2025年3月 保髋进展 JCR Q4 区

Total hip arthroplasty (THA) for severe developmental dysplasia of the hip (DDH) is technically difficult because of the anatomical features of dysplasia, such as a hypoplastic and shallow acetabulum, narrow femoral canal, and soft tissue contractures. Subtrochanteric osteotomy (STO) is effective technique to reduce the risk of sciatic nerve palsy while placing the acetabular cup in an anatomical position during THA for severe DDH. Few studies have compared THA performed without STO to THA performed with STO. We performed a systematic literature review and single-arm meta-analysis to integrate the results of studies regarding THA with STO for severe DDH.

The management of cam morphology of FAI associated with osteoarthritis (OA) is debated. However, current surgical indications are becoming obsolete, and hip arthroscopy spreads in different settings. The present clinical trial evaluated the outcome of one-stage unilateral hip arthroscopy and contralateral total hip arthroplasty (THA) in patients with bilateral cam deformity associated with labral tears and early and advanced OA stages, respectively. The outcomes of interest were patient-reported outcome measures (PROMs) and the rate of complications.

To assess hip symptomatology during the perioperative and peripregnancy periods and postoperative outcomes among reproductive age females undergoing arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) and pregnancy complications in females after hip arthroscopy.

Developmental Dysplasia of the Hip (DDH) is a relatively common hip joint disorders in infants, affecting one to three per a thousand births. If found early, it can be treated preemptively by simple non-invasive methods. But if not, then several surgical procedures may be required that can cause high economic burden. The accuracy of diagnosis using ultrasound (US) images heavily relies on locating anatomical landmarks on the image. However, there is an intra-observer/inter-observer variability in determining the exact location of the landmarks. In this study, an automated scan quality assessment system of pelvic US image by evaluating quality of five landmarks using transfer learning models was proposed.

This study aims to determine prevalence, risk factors and geographic distribution of Developmental Dysplasia of the Hip in Pakistan and to assess the cumulative outcomes of various treatments used and propose recommendations to establish preventive strategies and best treatment practices in Pakistan.

Prader-Willi syndrome (PWS) is an uncommon genetic disorder resulting from the loss of function of genes in the paternal copy of chromosome 15q11.2-q13. Although the clinical features and diagnosis of PWS are well described, the management protocol for hip dysplasia (HD) is still controversial.

This study aims to evaluate the effectiveness of total hip arthroplasty (THA) with subtrochanteric femoral osteotomy in patients with Crowe type IV DDH in terms of functional outcomes, complication rates, and implant stability. The study was prospective, conducted in the University Clinical Center of Kosovo and Otrila Hospital from 2016 to 2022 and included 22 patients with Crowe type IV hip dysplasia who underwent the THA with a subtrochanteric femoral osteotomy procedure. The treatment was performed using the posterior approach, and the placement of the dual mobility acetabular cup was based on the anatomic hip center using a Quattro non-cemented endoprothesis. There were no reported hip dislocations, and all patients had a negative Trendelenburg sign at approximately 6 months post-surgery. Harris Hip Score (HHS) and Functional Independent Score (FIS) were significantly increased after the treatment (t = 21.342, p < 0.0001; and t = 83.331, p < 0.0001, respectively). The limb-length discrepancy decreased significantly after surgery (Mean = 0.7 cm) compared to pre-surgery (Mean = 3.5 cm) (p < 0.05). The study concludes that THA with subtrochanteric osteotomy is a safe and effective treatment option for Crowe type IV hip dysplasia. Using dual mobility acetabular components and compression in the osteotomy led to improved outcomes and faster recovery. It can restore the anatomic hip center and improve functional outcomes while reducing the risk of dislocation.

This study aimed to compare the efficacy and safety of arthroscopy with physiotherapy or joint lavage in patients with femoroacetabular impingement (FAI). A meta-analysis using PubMed, Embase, Scopus, and the Cochrane Collaboration Library databases was performed in September 2022. We included studies focusing on patients with FAI who underwent arthroscopic surgery versus those who underwent physiotherapy or arthroscopic lavage. The outcomes were functional scores (iHOT-33 and HOS ADL) and adverse events. Randomized clinical trials were included in the study. The risk of bias in each study was assessed according to Cochrane guidelines for clinical trials. The data were combined using Review Manager version 5.4. (PROSPERO CRD42022375273). Six RCTs were included, from a pool of 839 patients (407 females). There were no significant differences between groups at 6 months regarding iHOT-33 (MD 4.68, 95% CI -0.07 to 9.44) and HOS ADL (MD 5.09, 95% CI -0.07 to 10.24). The iHOT-33 and HOS ADL scales showed significant differences at 12 months in favor of the arthroscopy group (MD 10.65, 95% CI 6.54 to 14.76) and (MD 8.06, 95% CI 1.05 to 15.07). MCID was not achieved through arthroscopy in functional variables. The rate of numbness was significantly higher in the arthroscopy group. Although the arthroscopy group demonstrated statistical superiority, the clinical significance based on the MCID remains controversial, and arthroscopy did not demonstrate clinical superiority.