Browsing by Subject "Hip Dislocation"
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Item Quantifying Differences in Femoral Head and Neck Asphericity in the Common Hip Conditions of Femoroacetabular Impingement (FAI) and Hip Dysplasia Versus Controls Using Radial 3DCT Imaging and Volumetric Segmentation(2018-01-23) Schauwecker, Natalie; Xi, Yin; Slepicka, Chenelle; Dessouky, Riham; Fey, Nicholas; Chatzinoff, Yonatan; Chopra, Rajiv; Wells, Joel; Chhabra, AvneeshAIM: 3DCT analysis of femoral head and bump anatomy in quantifying pathology in common hip conditions of FAI and hip dysplasia versus controls. Material and Methods: Consecutive patients who obtained 3DCT imaging for hip dysplasia or FAI were compared to asymptomatic controls. Alpha angles on radial CT and 3D volumetric femoral head and bump segmentations were obtained by two readers. Inter- and intra-patient comparisons were performed including inter-reader and ROC analyses. RESULTS: 25 FAI patients, 16 hip dysplasia patients and 38 controls were analyzed. FAI and dysplasia patients exhibited higher alpha angles and higher bump-head volume ratios than the controls (p<0.05). FAI patients exhibited larger bumps than dysplasia and the contralateral hips of FAI were also different than the controls. Alpha angle at 2 oメclock and bump to head ratio showed the highest area under the curve for cases versus controls. The reader reliability was better for volumetric segmentation (ICC= 0.35-0.84) as compared to the alpha angles (ICC= 0.11-0.44). CONCLUSION: Patients with both FAI and dysplasia exhibit different femoral head anatomy than the asymptomatic controls. Volumetric segmentation of femoral head and bump is more reliable and better demonstrates the bilateral femoral head anatomy differences of cases versus controls.Item The Relationship between Pre-Operative Pain Characteristics and Periacetabular Osteotomy Outcomes in Patients with Acetabular Dysplasia(2022-02-01) Everett, Brandon; Nakonezny, Paul A.; Mulligan, Edward P.; Chhabra, Avneesh; Wells, JoelINTRODUCTION: Bernese Periacetabular Osteotomy (PAO) is widely performed for patients with acetabular dysplasia, however the relationship between preoperative pain characteristics and patient-reported outcome measures (PROM) is not well-studied. AIMS: (1) Does maximum severity of pain in a location other than the groin that is greater or equal to that of the groin affect PROM? (2) Does the presence of nongroin pain affect PROM? (3) Does the severity of pain affect PROM? (4) Does the number of pain locations affect PROM? METHODS: We reviewed 52 hips (48 patients) treated with PAO for acetabular dysplasia from February 2017 to July 2020, using modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and international Hip Outcome Tool (iHOT-12) score, radiographic analysis, and pain location/severity questionnaires. Descriptive statistics, Analysis of Covariance (ANCOVA), and Spearman partial correlation coefficients were implemented. RESULTS: Twenty-six hips experienced the most severe pre-operative pain in the groin, and 26 hips experienced equal or greater pain in a non-groin location. Outcome scores between these groups were not significantly different (mHHS P = .59, HOS P = .48, iHOT-12 P = .99). Additionally, the presence of pre-operative pain in any non-groin location had no significant relationship with PROM (all Pvalues ≥ .14). Furthermore, the maximum severity of pre-operative pain and number of pain locations showed no significant relationship with PROM (maximum severity: mHHS P = .82, HOS P = .99, iHOT-12 P = .36; number of pain locations: mHHS P = .56, HOS P = 0.10, iHOT-12 P = 0.62). DISCUSSION: Location of most severe pre-operative pain and the presence of nongroin pain in a patient with acetabular dysplasia does not adversely affect PROM. Additionally, increased pain severity and pain locations does not appear to have any significant impact on outcomes. Therefore, a wide array of patients with acetabular dysplasia might expect similar, favorable outcomes from PAO regardless of pre-operative pain characteristics. CLINICAL RELEVANCE: This study attempts to fill a current gap in knowledge that could help orthopaedic surgeons better understand the relationship between pain location and hip outcomes for patients following PAO.