2025年2月 保髋进展 JCR Q3+Q4 区

To explore the application effect of grid locator in hip arthroscopy for the treatment of femoral acetabular impingement (FAI).

Survey-based studies are inherently subject to non-response bias. A comprehensive understanding of the factors contributing to non-response is important for minimizing attrition bias and ensuring generalizability of results. The purpose of this study was to determine the preoperative factors associated with survey non-response 2 years after hip arthroscopy.

This study aimed to measure the optimal osteotomy angle and length, as well as the available width of the osteotomy site in the posterior column for the safe performance of periacetabular osteotomy.

Breech presentation, family history, and physical examination are the most recognized risk factors for DDH, which form the basis of selective screening. However, this approach can lead to late diagnosis, invasive treatments, and complications. This study analyzes the effectiveness of selective screening and identifies additional factors related to DDH.

According to Association Research Circulation Osseous (ARCO) staging, patients with ARCO III osteonecrosis of femoral head (ONFH) have joint pain and dysfunction due to the collapse of femoral head. Current hip preservation surgeries are not satisfying in the treatment of ARCO III ONFH according to the long-term follow-up. In our practice, we focused on reconstructing femoral head by restoring the round shape of femoral head and subsequently preventing the development of hip arthritis. To lift the collapsed femoral head and postpone the potential total hip arthroplasty, we practiced Jack surgery, combining surgical hip dislocation, removal of necrotic bone, impaction bone grafting, and lifting the cartilage of femoral head.

OBJECTIVE: To explore the application effect of grid locator in hip arthroscopy for the treatment of femoral acetabular impingement (FAI). METHODS: Total of 50 patients of FAI were treated by arthroscopic hip joint surgery for from January 2020 to January 2021, and were divided into two groups according to intraoperative positioning methods. Among them, 27 cases in the positioner group were treated by hip arthroscopy assisted by grid positioner including 10 males and 17 females with a mean age of (35.91±9.92) years old. In the non-locator group, 23 cases were treated with hip arthroscopy by positioning puncture according to the operator's experience including 12 males and 11 females with a mean age of (36.01±11.03) years old. Intraoperative fluoroscopy times, puncture time, adjusted puncture times and operation time of two groups were compared. The α Angle and lateral central edge(LCE) angle of hip joint were measured and compared before and after operation. Four evaluation indexes were recorded and compared, including pain visual analogue scale(VAS), hip Harris score, non-inflammatory hip joint score (NAHS), hip joint activities of daily living (HOS-ADL). RESULTS: All patients were followed up for 6 to 12 months with an average of (18.69±3.72) months. The α angle and LCE angle of hip joint at 1 month after operation were decreased in both groups( CONCLUSION: The application of hip arthroscopy in the treatment of femoral acetabular impingement sign can obtain good postoperative results. Compared with the traditional positioning method, the grid locator can improve the accuracy of skin positioning point, shorten the puncture time, reduce the number of fluoroscopy, and improve the efficiency of surgical puncture.

Developmental dysplasia of the hip (DDH) is a complex static-dynamic condition resulting in chronic joint instability and osteoarthritis. Borderline acetabular dysplasia refers to slightly abnormal patterns in the acetabular shape and coverage that are not within the dysplastic range. However, they can predispose to mechanical dysfunction and hip instability. Diagnosis and treatment remain controversial topics in hip preservation, with little current comparative literature to guide accurate diagnosis and treatment decision-making. Historically, the diagnosis of borderline DDH relied on assessments of the acetabular anatomy on anteroposterior pelvic radiography, most commonly the lateral central-edge angle (LCEA), with normal values ranging from 20 to 25° or, in some more recent studies, 18 to 25°. Surgical treatment decision-making debates the use of isolated hip arthroscopy or periacetabular osteotomy, considering the difficulty in determining a fundamental mechanical diagnosis (instability versus femoroacetabular impingement) in subjects with borderline DDH. Therefore, for effective surgical decision-making, the evaluation of additional bone anatomy characteristics, instability, and patients' features is essential.