Hip arthroscopy after traumatic hip dislocation.

BACKGROUND: Traumatic posterior dislocation of the hip joint usually results from high-energy trauma, which can cause additional injuries that may need to be addressed after reduction. PURPOSE: This study was undertaken to present arthroscopic findings after traumatic posterior hip dislocation in patients with mechanical hip symptoms. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All patients treated with hip arthroscopy between 2002 and 2006 for mechanical hip symptoms after traumatic posterior hip dislocation with subsequent closed reduction were included in this study. The time between closed reduction and arthroscopy, arthroscopic findings and treatment, preoperative and last follow-up WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores, and last follow-up radiographs were analyzed. Complications or the need for further surgical treatment are reported. RESULTS: There were 17 patients (13 male, 4 female) with an average age of 28.5 years (range, 19-37 years). The average time between closed reduction and arthroscopy was 3 months. Fourteen patients had anterior labral tears, 6 had posterior labral tears, 16 had acetabular chondral damage, all had femoral chondral damage, and 14 had intra-articular fragments. The preoperative WOMAC score was 46; the last follow-up (average 45 months) WOMAC score was 87 (range, 45-93); this was considered statistically significant (P = .001). One patient required total hip replacement for osteoarthritis and 1 presented with osteonecrosis and is waiting for hip replacement. CONCLUSION: The clearest indication for arthroscopy after traumatic posterior hip dislocation was loose fragments inside the joint. Arthroscopy was also performed in every patient with mechanical hip symptoms. Intra-articular damage was demonstrated in every case. Most of the patients had significant improvement after hip arthroscopy.

[Functional outcomes in patients subjected to acetabular revision with reinforcement rings]. / Resultados funcionales de los pacientes sometidos a revisión acetabular con anillos de reforzamiento.

BACKGROUND: Total hip arthroplasty is the most successful orthopedic procedure and the frequency of use of revision components has grown exponentially. The increased number of revisions results from the longer life expectancy of the population and the greater frequency of the hip arthroplasty indication among young patients. The purpose of this study is to evaluate the functional results of patients subjected to revision of the acetabular component using reinforcement rings. MATERIAL AND METHODS: The study included patients with a diagnosis of septic or aseptic prosthetic loosening and sequelae of acetabular fractures between January 2007 and November 2009 in whom a reinforcement ring was used. The WOMAC scale was used for the functional evaluation. RESULTS: According to the WOMAC scale, the patient functionality results showed a mean preoperative score of 41.89 and a mean postoperative score of 74.26, which represented an improvement of 33.11 points in the median of patients subjected to the surgical intervention, with a statistically significant difference (p = 0.036). DISCUSSION: This study shows an improvement in the functionality of the patients subjected to surgery with a reinforcement ring, as, first and foremost, a statistically significant difference was seen between the preoperative and postoperative values and, secondly, there are papers published in the literature showing that a difference of more than 12 points between the preoperative and postoperative scores in the WOMAC scale indicates a significant clinical improvement of patients. CONCLUSION: Patients subjected to acetabular revision with a reinforcement ring together with cemented polyethylene have an improved quality of life after the surgical intervention.