Infantile DDH is diagnosed with neonatal examination and patients are routinely followed into adolescence. Adolescent/adult AD is not detected until symptoms develop. Further study is needed to determine whether younger family members of patients with hip osteoarthritis should be screened to detect potentially at-risk hips.
Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels of patients with FAI found no conclusive evidence to support a single disease-specific questionnaire. Using a systematic review of study methodology, the Copenhagen Hip and Groin Outcome Score and the 33-item International Hip Outcome Tool scored the best. Nevertheless, both of these instruments were developed recently and have not been established in the literature. Although currently used generic and activity-level measures have limitations, as well, they should be considered, depending on the specific goals of the study. Additional research is needed to assess the properties of these measures fully when used to evaluate patients with FAI.
Background Slipped capital femoral epiphysis (SCFE) is a common hip problem in adolescents that results in a camtype femoroacetabular impingement (FAI) deformity. Although the treatment for mild (slip angle of 0°-30°) and moderate (slip angle of 31°-60°) SCFE has historically been in situ fixation, recent studies have demonstrated impingement-related articular damage, irrespective of slip severity. Our series confirms previous reports that acetabular chondral injury occurs in mild to low-moderate (slip angle of B 40°) SCFE. Case Description We retrospectively reviewed five patients who underwent arthroscopy and femoral osteoplasty within 18 months after in situ stabilization. All had labral and/or acetabular damage. Literature Review Osteoarthritis rates after SCFE range from 24% to 92% at 11 to 28 years, depending on how osteoarthritis is defined. Long-term followup suggests patients have acceptable outcomes, but these studies are limited by heterogeneity and a ceiling effect from the instruments used to assess function. Although the femoral deformity remodels, it is unclear what secondary changes occur in the acetabulum. Recent investigations suggest patients are functionally limited after SCFE owing to FAI compared with controls.
Longer duration of surgery correlated with increased blood loss during PAO. Current guidelines recommend considering transfusion at haemoglobin ≤8 g/dL for postoperative patients. The median nadir post-HCT was 31% lower than the preoperative value, a ratio that may help determine the need for preoperative blood donation. This information facilitates future investigation of blood management with PAO.
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