Spinopelvic mobility in patients with hip osteoarthritis and total hip arthroplasty indication / Mobilidade espinopélvica nos pacientes com artrose do quadril e indicação de artroplastia total

ABSTRACT Introduction: Reduction of spinopelvic mobility is associated with an increased dislocation of total hip arthroplasty (THA). Objective: To assess 1) spinopelvic mobility in patients with primary hip osteoarthritis and THA indication and 2) the influence of hip flexion contracture on spinopelvic mobility. Methods: Thirty adult patients with primary hip osteoarthritis and THA indication were evaluated using radiographic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar flexibility, and spinopelvic mobility). Results: Spinopelvic mobility ranged from 6.90 a 54.50° (mean 32.79 ± 11.42) and the group of patients with hip flexion contracture had higher mobility. Spinopelvic mobility was correlated with pelvic tilt as well as with lumbar flexibility. Conclusion: Around 13.4% of patients had spinopelvic mobility under 20° , indicating reduced spinopelvic mobility and risk of THA dislocation. Level of Evidence III, Retrospective Comparative Study.

RESUMO Introdução: A redução da mobilidade espinopélvica tem sido associada com o risco de luxação da prótese total do quadril. Objetivos: Avaliar a mobilidade espinopélvica nos pacientes com artrose primária da articulação do quadril e com indicação de artroplastia total do quadril (ATQ), e a influência da contratura em flexão do quadril sobre a mobilidade espinopélvica. Métodos: Trinta pacientes adultos com artrose primária do quadril e indicação de ATQ foram avaliados por meio de parâmetros radiográficos (incidência pélvica, versão pélvica, inclinação do sacro, mobilidade da coluna lombar e mobilidade espinopélvica). Resultados: A mobilidade espinopélvica variou de 6,90 a 54,50 graus (média 32,79 ± 11,42), e foi estatisticamente maior no grupo de pacientes com contratura em flexão do quadril. Foi observado correlação entre a mobilidade espinopélvica e a versão pélvica e flexibilidade da coluna lombar. Conclusão: A mobilidade espinopélvica abaixo de 20 graus, que caracteriza a redução da mobilidade espinopélvica e risco aumentado de luxação ou impacto dos componentes da prótese total foi observada em 13,4% dos pacientes. Nível de Evidência III, Estudo Retrospectivo Comparativo.

Psoas Abscess with Hip Contracture in a Patient with Crohn's Disease / 대한소화기학회지

A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.

Clinical study of the pelvis obliquity accompanied with the gluteal muscle contracture / 中华骨科杂志

Objective To analyze the cause and treatment effect of pelvis obliquity accompanied with the gluteal muscle contracture. Methods 84 cases of gluteal muscle contracture with pelvis obliquity and their pelvis obliquity direction were examined. During surgery it was emphasized that release of the glutaeus minimus and glutaeus medius muscle contracture must be complete in order to expect correction of pelvis obliquity. Results Among the 84 cases of gluteal contracture with the pelvis obliquity, 76(90％ ) cases had gluteal muscle contracture of the longer limp. Follow-up had been done in 68 cases for 2.6 years. The pelvis obliquity disappeared completely in 63 of the 68 cases. Among the 63 cases, 61 cases underwent operation once while 2 cases needed revision operation. 3 of 68 cases were corrected partly. The other two cases had unstability in steps as a result of poor function of the gluteal abductors. Conclusion The main cause of the pelvis obliquity is contracture of the glutaeus minimus and medius muscles. The glutaeus minimus muscle contracture is an important factor that cause the pelvis obliquity in gluteal muscle contracture and should be released completely by surgery.

CLINICAL APPLICATION OF ARTHROSCOPY IN EXTERIOR JOINT SURGERY / 解放军医学杂志

To introduce the methods of the arthroscopy for exterior joint surgery, 45 cases have been subjected to surgical operations under arthroscopy in the exterior of joint during June 1999 to July 2002, including 14 for gluteus constrictor releasing by radiofrequency, 5 for removing of the screw and plate of the femur shaft, 3 for reduction and internal fixation for the fracture of humerus greater tubercle under the arthroscopy, 8 for removal of popliteal fosse cyst, and 15 for releasing carpal tunnel syndrome. The results showed that the function was satisfactory after reduction and internal fixation for humerus greater tubercle fracture, releasing of gluteus contracture and removing of popliteal fossa cyst by radiofrequency under arthroscopy. The symptoms of numbness and pain disappeared after carpal tunnel release by arthroscopy. No blood vessel and nerve injury, occurred and no recurrence and infection were found. In conclusion, the procedures of arthroscopy are with minimum invasion, less pain and easy for early rehabilitation for all treated cases. It can be used not only for joint disease but also be selective for the exterior joint surgery as well.