Hip fractures

Hip fractures are the most common reason for orthopaedic admission. There are approximately 65,000 per year in England and Wales and they cause significant morbidity and mortality. Knowledge of these fractures and their treatment is vital to ensure optimization of these patients and to improve patient outcomes.     

Hip arthroscopy

With adequate patient screening and attention to complications specific to the hip joint, hip arthroscopy can be performed safely and effectively. When used in appropriately selected patients, the reduced recovery and rehabilitation time is significant. In the past decade, the indications for hip arthroscopy have evolved to include a variety of pathologies, which has lead to a dramatic rise in its use.     

Hip instability

Understanding of the etiology and pathology of hip instability has increased in recent years as new information has emerged regarding the disease processes of the hip. Hip instability, heretofore considered uncommon in clinical practice, is increasingly recognized as a pathologic entity. Instability may be classified as traumatic or atraumatic, and diagnosis is made based on patient history, physical examination, and imaging studies. Plain radiography, MRI, MRI arthrography, and hip instability tests (eg, posterior impingement, dial) can be used to confirm the presence of instability. Nonsurgical management options include physical therapy and protected weight bearing. Surgical intervention, whether arthroscopic or open, is required for large acetabular fractures and refractory instability. Knowledge of the etiology and evolving research of hip instability is essential to understand the spectrum of hip disease.     

髋关节镜技术

作为微创与直视相结合的一种治疗手段,髋关节镜技术在电子光学、计算机和影像学的带动下,已成为诊断和治疗髋关节内疾患的有效方法 .髋关节镜的适应证逐渐扩大,目前几乎可对所有髋关节内疾惠进行诊断和治疗.髋关节镜在组织活检、腔内冲洗、骨赘清除、滑膜切除、微骨折技术诊治髋臼撞击综合征、软骨损伤、孟唇损伤、人工髋关节置换术后疼痛、不明原因髋痛,以及既往需开放手术的儿童先天性髋部疾患、股骨头坏死、髋部退行性变等方面,均表现出极大的优势.该文就髋关节镜的适应证、操作方法 、康复、评价标准及诊治常见髋部疾患的效果等作一简要综述.     

全髋关节置换术治疗髋关节发育不良

目的探讨髋关节发育不良的全髋关节置换术的手术要点和术后疗效。方法25例(28髋)根据CroweX线分型,Ⅰ型14例,Ⅱ型7例,Ⅲ型和Ⅳ型各2例。髋臼旋转中心的重建方法包括标准的全髋关节置换术、结构性自体植骨和髋臼旋转中心内移。恢复下肢长度的方法包括术中彻底切除挛缩的关节囊和纤维瘢痕组织并酌情进行软组织松解。随访内容包括:①Harris评分;②X线测量双下肢长度差和髋臼旋转中心位置。结果所有病例平均随访28.5个月,Harris评分由术前的平均43分(18~72分)升高至91分(79~100分)。所有病例髋臼旋转中心都恢复正常。术前双下肢长度差为0.5~5.5cm,术后双下肢长度差为-0.4~0.9cm。结论髋关节发育不良的全髋关节置换术中,除了标准的髋臼重建方法之外,结构性植骨和髋臼旋转中心内移可有效恢复髋臼旋转中心的高度。术前详细的计划,术中彻底切除挛缩的关节囊和纤维瘢痕组织并酌情进行软组织松解有助于恢复下肢长度。     

Hip Lift

While abdominoplasty has a long history of development, we have recently had several cases where a lateral hip lift was requested. The goal is to raise and tighten the skin and subcutaneous tissue of the lateral thigh after weight loss or to improve cellulite. We have modified the excellent technique of Ted Lockwood by eliminating undermining and suturing the resulting flaps only to the deep dermal layers. The complications have been limited to the spreading of scars as a result of so much tension, and the occasional delayed healing of those tense wounds.     

Observation Hip

“Observation Hip” is a provisional diagnosis. Although transient arthritis is the most frequent pathology, it is important to establish a diagnostic routine to consider the various types of hip pathology. Physical examination and clinical evolution are the most important factors in making a specific diagnosis.     

Midterm Results of Total Hip Arthroplasty in Patients With High Hip Dislocation After Suppurative Hip Arthritis

Background

Total hip arthroplasty (THA) is technically challenging in patients with high dislocation of the hip secondary to suppurative arthritis. The technical difficulty is attributable to the complex hip anatomy and the potential risk of recurrent infection in these patients. This study investigated the midterm results of THA in patients with Crowe type III and IV high dislocation of the hip secondary to suppurative arthritis.