Tetsu Yamaguchi

Total hip arthroplasty: the relationship between posterolateral reconstruction, abductor muscle strength, and femoral offset.

Purpose. To evaluate the relationship between posterolateral reconstruction, abductor muscle strength, and femoral offset following total hip arthroplasty. Methods. Of 28 patients (56 limbs) we assessed, 12 underwent posterolateral reconstruction (reconstruction group) and 16 did not (non-reconstruction group). Isometric abductor muscle strength was measured with a handheld dynamometer. Each patients muscle strength was converted into a force to body weight ratio, and this ratio was used in the comparisons. Results. The reconstruction group showed a higher value in abductor muscle strength than the non-reconstruction group (p<0.05). Significant correlation between abductor muscle strength and femoral offset was found in the reconstruction group (p=0.016; r=0.674). Conclusion. Posterolateral reconstruction and appropriate reconstruction of femoral offset following total hip arthroplasty are important to improve the abductor muscle strength.

Cementless Total Hip Arthroplasty Using an Autograft of the Femoral Head for Marked Acetabular Dysplasia: Case Series

Purpose. To assess the short-term outcome of cementless total hip arthroplasty involving an autograft of the femoral head in Japanese patients. Methods. Cementless total hip arthroplasty with autogenous bone block grafting was performed on 18 hips in 15 patients with marked acetabular dysplasia. The resected femoral head was used as a graft for the superior-lateral region of the true acetabulum. Clinical outcome was correlated with the placement of the acetabular component, as revealed in radiographs. Results. The 13 women and 2 men had a mean age of 60.2 years (range, 37.0–73.0 years) at primary surgery and a mean follow-up duration of 3.3 years (range, 2.0–5.3 years). According to the classification of Crowe, 4 hips were in group I, 3 were in group II, one in group III, and 10 in group IV. The mean Harris Hip Score preoperatively was 45.7 (range, 19–69) and that at follow-up was 82.5 (range, 44–100). All 15 cases showed a good clinical outcome. There were no major intra-operative complications in this series. The grafted bones united in all patients. Two patients need surgical revision because the lateral insertion of the acetabular component resulted in loosening of it. Conclusion. Medial insertion of the acetabular component provides satisfactory short-term outcomes. Lateral insertion of the acetabular component during total hip arthroplasty should be avoided in patients with marked acetabular dysplasia.

Arthroscopic surgery for synovial chondromatosis of the hip: a report of two cases

AbstractWe have used arthroscopy in the treatment of synovial chondromatosis of the hip joint. Two patients complained of pain of the hip joint that was aggravated by weight bearing. On admission, range of motion of the affected hip joints was slightly restricted. At hip arthroscopy, osteochondral loose bodies were removed from the joint and partial synovectomy was performed. Histologic examination revealed synovial chondromatosis. Pain relief was obtained in both patients postoperatively.