Displaying publications 1 - 20 of 26 in total

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  1. Malerba G, Basilico M, Bonfiglio N, Maccauro G
    Malays Orthop J, 2020 Nov;14(3):177-179.
    PMID: 33403082 DOI: 10.5704/MOJ.2011.029
    Isolated apophyseal avulsion of the greater trochanter is a rare condition in the paediatric population, frequently related to avascular necrosis of the femoral head. Since there are few cases in the literature, there is no consensus regarding the best treatment of this injury. Our study describes the case of a 9-year-old patient with an avulsion of the right greater trochanter. A minimally invasive osteosynthesis was performed, achieving complete clinical and radiographic healing of the patient and no long-term complications after four years.
    Matched MeSH terms: Femur Head; Femur Head Necrosis
  2. Hassan Shukur M
    Med J Malaysia, 2006 Feb;61 Suppl A:1-2.
    PMID: 17042219
    In this issue of the Journal, there are two articles addressing relevant clinical problems that we may encounter in our practice. The main issue related to the occurrence of the inevitability of the avascular necrosis (AVN) following treatment of two different major types of capital femoral epiphyseal 'injury'.
    Matched MeSH terms: Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology; Femur Head Necrosis/prevention & control
  3. Aminudin CA, Suhail A, Shukur MH, Yeap JK
    Med J Malaysia, 2006 Feb;61 Suppl A:94-6.
    PMID: 17042240
    Acute traumatic transphyseal fracture of the capital femoral epiphysis is a rare but serious injury. The injury is typically inflicted by a severe trauma. Because of the vulnerability and predisposed anatomy of the femoral epiphysis in relation to its blood supply, the fracture has been designated to have poor prognosis with inevitable osteonecrosis and eventual deformity of the hip. We report a case of such fracture in a 13-year-old child in view to highlight some of the anticipated problems in the management of such injury.
    Matched MeSH terms: Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology; Femur Head Necrosis/prevention & control
  4. Gharanizadeh K, Sharifi AM, Tayyebi H, Heidari R, Amiri S, Noorigaravand S
    BMC Pharmacol Toxicol, 2023 Sep 05;24(1):44.
    PMID: 37670365 DOI: 10.1186/s40360-023-00682-x
    BACKGROUND: Deferoxamine (DFO) angiogenesis induction potential has been demonstrated in earlier studies, but not in the osteonecrosis of the femoral head (ONFH). In this study, we evaluated the outcome of ONFH treated with combined core decompression and local DFO administration loaded on Polylactic Glycolic Acid (PLGA).

    PATIENTS AND METHODS: In a pilot experimental study, six patients (10 hips) with early-stage non-traumatic ONFH were treated by core decompression, and concurrent injection of local DFO loaded on PLGA scaffold into the subchondral femoral head. Outcome measures were evaluated before the surgery and 12 and 24 months after the surgery and included visual analog scale (VAS) for pain, modified Merle d'Aubigné-Postel (MAP) score for hip function by MRI, and rate of osteonecrosis assessed by the modified.

    RESULTS: The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P 

    Matched MeSH terms: Femur Head
  5. Kamarulzaman MA, Abdul Halim AR, Ibrahim S
    Med J Malaysia, 2006 Feb;61 Suppl A:71-8.
    PMID: 17042235
    Slipped capital femoral epiphysis (SCFE) is a relatively uncommon hip disorder in adolescents and its prevalence in Malaysia has not been studied. This retrospective study is undertaken to provide an overview of a 12-year review of SCFE treated in our institution. Fourteen patients (19 hips) with slipped capital femoral epiphysis (SCFE) admitted to Hospital UKM from 1990 to 2002 were reviewed with respect to demographic profile, functional outcome according to the Iowa Hip Score, and complications. There were ten boys (average age, 12.5 years) and four girls (average age, 12 years). Eight were Malays and six were Indians. The average body mass index was 26.1 verweight). The left hips (11 hips) were affected more than the right hips (eight hips). Five patients had bilateral slips. Thirteen hips were considered stable while the other six hips were unstable. The majority of cases were moderate slips (12 hips), four hips had severe slips while three hips had mild slips. Several methods of treatment were instituted. These include in situ cannulated screw fixation (11 hips), Knowles pin fixation (three hips) and gentle closed manipulative reduction with cannulated screw fixation (three hips). One patient with bilateral slips refused surgical treatment. Based on the Iowa Hip Score, most patients (nine) had satisfactory results (excellent or good), three had fair results while one patient had a poor result. Avascular necrosis developed in five hips while chondrolysis occurred in one hip. In situ cannulated screw fixation is the treatment of choice. SCFE is an uncommon condition in Malaysia.
    Matched MeSH terms: Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology
  6. Dhillon KS
    Med J Malaysia, 1985 Mar;40(1):41-3.
    PMID: 3831734
    Neonatal epiphyseal separatton of the head of femur is a rare obstetrical injury. This is confused with the more common proximal femoral metaphysical fracture, dislocation of hip or even an infection. Such a case is reported in this paper. Management was conservative, with abduction splint for three weeks and the outcome was satisfactory.
    Matched MeSH terms: Femur Head/injuries*
  7. Manuel JK, Yusof Bin Mohd M
    Am. J. Phys. Anthropol., 1974 Jul;41(1):133-7.
    PMID: 4843090
    Matched MeSH terms: Femur Head/anatomy & histology
  8. Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Mohd Noor A
    Biomed Res Int, 2014;2014:692328.
    PMID: 25025068 DOI: 10.1155/2014/692328
    A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.
    Matched MeSH terms: Femur Head/anatomy & histology*; Femur Head/pathology; Femur Head/radiography
  9. Aytekin K, Esenyel CZ
    Malays Orthop J, 2018 Mar;12(1):45-47.
    PMID: 29725513 DOI: 10.5704/MOJ.1803.010
    Hip arthroplasty is an extremely satisfying treatment method for coxarthrosis which is in increasing use throughout the world. However, loosening of the prosthesis is a significant complication and to overcome this, ceramic liners are increasingly being selected. If the survival of ceramic surfaces is prolonged, there is a risk of fracture of the ceramic materials. New ceramic materials developed to overcome this problem are more resistant. The case presented here is of a patient in whom liner fracture developed following ceramic-ceramic hip arthroplasty. The ceramic femoral head was observed to have protruded into the defect created in the acetabular component. Acetabular revision was applied to the patient.
    Matched MeSH terms: Femur Head
  10. Lee CK, Kwan MK, Merican AM, Ng WM, Saw LB, Teh KK, et al.
    Singapore Med J, 2014 Aug;55(8):436-8.
    PMID: 25189306
    INTRODUCTION: Hip arthroplasty is commonly performed worldwide. The objective of this study was to determine the diameter of the femoral head in the Malaysian population in relation to gender and race (i.e. among Malay, Chinese and Indian patients).

    METHODS: This was a retrospective cross-sectional study performed between January 1995 and December 2006, evaluating the femoral head diameters of all patients aged 50 years and above who underwent hemiarthroplasty at two major hospitals in Malaysia.

    RESULTS: A total of 945 femoral heads (663 women, 282 men) were evaluated. The mean age of the patients in our cohort was 75.2 ± 9.4 (range 50-101) years. The mean femoral head diameter (with intact articular cartilage) was 44.9 ± 3.2 (range 38-54) mm. In our study, men had a significantly larger mean femoral head diameter than women (47.7 ± 2.8 mm vs. 43.7 ± 2.4 mm; p < 0.05). Patients of Chinese ethnicity were also found to have significantly larger femoral head diameters, when compared among the three races studied (p < 0.05).

    CONCLUSION: Malaysians have a mean femoral head diameter of 44.9 ± 3.2 mm. Among our patients, Chinese patients had a significantly larger femoral head size than Malay and Indian patients. We also found that, in our cohort, men had significantly larger femoral head diameters than women.
    Matched MeSH terms: Femur Head/anatomy & histology*; Femur Head/pathology
  11. Mohamad JA, Kwan MK, Merican AM, Abbas AA, Kamari ZH, Hisa MK, et al.
    Med J Malaysia, 2004 Dec;59 Suppl F:3-7.
    PMID: 15941153
    We report our early experience of 20 cases of metal on metal articulation total hip arthroplasty in 19 young patients. Avascular necrosis of the femoral head (63%) was the commonest diagnosis for patients undergoing this procedure, followed by osteoarthritis (21%). In general, most of the patients were young and physically active with an average age of 43.1 years (range, 25 to 58 years). The average follow-up period was 18 months (range, 7 to 46 months). The mean total Harris Hip Score preoperatively and at final follow-up was 31 points and 89 points respectively. The mean total Pain Score improved from an average of 11.5 to 41.1 points at final follow-up. Sixteen (84%) of the patients had a good to excellent hip score. There was one dislocation, which stabilized after reduction and conservative management. One case of early infection underwent a two-staged revision.
    Matched MeSH terms: Femur Head Necrosis/radiography; Femur Head Necrosis/surgery
  12. Teh KH, Ruben JK, Chan CK, Abbas AA
    Malays Orthop J, 2020 Jul;14(2):134-137.
    PMID: 32983389 DOI: 10.5704/MOJ.2007.022
    Avascular necrosis and non-union are two most dreaded complications of femoral neck fracture fixations. Hip replacement seems to be a simple solution for this complex problem. However, the long-term efficacy of prosthetic replacement in the young population with higher functional demand is still questionable. Femoral head preserving valgus subtrochanteric osteotomies in properly selected cases have strong support from literature. The conventional technique of valgus subtrochanteric osteotomy involves lateral based wedge resection. Alternatively, a simpler sliding oblique subtrochanteric osteotomy without any wedge removal can also be performed. We hereby describe a successful case of sliding subtrochanteric osteotomy with 135° dynamic hip screw (DHS) plate fixation in treating non-union neck of femur fracture in a young gentleman.
    Matched MeSH terms: Femur Head
  13. Kamath SU, Agarwal S, Austine J
    Malays Orthop J, 2020 Nov;14(3):143-150.
    PMID: 33403075 DOI: 10.5704/MOJ.2011.022
    Introduction: With a higher proportion of young individuals undergoing uncemented hip arthroplasty, a close match in the dimension of the proximal femur and the implanted prosthesis is paramount. This is a study to gain insight into geographical variation in proximal femur morphology to determine the reference values to design uncemented femoral stems for a south Indian population, and also the effect of ageing and gender on the proximal femur morphology.

    Materials and Methods: The study comprised of two groups. For the first group, 50 unpaired dry femur bones were obtained from adult human cadavers; and the second group was a clinical group of 50 adult patients. Standardised radiographic techniques were used to measure the extra-cortical and intra-cortical morphometric parameters. Based on these, dimensionless ratios were calculated to express the shape of the proximal femur. The data were expressed in terms of mean and standard deviation and a comparison made with other studies.

    Results: A significant difference was noted across various population subsets within the Indian subcontinent and also in comparison to the Western population, suggestive of regional variation. The measurements made in cadaveric bone differed significantly from those in live patients, especially the femoral head diameter and extra-cortical and intra-cortical width. Femoral offset, head height and diameter were significantly less in females.

    Conclusion: The south Indian population needs customised implants with an increase in neck shaft angle and a decrease in intra-cortical and extra-cortical width for press fit in hip arthroplasty. The variation between the two sexes must also be accounted for during prosthesis design.

    Matched MeSH terms: Femur Head
  14. Solehuddin Shuib, Sahari, B.B., Wong, Shaw Voon, Arumugam, Manohar, Halim Kadarman, A.
    MyJurnal
    Bone is a living tissue. It continuously reproduces its structure and its growth depends partly upon the applied mechanical load. After an implant is inserted, the load equilibrium is disturbed, leading to bone resorption and the stress shielding phenomena. Aseptic loosening is the main contributor for hip prosthesis failure. The purpose of the study is to determine the effect of bone resorption on the stress values and hence obtain a better understanding of the behavior of the stress adaptive bone-remodeling. The bone material used for the analysis was assumed to be isotropic and linearly elastic, and the external loads applied comprised of a femoral head load and an abductor load. A Finite element computer program for evaluating the changes in bone's density and modulus was developed. The values of stress for bone, cement mantle in medial, and lateral positions of Total Hip Replacement (THR) are presented. The failure mechanisms of THR with bone resorption observed the implant loosening since stress is reduced.
    Matched MeSH terms: Femur Head
  15. Abbas, A.A., Merican, A.M., Mohamad, J.A.
    Malays Orthop J, 2007;1(1):5-7.
    MyJurnal
    We report the outcome of 32 patients who underwent total hip replacement (THR) augmented with morsellized fresh frozen femoral head allografts and acetabular reconstruction cages. Nine patients underwent primary THR and 23 patients underwent revision THR. Follow-up ranged from two to 9 years. Two most common indications for the procedures as reported in literature were rheumatoid arthritis and aseptic loosening of the hip. All but one patient achieved good outcome with radiographs showing full incorporation of bone grafts and no evidence of loosening of the implants. Morsellized bone grafting used with acetabular reinforcement devices is valuable for addressing severe acetabular deficiencies.
    Matched MeSH terms: Femur Head
  16. Law GW, Koh J, Yew A, Howe TS
    Malays Orthop J, 2020 Mar;14(1):7-17.
    PMID: 32296476 DOI: 10.5704/MOJ.2003.002
    Introduction: Medial migration is the paradoxical migration of the femoral neck element (FNE) superomedially against gravity with respect to the intramedullary component of the cephalomedullary device, increasingly seen in the management of pertrochanteric hip fractures with the intramedullary nail. We postulate that the peculiar anti-gravity movement of the FNE in the medial migration phenomenon stems from a ratcheting mechanism at the intramedullary nail-FNE interface, which should inadvertently produce unique wear patterns on the FNE that can be seen with high-powered microscopy. By examining the wear patterns on retrieved implants from patients with medial migration, our study aims to draw clinical correlations to the ratcheting mechanism hypothesis.

    Material and Methods: Four FNEs were retrieved from revision surgeries of four patients with prior intramedullary nail fixation of their pertrochanteric hip fractures complicated by femoral head perforation. The FNEs were divided into two groups based on whether or not there was radiographic evidence of medial migration prior to the revisions. Wear patterns on the FNEs were then assessed using both scanning electron microscopy and light microscopy.

    Results: Repetitive, linearly-arranged, regularly-spaced, unique transverse scratch marks were found only in the group with medial migration, corresponding to the specific segment of the FNE that passed through the intramedullary component of the PFNA during medial migration. These scratch marks were absent in the group without medial migration.

    Conclusion: Our findings are in support of a ratcheting mechanism behind the medial migration phenomenon with repetitive toggling at the intramedullary nail-FNE interface and progressive propagation of the FNE against gravity.

    Matched MeSH terms: Femur Head
  17. Maj MK, Ar AH, Das S
    Chang Gung Med J, 2011;34(6 Suppl):13-6.
    PMID: 22490452
    A slipped upper femoral epiphysis (SUFE) is a known hip disorder in adolescents in which the proximal femoral epiphysis slips and displaces relative to the metaphysis. We report an obese 12-year-old boy who presented with acute pain in the left hip after a fall. He was otherwise healthy with no prior joint pain. Pelvic radiography was misread twice before a second fall led to a severe SUFE.
    Matched MeSH terms: Femur Head/radiography*
  18. Ramdhan Ibrahim MA, Kamegaya M, Morita M, Saisu T, Kakizaki J, Oikawa Y
    J Pediatr Orthop B, 2020 May;29(3):261-267.
    PMID: 31688334 DOI: 10.1097/BPB.0000000000000681
    Shelf acetabuloplasty continues to be effective in the prevention or delay of osteoarthritis in adolescent dysplastic hips. We aimed to evaluate the efficacy and to determine the correct level of the bone graft objectively. We retrospectively analyzed 16 hips underwent Shelf acetabuloplasty originated by Spitzy. The mean age at surgery was 15.3 years old with the mean caput index at 39.7%. The average follow-up was 11 years. The radiological evaluation was based on acetabular-head index (AHI) at preoperative and latest radiographs, acetabular-Shelf distance (ASD) and Shelf-head ratio at immediate postoperative and latest radiographs. The cutoff value for the ideal ASD was determined by receiver operating characteristic (ROC) and the Pearson correlation test used in statistical analysis to assess the relationship between ASD and Shelf graft resorption. Clinical evaluation was performed using Harris Hip Score (HHS) at the latest follow-up. The AHI was improved in all cases, from mean 56.9 to 91.0% (P 
    Matched MeSH terms: Femur Head/surgery*
  19. Baharuddin MY, Salleh ShH, Hamedi M, Zulkifly AH, Lee MH, Mohd Noor A, et al.
    Biomed Res Int, 2014;2014:478248.
    PMID: 24800230 DOI: 10.1155/2014/478248
    Stress shielding and micromotion are two major issues which determine the success of newly designed cementless femoral stems. The correlation of experimental validation with finite element analysis (FEA) is commonly used to evaluate the stress distribution and fixation stability of the stem within the femoral canal. This paper focused on the applications of feature extraction and pattern recognition using support vector machine (SVM) to determine the primary stability of the implant. We measured strain with triaxial rosette at the metaphyseal region and micromotion with linear variable direct transducer proximally and distally using composite femora. The root mean squares technique is used to feed the classifier which provides maximum likelihood estimation of amplitude, and radial basis function is used as the kernel parameter which mapped the datasets into separable hyperplanes. The results showed 100% pattern recognition accuracy using SVM for both strain and micromotion. This indicates that DSP could be applied in determining the femoral stem primary stability with high pattern recognition accuracy in biomechanical testing.
    Matched MeSH terms: Femur Head/physiopathology*; Femur Head/surgery
  20. Park KS, Chan CK, Lee DH, Yoon TR
    Indian J Orthop, 2018 8 7;52(4):369-373.
    PMID: 30078894 DOI: 10.4103/ortho.IJOrtho_494_16
    Background: Conversion from failed bipolar hemiarthroplasty (HA) to total hip arthroplasty (THA) presents a great challenge to orthopedic surgeons for bipolar head removal and cup placement with or without change of femoral stem. Conversion THA after failed bipolar arthroplasty is known to offer both symptomatic and functional improvement. This study evaluates the midterm functional outcome and complications, especially dislocation associated with femoral head diameter, after conversion THA.

    Materials and Methods: Forty eight hips with the conversion of bipolar HA to THA were followed up for an average 6.2 years (range 2.0-11.5 years). Twenty one hips had conversion surgery to THA using metal-on-metal articulation (28 or 32 mm head). Nine hips used ceramic-on-ceramic (28-40 mm) and eighteen hips used large head metal-on-metal bearing (>40 mm). Outcome was evaluated using Harris Hip Score (HHS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) score. The radiographs were analyzed for evidence of osteolysis and/or loosening. The complications were evaluated, especially dislocation with different femoral head diameter.

    Results: Average HHS significantly improved from 42 preoperatively to 86 postoperatively and the average WOMAC score also significantly improved from 47 to 22 postoperatively. Radiological evaluation showed all the femoral components were stable. There was one acetabular component loosening, which required revision 9 years after conversion to THA. One dislocation and one recurrent dislocation were recorded in isolated acetabular revision hip; whereas one dislocation, one recurrent dislocation, and one trochanteric nonunion occurred in the hips with revision of both components. All dislocations occurred in hips with a femoral head size of 28 mm (P = 0.052). The cup and femoral head interval length was the most significant factor contributing to dislocation (P = 0.013).

    Conclusions: Conversion THA after failed bipolar HA offers a reliable pain relief and functional improvement. To prevent dislocation, it is highly recommended to use a larger diameter femoral head, especially where the cup size is big.

    Matched MeSH terms: Femur Head
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