Remplissage is a safe, relatively short procedure that allows the surgeon to address large humeral defects with a low postoperative recurrence rate. Humeral head large defects predispose to recurrent instability of the shoulder and deserve surgical management.
BackgroundTo analyse the prevalences of the cam and pincer morphologies in a cohort of patients with groin pain syndrome caused by inguinal pathologies.Materials and methodsForty-four patients (40 men and 4 women) who suffered from groin pain syndrome were enrolled in the study. All the patients were radiographically and clinically evaluated following a standardised protocol established by the First Groin Pain Syndrome Italian Consensus Conference on Terminology, Clinical Evaluation and Imaging Assessment in Groin Pain in Athlete. Subsequently, all of the subjects underwent a laparoscopic repair of the posterior inguinal wall.ResultsThe study demonstrated an association between the cam morphology and inguinal pathologies in 88.6% of the cases (39 subjects). This relationship may be explained by noting that the cam morphology leads to biomechanical stress at the posterior inguinal wall level.ConclusionsAthletic subjects who present the cam morphology may be considered a population at risk of developing inguinal pathologies.Level of evidenceLevel IV, Observational cross-sectional study.
Injuries of the rectus femoris tendon origin could result in a chronic tendinopathy, leading to groin pain and loss of function.Conservative treatment with analgesics and physical therapy is the gold standard, but in some cases excessive bone formation after avulsion injuries, can lead to a post-traumatic heterotopic ossification (PHO) and may benefit from surgical removal. Methods: Outcome was evaluated in 16 top soccer players (age 24-43 years) affected by calcification of the proximal rectus who underwent arthroscopic excision (6-12 and 24 months). X-ray and 3D CT was collected for all patients. Hip disability and Osteoarthritis Outcome Score, Oxford Hip Score, Modified Harris Hip Score, together with visual analog scales (VAS) for pain, sport activity level (SAL), and activities of daily living (ADL) were used to evaluate clinical outcome.Technical procedure: after central compartment examination and treatment was accomplished, attention was focused to the ossification of the rectus femoris. A complete exposure of the ossification was achieved; when possible attention was taken in detaching the minimum amount of fibers of the direct head of the rectus femoris from its insertion site. During the entire procedure, both dynamic direct visualization and fluoroscopic evaluation of the amount of resection were performed. Results: Clinical outcome was excellent; the percentage of return to pre-injury level sport was 68.75 % (11 athletes), with significant statistical improvement of MHHS, OHS and all 3 VAS subscales in all patients at 2 years follow-up. Conclusion: Arthroscopic removal using conventional hip arthroscopic portals represent both effective and safe procedure to adequately treat post-traumatic ossification of the rectus femoris.
The standard arthroscopic treatment of FAI resulted in satisfactory persistent symptom relief for about 70% of patients. No or minimal osteoarthritis, short time elapsed from the appearance of symptoms and high preoperative modified Harris Hip Score are independent predictive factors of SMO. The FAI-POPS is obtained as sum of 3 odds ratios corresponding to the above prognostic factors and is a useful predictor of mid-term outcome after conventional arthroscopic FAI treatment.
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