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At least 379 records · Page 21Linked to original sources
PubMed1998

Acetabular development after open reduction for developmental dislocation of the hip. 15-year follow-up of 22 hips without additional surgery.

We reviewed serial radiographs of 22 hips in 20 patients with developmental dislocation of the hip (DDH), who were treated by open reduction and followed without additional surgery until puberty, to identify predictive measures of subsequent acetabular development. The average age at surgery and at final follow-up was 14 (5-26) months and 15 (13-20) years, respectively. Hips with a CE angle above 20 degrees and femoral head coverage above 75 degrees at the final follow-up were classified as "satisfactory outcome". At the final follow-up, 14 hips were classified as satisfactory and 8 hips as unsatisfactory. In the former group, acetabular improvement continued throughout growth, whereas in the unsatisfactory group, the acetabulum did not improve after 3-5 years of age. Unsatisfactory condition at the final follow-up was noted in all hips that had a CE angle less than 0 degrees and head coverage less than 50%, when the patients were 3-5 years old and less than 5 degrees and 60%, respectively, at the age of 6-8 years. These findings should be useful in assessing the need for and the timing of acetabuloplasty after open reduction for DDH.

Acetabulum↗
PubMedDate not supplied

One-stage correction of the dysplastic hip in cerebral palsy with the San Diego acetabuloplasty: results and complications in 104 hips.

Ninety-two patients with cerebral palsy underwent a special type of pericapsular acetabuloplasty designed to correct the hip dysplasia that occurs in cerebral palsy. The osteotomy was performed as part of a combined procedure (including femoral osteotomy and soft-tissue releases). Retrospective analysis was performed on 75 of the children (104 hips from 1982 through 1995) with a mean follow-up of 6.9 years. Ninety-nine (95%) of the 104 hips remained well reduced at follow-up. There were no redislocations. If the preoperative migration percentage was >70% (severe subluxation), improved results were noted in hips that had an open reduction with capsulorrhaphy. There were 13 complications including intraarticular extension of the acetabuloplasty (one) and avascular necrosis of the femoral head (eight hips, 8%). Indications for addition of a pericapsular acetabuloplasty include an open triradiate cartilage, acetabular dysplasia (acetabular index >25 degrees), and subluxation or dislocation with a migration percentage of >40%. Even hips with relative incongruity and some deformity of the femoral head can be successfully treated with this combined approach.

Acetabulum↗
PubMedDate not supplied

Results of medial open reduction of the hip in infants with developmental dislocation of the hip.

Thirty-two patients who had medial open reduction of 40 hips were reviewed at an average of 10.3 years follow-up (range 2.5-18.6 y). Center-edge angles and acetabular indices were measured on preoperative, postoperative, and final radiographs. The presence of AVN was noted. The final radiograph was assigned a Severin grade. One hip re-dislocated. Eight (20%) have required subsequent pelvic osteotomies. AVN developed in 11 hips (27.5%). Of the 11, five were classified as type I, defined as temporary irregular ossification of the femoral head. Bilateral dislocations and age older than 1 year at surgery correlated with greater likelihood of AVN ( < 0.05), whereas absence of the ossific nucleus did not. Thirty hips were classified as Severin 1 or 2, six were rated Severin 3, and three were Severin 4. Nineteen patients completed gait analysis. Normal motion was documented in 12 of 14 unilateral patients. Significant hip flexor and extensor isokinetic weakness was seen. In conclusion, medial open reduction yielded satisfactory results in 75% of hips. Although iliopsoas weakness is common, gait is usually normal.

Child, Preschool↗
PubMed2004

A comparison of self-reported hip symptomatology in hip replacement patients and a population-based sample of medicare beneficiaries.

BACKGROUND: There exists variation over geographic areas in the use of total hip arthroplasty. This variation is not explained by the variation in the density per unit area of surgeons. The objective was to compare the severity of hip symptoms between a population-based sample of community-dwelling Medicare beneficiaries and a hospital-based sample of patients undergoing total hip replacement surgery. MATERIAL/METHODS: Population-based survey data on 113 community residents were compared to data from an independent sample of 157 hospital-based patients who underwent total hip replacement surgery, all of whom were 65 years and older. Severity of symptoms in both groups was rated using the Hip Rating Questionnaire (HRQ). RESULTS: The average population sample HRQ score was 63+/-9.0; overall arthritis impact 12+/-5, pain 14+/-6, walking 18+/-4, function 19+/-4. The average patient sample HRQ score was 56+/-14; overall arthritis impact 10+/-7, pain 11+/-4, walking 15+/-4, function 20+/-3. CONCLUSIONS: Community-dwelling individuals report symptoms as severe as patients who have undergone total hip arthroplasty. Further research is necessary to identify the reasons for the low incidence of treatment for those living in the community.

Activities of Daily Living↗
PubMed2004

Passive versus active stretching of hip flexor muscles in subjects with limited hip extension: a randomized clinical trial.

BACKGROUND AND PURPOSE: Active stretching is purported to stretch the shortened muscle and simultaneously strengthen the antagonist muscle. The purpose of this study was to determine whether active and passive stretching results in a difference between groups at improving hip extension range of motion in patients with hip flexor muscle tightness. SUBJECTS AND METHODS: Thirty-three patients with low back pain and lower-extremity injuries who showed decreased range of motion, presumably due to hip flexor muscle tightness, completed the study. The subjects, who had a mean age of 23.6 years (SD = 5.3, range = 18-25), were randomly assigned to either an active home stretching group or a passive home stretching group. Hip extension range of motion was measured with the subjects in the modified Thomas test position at baseline and 3 and 6 weeks after the start of the study. RESULTS: Range of motion in both groups improved over time, but there were no differences between groups. DISCUSSION AND CONCLUSION: The results indicate that passive and active stretching are equally effective for increasing range of motion, presumably due to increased flexibility of tight hip flexor muscles. Whether the 2 methods equally improve flexibility of other muscle groups or whether active stretching improves the function of the antagonist muscles is not known. Active and passive stretching both appeared to increase the flexibility of tight hip flexor muscles in patients with musculoskeletal impairments.

Adult↗
PubMed1987

[Synovial chondromatosis of the hip. Value of dislocation of the hip for complete removal of pathological synovial membranes].

Thirty-two synovial chondromatoses of the hip have been treated surgically. Nine cases were discovered accidentally in arthrotic hips being treated by total arthroplasty. Eleven partial joint clearances were made, five by an anterior approach and six by a lateral approach without dislocation of the hip, with bad results due to persistence of pathological synovium in the depth of the acetabular fossa. Twelve complete joint clearances were made with subtotal synovectomy and removal of all loose bodies, especially from the acetabular fossa, by dislocating the hip. The results were better and the prevention of secondary arthrosis and stabilisation of the hip condition was rendered more certain. Dislocation of the hip, with suitable precautions, does not cause avascular necrosis of the femoral head. Surgical treatment is indicated at an early stage in the disease and may prevent osteoarthrosis in a young subject.

Chondroma↗
PubMed1994

The contralateral hip in patients primarily treated for unilateral slipped upper femoral epiphysis. Long-term follow-up of 61 hips.

We reviewed, at an average age of 46 years, a series of 61 patients treated for unilateral slipped upper femoral epiphysis. At maturity there had been slipping of the contralateral hip in 11 patients (18%) and another 14 (23%) had originally had evidence of bilateral slipping when the primary radiographs were reviewed. In only two of these 25 patients (8%) was the slipping of the contralateral hip symptomatic. The incidence of early osteoarthritis of the contralateral hip was 7 of 36 with no slip, 5 of 16 with an untreated slip and 1 of 9 with a slip pinned in situ. If all 61 contralateral hips had been prophylactically pinned at the primary admission, 36 of the operations (59%) would have been unnecessary. We recommend that prophylactic pinning of the contralateral hip should not be standard, but that lateral radiography by the Billing technique be repeated every third to fourth month until closure of the growth plate begins. Hips in which a slip occurs should be pinned in situ.

Adolescent↗
PubMed1994

The Balgrist hip socket for cementless fixation in primary total hip replacements and in acetabular revisions.

The results of 532 hip arthroplasties in which an uncemented Balgrist hip socket had been used in 387 primary total hip replacements and in 145 acetabular revisions were reviewed after a maximum of six years. The socket consists of two tapered parts, namely an expansive outer titanium-alloy split ring and an insert of polyethylene. The mean age of the patients at the time of operation was 54.3 years in primary hip replacements, and 64.7 years in acetabular revisions. Acetabular deficiency according to the AAOS classification was found in 21% of the primary arthroplasties, and in 80.7% of the acetabular revisions. Using Kaplan-Meier survivorship analysis, with the use of prosthesis revision as the endpoint of failure, the survival rate at five years was 99% in primary arthroplasties, and 88.7% in acetabular revisions. Our data suggest that the unique socket design of the Balgrist hip socket gives very satisfactory clinical results not only in primary hip replacements but also in acetabular revisions even with various acetabular defects.

Adolescent↗
PubMedDate not supplied

Treatment of congenital dislocation of the hip. Results of closed reduction and immobilization in the hip spica cast.

Treatment of congenital dislocation of the hip (CDH) by closed reduction and immobilization in the hip spica cast is one of the accepted methods for use in patients under one year of age. We report 74 congenitally dislocated hips treated with premanipulation skin traction, closed reduction under anesthesia, adductor tenotomy and immobilization in the hip spica cast. Satisfactory results were obtained in 60 hips. In seven hips, avascular necrosis of the capital femoral epiphysis was observed with careful management, closed reduction and immobilization in a spica cast provides good results for treatment of CDH.

Casts, Surgical↗
PubMed2006

Tight fit technique in primary hybrid total hip arthroplasty for patients with hip dysplasia.

This article presents the midterm results of hybrid total hip arthroplasty for patients with hip dysplasia by use of a tight fit technique for the femoral component. We followed up 113 hips in 99 patients for a mean of 11 years. All final femoral rasps used in this study overrasped by 0.5 to 1.0 mm for stem insertion, resulting in relatively thin cement mantles. Both components of one hip were removed because of infection. The other 5 acetabular components were revised for osteolysis, recurrent dislocation, or dislodgement of the polyethylene liner. No femoral component was revised for aseptic loosening. We conclude that the tight fit technique using a canal-filling stem may produce good long-term results for patients with hip dysplasia.

Adult↗
PubMed2001

Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up of 7 years, 7 months (range, 5-15 years), 2 hips were revised. One cup was revised after 27 months for sciatic nerve problems; the other hip was revised for aseptic loosening of the cup at 12 years' follow-up. The cumulative survival of the acetabular reconstruction was 96.3% at 5- and 10-year intervals. Additionally, 2 hips (7.7%) showed stable radiolucent lines in zone III without migration of the cup. None of the cemented stems were revised. The bone impaction grafting technique is a safe and attractive method to restore bone deficiencies in dysplastic hips.

Acetabulum↗
PubMedDate not supplied

Cemented versus uncemented hip replacement for fracture of the hip.

PURPOSE: Review cemented versus uncemented hemi-arthroplasty hip replacement regarding morbidity and long term results. METHODS: A literature review searching PubMed and Medline was done. Publications applicable to hip fractures treated by hip replacement or hemi-arthroplasty replacement were reviewed. RESULTS: Several articles compared cemented femoral stems to fracture fixation. There were few articles comparing cemented and uncemented stems. Some noted increased problems with uncemented stems but did consider design factors. Unreamed tapered stems may have may have fewer problems. CONCLUSIONS: Prospective studies comparing cemented and uncemented femoral stems are needed to determine the best form of fixation for patients having hip surgery following hip fracture. Tapered uncemented stems may offer as good a result as cemented stems, with less morbidity.

Arthroplasty, Replacement, Hip↗
PubMed1998

Quantitative measurement of joint space narrowing progression in hip osteoarthritis: a longitudinal retrospective study of patients treated by total hip arthroplasty.

OBJECTIVES: To evaluate the rate of progression of radiological joint space narrowing (JSN) in patients operated on for hip osteoarthritis (OA) and to determine its predictive factors. METHODS STUDY DESIGN: retrospective longitudinal trial of 61 patients who underwent total hip arthroplasty (THA) for hip OA (69 operated hips). Mean follow-up 81.2 +/- 9.9 months. Collected data: (1) standing frontal radiographs of the pelvis from diagnosis to surgery (246 films) for morphological evaluation and quantitative measurement of joint space width (JSW) (computerized reading of digitized X-rays); (2) demographic data (sex, age, body mass index, smoking status, professional and sporting activities, family history of OA); (3) clinical data (age at onset-diagnosis and THA, drug consumption, time from diagnosis to permanent disability, OA at other joints, previous THA of the contralateral hip). STATISTICS: multivariate analysis. RESULTS: The yearly mean narrowing (YMN) of MeanJSW was 0.43 +/- 0.43 mm/yr (median 0.29, range 0.03-2.55). YMN correlated inversely with joint space width at operation and follow-up duration, and was increased in atrophic OA (r = 0.71). The time between diagnosis and THA correlated with JSW at diagnosis, and was inversely correlated with age at onset and YMN. It was longer in patients with hypertrophic OA (r = 0.69). CONCLUSION: Rapid progression of JSN, older age and absence of osteophytes appear to be the main factors leading to THA.

Adult↗
PubMed1993

Open reduction through a medial approach for congenital dislocation of the hip. A critical review of the Ludloff approach in sixty-six hips.

We reviewed the results of open reduction through the medial approach of Ludloff, done for congenital dislocation in sixty-six hips (sixty-three children). The mean age at the time of the operation was twelve months (range, two to sixty-three months), and the mean duration of follow-up was six years (range, two to thirteen years). Avascular necrosis was evident preoperatively in two hips (3 per cent) and was noted postoperatively in another seven hips (11 per cent). There was a correlation between the age of the patient at the time of the operation and postoperative avascular necrosis, with an increased prevalence of the complication in patients who had been managed with the open reduction after the age of twenty-four months. One redislocation and two subluxations were noted at the time of the first changing of the cast, four weeks postoperatively. Although the acetabular index decreased from a mean of 38 degrees preoperatively to a mean of 16 degrees at the time of follow-up, acetabular dysplasia did not resolve in 33 per cent of the hips and pelvic osteotomy was performed. We consider the Ludloff approach to be a safe and effective method for the treatment of congenital dislocation of the hip in infants who are less than the age of twenty-four months and in whom a concentric reduction with less than 60 degrees of abduction was not achieved following closed reduction. The advantages of this approach include direct access to the iliopsoas, the transverse acetabular ligament, and the constricted capsule; minimum loss of blood; and a cosmetically acceptable scar.

Child↗
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↗
PubMed2004

[The methods of shorting of proximal femoral and total hip arthroplasty for old femoral neck fracture with severe hip joint dislocation].

OBJECTIVE: To discuss the effective method and outcome to old femoral neck fracture with severe hip joint dislocation. METHODS: From April 1996, 7 cases of old femoral neck fracture with severe hip joint dislocation were treated by the shorting of posterior femoral and total hip arthroplasty. RESULTS: The average age of 7 patients was 51 years old and the mean follow-up was 27.3 months. The mean Harris score was improved to 84.3 from 36.7 before operation in the latest follow-up. The prosthesis position of acetabular and femoral was excellent, there was no sinking or softening of artificial joint, nonunion of femoral osteotomy. CONCLUSION: The preliminary clinical results are quite satisfactory of the shorting of posterior femoral and total hip arthroplasty to old femoral neck fracture with severe hip joint dislocation, the follow-up is necessary for further long-term outcome.

Adult↗
PubMed1995

Total hip replacement for developmental dysplasia of the hip.

Total hip arthroplasty relieves pain and improves function for many patients with endstage arthritis secondary to developmental dysplasia of the hip. Acetabular dysplasia, however, presents a special problem for total hip reconstruction in these patients. Structural bone grafting with femoral head autografting to the dysplastic acetabulum and cementing acetabular components into the graft provides satisfactory short-term results, but longer-term followup data show high acetabular component failure rates. At a mean followup period of 7 years, 20% of components were loose, and at a mean followup period of 12 years, 46% were loose. Noncemented porous-coated hemispherical acetabular components have considerably expanded the success of total hip replacement without the need for structural bone grafting in such patients. At a mean followup period of almost 7 years, none of the acetabular components were reported to be loose in 1 series. For most patients, the acetabular dysplasia can be managed by techniques such as reaming deeper, using small-diameter porous-coated acetabular components, using screws to provide rigid initial stability for the components, increasing the height of the prosthetic hip center, and covering small portions of the components with bone graft chips if necessary.

Hip Dislocation↗
PubMed1993

[Gait analysis of patients with osteoarthritis of the hip and those with total hip arthroplasty].

For the purpose of quantitative evaluation of gait after total hip arthroplasty (THA), the author performed gait analysis using a force plate and a light source spot-measuring device. In this study, the author laid emphasis on measuring the moments of the hip joint on the coronal and sagittal planes, using a rigid body link model. On the sagittal plane, an extension moment began to be noted in the early stance phase. This moment was lower in patients showing escape limping. Flexion moment appeared in the middle to late stance phases. This moment was lower in patients with restricted hip extension. On the coronal plane, an abduction moment appeared in the single stance phase. This moment was lower in patients showing Duchenne limping. Abnormalities in these moments were sometimes observed even in patients in whom distance-related factors, temporal factors, and floor reaction force curves had been normalized. Therefore, the measurement of hip joint moments is expected to facilitate the evaluation of the hip joint function itself, unmodified by the compensatory effects by other joints.

Adult↗