Search

Background: Since femoral and horizontal offsets may be contributing factors to hip and pelvic balance, this study seeks to determine whether there is a correlation between pelvic obliquity (PO) after unilateral total hip arthroplasty (THA) and horizontal/vertical offset differences of the replaced and contralateral natural joints., Methods: A cross-sectional study was performed on adult patients who underwent unilateral THA between 2017 and 2020. An expert orthopaedic resident measured PO angles and offset parameters. "Delta medial offset" is considered medial offset of the replaced hip minus the medial offset of the contralateral side. "Absolute delta medial offset" is considered the absolute value of the "Delta medial offset.", Results: Finally, 133 patients were included in the study with a mean (SD) age of 45.3 ± 14.8 years and 57.9% female. The PO values (median, IQR) changed from 3.2 (1.7-5.7) before THA to 3.0 (1.50-5.6) after THA, not significantly decreased (P = 0.31). The PO after THA is significantly correlated with PO before THA (correlation coefficient of 0.457, P < 0.001), the delta medial offset after THA (correlation coefficient of - 0.24, P = 0.006), and the absolute delta medial offset after THA (correlation coefficient of 0.284, P = 0.001). The amount of changes of delta medial offset, before and after surgery, was not significantly correlated to PO or PO changes after surgery., Conclusion: PO before the THA and medial offset discrepancy after THA are two important contributing factors for post-operative PO. Restoring the medial offset of the affected side and lowering the delta medial offset between the two sides can significantly decrease post-operative PO., (© 2022. The Author(s) under exclusive licence to SICOT aisbl.)

Background: To determine the mid-term outcomes of conventional cementless Total Hip Arthroplasty (THA) in patients with avascular necrosis (AVN) of the femoral head and compare to patients with primary hip osteoarthritis (OA)., Method: A total of 330 consecutive primary THA procedures (AVN and OA) performed between 2010 and 2013 by a single surgeon and in a single center using the direct anterior approach (DAA) were included. Assessments including SF-36, WOMAC, and Harris Hip Scores (HHS) were retrieved from patients before the surgery and at the latest follow-up. Clinical and functional outcomes were compared between the AVN and OA groups., Results: A total of 294 consecutive THA (AVN = 107, OA = 187) with 104.4 ± 6.2 months follow-up were analyzed, which AVN patients were significantly younger (32.0 vs. 59.6 y/o). Corticosteroid 34 (31.8%), idiopathic AVN 31 (29.0%) and use of unapproved weight gain supplements (UWGS) 23 (21.5%) were the main reasons for AVN. Despite that preoperative scores were comparable ( P  > 0.05), the HHS, SF-36, and WOMAC scores are significantly higher in the AVN group after THA surgery ( P  < 0.05). Moreover, flexion and abduction ROM were significantly higher in the AVN group ( P  < 0.05). Regarding each complication, no significant difference was observed between groups. In the whole sample, there were 5 (1.7%) revisions due to loosening of acetabular components, all the OA group ( P  > 0.05)., Conclusion: Conventional cementless THA with highly cross-linked polyethylene provides satisfactory mid-term results in patients with AVN with a low rate of postoperative complications. Compared to primary OA patients, this group reaches superior postoperative scores., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Delhi Orthopedic Association. All rights reserved.)

We report a mass without neurologic findings and moderate pain in a 33-year-old male's wrist at the 3 rd zone of the ulnar nerve due to schwannoma that was excised successfully, and the patient was free of symptoms. We further discuss the prevalence and management of this lesion.