Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HIP JOINT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2001

Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-clinical tests, predicting bone adaptation and mechanical failure of cemented reconstructions, ensuring an adequate representation of in vivo loading of the reconstruction. Loads were applied as occurring during heel-strike, mid-stance and push-off phases of gait. The stress/strain distributions within the reconstruction, produced by the hip-joint contact force, were compared to ones produced after sequentially including the abductors, the iliotibial tract and the adductors and vastii. Inclusion of the abductors had the most pronounced effect. They neutralized lateral bending of the reconstruction at heel-strike and increased medial bending at mid-stance and push-off. Bone strains and stem stresses were changed accordingly. Peak tensile cement stresses were reduced during all gait phases by amounts up to 50% around a bonded stem and 11% around a debonded one. Additional inclusion of the iliotibial tract, the adductors and the vastii produced relatively small effects during all gait phases. Their most prominent effect was a slight reduction of bone strains at the level of the stem tip during heel-strike. These results suggest that a loading configuration including the hip-joint contact force and the abductor forces can adequately reproduce in vivo loading of cemented total hip reconstructions in pre-clinical tests.

Biomechanical Phenomena↗
PubMed2004

Medial translation of the hip joint center associated with the Bernese periacetabular osteotomy.

This study assessed medial translation of the hip joint achieved by the Bernese periacetabular osteotomy (PAO) in correcting residual acetabular dysplasia deformities. 86 hips in 75 patients with an average age of 25 years (range, 12-50) were treated for symptomatic acetabular dysplasia with a periacetabular osteotomy. Radiographic analysis was performed to assess correction of the acetabular deformity with specific attention to the horizontal position of the hip joint center. All hips were followed until bony union of the iliac osteotomy and the average follow-up was 28 months. The lateral center edge angle improved an average 31.6 degrees (-0.4 degrees preoperative, 31.2 degrees at follow-up). The anterior center edge angle improved 39.3 degrees (-4.5 degrees to 34.8 degrees). The acetabular roof obliquity improved an average 21.8 degrees (25.1 degrees to 3.3 degrees). Preoperatively, the average distance from the medial aspect of the femoral head to the ilioischial line was 17.6 mm. This distance was decreased to an average 7.8 mm postoperatively. This change resulted in an average medial translation of the hip joint center of 9.8 mm, (range -6 to 31mm). Overall, some degree of medial translation of the hip joint center was obtained in 79 (92%) of the hips. Four (5%) were maintained in the same horizontal position, and 3 (3%) had slight lateral repositioning. For the hips translated medially, the average change was 10.0 mm, and 72% of all hips had an optimal correction with the distance between the medial aspect of the femoral head and the ilioischial line being between 0 and 10 mm. This study demonstrates that in addition to optimizing femoral head coverage, a major and distinct advantage of the periacetabular osteotomy is reproducible and consistent medial translation of the hip joint center.

Acetabulum↗
PubMed1989

Biomechanical analysis of selected principles of hip joint protection.

This review article discusses the role of the hip abductor muscles in the generation of forces at the hip joint. The biomechanical rationale behind selected clinical principles of hip joint protection for the patient with hip osteoarthritis is discussed. These principles are based primarily on the benefit of reducing the magnitude of hip abductor muscle forces during walking. The specific hip joint protection principles that are analyzed are loss of body weight, walking with an antalgic limp, the use of a cane, proper methods of load carriage, and the reasons for certain orthopedic surgeries. The reduction of these myogenic hip joint forces for the patient with a painful hip and/or hip with arthritis should be considered an important component of the clinical management of the hip.

Biomechanical Phenomena↗
PubMed2003

Direct comparison of calculated hip joint contact forces with those measured using instrumented implants. An evaluation of a three-dimensional mathematical model of the lower limb.

Characterisation of hip joint contact forces is essential for the definition of hip joint prosthesis design requirements. In vivo hip joint contact force measurements have been made using instrumented hip joint prostheses. However, to allow determination of the range of values of joint contact force and their directions relative to anatomical structures in a range of subject groups sufficient to form an agreed data base it is necessary to adopt a different approach without the use of an implanted transducer. The use of mathematical models of the lower limb to examine the forces in soft tissues and at the joints has provided valuable insight into internal loading conditions. Several authors have proposed mathematical musculo-skeletal models. However, there have been only limited attempts at validation of these models. It is possible to use the results of in vivo force measurements from instrumented prostheses to validate the results calculated using the mathematical models. In this study two subjects with instrumented hip joint prostheses were studied. Forces at the hip joints were calculated using a three-dimensional model of the leg. Walking at slow, normal and fast speeds (0.97-2.01m/s), weight transfer from two to one leg and back again, and sit to stand were studied. Direct comparisons were made between the 'gold standard' measured hip joint contact forces and the calculated forces. There was general agreement between the calculated and measured forces in both pattern and magnitude. There were, however, discrepancies. Reasons for these differences in results are discussed and possible model developments suggested.

Computer Simulation↗
PubMed1980

[Painful hip joint with epiphyseal dysplasia (author's transl)].

Among patients who visited our hip clinic, eighteen patients from ten families were diagnosed as mild or atypical cases of spondyloepiphyseal dysplasia or multiple epiphyseal dysplasia. Clinical and X-ray examinations of these patients showed common characteristic features as follows. 1. They usually had short stature but were not dwarfs. Their facial features and body proportions did not suggest hereditary bone dysplasia. 2. Although the disease might be transmitted in an autosomal dominant manner, its occurrence among these families was found to be sporadic. 3. Symptoms of the hip joint mainly resulted from limited range of motion, coxalgia being usually less than expected from X-ray findings. 4. Joints were always affected bilaterally although the degree might be different on each side. 5. In the majority of the cases, the spine, shoulder (in 7 cases), knee (in 6 cases), elbow (in 3 cases), ankle, and wrist joint (in 2 cases) were also affected. 6. Characteristic X-ray findings of the hip joints were as follows. a) Coxa vara, flattening or rectanglar deformity of the femoral head and shortening of the femoral neck. b) The trabecular pattern of the femoral head was irregular and subchondral cysts were often observed. c) Joint space was relatively better restored than expected from the deformity and subchondral bony changes of the femoral head. Spondyloepiphyseal dysplasia and multiple epiphyseal dysplasia are genetic disorders of the epiphyseal and apophyseal cartilage. The hip joint is loading greater mechanical force than any other joint. In both spondyloepiphyseal dysplasia and multiple epiphyseal dysplasia, the hip joint is always affected. As the hip joint is most vulnerable when there is some disorder of the epiphyseal cartilage, it is probably the only detectable abnormal joint. In relatively short period (1972-1978), the diagnosis of mild or atypical spondyloepiphyseal dysplasia was made in 18 patients in our hip clinic. This means that the mild or atypical cases of spondyloepiphyseal dysplasia is not so rare as expected. They might be misdiagnosed as aseptic necrosis, deformity of the femoral head due to Perthes disease or primary osteoarthrosis. An extreme care should be taken when we examine such patients.

Adult↗
PubMed1988

Scintigraphic presentation of hip joint synovial chondromatosis.

A case of hip joint synovial chondromatosis with an unusual scintigraphic pattern is described. This pattern was suggestive of a hip joint destructive reactive articular process or late manifestations of avascular necrosis of the femoral head. Concurrent radiographs were normal, as were laboratory investigations. Follow-up radiographs six months later showed radiolucencies and erosive bone changes in the diseased joint. Surgical and histopathological findings revealed well developed hip synovial chondromatosis (HSC) with thickened synovium and large, loose, cartilaginous bodies occupying and widening the tightened joint space, with destructive secondary juxta articular pressure and bone erosions. This and other scintigraphic patterns in HSC, and the differential diagnosis of the findings in patients with painful hip presentations are discussed.

Chondroma↗
PubMed1995

Combined realignment procedure (femoral and acetabular) of the hip joint in ambulatory patients with cerebral palsy and secondary hip dislocation.

In a retrospective study we evaluated the results of 11 patients with cerebral palsy and concomitant hip dislocation who were still able to walk. They had been surgically treated with proximal femoral osteotomy (varization and derotation) and acetabular osteotomy (triple osteotomy) in order to achieve stabilization of the hip joint. The patients' mean age was 14.4 +/- 3.7 years. The female:male ratio was 7:4. All 11 hip joints were successfully stabilized. The range of passive abduction significantly increased from 20 degrees preoperatively to 42 degrees postoperatively. The range of flexion slightly decreased from 101 degrees to 92 degrees. Internal rotation significantly decreased from 51 degrees to 37 degrees. External rotation increase from 27 degrees preoperatively to 41 degrees postoperatively. Preoperatively 4 of the 11 patients had been able to walk without any walking aids; 7 had been able to walk with support. Concerning the ambulatory status, mild improvement was achieved postoperatively in 3 patients. The CCD-angle decreased significantly from 138.9 degrees preoperatively to 118.7 degrees postoperatively. The migration index according to Reimers improved significantly from 50.2% preoperatively to 24.2% postoperatively. Prior to surgery 4 cases showed a grade 1 dislocation, 6 cases a grade 2 dislocation, and 1 case a grade 3 dislocation. We succeeded in performing a complete reposition in all patients. Preoperatively the CE- angle was only -3 degrees (+/- 11.3 degrees) and was improved to 27.1 degrees (+/- 5.3 degrees). The ACM-angle measured 45.4 degrees preoperatively and 49.5 degrees postoperatively. The sitting balance was improved in all patients. Furthermore the problem of anal care was reduced.

Acetabulum↗
PubMed2002

[Treatment of fracture of femoral neck in the aged with artificial hip joint replacement].

OBJECTIVE: To evaluate the clinical effect of total hip joint replacement and hemiarthroplasty in treatment of fracture of femoral neck in old patients. METHODS: One hundred and ten cases with femoral neck fracture in the aged, 70 to 106 years old, from Aug 1990 to Aug 1999 were reviewed, 96 cases were followed up, among which 52 cases received total hip joints replacement and the other 44 cases received hemiarthroplasty. All of the 96 cases were followed up for 15 to 112 months, averaged 51 months, and were evaluated in operation procedures, post-operative recovery and joint function according to Harris Scoring. RESULTS: The operation time of total hip joints replacement was 20 minutes longer, bleeding volume was 120 ml larger, and post-operative drainage was 140 ml more, in average, than those in hemiarthroplasty. There was no obvious difference between the two types of operation in bed-resting time, length of stay and hospitalizing costs. According to Harris Scoring, there were 38 cases of excellent in hemiarthroplasty (86.4%) and 48 cases of excellent in total hip joints replacement (92.3%). CONCLUSION: Both of the artificial joint replacements are reasonable choices for treatment of fracture of femoral neck in old patients, but total hip joints replacement is recommendable for those comparatively younger patients with good systematic status, and hemiarthroplasty is a good option for those elderly with some systematic diseases.

Aged↗
PubMed2006

Localization of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties.

Using immunohistochemical methods we determined the presence of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with femoral neck fracture (controls, group 1), painful osteoarthritis (group 2), and painless failed total hip arthroplasties (group 3). Immunoreactive nerve fibers were found in the soft tissue of the fossa acetabuli as well as in the subintimal part of the synovial layer in the hip joint capsule of groups 1 and 2. In the capsule of controls the innervation density had a median of 5.7fibers/cm(2) for CGRP-ir and 3.2fibers/cm(2) for SP-ir afferents. In the osteoarthritic group, the density significantly increased to a median of 15.6fibers/cm(2) for CGRP-ir and 8.2fibers/cm(2) for SP-ir neurons (p=0.05). Patients with failed hip arthroplasties completely lacked these neuropeptide containing afferents. Innervation density in the fossa acetabuli of osteoarthritc patients showed a median of 14.1fibers/cm(2) for CGRP-ir and 5.9fibers/cm(2) for SP-ir afferents. From these data we assume that the hip joint capsule and the soft tissue of the fossa acetabuli are important triggers of nociception. This is supported by the fact, that patients with loosened total hip arthroplasties, where we failed to detect SP- and CGRP-immunoreactive fibers, did not feel pain. The upregulation of SP- and CGRP-positive neurons in response to arthritic stages suggests a mechanism involving neuropeptides in the maintenance of a painful degenerative joint disease and in mediating noxious stimuli from the periphery. Furthermore, these findings help to explain clinical observations, such as effectiveness of local therapy to control hip pain with intraarticular injection, synovectomy and denervation procedures.

Aged↗
PubMed2006

Lifelong diet restriction and radiographic evidence of osteoarthritis of the hip joint in dogs.

OBJECTIVE: To evaluate the effects of diet restriction on development of radiographic evidence of hip joint osteoarthritis in dogs. DESIGN: Longitudinal cohort study. ANIMALS: 48 Labrador Retrievers from 7 litters. PROCEDURES: Forty-eight 6-week-old puppies from 7 litters were paired with littermates by sex and weight, and each pairmate was randomly assigned to 1 of 2 groups of 24 dogs each. Starting at 8 weeks of age, 1 group was fed ad libitum (control fed) and the other was fed 25% less (restricted fed) of the same diet for life on a pairwise basis. The dogs' hip joints were radiographed in the standard ventrodorsal hip-extended view at multiple intervals prior to 1 year of age and at annual intervals thereafter on the basis of birth anniversary. A board-certified radiologist unaware of group assignment scored the radiographs for evidence of osteoarthritis. RESULTS: Prevalence of radiographic evidence of hip joint osteoarthritis in all dogs increased linearly throughout the study, from an overall prevalence of 15% at 2 years to 67% by 14 years. Restricted-fed dogs had lower prevalence and later onset of hip joint osteoarthritis. Median age at first identification of radiographic evidence of hip joint osteoarthritis was significantly lower in the control-fed group (6 years), compared with the restricted-fed group (12 years). CONCLUSIONS AND CLINICAL RELEVANCE: Restricted feeding delayed or prevented development of radiographic signs of hip joint osteoarthritis in this cohort of Labrador Retrievers. Lifetime maintenance of 25% diet restriction delayed onset and reduced severity of hip joint osteoarthritis, thus favorably affecting both duration and quality of life. In addition, the data indicated that development of hip joint osteoarthritis was not bimodal in these dogs but occurred as a continuum throughout life.

Age Factors↗
PubMed2007

Quantitative genetics of secondary hip joint osteoarthritis in a Labrador Retriever-Greyhound pedigree.

OBJECTIVE: To evaluate the quantitative inheritance of secondary hip joint osteoarthritis in a canine pedigree. ANIMALS: 137 Labrador Retrievers, Greyhounds, and mixed-breed dogs. PROCEDURES: Necropsy scores ranging from 0 to 4 were obtained for each hip joint. Seven unaffected Greyhounds with normal hip joint conformation were also used for genetic modeling, but were not euthanized. Sixty-six male and 71 female dogs were allocated to 2 groups (< or = 12 months of age and > 12 months of age). Statistical models were developed to establish the inheritance pattern of hip joint osteoarthritis that developed secondary to hip dysplasia. RESULTS: 62 dogs had evidence of osteoarthritis in a hip joint, and 75 had no evidence of osteoarthritis. After sex was adjusted for, the necropsy score was found to be inherited additively but without dominance. Each Labrador Retriever allele increased the necropsy score by 0.7 to 0.9 points, compared with the Greyhound allele, and male sex increased the necropsy score 0.74 over female sex. Approximately 10% of the variation in necropsy score was attributable to the litter of puppies' origin. CONCLUSIONS AND CLINICAL RELEVANCE: Because secondary hip joint osteoarthritis is inherited additively, selection pressure could be applied to reduce its incidence. Similar statistical models can be used in linkage and association mapping to detect the genes in the underlying quantitative trait loci that contribute to hip joint osteoarthritis.

Age Factors↗
PubMed2001

Accuracy of the functional method of hip joint center location: effects of limited motion and varied implementation.

Accurate location of the hip joint center is essential for computation of hip kinematics and kinetics as well as for determination of the moment arms of muscles crossing the hip. The functional method of hip joint center location involves fitting a pelvis-fixed sphere to the path traced by a thigh-fixed point while a subject performs hip motions; the center of this sphere is the hip joint center. The aim of the present study was to evaluate the potential accuracy of the functional method and the dependence of its accuracy on variations in its implementation and the amount of available hip motion. The motions of a mechanical linkage were studied to isolate the factors of interest, removing errors due to skin movement and the palpation of bony landmarks that are always present in human studies. It was found that reducing the range of hip motion from 30 degrees to 15 degrees did significantly increase hip joint center location errors, but that restricting motion to a single plane did not. The magnitudes of these errors, however, even in the least accurate cases, were smaller than those previously reported for either the functional method or other methods based on pelvis measurements of living subjects and cadaver specimens. Neither increasing the number of motion data observations nor analyzing the motion of a single thigh marker (rather than the centroid of multiple markers) was found to significantly increase error. The results of this study (1) imply that the limited range of motion that is often evident in subjects with hip pathology does not preclude accurate determination of the hip joint center when the functional method is used; and (2) provide guidelines for the use of the functional method in human subjects.

Biomechanical Phenomena↗
PubMedDate not supplied

[Stabilization of the proximal femur in hip joint replacement using M.E. Müller's acetabular roof socket].

Extreme changes of the hip joint often require individual technical supplements in addition to the endoprosthesis. But the base of success are procedures using a model of prosthesis and a technique that are matured. This is available e.g. with the old M. E. Müller curved stem hip joint prosthesis. In special cases of extreme changes or damage of the proximal femur we perform in artificial joint-replacement of the hip or changing of prostheses a special kind of operative treatment. This is a combination of the Original-M. E. Müller curved stem endoprosthesis, long or short version of the femoral part, in addition fixated by bone-cement and M. E. Müller's special metal socket--primary indicated for stabilization of the acetabular roof. The indications for this method can be changes of proximal femur and hip-joint, especially dysplasias of pelvis or hip joint, extensive fractures especially in old patients, destructions in polyarthritis, dysplasia of pelvis and coxitis caused by juvenile chronic arthritis and long time therapy with corticosteroids, destructions, loosenings and fractures in changing operations of hip-endoprostheses. Until today we treated 15 different cases by this method--one case was operated 13 years ago--with good results, prooved by Merle d'Aubigné's score.

Acetabulum↗
PubMed1993

Biomechanical analysis of various operative hip joint rotation center shifts.

A mathematical model was used to evaluate the mechanical situation after various operative shifts of the hip joint rotation center. It was concluded that while performing different pelvic osteotomies and the total hip replacement the hip joint rotation center should be shifted as far medially as is technically possible to reduce the magnitude of the hip joint contact force. By contrast, lateralization of the hip joint rotation center strongly increases the magnitude of the hip joint contact force; therefore this should be avoided whenever possible. The superior shift of the hip joint rotation center decreases the strength of the patient's hip abductor muscles and must therefore also be avoided. The inferior shift of the hip joint rotation center is favorable because it increases the strength of the patient's hip abductor muscles.

Adult↗
PubMedDate not supplied

Treatment of septic arthritis of the hip joint by repeated ultrasound-guided aspirations.

Arthrotomy of the hip joint followed by a variable period of drainage or continuous irrigation and drainage is considered the accepted treatment of septic arthritis of the hip joint (SAHJ). The authors reviewed the results of a cohort of children with SAHJ with repeated aspirations of the hip joint. Thirty-four children diagnosed with SAHJ were treated with repeated aspirations of the hip joint. The aspirations were performed under ultrasound guidance and topical anesthesia or under sedation. After the aspiration the joint was irrigated using the same needle, and the procedure was repeated daily. Six of the patients were operated on and then treated with aspirations because of drain dislodgement or clogging. Twenty-eight of the patients were treated primarily with repeated aspirations. Four of those patients did not improve and underwent arthrotomies, and 24 were treated only by repeated aspirations and healed completely. The mean number of aspirations was 3.6 (range 3-5), and 75% of the patients resumed walking after 24 hours. The mean follow-up time was 7.4 years (range 3-18). No complications were seen. Repeated aspiration is a safe and efficacious method of treatment for SAHJ. This method of treatment is not associated with surgery and its complications and prevents scarring of the skin and the need for general anesthesia. Faster return to normal activity was noted in this series.

Adolescent↗