Conversion total hip arthroplasty after previous transtrochanteric rotational osteotomy for osteonecrosis of the femoral head.

The results of conversion total hip arthroplasty (THA) after failed transtrochanteric rotational osteotomy (TRO) are still controversial. We retrospectively reviewed 18 patients with ONFHs who had been treated previously by TRO and were later converted to THAs (conversion group). We made a matched control group of 18 primary THAs for ONFH done by same hip surgeon (PTHA group). There was an improvement in the Harris hip score and WOMAC score at the final follow-up but the improvement was not statistically significant between the two groups. Only internal rotation was significantly better in the PTHA group than in the conversion group. THA after TRO provides satisfactory clinical and radiological outcomes with no significant increase in perioperative morbidity in comparison with that in the primary THA.

Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting.

Comparison of the Outcome in Bilateral Staged Total Hip Arthroplasty: Modified Two-Incision Minimally Invasive Technique versus the Conventional Posterolateral Approach.

This retrospective study was undertaken to compare the outcomes of staged bilateral total hip arthroplasty (THA) by the conventional approach with those of two-incision minimally invasive (MIS-2) THA in terms of clinical and radiological results, complications, and patient preferences. Twenty-two patients aged 30 to 80 years underwent staged bilateral THA. The conventional posterolateral approach was used on the first hips treated and a modified MIS-2 approach on the second hips. The mean time between the first and second procedures was 73.8 months, and the patients were followed up for at least 12 months after both procedures. At the last follow-up visits, THA via the MIS-2 approach was found to provide significantly earlier partial-weight-bearing ambulation, better postoperative Harris hip scores, and better ability to sit cross-legged and was found to be more preferred by patients than conventional THA. There were no significant differences in the complication rates for the two approaches. The present results show that MIS-2 THA is as safe as the conventional posterolateral approach in experienced hands and presents no additional complication risks.