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PubMedDate not supplied

Forces acting on the juvenile hip joint in the one-legged stance.

A two-dimensional biomechanical model of the juvenile hip joint was developed to describe the forces acting on the capital epiphysis and the greater trochanter apophysis in the one-legged stance. Based on anatomic femur specimens of 16 children, ranging from toddlers to teenagers, and radiographic studies of 1,350 hip joints of healthy children, we showed that the apophysis of the greater trochanter is a pressure apophysis. If the muscular forces acting on the apophysis of the greater trochanter are added, the unit sum may be considered a resultant force acting from a craniolateral direction. The trochanteric resultant force near the end of the growth period is equivalent to approximately 1.7 times body weight. The trochanteric resultant force stimulates craniolateral growth of the greater trochanteric apophysis. This mechanism is responsible for the direction of the forces exerted by the hip abductors and thus the direction and magnitude of Pauwels' hip-joint resultant, and finally influences the neck-shaft angle.

Adolescent↗
PubMedDate not supplied

The supercilium acetabuli score: an additional criterion for estimating the biomechanics of the hip joint.

There are significant correlations between the surface of the acetabular roof sclerosis (supercilium acetabuli) in the hip joint on a normal a.p. radiograph and the corresponding surface of cartilage. This correlation can be defined through mathematical formulas and scaled afterwards. These scales are determined on the basis of our clinical experience with the new supercilium acetabuli score. The score is related to the biomechanical situation of the hip joint and describes 3 classes: Class I = optimum, class II = balance, class III = imbalanced correlation between the supercilium acetabuli and the corresponding part of the joint space. For simple measurement of both surfaces, we developed a measuring instrument, the superciliometer, with which it is possible to obtain standardized conclusions describing the functional morphology of the cartilage in the pressure distribution zone of the hip joint, irrespective of whether there are already any visible radiological signs of coxarthrosis or not.

Acetabulum↗
PubMed1984

[Uncemented total prosthetics as exemplified by a carbon-fiber prosthesis of the hip joint].

A new artificial total hip joint was designed and tested in animals and human patients up to five years. For implant combined carbon material (Endocarbone) was used. The primary anchorage was achieved by a hydraulic pin system without bone cement. The follow-up of bone growth at the implant bone border line was proved by X-ray, computer-tomography, arthrography and histo-morphological tissues. The Endocarbone hip prosthesis has been proved as a biological implant. The good bonely incorporation justifies a more intensive clinical testing.

Animals↗
PubMed2003

Hip joint pathology: clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases.

BACKGROUND: The hip joint is becoming increasingly recognized as a source of groin pain and, in the authors' experience, buttock and low back pain. OBJECTIVES: To determine the range of pathologic diagnoses, clinical presentation, and the correlation between magnetic resonance arthrographic, ultrasonographic, and arthroscopic findings in the hip joint. METHODS: We prospectively studied 25 consecutive hip arthroscopies to determine the range of pathologic diagnoses, clinical presentation, and the correlation between magnetic resonance arthrographic, ultrasonographic, and arthroscopic findings. RESULTS: All of the hips arthroscoped had pathology. Back pain and hip pain were the 2 most common presentations. The only consistently positive clinical test result was a restricted and painful hip quadrant compared with the contralateral hip. Of the 17 patients whose flexion, abduction, external rotation (FABER) test results were reported at the time of examination, 15 (88%) were positive, and 2 (12%) negative. Plain radiographs were normal in all patients. All but 1 patient underwent magnetic resonance arthrography. Although specificity of 100% was achieved in our study, the sensitivity was significantly lower, with a relatively high number of false negatives. Hip arthroscopy proved the definitive diagnostic procedure for intraarticular pathology. CONCLUSIONS: Hip pathology, particularly labral pathology, may be more common than has been previously recognized. In those patients with chronic groin and low back pain, a high index of suspicion should be maintained. Clinical signs of a painful, restricted hip quadrant and a positive FABER test result should suggest magnetic resonance arthrography in the first instance, but a negative magnetic resonance image should not preclude hip arthroscopy if there is high clinical suspicion of hip joint pathology.

Adolescent↗
PubMed2002

Effects of changes in hip joint angle on H-reflex excitability in humans.

We examined the amplitude modulation of the soleus (Sol) H-reflex during controlled variations of the hip joint angle in 21 healthy adult human subjects. Hip angle variations were imposed separately, or in combination either with stimulation of the plantar skin or with electrical activation of muscle afferents from the medial gastrocnemius (MG) nerve. We found that with subjects in the supine position, flexion of the hip significantly depressed Sol H-reflex excitability, by as much as 50% of control reflex values (Ho) recorded at 10 degrees of hip flexion. Conversely, significant facilitation of the H-reflex was observed when the hip joint was extended (10 degrees), with amplitudes reaching 200+/-15.3% of Ho. Changes in H-reflex amplitude were also observed during electrical stimulation of either the foot sole or the MG nerve, when stimuli were delivered at different hip angles. Foot sole stimulation resulted in facilitation of the H-reflex with the hip extended while depression of the reflex was recorded with the hip flexed. In contrast, MG nerve stimulation at group-I muscle afferent strength resulted in a significant increase in the Sol H-reflex magnitude with the hip flexed, while during hip extension, no significant effects were observed [corrected]. This study provides evidence for the existence of a spinal mechanism, determined principally by the hip joint angle, which promotes switching between inhibitory and facilitatory pathways during hip flexion and extension. The origins of such a spinal mechanism are discussed.

Adult↗
PubMed1990

[Electromyographic findings in the gluteal muscles in the Watson-Jones and the Bauer surgical approaches to the hip joint].

The authors have made electromyographic examination of m. tensor fasciae latae and m. glutaeus medius and sometimes also minimus in patients after the implantation of total endoprosthesis of the hip joint by anterolateral Watson - Jones approach and transgluteal Bauer approach with the aim to find out if there occurs the anticipated transection of n. glutaeus usp. and dennervation of m. tensor fasciae latae and compare from this viewpoint both approaches. The examination was performed in 18 patients after the implantation of 20 total endoprostheses of the hip joint (out of which 10 hip joints were operated on by Watson - Jones approach and 10 by Bauer approach) in the period of 6-20 weeks after operation. In the examination concentric needle electrodes and NEUROMATIC 2000 C device (produced by DANTEC Co.) were applied. It was found out that the transection of n. glutaeus sup. is inevitable in neither approach. In patients operated on by Watson-Jones approach there occurred only twice complete transection of the nerve with the dennervation of m. tensor fasciae latae, six time incomplete interruption of the nerve and twice the finding in m. tensor fasciae latae was normal. In patients operated on by Bauer approach complete transection of n. glutaeus sup. was found out six times and incomplete interruption of this nerve four times. Thus from this viewpoint Watson-Jones approach is more considerate. Moreover, in Bauer approach eight times there occurred partial interruption of the innervation of the ventral portion of m. glutaeus medius. Consequently, the study has not proved the assumption that both approaches must necessarily result in complete transection of n. glutaeus sup.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Soft tissue collagen in congenital dislocation of the hip. Biochemical studies of the ligamentum teres of the femur and the hip joint capsule.

Collagens of the ligamentum teres of the femur and the hip joint capsule of 14 patients with congenital dislocation of the hip (CDH) were studied biochemically. Collagen was a major component of these tissues. Solubility of collagen was reversely related to age except in two cases. Collagen of both ligamentum teres of the femur and hip joint capsule was composed of type I, III and V collagens except in three cases. In these three cases with nevus or general joint laxity, two additional collagenous components were also found. The ratios of type III collagen to type I collagen were increased in CDH except in one case with short stature. These abnormalities of collagen metabolism could be the underlying cause of CDH and other clinical symptoms in these patients.

Amino Acids↗
PubMed1978

Hip joint instability after the neonatal period. Diagnosis and treatment of 20 consecutive cases.

A consecutive series of 20 children (21 hips) with idiopathic hip joint instability, diagnosed after the neonatal period, is presented. The diagnosis was confirmed by hip joint arthrography. In all the children, 1.5-21 months old at the time of diagnosis, closed reduction could be achieved. They were treated in plaster directly or after treatment of contractures in the adductor muscles of the hip joint. Stability was rapidly attained during plaster treatment. The results of the treatment in plaster were checked by a second arthrography in two thirds of the cases, and all cases have been clinically and radiologically evaluated 1-4.5 years after diagnosis. All of the children developed clinically stable hips and they walk normally. In two hips signs of avascular necrosis of the femoral head were found and in three hips (two children) the skeletal development was markedly delayed. In 81 per cent (17/21 hips) the prognosis was considered good; it is uncertain in the remaining four hips. The appropriate period of fixation in plaster related to the age of the child is discussed.

Casts, Surgical↗
PubMed1990

Determination of contact area in 'cushion form' bearings for artificial hip joints.

Current forms of artificial hip joints produce wear debris, which contributes to loosening of the prostheses. These 'hard' joints articulate with boundary or mixed lubrication, whereas the natural joint articulates with full fluid film lubrication. An artificial joint that articulates with full fluid film lubrication could greatly reduce wear and frictional torque and hence reduce the incidence of loosening and inflammatory tissue reaction. The use of a thin lining of low elastic modulus in the acetabular cup is one possible way of promoting full fluid film lubrication. In the design of such cushion forms of bearings, it is important to be able to predict the contact area, stress distribution and film thickness. This paper presents experimental techniques to determine the contact area in low elastic modulus layers and compares these measured areas with theoretical predictions using linear elasticity theory. At low loads experimental results and theoretical predictions were close. However, at loads above 300 N, the theory overestimated the width of the contact area by up to 8.5 per cent. This difference is mainly attributed to the non-linear behaviour of the elastomer at the higher levels of stress.

Elasticity↗
PubMed1983

[Changes of the acetabular cartilage following experimental subluxation of the hip joint in rabbits].

Subluxation of hip joints and subsequent acetabular dysplasia was experimentally produced by fixation of young rabbits' knee joints at each extension position. The restoration of processes of acetabulum after the reduction of subluxation of one-week-fixed group (Group I) and of two-week-fixed one (Group II) were followed up. The difference in time course of the processes were discussed roentgenographically, histologically and autoradiographically using 35S. The results are as follows; Roentgenologically, acetabular angles of Group I were restored in two weeks after the removal of the wires. However, acetabular dysplasia of Group II persisted at four weeks and even six weeks after the removal of the wires. Histologically, a remarkable change of growth cartilage was observed in each hypertrophic zone of the two groups when the wires were removed. Normalization of histological changes required two weeks in case of Group I and four weeks in that of Group II. In autoradiograms using Na2 35SO4, acetabulum was normalized in four weeks after the reduction of subluxation in both groups. However, the two restoration processes showed a different pattern from each other. Judging from the above results, it is assumed that a restricted unusual stress on an acetabulum causes some morphological and functional lesion to growth cartilage more quickly than expected and that the lesion becomes more unrestorable the more the period of the stress is prolonged.

Acetabulum↗