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. 10 Sedel L , Kerboull L , Christel P , Meunier A , Witvoet J . Alumina-on-alumina hip replacement. Results and survivorship in young patients . J Bone Joint Surg [Br] 1990 ; 72 : 658 - 63 . PMID
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remains for patient selection. Outpatient TKA has been performed thus far in relatively young patients with few comorbidities. Although Gogineni et al have reported that predictors of successful SDD are duration of surgery and first ambulation distance
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achieved in the general population, but the outcomes of THA in young and active patients remain poorer than those in their older counterparts. 3 - 5 Poorer survivorships in young patients have been attributed to wear of conventional polyethylene (PE
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Department of Orthopaedic Surgery, International Knee and Joint Centre, Abu Dhabi, UAE
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Treatment of complex epiphyseal fractures is multifaceted and challenging. Today, especially in young patients, the first choice of treatment remains open reduction and internal fixation. Management of these fractures in the osteoporotic elderly is more
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fourth to the sixth decades of life. 1 , 2 Incidence Chondrosarcomas are very uncommon in children and adolescents and there are very few studies that specifically discuss extremity chondrosarcomas in young patients. 3 – 7 A nationwide
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Introduction Lumbosacral and sacral fractures are rare features that occur mostly after high-energy trauma in young patients ( 1 , 2 ). In the context of this trauma, they are frequently associated with visceral lesions (brain, chest, abdomen
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for young patients when trying to relieve pain and restore function, and when attempting to reduce risk of secondary OA in the hip. DDH is believed to be an osseous abnormality resulting in a pathological painful labral complex and musculotendinous
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malleolus has a residual of less than 3 cm, bone and soft tissue reconstruction should be preferred, also in young patients ( 18 ). Figure 8 Artistic drawing realized by AA shows techniques of ankle arthrodesis: (A) retrograde nail for
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Casa di Cura Villa Betania, Rome, Italy
Marrelli Hospital, Crotone, Italy
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results in good to excellent clinical results regardless of the surgical techniques performed, and the complication and failure rates are also negligible in this case. Due care must be given to femoral and tibial tunnel convergence. In young patients with
Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
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Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
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Institute of Orthopaedics and Musculoskeletal Science, University College London, United Kingdom
Cleveland Clinic London, United Kingdom
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CT is the principal imaging modality used for the pre-operative 3D planning and assessment of total hip arthroplasty (THA).
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The image quality offered by CT has a radiation penalty to the patient. Higher than necessary radiation exposure is of particular concern when imaging young patients and women of childbearing age, due to the greater risk of radiation-induced cancer in this group.
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A harmonised low-dose CT protocol is needed, evidenced by the huge variability in the 17 protocols reviewed. The majority of the protocols were incomplete, leading to uncertainty among radiographers when performing the scans.
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Only three protocols (20%) were optimised for both ‘field of view’ and image acquisition parameters. 10 protocols (60%) were optimised for ‘field of view’ only. These protocols included imaging of the relevant landmarks in the bony pelvis in addition to the knees – the reference for femoral anteversion.
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CT parameters, including the scanner kilovoltage (kV), milliamperage–time product (mAs) and slice thickness, must be optimised with a ‘field of view’ that includes the relevant bony landmarks. The recommended kV and mAs values were very wide ranging from 100 to 150 and from 100 to 250, respectively.
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The large variability that exists amongst the CT protocols illustrates the need for a more consistent low-dose CT protocol for the planning of THA. This must provide an optimal balance between image quality and radiation dose to the patient.
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Current CT scanners do not allow for measurements of functional pelvic orientation and additional upright imaging modalities are needed to augment them.
