-related problems.展开更多
We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. Sh...We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.展开更多
BACKGROUND Postoperative pain following total hip arthroplasty(THA)may occur in a few patients but may pose a significant challenge to surgeons if the etiology is not identified.Herein,we report the case of a patient ...BACKGROUND Postoperative pain following total hip arthroplasty(THA)may occur in a few patients but may pose a significant challenge to surgeons if the etiology is not identified.Herein,we report the case of a patient who developed late-onset pain following THA due to screw penetration of the iliopsoas tendon.CASE SUMMARY We report the case of a 77-year-old man who developed inguinal pain 7 years after THA.While the symptoms resembled that of iliopsoas impingement by the acetabular cup,the pain resolved only when the supplementary acetabular screw protruding through the ilium was decompressed.Decompression was performed using the pararectus approach.The patient was able to ambulate pain-free immediately after surgery.CONCLUSION A protruded screw through the ilium may penetrate the iliopsoas muscle,causing pain following THA.Pain may resolve with the decompression of the protruded screw.展开更多
BACKGROUND The use of uncemented cups during total hip arthroplasty(THA)has gained popularity in recent years.The Robert Mathys(RM)pressfit cup,an uncemented monoblock implant is expected to preserve bone density due ...BACKGROUND The use of uncemented cups during total hip arthroplasty(THA)has gained popularity in recent years.The Robert Mathys(RM)pressfit cup,an uncemented monoblock implant is expected to preserve bone density due to its composition and external surface,while reducing backside wear with its monoblock construction.These factors should lead to a high survival rate of the implant.AIM To evaluate the mid-term survival and functional outcome of the RM Pressfit cup in a large study population.METHODS Between 2011 and 2020,we included 1324 patients receiving a primary THA using the RM pressfit cup.Final clinical follow-up was performed at 2 years postoperatively with the Dutch arthroplasty register used to assess implant status thereafter.Revision for acetabular failure and reason for revision were reported to evaluate implant survival,while the hip disability and osteoarthritis outcome score(HOOS)scores were used to assess functional outcome.RESULTS The mean age at surgery was 64.9 years.The mean follow-up was 4.6 years.Of the 1324 THAs performed,13 needed cup revisions within 5 years after index THA:5 due to aseptic loosening,6 due to infection,2 due to dislocation and 2 due to other causes.This resulted in a 5-year cup survival of 98.8%(95%CI:98.1-99.5).Nine of the cup revisions occurred within the first year after index THA.HOOS scores increased significantly in all domains during the first year and levelled out during the second year.CONCLUSION In the present study,the RM pressfit cup demonstrated excellent clinical outcomes at mid-term follow-up;however,future studies are needed to assess the long-term outcomes of this acetabular implant.展开更多
目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院...目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院收治的30例患者分成测量仪组(采用三维角度仪辅助进行THA组,15例)和传统组(传统THA组,15例),两组术前规划髋臼臼杯置入的外展角为38º、前倾角为20º,比较两组术后X线片上所测得髋臼臼杯置放的角度(外展角和前倾角)与其术前所规划臼杯置入角度之间的误差。结果测量仪组术后髋臼臼杯置放的角度(外展角和前倾角)与术前所规划角度的误差明显小于传统组。结论相对于传统THA术中医生用肉眼瞄髋臼臼杯置入方向而言,采用此三维角度仪辅助进行THA,能在术中对髋臼臼杯置入的方向进行刻度化测量,能提高髋臼臼杯置入角度的精准度,其操作简单,值得推广。展开更多
文摘BACKGROUND Optimal treatment for iliopsoas tendinitis after total hip arthroplasty(THA)with cup malposition,iliopsoas release alone or with cup revision,is controversial,particularly in young,active patients.Moreover,arthroscopic iliopsoas tendon(IPT)release in these patients has been rarely described,and midterm effects of this procedure on THA longevity and groin pain recurrence remain unclear.We performed arthroscopic IPT release after THA and report midterm outcomes in two young patients with acetabular cup malposition.CASE SUMMARY In the two patients,groin pain started early after THA.Physical examination revealed nonspecific findings,and laboratory tests showed no evidence of infection.Radiography and computed tomography showed reduced acetabular component anteversion angle and anterior cup prominence of more than 16 mm.For therapeutic diagnosis,ultrasonography-guided lidocaine with steroid was injected into the IPT sheath.In both patients,groin pain improved initially but worsened after a few months.Therefore,the patients underwent arthroscopic IPT release under spinal anesthesia.Arthroscopy revealed synovitis with fibrous tissues around the IPT and various lesions related to the implants after THA.IPT tenotomy and debridement with biopsy were performed;histopathologic studies showed chronic inflammation with synovial hyperplasia.Both patients were encouraged to start walking immediately after surgery,and they returned to complete daily function early after surgery.They experienced no recurrence of groin pain or any implant-related problems 5 years postoperatively.CONCLUSION Arthroscopic IPT release for cup malposition produced excellent midterm outcomes without recurrence of groin pain and implant-related problems.
文摘We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.
基金by Research Fund from Chosun University Hospital,2019。
文摘BACKGROUND Postoperative pain following total hip arthroplasty(THA)may occur in a few patients but may pose a significant challenge to surgeons if the etiology is not identified.Herein,we report the case of a patient who developed late-onset pain following THA due to screw penetration of the iliopsoas tendon.CASE SUMMARY We report the case of a 77-year-old man who developed inguinal pain 7 years after THA.While the symptoms resembled that of iliopsoas impingement by the acetabular cup,the pain resolved only when the supplementary acetabular screw protruding through the ilium was decompressed.Decompression was performed using the pararectus approach.The patient was able to ambulate pain-free immediately after surgery.CONCLUSION A protruded screw through the ilium may penetrate the iliopsoas muscle,causing pain following THA.Pain may resolve with the decompression of the protruded screw.
文摘BACKGROUND The use of uncemented cups during total hip arthroplasty(THA)has gained popularity in recent years.The Robert Mathys(RM)pressfit cup,an uncemented monoblock implant is expected to preserve bone density due to its composition and external surface,while reducing backside wear with its monoblock construction.These factors should lead to a high survival rate of the implant.AIM To evaluate the mid-term survival and functional outcome of the RM Pressfit cup in a large study population.METHODS Between 2011 and 2020,we included 1324 patients receiving a primary THA using the RM pressfit cup.Final clinical follow-up was performed at 2 years postoperatively with the Dutch arthroplasty register used to assess implant status thereafter.Revision for acetabular failure and reason for revision were reported to evaluate implant survival,while the hip disability and osteoarthritis outcome score(HOOS)scores were used to assess functional outcome.RESULTS The mean age at surgery was 64.9 years.The mean follow-up was 4.6 years.Of the 1324 THAs performed,13 needed cup revisions within 5 years after index THA:5 due to aseptic loosening,6 due to infection,2 due to dislocation and 2 due to other causes.This resulted in a 5-year cup survival of 98.8%(95%CI:98.1-99.5).Nine of the cup revisions occurred within the first year after index THA.HOOS scores increased significantly in all domains during the first year and levelled out during the second year.CONCLUSION In the present study,the RM pressfit cup demonstrated excellent clinical outcomes at mid-term follow-up;however,future studies are needed to assess the long-term outcomes of this acetabular implant.
文摘目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院收治的30例患者分成测量仪组(采用三维角度仪辅助进行THA组,15例)和传统组(传统THA组,15例),两组术前规划髋臼臼杯置入的外展角为38º、前倾角为20º,比较两组术后X线片上所测得髋臼臼杯置放的角度(外展角和前倾角)与其术前所规划臼杯置入角度之间的误差。结果测量仪组术后髋臼臼杯置放的角度(外展角和前倾角)与术前所规划角度的误差明显小于传统组。结论相对于传统THA术中医生用肉眼瞄髋臼臼杯置入方向而言,采用此三维角度仪辅助进行THA,能在术中对髋臼臼杯置入的方向进行刻度化测量,能提高髋臼臼杯置入角度的精准度,其操作简单,值得推广。
