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PubMed1989

[Experimental substantiation of a transosseous approach in arthroplasty of the hip joint].

The author analyses the results of 40 experimental operations on cadavers to work through and to improve the approach for the hip joint arthroplasty performed by means of intertrochanteric osteotomy of the femur. The main parameters of the approach at various stages of the procedure have been evaluated according to O. Y. Sozon--Yaroshevich, the traumatizing factors of the operation have been determined and the peculiarities of mobilization of the proximal part of the femur and the possibility of displacement of the femoral head in various directions have been studied. Variations of the approach have been proposed taking into consideration the degree of limitation of the movements and the character of pathologic changes in the joint for performing hip joint arthroplasty in clinical practice. An approach to the supraacetabular area from the part of the joint cavity has been worked out which preserves the gluteal muscles, at the same time allowing to perform the arthroplasty and to reconstruct the supraacetabular area.

Acetabulum↗
PubMed1991

Ultrasound appearance of the hip joint in newborns during the first week of life.

The frequency of different types of hip joints in newborns was determined on the basis of ultrasound screening examinations performed during the first week of life. A higher percentage (14.1%) of abnormal hip joints were seen in comparison with the groups examined in later weeks of life suggesting the possibility of natural improvement in a number of cases. The more frequent appearance of pathology in girls was confirmed. Further investigations on the natural history of hip joint development in the newborn and on the general principles of screening examinations are needed.

Female↗
PubMed1997

[Sonographic measures of the hip joint of 1328 newborns of Han and Uygur nationalities-relative factors of congenital dislocation of hip].

The four sonographic methods (Engesaeter, Terjesen, Graf, Morin-Harcke) were used for examining the hip joint of 1328 newborns of Han and Uygur nationalities. The difference between Han and Uygur newborns was not statistical significant, but some literatures reported that in our country, the incidence of different nationalities in different regions varied. Our conclusion is that there is no obvious relationship between the depth of the acetabulum and the percentage of the femoral head covered by the acetabulum. It is caused by other factors, inherent or acquired. The value of the hip joint of the male and female has significant difference (P < 0.0005). The incidence of CDH in girls is much higher than that in boys. This may be related to the different depth of the acetabulum and different percentage of the femoral head covered by the acetabulum. In the period of newborn, girl's depth of the acetabulum is smaller than that of boys.

Anthropometry↗
PubMed2002

Transient synovitis: is there a need to aspirate hip joint effusions?

There is debate as to the optimal management of children with hip joint effusions especially regarding the decision to aspirate. The objective of this study was to determine whether there is a need to aspirate hip joint effusions detected on ultrasound in patients with clinical transient synovitis (TS) and to identify the natural history of these effusions. Twenty-five children with proven hip joint effusions were followed up sequentially by clinical and radiological examination until symptom free. The mean age was 6 years with equal right/left distribution. No child underwent hip aspiration and no cases of sepsis were missed. The median size of hip effusion detected on ultrasound at presentation was 9 mm. At 7 days 60% (15/25) of patients had a normal clinical examination with no detectable effusion on ultrasound. At 14 days 16% (4/25) had an effusion detectable on ultrasound but they were all pain and limp free and their effusions were reducing in size. These results support the known benign nature of TS and that it will settle with conservative treatment.

Child↗
PubMed1992

Acute septic arthritis of the hip joint in infancy and childhood.

Forty-three children with 45 hip joint infections were admitted to the hospital between 1983 and 1988. The duration of symptoms was the single most important prognostic feature. Almost all children who were treated within four days of symptoms had a satisfactory outcome. Concomitant osteomyelitis of the proximal femur produced by far a worse prognosis than if the infection was confined to the synovium of the hip joint. In addition, patients whose hips were infected with Staphylococcus aureus bacteria were more likely to have a poor prognosis than those whose hips were infected with non-S. aureus bacteria.

Acute Disease↗
PubMed2000

Messenger ribonucleic acid expression of 16 matrix metalloproteinases in bone-implant interface tissues of loose artificial hip joints.

Matrix metalloproteinases (MMPs) have been reported to be the major factors responsible for aseptic loosening of artificial hip joints. So far, messenger ribonucleic acid (mRNA) expression patterns of seven MMPs have been reported, but that of many other MMPs which have been newly discovered or recently considered to be responsible for prosthetic loosening is still unknown. In this study, mRNA expression pattern of 16 different types of MMPs were analyzed to evaluate which MMPs were locally produced and contributed to prosthetic loosening. Synovium-like interface tissues between bone and prosthesis were collected from 18 cases of aseptic loose artificial hip joint at revision surgery. Six cases of normal synovium were used as controls. Total RNA was extracted by single-step acid guanidinium-thiocyanate-phenol-chloroform procedure. mRNA expression of MMPs was analyzed by semiquantitative reverse transcription-polymerase chain reaction. Based on local expression pattern of MMPs at the mRNA level, aseptic loose artificial hip joint was characterized by elevated expression of MMP-1, MMP-9, MMP-10, MMP-12, and MMP-13; moderate expression of MMP-2, MMP-7, MMP-8, MMP-11, membrane type (MT)1-MMP (MMP-14), MT2-MMP (MMP-15), MT3-MMP (MMP-16), MT4-MMP (MMP-17), and MMP-19; lower expression of MMP-3; and little significance of MMP-20. The MMPs detected in this study can potentially degrade almost all components of the periprosthetic extracellular matrix. Thus, many MMP type enzymes possibly contribute to prosthetic loosening and osteolysis through pathologic extracellular matrix degradation and connective tissue/bone remodeling around prostheses.

Aged↗
PubMed1987

Contact pressures in the human hip joint.

The pressure distribution between the cartilaginous surfaces in the human hip joint was measured using pressure-sensitive film. Five cadaveric hip joints (aged between 58 and 87 years) were measured at three positions and loads, representing three instants in the stance phase of the walking cycle. The pressure distribution was not uniform, indicating that the cartilage did not, to any great extent, distribute the applied load. The maximum pressures recorded were about 10 MN/m2. The anterosuperior surface of the cartilage was identified as an area of high pressure.

Aged↗
PubMed1975

Motion of the hip joint.

It has been demonstrated that in the normal hip abduction to adduction motion of the femoral head in the neutral position is equivalent to internal to external rotation of the femoral head in the 90 degree flexed position. For similiar reasons external to internal rotation of the femoral head in the neutral position is equivalent to abduction to adduction motion in the 90 degree flexed position. Due to the architecture of the hip joint, therefore, the hip motion in some pathological conditions can be anticipated and explained.

Acetabulum↗
PubMed2001

Septic arthritis of the hip joint in cervical cancer patients after radiotherapy: Three case reports.

Cervical cancer patients may experience hip problems related to the cancer itself or therapeutic management for the cancer. Septic arthritis should be one of the possibilities but there have been no reports on this. Here we present three patients who developed hip problems more than two years after radiotherapy with or without a radical operation. One patient was managed as septic arthritis because of significant inflammatory signs around the affected hip joint even though the causative organism was not confirmed. Succeeding total hip arthroplasty functioned well and had no recurrence of infection. The hip problems of the other two patients were diagnosed as radiation osteonecrosis of the femoral head initially. However, Bacteroides fragilis infection was found several months after total hip arthroplasties. Radiotherapy to the pelvis may damage the hip joint and compromise host-defense mechanisms of the pelvic region. Both factors may increase the possibility of infection of hip joints. Further clinical evidence is needed to understand whether subacute or chronic anaerobic infection could also be one of the causes leading to progressive destruction of the femoral head.

Journal Article↗
PubMed1978

[Reactive-destructive changes in the nervous elements of the capsule of the hip joint in coxarthrosis].

Specimens of the hip joint capsule were obtained during surgical treatment in 56 patients suffering from different kinds and stages of coxarthrosis. Neuronal elements of the capsule were stated to undergo reactive-destructive changes. Demyelinization of the capsule nerve fibers seems to be one of the causes producing painful sensation in the affected joint at coxarthrosis. Displastic and idiopathic coxarthrosis produces the destruction of less degree with preservation of the capsule nerves for a longer period; traumatic coxarthrosis with an aseptic necrosis of the femoral head is followed by a more profound destruction and the development of the disease is of shorter duration.

Adult↗
PubMed1988

A new method of estimation of interobserver variation and its application to the radiological assessment of osteoarthrosis in hip joints.

Four frequently referenced radiological methods for assessment of osteoarthrosis in hip joints are compared with respect to their interobserver variation. One hundred hip joints were rated by four observers. Each observer applied all four methods to all the radiographs. The results were analysed by a new statistical method, which allowed detailed assessment of the nature and extent of interobserver variation. Significant differences in terms of intraobserver disagreement were found, and Heripret's method was the best in this respect. All four methods showed a significant degree of systematic disagreement among the observers. This suggests that the interobserver variation might be reduced by confronting the observers with the results of the statistical analysis of their judgements.

Bone Diseases↗
PubMed1992

[Injury of the inguinal blood vessels in implantation of hip joint prosthesis].

Vascular injuries during or after total hip replacements have often been reported. In 2257 artificial hip joint replacements, we observed 8 cases of vascular injuries requiring reconstruction (3 cases), suturing (2 cases), end-to-end anastomosis (1 case), or ligature (2 cases) performed by a vascular surgeon. A separate skin incision for vascular repair was necessary in all patients. Most of the injuries occurred as a result of technical errors through lack of caution when using bone hooks or rough handling, resulting in dislocation of the hip joint. The latter occurs mainly in revision procedures. Six patients recovered fully, but two died, one of hemorrhagic shock and the other of cardiac decompensation.

Aged↗
PubMed1999

Effects on acetabular development of resection of the labrum acetabulare (limbus) in the hip joint.

The effect of resecting the hip joint limbus on acetabular development was studied. Ten infant Japanese monkeys were used as experimental subjects. The limbus was resected on one side and the developmental effects were observed. The period of observation ranged from 12 to 31 months with a mean of 17 months. After histological examination of the resected limbus, the monkeys were divided into two groups, group A (5 cases) in which the hyaline cartilage had not been resected, and group B (5 cases) in which the hyaline cartilage had been resected. Every 2 months after the operation, each monkey was x-rayed and the acetabular angle, acetabular index, acetabular edge angle and Wiberg's Center-Edge angle were measured and the differences between the resected and unoperated sides were subjected to regression analysis. Neither Group A nor Group B developed acetabular dysplasia.

Acetabulum↗
PubMed2002

Sonographic investigation of anatomical specimens of infant hip joints.

The anatomical foundations of infant hip sonography techniques are ill-defined. We investigated anatomical specimens of infant hip joints in a water bath, with Graf's and Terjesen's methods. Acetabular position was varied in defined increments, with respect to the ultrasound beam. The alpha angles and the femoral head coverage were measured. Plastic acetabular casts were sawn along the sonographic section planes, and the cut sections compared with the sonographic sections. For images to be obtained, which were analysable by the two methods, the ultrasound beam had to intersect with the acetabular inlet plane at defined angles. The acetabular notch had to be anteriorly rotated from the ultrasound beam plane by at least 20 degrees. Beam entry within a 50 degrees sector posterior to the perpendicular on the inlet plane gave analysable images. The alpha angles and femoral head coverage were much affected by coronal-plane transducer tilt. Caudad tilts were associated with lesser values, a fact that should be borne in mind in clinical ultrasound investigations.

Acetabulum↗
PubMed1991

[The correlations of dysplastic hip joint pathology with fetal breech presentation].

In the article are discussed the causes of hip joint instability at breech presentation. In the article are presented the results of examination of 116 probands with hip joint dysplasia, aged 5-15 years, and 69 breech presentation born probands, It has been carried out genetic-correlative analysis on the basis of population frequency and frequency among the probands' relatives, differentiated in accordance with the signs discussed. The principal cause of the hip joint dysplastic pathology formation at breech presentation is the mechanical factor.

Adolescent↗
PubMed1991

[Corrective osteotomy of the femur in the treatment of the syndromes of dysplastic instability of the hip joint].

On the basis of analysis of short-term outcomes (1-5 years) of treatment of 139 patients (150 joints) with congenital dislocation and oluzation of the thigh, conclusion has been drawn that the application of corrective femur osteotomy with these patients should be limited with the cases of formation of pathology loading of the joint under conditions of negative intercomponental trophism. Restoration of correct anatomical interrelations between the components of the joint can be accompanied by the clinical decompensation of the hip joint state. Position of the cotyloid cavity and epiphysis of the head of the femur is of fundamental importance for further formation of the hip joint and its neck and diaphysis position is of minor importance. When positing indications for corrective femur osteotomy and its efficiency prognostication it is necessary to be orientated towards epidiaphysar and not cervicodiaphysar correlations. Removal of antetorsion of the head of the femur without due regard for the grade of its proximal epiphysis retroversion can lead to the development of external rotary contraction in hip joint.

Abnormalities, Multiple↗
PubMedDate not supplied

The arterial folding point during flexion of the hip joint.

PURPOSE: Endovascular stents placed in periarticular vessels may be at a greater risk of neointimal hyperplasia and eventual occlusion than those placed in non-periarticular vessels. The purpose of this study was to investigate the location of maximal conformational change along the iliac and femoral artery, the folding point, during flexion of the hip joint and its location relative to the hip joint and the inguinal ligament. METHODS: Seventy patients undergoing femoral artery catheterization were evaluated. The patients were 47 men and 23 women and ranged in age from 26 to 75 years (mean 54 years). The arteries (right:left=34:36) were measured using a marked catheter for sizing vessels. Fluoroscopic images were obtained in anteroposterior and lateral projections in neutral position, and in the lateral projection in flexed position of the hip joint. The folding point was determined by comparing the lateral projection images in the neutral and flexed positions. The distance from the acetabular roof to the folding point and the distance from the inguinal ligament to the folding point was evaluated. RESULTS: The folding point was located 42.8 +/- 28.6 mm cranial to the acetabular roof and 35.1 +/- 30.1 mm cranial to the inguinal ligament. As the patient's age increased, the folding point was located more cranially (p < 0.001). CONCLUSIONS: The folding point during flexion of the hip joint was located 42.8 +/- 28.6 mm cranial to the acetabular roof and 35.1 +/- 30.1 mm cranial to the inguinal ligament. As the patient's age increased, the folding point was located more cranially. When a stent is inserted over this region, more attention may be needed during follow-up to monitor possible occlusion and stent failure.

Acetabulum↗