Acetabular component position of the noncemented total hip endoprosthesis after previous Chiari pelvic osteotomy.

INTRODUCTION: The aim of the study was to determine the validity of acetabular component position of the noncemented total hip endoprosthesis after Chiari pelvic osteotomy. MATERIAL AND METHODS: The study involved 75 patients operated on at the Institute of Orthopedic Surgery "Banjica" in the period from 1990-2009. The first group consisted of 39 patients (46 hips) who underwent Chiari pelvic osteotomy and also later the implantation of a noncemented total hip endoprosthesis. A control group consisted of 36 patients (47 hips) who underwent total hip arthroplasty due to degenerative hip dysplasia. RESULTS: In the previously operated patients the centre of rotation of the hip was on the average placed more proximally, while in the control group of patients the position of the acetabular component was closer to the anatomical one. In the group of patients after Chiari osteotomy the mean acetabular cup abduction angle rated 41.8°±9.8°, while in the control group this value was on the average higher (45.4°±8.6°). DISCUSSION: There was a significant difference between the studied groups in relation to the distance between the acetabular component of endoprosthesis and the acetabular teardrop (t=-2.763; p=0.007). No statistically significant difference was determined in the mean value of the angle of acetabular abduction component of endoprosthesis between the studied groups of patients (t=1.878; p=0.064). CONCLUSIONS: Acetabular component position of the total hip endoprosthesis was not compromised by anatomic changes of the acetabulum caused by Chiari pelvic osteotomy.

Epidemiology of hip fractures in Belgrade, Serbia Montenegro, 1990-2000.

INTRODUCTION: This study retrospectively determined the incidence rates of hip fractures in Belgrade, Serbia and Montenegro, during the period 1990-2000. MATERIALS AND METHODS: All patients with hip fractures treated at all Belgrade hospitals were identified from the Republic of Serbia's Ministry of Health National Health Care database. Patient demographics, type of hip fracture, and details of the mechanism of injury were collected. The annual incidence rates were calculated with interpolation according to the Belgrade population census of 1991 and 2002. RESULTS: There were a total of 8,904 hip fractures with a mean annual incidence of 51.7 per 100,000 adults (62.2 females and 35.5 males). Mean age at the time of fracture was 67 years (72.6 for females and 59.3 for males), with 64.7% of all fractures occurring in women. There was a significant increase in hip fracture incidence rates over the observed period in females (P = 0.006), but not in males (P = 0.962). Trochanteric fractures predominated, accounting for 53% compared with cervical fractures. In patients over 50 years of age there was an exponential increase in the incidence of hip fractures in both sexes; though more so in females. 91% of hip fractures occurred in these older patients with incidence rates of 143.6 per 100,000 (185.9 for female and 92.2 for male patients). The most common mechanism of injury in the older group was low-energy trauma (70.3%) resulting from a fall from standing height onto a flat surface (same level). Standardizing incidence rates in the older age group to the US 1985 white population gave values of 228 per 100,000 females and 96 per 100,000 males. These incidence rates are similar to those reported in Italy, France and Great Britain, but lower than those in Scandinavian countries. CONCLUSION: In view of growing population numbers and an increase in the proportion of patients aged over 60 years, we can expect an increase in the prevalence of osteoporosis and an increase in the incidence of fragility hip fractures in the future, with resource implications.