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BMC Musculoskelet Disord 2021 May 14;22(1):442. Epub 2021 May 14.

Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Jilin, 130033, China.

Background: Modular prosthesis fracture, especially distal femoral fracture, is a rare complication of total hip arthroplasty (THA). However, it is catastrophic, and may have a serious impact on the patients. A distal femoral prosthesis fracture in a patient with developmental dysplasia of the hip (DDH) with nonunion at the subtrochanteric osteotomy site has not yet been reported in any literature. Read More

J Bone Joint Surg Am 2021 May 14. Epub 2021 May 14.

Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan.

Background: Spherical periacetabular osteotomy (SPO) is a novel osteotomy involving splitting the teardrop, using patient-specific preoperative planning, and requiring only a 7-cm skin incision. We report preoperative planning methods and short-term results of SPO.

Methods: In preoperative planning, computed tomography (CT) images were imported into 3-dimensional templating software. Read More

Injury 2021 May 1. Epub 2021 May 1.

Department of Orthopaedic Surgery, Stanford Hospitals and Clinics, 300 Pasteur Drive, Room R144, Stanford CA, United States.

Introduction: Bridge plating of distal femur fractures with lateral locking plates is susceptible to varus collapse, fixation failure, and nonunion. While medial and lateral dual plating has been described in clinical series, the biomechanical effects of dual plating of distal femur fractures have yet to be clearly defined. The purpose of this study was to compare dual plating to lateral locked bridge plating alone in a cadaveric distal femur gap osteotomy model. Read More

BMC Musculoskelet Disord 2021 May 13;22(1):437. Epub 2021 May 13.

Hip and Knee arthroplasty, Joint Reconstruction Research Center, Imam Khomeini hospital, Tehran University of Medical Sciences, End of Keshavarz Blvd, 1419733141, Tehran, Iran.

Background: Anterior cruciate ligament (ACL) injury may be associated with genu varum. There are a few indications in which the varus deformity can be corrected at the time of ACL reconstruction. However, as the genu varum originates mostly from the tibia and the simultaneous presence of ACL deficiency and femur originated genu varum is uncommon, only a few papers have described their management for ACL deficient patients with femur originated genu varum. Read More

Acta Chir Orthop Traumatol Cech 2021 ;88(2):95-100

Oddělení ortopedie a traumatologie, AGEL Středomoravská nemocniční a.s., Nemocnice Přerov.

PURPOSE OF THE STUDY The study aimed to evaluate the intraoperative and early postoperative response to simultaneous bilateral femoral osteotomy usually accompanied by soft tissue release of hip joints, or open reduction, capsuloplasty, pelvic osteotomy or extraarticular shelf procedure. MATERIAL AND METHODS A bilateral surgery was performed in 16 children. Twelve children suffered from (spastic) cerebral palsy and there was one case of paralytic dislocation in a patient with myelomeningocele, while the remaining patients suffered from chromosome I aberrations, Dandy-Walker syndrome and merosin-deficient muscular dystrophy. Read More

Acta Chir Orthop Traumatol Cech 2021 ;88(2):87-94

Ortopedická klinika 1. lékařské fakulty Univerzity Karlovy, IPVZ a Fakultní nemocnice Na Bulovce, Praha.

PURPOSE OF THE STUDY Hemiepiphyseodesis is commonly used to correct a coronal plane knee deformity during childhood. Since 2007 Blount staple method has been replaced by the eight-Plate Guided Growth System. We retrospectively analysed the indications, results and complications of the older Blount staple method so as to compare them with the newer eight-Plate Guided Growth system. Read More

JBJS Case Connect 2021 05 6;11(2). Epub 2021 May 6.

Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.

Case: A 34-year-old woman with developmental dysplasia of the hip (DDH) presented with chronic left hip pain related to a femoral head cyst. The patient strongly preferred a joint-preserving option. Periacetabular osteotomy (PAO) has shown reliable options for managing DDH, and femoral head fresh osteochondral allograft (FOCA) can be performed for cysts. Read More

J Orthop Case Rep 2020 May-Jun;10(3):36-42

The Orthopaedic Speciality Clinic, Pune, Maharashtra, India.

Introduction: Injuries to the knee ligaments, menisci, and cartilage are possible in high-velocity trauma as in road traffic accidents. Similarly, these structures can be disrupted in proximal tibia fractures. We present a series of three cases which had a previously undescribed injury combination. Read More

Knee Surg Sports Traumatol Arthrosc 2021 May 5. Epub 2021 May 5.

BG Center for Trauma and Reconstructive Surgery, Eberhard-Karls University of Tübingen, Tübingen, Germany.

Purpose: The ischiofemoral distance (IFD), defined as the distance between the ischial tuberosity and the lesser trochanter of the femur, is gaining recognition as an extra-articular cause of hip pain. It is unknown whether the IFD is influenced by the frontal knee alignment. The aim of this study was to determine the influence of realignment surgery around the knee on the IFD. Read More

J Hip Preserv Surg 2020 Aug 10;7(3):591-595. Epub 2020 Nov 10.

Department of Hip Preservation, University College London Hospitals, 235 Euston Road, London NW12PQ, UK.

The periacetabular osteotomy (PAO) is an extensive surgical procedure associated with potential risk to the adjacent neurovascular structures. A steep learning curve exists, with surgeon experience an important factor in outcome. Little detail exists of the osteotomies themselves, and how to make them safe and reproducible. Read More

J Hip Preserv Surg 2020 Aug 21;7(3):583-590. Epub 2020 Dec 21.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.

The aim of this study was to evaluate the relationship between the correction of radiographic parameters and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Sixty-nine patients with hip dysplasia were enrolled and underwent curved PAO. The pre- and post-operative 3D center-edge (CE) angles, total anteversion (acetabular and femoral anteversion), and radiographic acetabular roof angle were measured and compared with the post-operative ROM. Read More

J Hip Preserv Surg 2020 Aug 20;7(3):575-582. Epub 2020 Dec 20.

Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E. 70th St, New York, NY 10021, USA.

Hip dysplasia is a three-dimensional pathomechanical condition that is often more complex than the standard method of measuring lateral center edge angle (CEA) can quantify. Yet there is a paucity of literature examining the differences in version seen between dysplastic and non-dysplastic femoroacetabular impingement (FAI) hips, the relationship of acetabular and femoral version (FV) within dysplastic hips and the contribution of each of these factors to symptoms and outcomes of dysplasia treatment. We sought to describe the acetabular version (AcetV) and FV in dysplastic hips and quantify how these measurements compared with non-dysplastic FAI hips. Read More

J Hip Preserv Surg 2020 Aug 14;7(3):378-389. Epub 2020 Dec 14.

Division of Orthopaedic Surgery, Department of Surgery, Evidence, and Impact, McMaster University Medical Centre, 1200 Main Street West, 4E15, Hamilton, ON L8N 3Z5, Canada.

 : This systematic review aims to assess the diagnosis, indications and treatment of femoroacetabular impingement (FAI) prior to the year 2000 and to determine if historical concepts remain applicable today. PUBMED, MEDLINE and EMBASE were searched for literature evaluating the diagnosis/treatment of FAI prior to 2000. Cadaver/non-human, non-English and review studies were excluded. Read More

Gait Posture 2021 Apr 22;87:184-191. Epub 2021 Apr 22.

Gillette Children's Specialty Healthcare, 200 University Avenue East, Saint Paul, MN, 55101, United States; University of Minnesota, Orthopedic Surgery, 2450 Riverside Ave, Minneapolis, MN, 55454, United States. Electronic address:

Background: It is unknown how a femoral derotation osteotomy (FDO) during childhood affects functional outcomes in adulthood among individuals with bilateral cerebral palsy (CP).

Research Questions: How do long-term functional outcomes after an FDO compare to matched individuals who did not have an FDO? How do outcomes change over time?

Methods: We queried the gait laboratory database for individuals who underwent an external FDO in childhood and were currently ≥25 years old. Participants returned for a long-term analysis (gait, physical examination, functional tests, imaging, questionnaires). Read More

Arthroscopy 2021 Apr 30. Epub 2021 Apr 30.

American Hip Institute Research Foundation, Chicago, IL 60018; American Hip Institute, Chicago, IL 60018; AMITA Health St. Alexius Medical Center, Hoffman Estates, IL 60169. Electronic address:

Purpose: To investigate the correlation between hip capsular management (repair or reconstruction) and biomechanical results in the setting of femoroacetabular impingement and microinstability.

Methods: A search of the PubMed and Embase databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies focused on hip biomechanics related to capsular release, repair of I- and T-capsulotomy, or capsular reconstruction. Read More

Interact J Med Res 2021 May 3;10(2):e27075. Epub 2021 May 3.

Orthopedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Legg-Calvé-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. This condition occurs due to the interruption of blood supply to the femoral head. Up to now, different surgical and nonsurgical treatments, including femoral varus osteotomy, innominate osteotomy, pelvic osteotomies, triple osteotomy, Chiari osteotomy, and shelf acetabuloplasty, have been suggested for noncontainable LCPD hips. Read More

Hip Int 2021 May 2:11207000211013029. Epub 2021 May 2.

Division of Paediatric Orthopaedics, Rainbow Babies and Children's Hospitals at Case Western Reserve University, Cleveland, OH, USA.

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip.

Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. Read More

Arthroscopy 2021 Apr 29. Epub 2021 Apr 29.

Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: This study aimed to evaluate serial changes in the joint space width (JSW) of the medial and lateral compartments after medial open-wedge high tibial osteotomy (MOWHTO) and its associated factors.

Methods: Medial and lateral weight-bearing JSWs were measured on serial radiographs and analyzed preoperatively, postoperatively, and at 3 months, 6 months, 1 year, and 2 years. Associations between medial and lateral JSWs and age, body mass index, mechanical axis, correction angle, lateral distal femoral angle, medial proximal tibial angle, joint line convergence angle (JLCA), JLCA on stress radiographs and arthroscopic cartilage status were examined. Read More

Cartilage 2021 Apr 27:19476035211011503. Epub 2021 Apr 27.

CHUM, Montreal, Quebec, Canada.

Introduction: High tibial osteotomy (HTO) is a surgical procedure aimed at inhibiting the progression of osteoarthritis of the knee joint. The aim of this study was to identify factors influencing the functional outcome after opening wedge valgus HTO.

Methods: A total of 175 cases (155 patients) of varus-correcting high tibial open-wedge osteotomies using the Tomofix plate were reviewed retrospectively. Read More

Asian J Surg 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopaedic Surgery the Affiliated Hospital of Southwest Medical University Luzhou, China. Electronic address:

Recurrent patellar dislocation (RPD) is multifactorial disease, and excessive femoral internal torsion has been considered as an important risk factor for recurrence of patellar dislocation and graft failure after surgery 1 . Satisfactory clinical outcomes depend on correcting of the pathologic abnormalities around the patellofemoral joint and torsional deformity of the lower extremity. At present, conventional isolated medial patellofemoral ligament (MPFL) reconstruction without addressing excessive femoral internal torsion may lead to MPFL graft failure 2,3 , because increased femoral internal torsion can significantly increase a persistently lateralizing force on the patella 4 . Read More

Orthop J Sports Med 2021 Apr 6;9(4):2325967121996487. Epub 2021 Apr 6.

Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Background: Injured anterior cruciate ligament (ACL) tissue retains proprioceptive nerve fibers, vascularity, and biomechanical properties. For these reasons, remnant ACL tissue is often preserved during the treatment of ACL injuries.

Purpose: To assess through a cadaveric model whether reorienting and retensioning the residual ACL via an osteotomy improves knee stability after partial ACL tear, with substantial remnant tissue and intact femoral and tibial attachments. Read More

J Exp Orthop 2021 Apr 20;8(1):32. Epub 2021 Apr 20.

Department for Trauma and Reconstructive Surgery, BG Klinik, University of Tübingen, Tübingen, Germany.

Purpose: Osteotomies represent well-established treatment-options for the redistribution of loads and forces within and around the knee-joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal-femoral-rotation-osteotomy on the coronal alignment of the ankle. Read More

BMC Musculoskelet Disord 2021 Apr 20;22(1):371. Epub 2021 Apr 20.

University of Basel, Basel, Switzerland.

Background: With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing.

Methods: Eight pairs of fresh-frozen human cadaveric femora aged 72. Read More

Musculoskelet Surg 2021 Apr 18. Epub 2021 Apr 18.

Department of Paediatric Orthopaedics, Kasturba Hospital, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

Background: Little literature exists regarding aggressive treatment of the extrusion in the early stage of the disease and the outcome at skeletal maturity. The purpose of the study was to evaluate the outcome of the disease with onset younger than 7 years, treated in the early stage of the disease, with aggressive management of significant extrusion (immediate containment with fixed abduction brace in children less than 5 years and varus derotation osteotomy in older children), and reached skeletal maturity.

Methods: All children with the age of onset younger than 7 years of disease during active Perthes disease were prospectively followed. Read More

Front Neurol 2021 18;12:635894. Epub 2021 Mar 18.

Department of Pediatrics Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland.

Pain appearance is one the most common complication of spastic hip disease in children with cerebral palsy (CP). It determines child and caregiver quality of life and life priorities. Reconstruction hip surgery should be considered as a treatment of choice. Read More

Clin Orthop Relat Res 2021 May;479(5):1040-1049

L. M. Fowler, J. J. Nepple, C. Devries, J. C. Clohisy, Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.

Background: Periacetabular osteotomy (PAO) increases acetabular coverage of the femoral head and medializes the hip's center, restoring normal joint biomechanics. Past studies have reported data regarding the degree of medialization achieved by PAO, but measurement of medialization has never been validated through a comparison of imaging modalities or measurement techniques. The ilioischial line appears to be altered by PAO and may be better visualized at the level of the inferior one-third of the femoral head, thus, an alternative method of measuring medialization that begins at the inferior one-third of the femoral head may be beneficial. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):409-413

Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P.R.China.

Objective: To simulate and validate the performance, accuracy, and safety of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through cadaver-based experiment, thus optimizing the robotic system for the future human clinical application.

Methods: Six unilateral adult cadaver specimens of the lower limbs were scanned by three-dimensional CT before the experiment, and then the three-dimensional models of femur and tibia were obtained by using the preoperative software of YUANHUA-TKA system, so as to plan the type of prosthesis implant, the osteotomy volume and osteotomy angles [hip-knee-ankle angle (HKA), coronal frontal femoral component (FFC) and frontal tibial component (FTC)], the ideal value of HKA was set to 180°, and of FFC and FTC were set to 90°, respectively. The operator could further confirm the osteotomy plan according to the intraoperative situation before osteotomy, and then install the prosthesis after completing the osteotomy in each plane with the assistance of YUANHUA-TKA system. Read More

Tohoku J Exp Med 2021 04;253(4):261-267

Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine.

Bisphosphonates have been the first drug of choice for osteoporosis in the recent years because of their known ability to suppress osteoclast activity. The adverse effect of long-term bisphosphonate administration in the fracture-healing process is controversial. The aim of our study was to observe not only morphology but also morphometry of the fracture site of atypical femoral fracture with and without long-term bisphosphonate administration, in a case study of two difficult-to-obtain human samples. Read More

Orthopade 2021 May 13;50(5):387-394. Epub 2021 Apr 13.

Klinik für Orthopädie, Uniklinikum Magdeburg, Magdeburg, Deutschland.

Unicompartmental knee arthroplasty, especially for both femorotibial compartments of the knee, is an established partly joint-saving treatment option for osteoarthritis of the knee if the disease is limited to one compartment. Even smaller implants or resurfacing of the patellofemoral joint have been shown-in smaller patient collectives-to have the potential to yield good clinical results. Read More

Clin Biomech (Bristol, Avon) 2021 Apr 24;84:105333. Epub 2021 Mar 24.

Paediatric Orthopaedic Unit, Department of Orthopeadics and Trauma, Medical University of Graz, Auenbruggerplatz 34, A-8036 Graz, Austria.

Background: Patellar instability is a considerable problem that leads to pain and anxiety during simple functional tasks. Femoral derotational osteotomy has become a common surgical procedure to improve patella mechanics, stability and loading. However, it remains unclear if static (MRI measured) femoral anteversion is sufficient to capture the dynamic femoral rotation during walking and represents a good indication for the surgical procedure. Read More