Arthritis Arthritis of the hip in children and adolescent can induce lesions of the articular cartilage and extreme handicap. When conservative surgical strategies are with out profit, whole hip arthroplasty must be an alternate resolution.
Chronic ache, irregular social life and scolarity, stiffness and impossibility for osteotomies are the primary standards to determine and to decide on for an arthroplasty.Two most important teams of etiology are as comply with * group I considerations rhumatologie arthritis. Arthroplasty is determined with pediatricians, physiotherapists… Other joints are sometimes concerned and post-operative cares want intensive physiotherapy.
Femoral head necrosis of renal illness and sickle cell illness belong to this group.* group II considerations sequelae of earlier femoral osteotomy: septic osteoarthritis, extreme stiffness, sequelae of hip dislocation, necrosis of slipped capital epiphysiolysis…Since 1990, Dr J.L. Jouve has operated on 11 hips in sufferers aged for 14 to 20. Prosthesis used have been customized made, Symbios, Switzerland.Results group I: The customized made in this group is fascinating as a result of it’s apparent to take care of the biggest bony pool and to keep away from to ream the metaphysis and diaphysis. It can be essential to thinck in advance for additional process as a result of these sufferers are younger.
Technical surgical strategy is with none particularity, no case of fracture was seen. Post-operative weight-bearing was delayed for 45 days. With a brief follow-up of two years, outcomes are wonderful.Results group II: The customized made is necessery in these circumstances with an irregular morphology of the proximal femur and slender canal following earlier femoral osteotomies. Immediate outcomes are additionally wonderful.
Hip arthroplasty with customized made is a pleasant process when different surgical remedies should not doable. But additional research are needed with a bigger follow-up.Tumors Osteosarcoma and Ewing’s sarcoma wants typically vast resections of the proximal femur and reconstruction of the hip joint. In our expertise and ISOLS’ sequence, evidently following information are beneficial: – cemented full prosthesis of the femur resected and no allograft, – wonderful reconstruction of the muscle tissues of the hip: extensors, abductors and fascia lata, with out to attempt a fixation of those muscle tissues on the prosthesis – use of an acetabular cell cup to protect additional surgical procedure with, for exemple, an acetabular arthroplasty. Two circumstances of Ewing’s sarcoma are introduced, ladies aged 15 and 12.Length of the resection was 23 and 19 cm. Post-operative outcomes are good.
Comparison of anatomic vs. straight femoral stem design in whole hip alternative – femoral canal fill in vivo.
The femoral canal fill between an anatomic and a straight prosthesis design in cementless whole hip arthroplasty (THA) was in contrast. We hypothesised that the anatomic SPS stem has increased proximal fill and lesser distal fill than the straight stem.
The femoral canal fill was measured on Three months routine postoperative x-rays at 5 ranges of the stem in 50 consecutive sufferers, aged 35-83 years, who underwent 56 THA procedures by a single surgeon in this hospital. 22 sufferers obtained a straight design Ceramconcept Global stem, 34 sufferers obtained an anatomic design Symbios SPS stem. Both anteroposterior (AP) and lateral x-rays have been mixed to recommend a 3-D measurement.
On the AP x-rays, the canal fill was considerably increased utilizing the anatomic design stem on the proximal measurement ranges, and was considerably increased on the distal ranges utilizing the straight stem. With the AP and lateral x-rays mixed, the canal fill on the proximal ranges was additionally considerably increased in the anatomic teams, nonsignificantly decrease on the central stage and considerably decrease on the distal ranges.
In THA surgical procedure, attaining excessive fill on the metaphysis of the femur and much less fill on the diaphysis has been recommended to consequence in passable end result and excessive stability of the prosthesis. This research demonstrated that, in comparison with straight stem design, an anatomically designed stem has a considerably increased metaphyseal femoral canal fill.