Effect of a modular neck hip prosthesis on anteversion and hip rotation in total hip arthroplasty for developmental dysplasia of the hip.

Total hip arthroplasty (THA) is often required to decrease the excessive anatomical femoral anteversion (AA) in developmental dysplasia of the hip. Studies have recommended decreasing the AA via the use of a retroverted modular neck. However, hip rotation after THA may strengthen or weaken the effect of changing the AA. Thus, the present study analyzed the effect of a retroverted neck on AA and hip rotation. Patients who underwent THA using a straight neck (ST group) or a 15° retroverted neck (RV group) in a version changeable dual modular system (Mainstay stem, Kyocera, Kyoto, Japan) were retrospectively reviewed. After matching for age, body mass index, and surgical approach, 44 patients were included in each group. The AA and hip rotation (femoral rotational angle: FRA) were measured on CT images acquired preoperatively and 1 month after THA, and were compared between the groups. The mean ± standard deviation preoperative AA of the ST group (26.1 ± 10.7°) was significantly smaller than that of the RV group (44.2 ± 7.8°) (p < 0.001). In contrast, the postoperative AA did not significantly differ between the groups (ST group 27.5 ± 9.8°, RV group 25.1 ± 8.3°, p = 0.406). The change in FRA after THA did not significantly differ between the groups (ST group - 3.8 ± 9.9°, RV group - 3.5 ± 9.1°, p = 0.841). In conclusion, a 15° retroverted neck was useful in controlling AA in hips with excessive AA, and the change in FRA after THA did not differ between the ST group and the RV group.

Correction to: Raman spectroscopy reveals differences in molecular structure between human femoral heads affected by steroid-associated and alcohol-associated osteonecrosis.

The original publication of this paper contain an error for the first name and last name of the second author have been mixed up as "Wenliang, Z.".

Raman spectroscopy reveals differences in molecular structure between human femoral heads affected by steroid-associated and alcohol-associated osteonecrosis.

PURPOSE: The purposes of this study were to document novel Raman spectroscopic findings in femoral heads affected by osteonecrosis and to identify molecular structure differences based on aetiology. METHODS: We obtained 13 femoral heads with osteonecrosis from 13 different patients who underwent total hip arthroplasty. Comparisons were made between the viable zones of each femoral head examined. The samples were scanned with X-ray micro-CT for structural mapping and a central coronal section slab was prepared for Raman spectroscopy and histological analyses. Raman spectra were collected at different locations, including the viable and necrotic zones of the femoral head, using a highly spectrally resolved Raman microprobe. RESULTS: Significant alterations in the spectral morphology in the high wavenumber region were found, with a pronounced inhibition of peculiar lipid signals in the frequency interval 2851 ~ 2890 cm-1 and at ~ 1750 cm-1. The necrotic zone in steroid-associated osteonecrosis showed an increase in the ratio of lipid-related bands to protein-related bands, while alcohol-associated osteonecrosis exhibited a decrease in this ratio. CONCLUSIONS: We systematically found a decrease in Raman intensity for sphingomyelin and phenylalanine fingerprint bands in the necrotic zones, and these differences may be related to the etiology of osteonecrosis.