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At least 235 records · Page 13Linked to original sources
PubMed2000

High macrophage-colony stimulating factor levels in synovial fluid of loose artificial hip joints.

OBJECTIVE: To clarify a macrophage-colony stimulating factor (M-CSF) related mechanism of aseptic loosening of artificial hip joints. METHODS: Synovium-like interface tissues between bone and prosthesis, regenerated pseudocapsular tissues, and synovial fluid (SF) were collected from 9 patients with loose artificial hip joint at revision surgery. Tissue distribution, production site, and SF level of M-CSF in loose hip joints were investigated by immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR), and ELISA, respectively. For a comparative assessment of the M-CSF level in loose hip joints, SF of active rheumatoid arthritis (RA) and mild osteoarthritis (OA) also were analyzed by ELISA. RESULTS: Immunohistochemical analysis showed the presence of M-CSF immunoreactive cells mainly in the interface tissues between bone and prosthesis and inner pseudocapsular tissues, both of which were in contact with joint fluid. RT-PCR analysis confirmed the local production of M-CSF in these periprosthetic tissues. Significantly higher M-CSF level in loose hip joint fluid than in active RA and mild OA fluid was revealed by ELISA. CONCLUSION: High M-CSF level in loose hip joint fluid suggests transportation of M-CSF from production sites to joint fluid. This indicates that not only polyethylene wear particles (reported to induce foreign body reaction at the bone-prosthesis interface), but also M-CSF, abundant in joint fluid, are transported to and affect the interface. Thus, M-CSF is locally produced in periprosthetic tissues of loose hip joints and possibly contributes to periprosthetic weakening and osteolysis via joint fluid, leading to prosthetic loosening.

Aged↗
PubMed1985

Total hip replacement combined with bone grafting for acetabular dysplasia causing severe osteoarthritis of the hip joint.

Over a 10 year period 18 total hip joint arthroplasties (THJA) were performed on 15 patients with disabling osteoarthritis of the hip joint secondary to congenital dislocation or subluxation. In all cases reconstruction of the deficient acetabulum was necessary in order to provide total bony containment of the acetabular prosthesis. This was achieved using a bone graft, fashioned from the femoral head and securing it above the true acetabulum. At follow-up all patients were pain free. Radiographically, there had been no loosening of the acetabular prosthesis and all grafts appear to have united. The operative technique is described in detail.

Acetabulum↗
PubMed2000

[Standardized sonographic examination of the hip joint].

AIM: We demonstrate a technique for examining the hip joint sonographically in a standardised way using sectional planes corresponding to the guidelines provided by the work group "Sonography of the Musculo-Skeletal System" of the German Society of Ultrasound (DEGUM). MRT-scans were used as a comparative standard. METHOD: The ultrasound examination was performed in the following standardised way: a transversal and longitudinal scan were done in the ventral region and additionally a longitudinal scan in the lateral region. In cases without pathological findings two standardised planes should be documented. In the case of pathological findings the picture should be documented in two standardised planes and compared to the corresponding contralateral site. An ultrasound examination standardised in this way facilitates a precise assessment of the ventral joint capsule, the bone structures, the ventral and lateral aspects of the glenoid cavity and the peri-articular soft tissue structures of the hip joint. RESULTS: An examination technique is presented which offers additional pictorial information, saves costs and is not harmful to the patient. CONCLUSION: The ultrasound examination of the hip joint can supply additional information about diseases and traumatic changes in this region. In paediatric hip disorders such as transient synovitis, septic arthritis, juvenile arthritis, Leg-Calvé-Perthes disease and slipped femoral epiphysis, the ultrasound examination can provide important additional information for the initial differential diagnosis and during follow-up.

Germany↗
PubMed2001

[Long-term results after resection arthroplasty according to Girdlestone for treatment of persisting infections of the hip joint].

INTRODUCTION: Persisting infections of the hip joint are regarded as one of the most feared complications following total hip arthroplasty or failed osteosynthetic treatment of fractures of the proximal femoral part. In these cases resection arthroplasty according to Girdlestone often is the ultimate treatment. METHODS: Twenty-seven patients (11 men and 16 women) who had undergone resection arthroplasty according to Girdlestone could be included in this study. In all cases Girdlestone operations had been performed because of persisting infections of the hip joint. The mean follow-up was 7.1 years. RESULTS: In 22 out of 27 cases (81.5%) eradication of the infection was finally achieved. At the time of re-evaluation 6 patients had no pain, 12 sometimes suffered from moderate pain, 7 from pain during physical activities and 2 patients experienced pain even at rest. At the time of follow-up, 11 patients used a cane, 14 patients needed two canes or crutches and in 2 cases a wheelchair was necessary. The mean shortening of the leg was 5.2 cm (range 3-15 cm). Clinical evaluation using the score according to Merle d'Aubigné and Postel to assess the functional results showed a mean of 6.7 points (range 2-10 points). Of our patients, 59.3 % were satisfied with the functional results obtained. CONCLUSION: In the long run the Girdlestone procedure still seems to be a reasonable salvage operation for persisting deep infections following hip surgery.

Activities of Daily Living↗
PubMed1977

A scanning electron microscopic study of wear in the plastic components of prosthetic knee and hip joints.

The polyethylene surfaces of four metal on plastic prosthetic knee joints were compared with those of four hip joint replacements, by the use of scanning electron microscopy. The acetabular components of the hip joints showed concentric machining marks, but were generally smooth, and in some areas plastic deformation of the articular surface was evident after 24 months' use. In contrast, the tibial components of knee joints removed after 12 to 22 months showed deep scoring and pitting near the centre of their articular surfaces. This appeared to be due to abrasion by a third material, possibly fragments of cement, which sometimes became embedded in the joint surface. These results indicate that wear in prosthetic knee joints may be much more rapid than in hip joint replacements made from similar materials.

Hip Joint↗
PubMed2005

Accuracy of an electromagnetic tracking device for measuring hip joint kinematics during gait: effects of metallic total hip replacement prosthesis, source-sensor distance and sensor orientation.

The present study sought to investigate the effects of source-sensor distance, sensor orientation and the effects of metallic total hip replacement (THR) prostheses on the accuracy of the 3Space Tracker System (3STS). Using a simulated hip joint, the angles measured by the 3STS with six different source-sensor distances and two source-sensor orientations were recorded. Then the angles measured in the absence and presence of three different THR prostheses were compared. Both source-sensor distance and sensor orientation affects the accuracy of the 3STS. Measurements were only affected by the presence of one type of prosthesis. The 3STS was equally reliable, but less accurate with source-sensor distances of more than 25 cm. The small angular error and insensitivity of this device to the presence of some metallic THR prostheses make it a useful measurement tool for gait studies performed before and after THR surgery.

Arthroplasty, Replacement, Hip↗
PubMed1988

Sonography of the hip joint as part of the evaluation of acute lower abdominal pain.

Ultrasound evaluation of the hip joint was performed in 17 patients as part of the sonographic investigation of lower abdominal pain with referred symptomatology to the groin and thigh. Sonographic features consistent with hip joint effusion were detected in 12 of the patients. In four patients with positive arthrosonogram the possibility of hip joint involvement was not considered by the examining physician. In 11 other cases, hip pathology was included in the differential diagnosis. Of these, hip involvement was confirmed by sonography in eight patients and excluded in three. Sonography was found to be a useful objective method for the confirmation or exclusion of hip joint effusion. The examination had a significant influence on the patient management for shifting the attention of the clinician from the abdomen to the hip joint in four of the cases in this series.

Abdomen↗
PubMed2006

Soft-tissue balance evaluation system for total hip arthroplasty by intraoperative contact pressure measurement at the hip joint.

We developed a system for measurement of contact pressure at the hip joint surfaces that enables checking of the artificial hip joint condition during surgery. First, we constructed the pressure sensor that forms the artificial joint. We installed eight small pressure sensors to the spherical head component, a part of the ball-socket joint. Next, we developed software for recording and visualizing the detected pressures that were recorded every 1 ms. The pressure distribution was displayed with the 3D computer graphics in real-time. The system enabled intuitive recognition of pressure direction 3-dimensions. Next, using the system, we conducted measurements during total hip arthroplasty. Although it requires some improvements in its measurement accuracy, the system allows real-time acquisition of information on the artificial hip joint in real-time. Further improvements of the calibration method should enable more accurate measurements. As a complete system, it will be a useful tool for selecting an appropriate implant that fits a patient's hip joint or for estimating the risk of complications after surgery.

Arthroplasty, Replacement, Hip↗
PubMed1989

[Bone dynamic study--evaluation for factor analysis of hip joint].

Factor analysis was applied to dynamic study of Tc-99m MDP for the evaluation of hip joint disorders. Fifteen patients were examined; eight were normal, six were osteoarthritis in which one accompanied synovitis was included, and one was aseptic necrosis on the head of the femur. In normals, according to the Tc-99m MDP kinetics, three factor images and time-activity curves were obtained which were named as blood vessel, soft tissue, and bone factor images and curves. In the patient with osteoarthritis, increased accumulation of the hip joint was shown in bone factor image only. But in one patient, who took osteoarthritis with synovitis, marked accumulations of the Tc-99m MDP appeared not only on the bone factor image but also on the soft tissue. Operation revealed thickening synovial tissue around the hip joint, caused by inflammatory process. In follow-up studies of the patient with aseptic necrosis on the head of the left femur, excessive accumulations, which were seemed in his left hip joint on both bone and soft tissue factor images at first, were decreased respondently to the treatment of this lesion. In conclusion, the factor analysis was useful for differencial diagnosis of the hip joint disorders and observation of the clinical course of the hip joint disorders.

Adult↗
PubMed2004

[Total endoprosthesis replacement after hip joint arthrodesis].

PURPOSE OF THE STUDY: To evaluate mid-term results of conversion of arthrodesis to total hip replacement in terms of X-ray findings and benefits for the patient. MATERIAL: Ten patients who had undergone hip joint arthrodesis were clinically examined and X-rayed and the findings evaluated. The most common indications for arthrodesis were posttraumatic lesions or the sequelae of a dysplastic hip joint, Perthes disease and inflammatory hip arthritis. The average age was 24.6 years (range, 15-37) at the first operation (arthrodesis) and 42.5 years (range, 30-61) at the second operation (hip arthroplasty). The average follow-up was 9.3 years (range, 1-16). Patients with true ankylosis of the hip joint were not included. METHODS: The patients were clinically examined for the range of motion, which was evaluated by Harris hip scores and X-ray findings. RESULTS: All eight patients who underwent total hip replacement due to persistent pain in the lumbosacral region experienced pain relief or its absence. This also applied to the patients whose X-ray films showed signs of spondylarthritis. The Harris hip scores showed that six patients were able to walk to longer distances without any support. No radiographic evidence of acetabular component loosening was found. One patient had to undergo reimplantation of the femoral component because of aseptic loosening. In the early postoperative period, one dislocation of the prosthesis and one sciatic nerve injury resulting in transient paresis of the peroneal nerve were recorded. None of the complications required repeat surgery. All patients reported that they would undergo the procedure again despite an increased risk associated with this procedure. DISCUSSION: Our results are in agreement with similar findings in this field. We did not find an increase in failed hip arthroplasty in older patients. The X-ray findings were very satisfactory, particularly those concerning the acetabular component. Patients who had true ankylosis of the hip joint were not included in the study. The average range of motion achieved in our patients corresponds to that reported in the literature. CONCLUSIONS: Conversion of hip arthrodesis to total hip replacement is not a frequent surgical procedure. It is associated with a higher degree of risk because of changed anatomy due to previous surgical interventions in that region. Motion restoration in the hip joint results in reducing low back pain and, consequently, improving the quality of life. All evaluated patients would be willing to undergo the operation again.

Adolescent↗
PubMed1994

An electromyographic analysis of the hip abductors during load carriage: implications for hip joint protection.

Decreasing the relative force demands on the hip abductor muscles may reduce hip joint forces. The purpose of this study was to use surface electromyography (EMG) to determine the relative demand on the hip abductor muscles as subjects walked and carried single hand-held loads of multiple weights. Thirty healthy, college-aged subjects carried single hand-held loads by their side. The loads weighed between 3 and 30% of body weight. Loads were carried in a position either ipsilateral or contralateral to a given hip side. Normalized EMG (%EMG) was collected during the middle stance phase of walking. The amount of %EMG remained statistically equal to or less than the no-load EMG baseline for all ipsilateral-held loads and greater than the no-load EMG for all contralateral-held loads above 3% body weight. Load positions and weights that generated %EMG levels less than or equal to the no-load baseline most likely offer a degree of hip joint protection for persons with hip disability.

Adult↗
PubMed1980

Quantitative analysis of the growth of the hip joint. A radiological study.

Growth of the hip joint is described on the basis of annual radiographs taken of the intact hip joints of 50 boys aged between 5-15 years. The ossification centre of the femoral head grows at a faster rate in breadth than in height. The growth rate in breadth of the bony centrum exceeds also that of the proximal metaphysis and, accordingly, in the case of normal ossification, the radio-anatomical condition of these two parts is characteristic of the age of the individual. The osseous acetabulum also grows at a faster rate in breadth than in depth. In the period studied up until the 15th year the width of the "articular space" gradually decreases. The ossification rate in the age group examined manifests--with slower and faster periods--a gradually declining tendency. The changes revealed by the radiographs have been interpreted from the viewpoint of bone development and an analysis is also given of the spatial conditions of ossification.

Acetabulum↗
PubMed1990

[Ultrasound examination of the hip joint in infants].

The authors investigated 236 hip joints in children aged from 10 days to 3 months by ultrasound method. Joints were classified after Graph in 4 types. Angular values of osseous and cartilaginous reference points of hip joints are determined and therapeutic measures are prescribed depending on the joint type. Sonography provides quite objective information about non-cartilaginous elements of a joint and deserves spreading in all areas.

Age Factors↗
PubMed2001

High-turnover periprosthetic bone remodeling and immature bone formation around loose cemented total hip joints.

Aseptic loosening and periprosthetic osteolysis are the major problems awaiting solution in total hip surgery. The clinical investigation focused on the analysis of periprosthetic bone remodeling to clarify one important key event in the cascade of periprosthetic connective tissue weakening and osteolysis around loose artificial hip joints. Twelve acetabular bone samples adjacent to granulomatous synovial-like membrane of loose hip prosthesis were retrieved at revision surgery and processed for Villanueva bone staining for morphological observation and bone histomorphometric analysis. Eight well-fixed bony samples were used as control. Although osteoclastic surface and eroded surface by osteoclasts were evident in the periprosthetic bone from loose hip joints (p = 0.003 and p = 0.027), increased osteoid/low-mineralized bone matrix (p < 0.001) and osteoid width (p < 0.001) also were significant findings in structural analysis. In addition, not only elevated mineral apposition rate (MAR; p = 0.044) but also increased mineralizing surface (p = 0.044) and bone formation rate (BFR; p = 0.002) in loose periprosthetic bones were shown in dynamic data analysis. These results were confirmed by precise morphological observation by confocal laser scanning microscopy. Active coupling of bone formation and resorption and increased osteocytes with abundant bone canalicular projections were found in combined with the presence of immature bone matrices (osteoid and low-mineralized bone areas) in periprosthetic bones from loose hip joints. These results indicated that active osteoclastic bone resorption and/or defective bone formation are coupled with monocyte/macrophage-mediated foreign body-type granuloma in the synovial-like interface membrane of loose hip joints. Thus, this unique high-turnover periprosthetic bone remodeling with bad bone quality probably is caused by the result of cellular host response combined with inappropriate cyclic mechanical loading. The fragile periprosthetic bone may contribute to hip prosthesis loosening.

Aged↗
PubMed2001

Reciprocal angular acceleration of the ankle and hip joints during quiet standing in humans.

Human quiet standing is often modeled as a single inverted pendulum rotating around the ankle joint, under the assumption that movement around the hip joint is quite small. However, several recent studies have shown that movement around the hip joint can play a significant role in the efficient maintenance of the center of body mass (COM) above the support area. The aim of this study was to investigate how coordination between the hip and ankle joints is controlled during human quiet standing. Subjects stood quietly for 30 s with their eyes either opened (EO) or closed (EC), and we measured subtle angular displacements around the ankle (thetaa) and hip (thetah) joints using three highly sensitive CCD laser displacement sensors. Reliable data were obtained for both angular displacement and angular velocity (the first derivative of the angular displacement). Further, measurement error was not predominant, even among the angular acceleration data, which were obtained by taking the second derivative of the angular displacement. The angular displacement, velocity, and acceleration of the hip were found to be significantly greater (P<0.001) than those of the ankle, confirming that hip-joint motion cannot be ignored, even during quiet standing. We also found that a consistent reciprocal relationship exists between the angular accelerations of the hip and ankle joints, namely positive or negative angular acceleration of ankle joint is compensated for by oppositely directed angular acceleration of the hip joint. Principal component analysis revealed that this relationship can be expressed as: thetah=gammathetaa with gamma=-3.15+/-1.24 and gamma=-3.12+/-1.46 (mean +/-SD) for EO and EC, respectively, where theta is the angular acceleration. There was no significant difference in the values of y for EO and EC, and these values were in agreement with the theoretical value calculated assuming the acceleration of COM was zero. On the other hand, such a consistent relationship was never observed for angular displacement itself. These results suggest that the angular motions around the hip and ankle joints are not to keep the COM at a constant position, but rather to minimize acceleration of the COM.

Acceleration↗
PubMed2005

[Stress distribution on the femoral neck at different abduction angles of the hip joint: a finite element analysis].

OBJECTIVE: To analyze the stress distribution and its changes of the femoral neck at different abduction angles of the hip joint to provide biomechanical evidence for the treatment of hip joint disease. METHODS: A three-dimensional finite element model of the femoral head region was reconstructed on the basis of data available in the dataset of No.1 Virtual Male Chinese. Different abduction angles of the hip joint were simulated under the load of body weight, and the stress distribution on the femoral neck was calculated and compared. RESULTS: With different abduction angles of the hip joint, the stresses on the medial and lateral sides of the femoral neck were obviously greater than those on the anterior and posterior regions. As the abduction angle of the hip joint increased, the stress on the posterior aspect of the femoral neck decreased while that in other regions increased (except for the anterior aspect of the femoral neck which remained unchanged). CONCLUSION: The lateral aspect of the femoral neck withstands the most intense stress of the body weight, which increases with the abduction angle of the hip joint.

Biomechanical Phenomena↗
PubMed2004

[A study on new computer-aided modeling method of hip joint].

The main reason of invalidation of prosthetic hip joint is the prostheses flexibility and shift, dislocation and disjunction. Promoting the long time stability of the prostheses is the key of improving the long term hip joint replacement effect. Former research work was focused on the upper segment of femur, and assumed the acetabulum cup to be a spheric concave, and the external form of acetabulum prostheses was basically semi spheric. This paper presents a method of acquiring the point data on the surface of the hip bone using the reverse engineering technology. By analyzing the acetabulum surface fitting error we use rotating elliptical surface to fit the acetabulum surface, together with the optimal technique to build up the CAD model of acetabulum surface. We compare the fitting error between the sphere fitting and rotating elliptical surface fitting and get the result that the rotating elliptical surface fitting error is smaller than the sphere fitting error, and the rotating elliptical surface can describe the shape of the acetabulum better.

Acetabulum↗