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LCF in 2024 (October)

 

Publications about the LCF 2024 (October).

 

Gänsslen, A., Lindtner, R. A., Krappinger, D., & Franke, J. (2024). Pipkin fractures: fracture type-specific management. Archives of Orthopaedic and Trauma Surgery. 1-14. [i] link.springer.com

 

Vesey, R. M., MacDonald, A. A., Brick, M. J., Bacon, C. J., Foo, G. L., Lu, M., ... & Woodward, R. M. (2024). Imaging characteristics of hip joint microinstability: a case–control study of hip arthroscopy patients. Skeletal Radiology. 05 Oct: 1-11. [ii] link.springer.com

 

Wu, W., Liu, M., Zhou, C., Mao, H., Wu, H., Wu, Z., & Ma, C. (2024). Efficacy of Outside‐In Hip Arthroscopy without Traction in the Treatment of Hip Synovial Osteochondromatosis. Orthopaedic Surgery. 9999:n/a. [iii] onlinelibrary.wiley.com

 

Yang, J., Zhang, T., Zhu, X., He, Z., Jiang, X., & Yu, S. (2024). miRNA-223-5p Inhibits Hypoxia-induced Apoptosis of BMSCs and Promotes Repair in Legg-Calvé-Perthes Disease rabbit model by Targeting CHAC2 and Activating the Wnt/β-catenin Signaling Pathway. Research Square. doi.org/10.21203/rs.3.rs-5035545/v1. [iv] researchsquare.com

 

Conyer, R. T., Cleary, E. J., Wang, A. S., Boos, A. M., Crowe, M. M., Economopoulos, K. J., ... & Hevesi, M. (2024). A Multicenter Analysis of 3 Decades of Hip Arthroscopy: Evolving Techniques and Growing Patient Volumes From 1988 to 2022. Orthopaedic Journal of Sports Medicine. 10, 23259671241277793. [v]  journals.sagepub.com

 

Patel, S., Russo, M., Miller, D., Martin, H., Deb, S., & De, E. (2024). 298-Video Screening Exam to Determine Hip Etiologies of Chronic Pelvic Pain. Continence. 12, 101640. [vi] sciencedirect.com

 

Zhang, S., Gao, G., Zhou, X., Du, C., Zhu, Y., He, T. C., & Xu, Y. (2024). Development of a novel rabbit model for femoroacetabular impingement through surgically induced acetabular overcoverage. Journal of Orthopaedic Research. 13 October, doi.org/10.1002/jor.25994. [vii] onlinelibrary.wiley.com

 

Gao, G., Zhou, C., Zhou, G., He, S., Ju, Y., Wang, J., & Xu, Y. (2024). Clinical Outcomes of the Arthroscopic Capsular Suture-Lifting Technique in the Treatment of Femoroacetabular Impingement in Patients With Borderline Developmental Dysplasia of the Hip. Orthopaedic Journal of Sports Medicine. 12(10), 23259671241275661. [viii] journals.sagepub.com

 

Gianechini, F. A., Meso, J. G., Méndez, A. H., Garrido, A. C., & Filippi, L. S. (2024). A new maniraptoran femur with alvarezsaurian affinities from the Plottier Formation (Coniacian-Santonian), northern Patagonia. Historical Biology. 1-11. [ix]  tandfonline.com

  

KURTULUŞ, B. (2024). Comparison of treatment methods in patients with developmental dysplasia of the hip. Turkish Journal of Medical Sciences. 54(5), 1060-1070. [x] journals.tubitak.gov.tr

  

Sun, S., Li, Z., Zhang, C., Wu, Z., Guo, L., Yang, T., ... & Chen, D. (2024). Investigation of the Bone Repair Mechanism in Femoral Head Necrosis Promoted by Spleen-invigorating Huo-Gu Formula Via the MPET Model. Research Square. doi.org/10.21203/rs.3.rs-5241023/v1. [xi] researchsquare.com

 

Dharmshaktu, G. S. (2024). Ligament Teres Injury: An Uncommon Hip-Hop Hurt. Matrix Science Medica. 8(4), 95-96. [xii] Journals.lww.com

 

Kynigopoulou, Z., Shelley, S. L., Williamson, T. E., & Brusatte, S. L. (2024). The post-cranial anatomy and functional morphology of Conoryctes comma (Mammalia: Taeniodonta) from the Paleocene of North America. PloS one. 19(10), e0311053. [xiii] journals.plos.org

 

Wiak, I., Banyś, F., Czyżewski, F., Bochen, K., Dudek, S., Jasiński, F., ... & Wojtach, K. (2024). Hip Dysplasia in Adults: Surgical Correction vs. Conservative Treatment Options. Quality in Sport. 29, 55566-55566. [xiv] apcz.umk.pl

 

Roy, T., BASu, R., & BAiSAkhi, D. A. S. Morphological and Morphometric Variations of Fovea Capitis Femoris: A Cross-sectional Study from Kolkata, West Bengal, India. International Journal of Anatomy, Radiology and Surgery. 2024; Sep, 13(5): AO14-AO18. [xv] ijars.net

  

Domb, B. G., Wallace, I. A., & Becker, N. (2024) Editorial Commentary: Arthroscopic Treatment of Mild Hip Dysplasia Can Result in Excellent Outcome and Avoid More Invasive Periacetabular Osteotomy. Arthroscopy: The Journal of Arthroscopic and Related Surgery. doi.org/10.1016/j.arthro.2024.10.023. [xvi] arthroscopyjournal.org

 

                                                                     

NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7



[i] presents a Pipkin type II fracture with the femoral head fragment attached to the ligament of head of femur (ligamentum teres) (Fig. 1). …

Reason for an irreducible joint may be an avulsed ligament of the head of the femur, …

 

[ii] Labral tears, chondral loss, abnormal ligamentum teres, anterior capsule thinning, iliocapsularis to rectus femoris ratio, posterior crescent sign, cliff sign, and femoro-epiphyseal acetabular roof (FEAR) index were not associated with microinstabillity.

 

The function and significance of the ligamentum teres are debated; however, it is increasingly recognized as a secondary stabilizer of the hip joint, and biomechanical and surgical studies have suggested ligamentum teres injuries are associated with joint instability [40, 41]. While complete tears of the ligamentum teres are relatively rare, with the prevalence of up to 1.5% reported at arthroscopy [42], partial tears and other abnormalities such as hyperplasia are commonly reported at arthroscopy. Abnormal ligamentum teres on MR was not associated with hip microinstability in this study.

 

However, the other imaging findings on MR showed only fair or moderate agreement, except for abnormal ligamentum teres which showed no agreement, when assessed by experienced musculoskeletal radiologists. This is consistent with the published literature that has documented that many of these findings can be challenging to accurately detect on MR with limited or even poor reliability; diagnosis of ligamentum teres tear, especially chronic and partial tears, may be challenging on MR with poor sensitivity and specificity [24, 50, 51].

24. Blankenbaker DG, De Smet AA, Keene JS, Munoz del Rio A. Imaging appearance of the normal and partially torn ligamentum teres on hip MR athrography. Am J Roentgenol. 2012;199:1093–8.
40. Cerezal L, Kassarjian A, Canga A, Dobado MC, Montero JA, Llopis E, et al. Anatomy, biomechanics, imaging, and management of ligamentum teres injuries. Radiographics. 2010;30:1637–51.
41. Bardakos NV, Villar RN. The ligamentum teres of the adult hip. J Bone Joint Surg Br. 2009;91:8–15.
42. Chahla J, Soares EAM, Devitt BM, Peixoto LP, Goljan P, Briggs KK, et al. Ligamentum teres tears and femoroacetabular impingement: prevalence and preoperative findings. Arthrosc J Arthrosc Relat Surg. 2016;32:1293–7. 
50. Devitt BM, Philippon MJ, Goljan P, Peixoto LP, Briggs KK, Ho CP. Preoperative diagnosis of pathologic conditions of the ligamentum teres: is MRI a valuable imaging modality? Arthrosc J Arthrosc Relat Surg. 2014;30:568–74.
51. Datir A, Xing M, Kang J, Harkey P, Kakarala A, Carpenter WA, et al. Diagnostic utility of MRI and MR arthrography for detection of ligamentum teres tears: a retrospective analysis of 187 patients with hip pain. Am J Roentgenol. 2014;2203:418–23.

 

[iii] A complete diagnostic hip arthroscopy requires traction, especially for a comprehensive inspection of the direct weight-bearing cartilage, acetabular fossa, and ligamentum teres. Therefore, arthroscopy without traction was not effective in diagnosing and treating hip central compartment diseases such as FAI, acetabular cartilage injury, and loose bodies in the central compartment.

 

[iv] Wang et al. developed a juvenile rabbit model by disrupting the femoral round ligament [6]. Currently, many scholars predominantly use a piglet model of ischemic necrosis, which is established by placing a non-absorbable ligature tightly around the femoral neck to cut off the blood supply to the capital femoral epiphysis [7,37]. Due to the limitations of space, large-scale rearing of piglets is not feasible; therefore, we established a Perthes disease model using rabbits. Similar to the piglet model of Perthes disease, we cut the ligament of the femoral head and tightly ligated the base of the femoral neck with non-absorbable sutures. This method successfully created a rabbit model of Perthes disease.

 

The femoral head was dislocated, and the Ligamentum teres was cut, severing the blood supply. Using a curved clamp, non-absorbable sutures were placed around the femoral neck, severing the vascular supply. The hip was then reduced, and the wound was sutured.

6. Wang Z, He R, Tu B, et al. Drilling combined with adipose-derived stem cells and bone morphogenetic protein-2 to treat femoral head epiphyseal necrosis in juvenile rabbits[J]. Current Medical Science, 2018, 38(2): 277-288.
7. Martínez-Álvarez S, Galán-Olleros M, Azorín-Cuadrillero D, et al. Intraosseous injection of mesenchymal stem cells for the treatment of osteonecrosis of the immature femoral head and prevention of head deformity: A study in a pig model[J]. Science Progress, 2023, 106(2): 00368504231179790.
37. Upasani V V, Jeffords M E, Farnsworth C L, et al. Ischemic femoral head osteonecrosis in a piglet model causes three dimensional decrease in acetabular coverage[J]. Journal of Orthopaedic Research®, 2018, 36(4): 1173-1177. 


[v] Arthroscopic procedures included diagnostic arthroscopy, labral debridement, labral repair, labral reconstruction, capsular repair, cam resection, fractional iliopsoas lengthening, loose body removal, ligamentum teres debridement, trochanteric bursectomy, and abductor repair.

Figure 7. Trends in proportion of loose body removal, ligamentum teres debridement, iliopsoas release or fractional lengthening, and lateral hip procedures in true primary hip arthroscopies by year. (This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/ licenses/by-nc-nd/4.0/)

  

[vi] Flexion, adduction, and internal rotation of the leg in the supine position causing pelvic pain can indicate a premature osseous abutment (CAM) deformity. A supine flexion, adduction, internal rotation test can be used to determine internal hip impingement. The FABERS (flexion, abduction, and external rotation) can be used to screen the ligament of teres function, femoral anteversion, SI joint or some pubofemoral ligament contribution.

 

[vii] Upon completion of the imaging assessment, the joint capsule was incised and the round ligament was severed to expose the articular surface.

 

Our study confirmed that the novel rabbit FAI model created acetabular over coverage and produced articular cartilage injury at the impingement zone.

 

[viii] Arthroscopic procedures are detailed in Table 2.

Ligamentum teres debridement:  

Suture-Lifting Group 6 (7.8%) 

Control Group   5 (7.5%)

(Data are presented as numbers of patients, with percentages in parentheses.)

 

[ix] Other differences with MAU-Pv-PH-453 are the presence of a trochanteric shelf on the proximal and lateral surface of the bone, a posterior trochanter on the proximal posterolateral surface, and a groove for the ligamentum capitis femoris ...

 

[x] According to the findings detected during intraoperative OR (open reduction), the acetabulum was shallow in 52 (65.82%) hips. The teres ligament was intact and thickened in 62 (78.48%) hips. The ligamentum teres was ruptured in four (5.06%) and thinned in 13 (16.45%) hips. The limbus was inverted in 12 (15.18%) hips, everted in 46 (58.22%) hips, and normal in 21 (26.58%) hips. The posterior wall was inadequate in 18 (22.78%) hips. All patients treated with OR underwent iliopsoas tenotomy. They also all underwent careful capsulorrhaphy. Partial excision was performed in some of the hypertrophic capsules. If stabilization was deemed sufficient after OR, no additional intervention was performed.


[xi] The major branch group of the medial circumflex femoral artery, the retinacular artery, connects with the artery of the ligamentum teres within the femoral head, forming epiphyseal and metaphyseal arterial networks.

 

[xii] A 32-year-old male presented with an acute painful left hip region for the last 2 months following a minor misstep during hip-hop routine. The pain increases with weight-bearing and gets relieved by rest and pain medications. Radiographs were unremarkable with no underlying bony abnormality. Magnetic resonance imaging (MRI) revealed no bony injury except hyperintensity or edema surrounding the LT with the contralateral side unaffected [Figure 1]. Apart from the injury, there was also the anatomical difference between both the fovea capitis with the affected left side being deep and notched as compared to the right side.

On the basis of clinical and radiological findings, diagnosis of LT injury or sprain was made. A period of conservative methods including rest to the extremity and crutch use was advised along with pain medication on as and when required basis. After a period of 5 weeks, clinical improvement was noted, and with another 2 weeks of protected ambulation, the patient was having painless ambulation and range of motion.

...

This briefcase snippet is described here for the recognition of uncommon LT injury by appropriate investigation and clinical correlation. We advocate suspecting and keeping this injury as an uncommon differential diagnosis in cases with unexplained hip pain following the injury related with sports or recreational activity. Appropriate diagnosis results in optimal management, and the use of MRI helps in identifying subtle injuries of the ligamentous origin.


[xiii] Conoryctes has a continuous lunate surface that is subequal in width as seen in Stylinodon. There is a foramen in the pubic area of the acetabular fossa in Stylinodon where the ligamentum teres attached; Conoryctes lacks this foramen.

  

[xiv] Although hip arthroscopy was controversial until recently, advancements in tools and surgical techniques have made it an increasingly common method in orthopedics. This procedure allows for detailed visualization of the cartilage surfaces of the femur and acetabular labrum, and provides a view of the ligamentum teres, synovial membrane, and peri-trochanteric spaces.

 

[xv] CONCLUSION(S)

A detailed study of the morphology and morphometry of the FCF (Fovea Capitis Femoris) in the West Bengal population revealed that the most common shape of the fovea is oval, and its most frequent position is in the posterior-inferior quadrant of the femoral head. The mean values for the transverse diameter, vertical diameter, and DF were found to be 1.53±0.367 cm, 1.28±0.303 cm, and 0.304±0.141 cm, respectively. This data will contribute to the existing knowledge of anatomists, radiologists, and surgeons and may be useful in the planning and execution of surgical interventions involving the proximal end of the femur.


[xvi] Primary stability of the hip comes from bony coverage of the femoral head, influenced by acetabular version and femoral antetorsion. In addition, soft tissue structures such as the acetabular labrum, the ligamentum teres, and the hip capsule play a significant role in maintaining joint stability. Untreated hip instability may lead to pathological force transmission between the acetabular socket and femoral head, and subluxation resulting in osteoarthritis.

 

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