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PubMed2001

Regional material properties of the human hip joint capsule ligaments.

The hip joint capsule functions to constrain translation between the femur and acetabulum while allowing rotational and planar movements. Despite the crucial role it plays in the pathogenesis of hip instability, little is known about its biomechanical properties. The goal of this study was to determine the regional material properties of the iliofemoral and ischiofemoral ligaments of the capsule. Ten human cadaveric specimens of each ligament were tested to failure in tension. The stress at failure, strain at failure, strain energy density at failure, toe- and linear-region elastic moduli, and the Poisson's ratio were measured for each ligament. The strain to failure was greatest in the ischiofemoral ligament, while no significant difference was noted in failure stress by region or ligament. The Young's moduli of elasticity ranged from 76.1 to 285.8 MPa among the different ligaments, and were generally consistent with properties previously reported for the shoulder capsule. The elastic moduli and strain energy density at failure differed by region. No significant differences in Poisson's ratio were found by region or ligament. The average Poisson's ratio was approximately 1.4, consistent with anisotropic behavior of ligamentous tissues. Understanding the material properties of the hip capsule may help the orthopaedic surgeon better understand normal ligament function, and thereby choose a surgical approach or strategy of repair. Furthermore, knowledge of the normal mechanical function of the hip capsule ligaments could assist in the evaluation of the success of a repair.

Aged↗
PubMedDate not supplied

[New possibilities in the detection and surgical therapy of synovitis of the hip joint].

Missing pathognomonic clinical and radiological signs, an early diagnosis of hip joint synovitis is often impossible. Ultrasonography and arthroscopy of the hip joint are useful methods to accomplish recognition and exact description of chronic inflammatory hip joint diseases. These new diagnostic methods enable an early adequate treatment. Until today synovectomy of the hip joint is still a rare surgical procedure. Reasons are the difficulties in diagnosis of the synovitis and the insufficient radicality of synovectomy if the femoral head is not luxated temporarily. The semi-arthroscopic synovectomy of the hip joint allows a radical removal of the synovial membrane even in the fossa acetabuli, avoiding the inherent risks of a luxation of the femoral head.

Arthroscopy↗
PubMed2001

Investigation of hip joint prosthesis damage.

Following total hip arthroplasty the durability of a prosthetic implant depends on many factors but is generally limited by two types of damage: wearing of frictional surfaces of the acetabular and femoral component as well as the loosening and migration of the "rosthesis-cement-bone" system. Since it is possible to establish a cause-and-effect relationship between these two damage types, the aim of this research is to investigate the phenomena related to the contact surface and their influence on the prosthesis-bone relationship in general for various sizes and conditions of loading of the hip joint. The experimental study was conducted using a Timken testing device modified in such a way that simulation of relative movements of the joint elements was achieved using a mechanism that produces conditions similar to those in the human hip joint. The analysis of obtained measurements showed that actual radii of friction of the hip prosthesis did not correspond to the theoretical ones and that only a small portion of the total friction surface is realized. Variations of the radius of friction for the examined prosthesis type were very large, which changes the hypotheses on the ability of the prosthetic head and the "prosthesis-cement-bone" system to bear a certain amount of load. The construction and design of prosthetic implant components has a significant influence on both the amount of wear at the site of contact and the loosening of prosthesis.

Arthroplasty, Replacement, Hip↗
PubMed2000

Size and direction of hip joint forces associated with various positions of the acetabulum.

When total hip replacement is performed, the position of the acetabular component may affect wear and component survival time. We considered the questions: In what way does displacement of the hip joint center alter (1) the magnitude and (2) the direction of the resultant force? Biomechanical tests were carried out on a human multibody model. After displacement of the hip joint center, the resultant forces were calculated for the single leg stance. With the flexed single leg stance, maximum hip joint forces were observed with lateral, cranial, posterior displacement. The peak forces were affected by the modeling of a gluteus maximus wrapping point at the ischial tuberosity and were overestimated when this was removed. With the straight single leg stance, posterior displacement decreases the total load on the hip joint because of the increased leverage of the rectus femoris. With regard to the direction of the resultant force, medial displacement increases the angles in both planes, cranial displacement increases it in the sagittal plane (cranial, posterior-caudal, anterior), and anterior displacement decreases the angle in the sagittal plane and increases it in the frontal plane (medial, cranial-lateral, caudal). The direction of the force is relatively insensitive to displacement of the hip joint center. The results presented here indicate a marked increase in the force after lateral, cranial, posterior displacement of the center in the flexed single leg stance. To avoid extreme joint loading and to reduce the wear after total hip arthroplasty, the cranial and posterior regions of the acetabulum should be fully reconstructed. A high hip joint center has an adverse effect on the magnitude of the force, although the directions are hardly affected by it.

Acetabulum↗
PubMed2003

[Cases of complex endoprosthetic surgery of the hip joint].

140 complex endoprosthetics of the hip joint were performed in 124 patients treated in the traumatology and arthrology Center of the Buyrdenko Main Military Clinical Hospital during the period from 1988 to 2001. It constituted 14.3% of all patients with diseases and trauma sequelae of such localization treated in the Hospital. There were 6 main patient groups in whom the pathological changes were considerably expressed and required the special approaches to the operation, i.e. the primary simultaneous bilateral hip joint endoprosthetics. The patients' age was 17-65 (the mean age 48.7), while during the conventional primary endoprosthetics the mean age was 68. We have developed the method of hip joint endoprosthetics performed in two stages. (Patent No 2173108 RF). This method was applied in 16 patients (group 1-11 and group 2-5 patients). The post-operative follow-up period lasted 1-6 years. Excellent and good results were obtained in 14 (87.5%) patients that were evaluated according to Harris's method. We think that it is reasonable to consider the primary complex endoprosthetics as the independent type of surgical intervention as it requires the special approaches to planning and performance of the operation, high skill and special up-to-date equipment.

Adolescent↗
PubMed1987

Diagnosis by ultrasound of congenital dislocation of the hip joint.

Two hundred thirty-four hips of 117 babies from one day to 18 months of age were examined ultrasonographically for congenital dislocation of the hip joint. Ten hips in eight babies were dislocated or subluxated and there were 11 hip dysplasias in seven babies. In the normal hip, the adaptation between the acetabulum and the femoral head is well demonstrated, and there is no apparent interposition of the limbus between the acetabular roof and the cartilaginous head. In the dislocated hip, the protrusion of the acetabular rim is not so clear as that of the normal hip, and the limbus is seen to be interpositioned between the acetabular roof and the cartilaginous head. In severe cases, the acetabular rim is hidden under the shade of the femoral head. Ultrasonography is an effective method of determining the incidence of dislocation and of diagnosing hip subluxation as well as dysplasia and does not have the hazards of x-ray examination.

Female↗
PubMed1997

Hip joint forces during load carrying.

In some diseases affecting only 1 hip joint, it is necessary to keep the contact force between femoral head and acetabulum (hip joint force) permanently low at the affected side. Six subjects were examined while they were walking and carrying a load in 1 or 2 hands. It was determined how the forces in both hip joints are influenced by the magnitude of the load and the manner in which it is carried. A mathematical model was used to calculate the maximum forces in the frontal plane. One subject had instrumented endoprostheses implanted in both hips. For him the measured values were slightly higher than the calculated ones, but the overall results were similar. Carrying a load on 1 side keeps the force constant at the ipsilateral hip joint or even slightly lowers it. At the same time, there is a large increase on the opposite side. Carrying 25% of body weight with 1 hand causes about 2/3 higher forces in the contralateral joint than on the loaded side. If this load is evenly distributed between the 2 sides, both hip joint forces increase by 25%. In unilateral load carrying, additional relief of the ipsilateral joint can be achieved if the upper body is held upright and the loadcarrying arm is abducted, such as when using a large shopping basket.

Adult↗
PubMed1990

[Evaluation of the hip joint after Kee-Farrar total hip arthroplasty from the aspect of certain clinical biomechanical criteria].

Hundred hips in 84 arthritic patients after Mc Kee-Farrar total hip arthroplasty were reviewed. Biomechanical measurements in operated, arthritic non-operated and normal hips were compared. The moment of adductive forces, adductive forces, the strength of abductors, Hamacher-Roesler index and Woźny coefficient were determined. In nonoperated arthritic hips these measurements were abnormal. They were close to normal values in operated hips with negative Trendelenburg sign.

Adult↗
PubMed2005

Test bed for assessment of the kinematical determination of navigation systems for total knee arthroplasty. Does a limited range of motion of the hip joint influence the accuracy of the determination?

OBJECTIVE: To locate the rotational center of the hip joint, CT-less navigation systems for artificial knee-joint replacement use movements of the femur with a rigid body attached. It cannot be assumed that the hip joint provides free mobility at all times. The purpose of the present study was: 1) To build a mechanical model to assess the system's accuracy in locating the rotational center of the hip by simulating a step-wise reduction of the range of motion (ROM) of the hip joint. 2) To determine the system's resolution by assessing a critical distance between two positions of the same femoral rigid body during the process of locating the rotational center of the hip. 3) To determine the sensitivity of the navigation system to the rotation of a femoral rigid body relative to the femoral bone while locating the rotational center of the hip joint. MATERIAL AND METHODS: To assess the impact that a limited ROM of the hip joint has on the accuracy of determination of the hip joint's rotational center, a test bed was built. This enables validation of the algorithm used by a CT-less navigation system. RESULTS: In the first part of the study, it was shown that a reduction of the ROM of the hip joint to 30% of its initial value had no evident influence on the accuracy of locating the rotational center of the joint. In the second part of the study, it was determined that the limit of resolution between two spatial points of the pivoting process is between 4.4 and 8.7 cm. The third part of the study showed that the examined system rejected the determination of the hip center even when the rigid body was only rotated through 22.5 degrees . CONCLUSIONS: The results show that osteoarthritis of the hip with a limited ROM, for example, cannot be taken as a contraindication for the use of the evaluated CT-less navigation system. However, the surgeon should ensure that the pivoting of the femur is performed without hindrance within the free range of motion of the hip joint. In accordance with the vendor's recommendation, a minimum distance of 10 cm should be maintained between two spatial points. To ensure safe and unconstrained operation, the rigid body must be firmly attached to the bone and must not be dislocated.

Arthroplasty, Replacement, Knee↗
PubMed2006

Familial osteoarthritis of the hip joint associated with acetabular dysplasia maps to chromosome 13q.

Genetic factors have been implicated in osteoarthritis (OA), particularly in OA of the hip joint (hip OA). Several instances of familial hip OA that show distinctive modes of inheritance but that differ from chondrodysplasia have been reported. Here, we report the characterization of a large Japanese family with an inherited disease of the hip that is indistinguishable from common hip OA, as evidenced by clinical symptoms and radiographs of the joint. This family contained eight patients in 4 generations. Affected individuals develop pain in the hip joint during adolescence, and the disease progresses to severe crippling before age 60 years. Patients generally are in good health, height is not reduced, and there is no extraskeletal involvement suggestive of chondrodysplasia. The skeletal change is bilateral acetabular dysplasia followed by OA, which occurs after age approximately 40 years and is indistinguishable from idiopathic nonfamilial dysplastic hip OA. This trait shows autosomal dominant inheritance, with a considerably consistent phenotype. Genomewide screening revealed linkage at chromosome 13q22, and haplotype analysis narrowed the locus to a 6.0-cM interval between markers D13S1296 and D13S162, with a maximal multipoint LOD score of 3.57. The family described here represents a novel genetic entity as a monogenic form of hip OA. Its further characterization can aid in elucidating the etiology and pathogenesis of a common idiopathic form of OA.

Chromosome Mapping↗
PubMed1990

Radiological and computed tomographic studies of the width of the normal hip joint in men aged 30-60 years.

We made an attempt to evaluate the width of the joint space of the normal hip joint in men aged 30-60 years. We analysed 164 roentgenograms and 68 CT scans of the pelvis measuring the width of the right and left hip joint in four segments of the frontal plane (roentgenograms) and in three segments of the horizontal plane (CT scans). In each segment we determined the mean width of the joint space and mutual relation between the measurements by an analysis of variance and correlation coefficient. It was shown that with advancing age of the patient the joint space increased bilaterally in the inferoposterior part (segment IV on the roentgenograms and segment III on the CT scans). The width of the joint space did not change significantly with age in the remaining segments of the hip joint.

Adult↗
PubMed2006

Clinical and genetic assessments of hip joint laxity in the Boykin spaniel.

Canine hip dysplasia (CHD) is characterized by a malformation of the hip joint that leads to joint laxity and consequential degenerative joint disease. The most widely used method for diagnosis of CHD is the ventrodorsal hip-extended radiologic view, commonly referred to as the Orthopedic Foundation for Animals (OFA) method. The method of the University of Pennsylvania Hip Improvement Program (PennHIP), an alternative technique that is based on hip joint laxity, provides a quantitative assessment, the distraction index (DI), of the likelihood of the development of CHD because of increased laxity in the hip joint. Linear regression analysis showed that, across many breeds of dog, the incidence of CHD, as defined by the OFA, is positively correlated with the mean DI, the determination coefficient (r2) being 26%. We used families of Boykin spaniels (BSs) to determine the level of joint laxity in the breed and to conduct an initial whole-genome screening to identify markers that co-segregate with increased joint laxity. Although there was a positive correlation between the incidence of hip dysplasia and increased joint laxity, we did not find significant linkage in the 28 BSs that underwent genotyping, likely owing to the small size of the pedigree.

Animals↗
PubMedDate not supplied

Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain.

BACKGROUND AND OBJECTIVES: The sensory innervation of the hip joint includes the sensory articular branches of the obturator and femoral nerves. In this report, we retrospectively evaluated 14 cases in which hip joint pain was treated by percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves. METHODS: Fourteen patients who had hip joint pain and underwent percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves were studied. In all cases, intra-articular hip joint block or articular branch block of obturator nerve with local anesthesia was transiently effective. Radiofrequency lesioning was performed at 75 degrees C to 80 degrees C for 90 seconds using an RFG-3B generator and Sluijter-Mehta cannulae kit (Radionics, Burlington, MA) for the obturator nerve in 9 patients and for both the obturator and femoral nerves in 5 patients. To assess pain intensity, a visual analog scale (VAS) was used. RESULTS: The VAS scores before and after the radiofrequency lesioning were 6.8 +/- 0.9 and 2.7 +/- 1.3, respectively. Twelve patients (86%) reported at least 50% relief of pain for 1 to 11 months. There were no side effects or motor weakness observed. CONCLUSIONS: Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves is an alternative treatment in patients with hip joint pain, especially in those where operation is not applicable.

Adult↗
PubMed2002

[Ipsilateral knee and hip joint dislocation].

Knee and hip dislocations are often serious injuries with an uncertain outcome. Simultaneous ipsilateral dislocation of the knee and hip joints is very rare; consequently, there is an inadequate amount of literature on the subject. In this case report we present a 35-year-old male patient with this combination of both injuries and discuss it in comparison with the available literature. This case report shows, that a methodical and sequential treatment can lead to good results in spite of this complex combination of injuries.

Acetabulum↗
PubMed2004

[Criteria of assessment of restriction of vital activity of patients after total endoprosthesis of the hip joint].

Total endoprosthesis of the hip joint is an effective method of rehabilitation of patients with a severe pathology of the hip joint. But the lack of exact criteria of assessment of restriction of vital activity of patients after total endoprosthesis results in leveling the effects of medical rehabilitation due to the existing stereotype solution of the MSE bureau and so the majority of patients (90%) after operation get invalidization of the I and II groups for a long time without sufficient causes. Results of complex clinico-rentgenological, biomechanical, electrophysiological examinations and expert assessment of 450 patients after implantation of various domestic and foreign endoprostheses allowed the elaboration of differentiated criteria for the examination of restricted viral activity depending on the nosological form of the disease, degree of the disturbance of the statico-dynamic function, prognosis, complications, character and conditions of work.

Arthroplasty, Replacement, Hip↗
PubMed2000

[Clinical evaluation of the hip joint after implantation of cementless Mittelmeier type and Parhofer-Mönch type hip prosthesis].

Total hip replacement is the most common procedure in the treatment of severe degenerative changes in the hip joint. The authors present clinical evaluation of 129 patients (151 hips) who underwent total hip replacement using either the Mittelmeier type or the Parhofer-Mönch type hip prothesis. The age of the patients ranged at the time of the operation between 17 and 74 years (average 44.9). The follow-up ranged from 24 to 143 months (average 61.2 months). The P-M prothesis was implanted in 53 hips, the P-M "Plasmapore" prothesis in 42 patients, Mittelmeier Autophor 900 prothesis in 49 patients and the Mittelmeier Autophor 900S prothesis in 7 patients. Clinical evaluation was performed according to the d'Aubigne-Postel method with the Charnley modification. The results were graded as very good in 17 cases, good in 64 cases, satisfactory in 53 cases and poor in 17 cases. Very good and good results were mainly observed after implantation of the P-M type prothesis and P-M "Plasmapore" type prothesis. Worse results were observed in patients, who at the time of the operation were aged 45 years or less and who had congenital hip dysplasia. P-M type prothesis gives better clinical results in the treatment of degenerative changes of the hip joint.

Adolescent↗
PubMed1986

Diseases of the developing hip joint.

The best treatment for diseases of the hip can begin if one diagnoses the disorder as soon as possible after onset. In many cases, successful management of the disease will prevent permanent damage to the hip joint. If injury occurs to the developing hip joint, major hip surgery may be necessary in adult life.

Adolescent↗
PubMedDate not supplied

Relationship of pain to the radiological anatomy of the hip joint in adults treated for congenital dislocation of the hip as infants: a long-term follow-up of patients treated by three methods.

Sixty female patients with congenital dislocation of the hip treated by three methods were followed up to a mean age of 27.3 years. Standard radiographic measurements of hip joint morphology, including stereoscopic measurements of acetabular and femoral neck anteversion, were made. The Severin score of the hip joint, but not acetabular or femoral neck anteversion, was related to symptoms. Hips treated by femoral derotation osteotomy had superior results to hips treated by traction reduction alone. Both of these methods gave much better results than treatment by closed manipulative reduction. The "normal" opposite hip was morphologically abnormal, although usually asymptomatic.

Female↗