Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HIP”

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 415 records · Page 23Linked to original sources
PubMed1997

Intracapsular pressure and loosening of hip prostheses. Preoperative measurements in 18 hips.

We measured the intracapsular pressure preoperatively in 18 hips (17 patients) before revision of a total hip arthroplasty because of aseptic loosening. Distension of the joint capsule was measured with sonography in 13 cases. In extension, the mean intracapsular pressure was 26 (0-60) mmHg, in extension and inward rotation it was 159 (24-280) mmHg, in extension and outward rotation it was 30 (3-67) mmHg and in 45 degrees of flexion it was 12 (0-28) mmHg. A mean of 6 (0.5-20) mL of joint fluid was aspirated after the pressure measurements. Sonography showed increased joint fluid/synovial edema and/or increased capsular thickness, as compared to 34 unrevised, radiographically not loose prosthetic hips, and that the capsular distension correlated to intracapsular pressure during extension and inward rotation. We conclude that the intracapsular pressure usually is elevated in a hip joint with loose prosthetic components, that the intracapsular pressure varies with the position of the hip and that capsular distension reflects increased intracapsular pressure. The increased and often very high pressure, varying during gait, may pump debris away from the joint along the interfaces and even by itself cause osteolysis and loosening.

Aged↗
PubMed1999

[Reconstruction of hip joint function: old fracture-dislocation of hip joint complicated with deformed healing of upper 1/3 of fractured femur--a case report].

OBJECTIVE: To explore a method of reconstruction of hip joint function after deformed healing of the upper 1/3 of fractured femur as a complication of old fracture dislocation of hip joint. METHODS: A patient with loss of function in hip joint and fusion of knee joint was treated with lock for femur intra-medullary fixation in April 1997. RESULTS: Before operation, the diseased hip joint lost its most functions and the entire lower extremity was disabled because the knee joint had been fused. One year after operation, the follow-up examination revealed that the patient could walk by crutches without discomfort, his daily life and work recovered to normal. CONCLUSION: It is effective to treat a patient suffering old fracture-dislocation of hip joint complicated with deformed healing of the upper 1/3 of fractured femur by means of individualized artificial joint replacement and a prosthesis body with lock for femur intra-medullary fixation, and it is helpful for the development of a new clinical idea to reconstruct functions in the management of some particular cases.

Accidents, Traffic↗
PubMed1992

[Total hip replacement for congenital dislocation of the hip in elderly patients].

From 1986 to 1989, total hip replacement was performed on ten patients (twelve hips) with congenital dislocation of the hip. The average age of the patients was fifty-three years (ranging from forty-eight to sixty years), and the mean follow-up period was twenty-eight months (ranging from six to forty-eight months). Of the ten patients, eight had unilateral replacement and two had bilateral replacement, for a total of twelve arthroplasties. Eight arthroplasties were performed on the right and four on the left. Most patients left the hospital two to three weeks after operation. All the patients obtained satisfactory results. Only one patient developed late infection two years postoperatively. This patient occasionally used a cane for walking. The other patients had no hip pain, the motion of the hips was approximate to a normal person. No patient required a shoe-lift for limb-length discrepancy.

Age Factors↗
PubMed2003

[Radiological status of hip joints of children at the beginning of walking, when treatment of congenital hip dysplasia and dislocation was begun in the first two weeks of life].

This paper describes the radiological status on the start of walking in 31 hip joints in 24 children, in which the treatment of the developmental dysplasia with dislocation of the hip began in the first 2 weeks. Before the beginning of the treatment, ultrasonographic assessment revealed type D in 22% hips, type III in 55% and type IV in 23%. The radiographic evaluation was based on 6 parameters, which values were compared to the normal ones for the age group. It was estimated that only 32% hips had a correct radiological status, the other hips revealed smaller or greater dysplasia.

Female↗
PubMed2005

[Clinicaly silent developmental hip dysplasia--significancy of the hip ultrasonographic examination].

We present the significancy of the hip USG examination in the diagnosis of the clinically silent developmental hip dysplasia (DDH). The clinical and ultrasonographic hip assessment were performed in 972 children and sonographic abnormalities silent in clinical examination were stated in 155 of them (15.9%). Physiological immaturity was stated in 87% of this group. An orthopedic treatment was nessesery in 34 children (3.5% of cohort). Children with pathological hip dysplasia (type II D or above according to the Graf classification) with no pathological signs in clinical assessment constituted 0.25% of the cohort. We claim the USG examination of the infant hip is a method of choice in the early diagnosis of the DDH and the only method to detect clinically silent DDH.

Academic Medical Centers↗
PubMed1987

Results of total hip arthroplasty without trochanteric osteotomy following hip fusion.

Other than the results of the Charnley group, using a transtrochanteric approach, there is little in the literature regarding the techniques and results of total hip arthroplasty following hip fusion. Thirteen cases carried out via an anterior Smith-Peterson approach have been performed by the senior author over the last few years. These cases have been studied to determine pitfalls and outcomes using this method. At one year, seventy-five percent of the cases became Trendelenberg negative. The average range of flexion at one year was 88 degrees and the Harris Hip Score was 2 poor, 2 fair, and 9 good or excellent. Retrospectively, one patient would rather not have had surgery. Nerve and vessel damage was not a problem and neither was myositis ossificans. Where possible, existing hardware was removed six months prior to arthroplasty. However, three femoral shaft splits occurred where noncemented femoral components were used. While it is a technically demanding exercise, the results of total hip replacement following hip fusion are acceptable.

Adult↗
PubMed1983

The hip cast-brace for hip prosthesis instability.

The use of a hip cast-brace in the treatment of unstable hips following prosthetic replacement is described. A retrospective study of 21 patients with 22 hip prostheses treated with the cast-brace is reported. Seventeen Charnley low friction arthroplasties (LFA) were treated--four cast-braces were used for prophylaxis, five for single dislocations and eight for recurrent dislocations. To date, only four hips have required an operation to achieve stability. Five patients with Thompson hemi-arthroplasties were treated following dislocation with only one requiring surgery to achieve stability. A hip cast-brace is recommended as a useful alternative to surgical management of prosthetic instability.

Adult↗
PubMed1980

Hip deformities after successful treatment of congenital dislocation of the hip in infancy.

Much attention has been given to early detection of congenital dislocation of the hip. Early reduction, however, does not always ensure normal hip development. A retrospective study of 14 hips in 11 females treated successfully by closed methods in infancy and discharged at one year of age without further follow-up was carried out. All the patients returned between the ages of 6 and 11 years because of insidious onset of waddling gait, limping and limitation of abduction. X-rays revealed early closure of the capital femoral growth plate and progressive overriding of the greater trochanter. These changes were explained as late results of total avascular necrosis. Treatment consisted of displacement osteotomy of the greater trochanter in 11 hips for overriding trochanter, Chiari osteotomy in two for hip dysplasia, and epiphysiodesis for leg length discrepancies of 3 to 3.8 cm in four patients. The late results of early asymptomatic total avascular necrosis cannot be predicted in infancy. Long follow-up of CDH, even in cases of successful reduction in infancy, is as important as early detection and reduction of CDH,

Adolescent↗
PubMed1980

Management of hip fractures by total hip arthroplasty.

One hundred and twelve patients ranging in age from 40 to 89 with acute intracapsular fractures of the hip were treated between the years 1970 to 1978 by total hip arthroplasty; 63% were subcapital, 27.6% were midcervical, and 8.9% were basilar; 53.5% were classified as Garden's Stage IV, 34.8% as Stage III and 11.6% as Stage II. A significant number of patients had associated medical conditions that made them poor risks for a possible second-stage operation. Moreover, 16 patients were considered for total hip arthroplasty because of associated hip disease. Of 85 patients evaluated after one year, 81.2% had no pain. Most patients maintained their previous levels of activity, but 13 were more active than before injury; 33 were worse. The decrease in activity was generally due to deterioration in associated medical conditions. Our experience indicates that total hip arthroplasty is best reserved for the previously active elderly patient with a displaced subcapital fracture who meets the criteria for prosthetic replacement.

Adult↗
PubMed1995

Experience of total hip replacement and its effect on recovery after second hip replacement.

OBJECTIVE: To determine whether the knowledge gained through total hip replacement (THR) influences the time to recovery after a second THR. DESIGN: A retrospective study of data gathered prospectively on the recovery course of patients from their preoperative visit to 1 year after surgery. SETTING: A university teaching hospital. PATIENTS: Sixty-nine patients underwent bilateral hip replacements at the Royal Victoria Hospital, Montreal, between May 1985 and May 1992. The inclusion criteria were: (a) similar diagnoses and prostheses bilaterally, (b) time between the two THRs of less than 3 years, (c) both replacements carried out by the same surgeon and (d) attendance at the arthroplasty clinic. Forty-one patients did not fulfil the criteria for inclusion, leaving 28 patients having 56 THRs for the study. An additional 28 patients who had unilateral hip arthroplasty were randomly chosen on the basis of sex and age to act as the control group. INTERVENTION: Bilateral cementless THR. MAIN OUTCOME MEASURES: Harris hip score at one preoperative visit and postoperatively at 6 weeks, 3 months, 6 months and 1 year. RESULTS: There were no significant differences in measures of recovery between the initial and the subsequent hip replacement at any of the time intervals. Significant differences were found only between the various time periods. CONCLUSIONS: Time and not familiarity dictated progress toward recovery for patients who underwent bilateral THR with cementless prostheses. Randomized clinical trials, assessing whether time to recovery, ultimate outcome and cost-effectiveness are affected by preoperative teaching programs, are necessary to further elucidate this important issue.

Female↗
PubMed1994

Total hip replacement using femoral neck bone to graft the dysplastic acetabulum. Follow-up study of 18 patients with old congenital dislocation of the hip.

We performed total hip replacement on 25 congenitally dislocated hips using corticocancellous bone from the femoral neck as a bone graft to reconstruct the deficient acetabulum. Two patients (two hips) died less than five years after surgery and three hips developed deep infection. We reviewed the remaining 20 hips at an average interval of 8.4 years (5.2 to 12.9). Their functional scores (modified Merle d'Aubigné and Postel) averaged 5.7 for pain, 5.1 for walking ability, and 4.2 for range of motion. Radiographs showed union and remodelling of the grafted bone in every case. There were radiological signs of aseptic loosening in three sockets (15%) without collapse of the grafted bone. None of the femoral stems was loose. No revision operation has been performed. Our results confirm the usefulness in the long term of femoral autografts for severe acetabular deficiency.

Acetabulum↗
PubMed1994

Cementless total hip arthroplasty in patients with steroid-induced avascular necrosis of the hip. A 62-month follow-up study.

Twenty cementless porous-coated primary total hip arthroplasties (THA) were performed on 15 patients, all of whom were diagnosed with steroid-induced avascular necrosis (AVN). The average age of the patients at the time of surgery was 45 years. Minimum follow-up period for all patients was 24 months (average follow-up period: 62 months). Patients were rated using the modified Harris hip score, as well as serial radiographs. The average hip score at follow-up examination was 88, with 17 of the 20 hips having good or excellent clinical results. No revisions of the prostheses were performed. Using radiographic criteria, 12 femoral components met the criteria for bone ingrowth, seven were considered stable with fibrous fixation, and one femoral component was loose. When good initial femoral component fit was achieved, bone ingrowth reliably followed. Three acetabular components showed migration on serial radiographs. A high rate of acetabular component wear and osteolysis was noted. Avascular necrosis has been shown to adversely affect the outcome of hip arthroplasty surgery. Previous studies of patients with advanced AVN undergoing cemented THA report a high incidence of component loosening. Literature on the results of cementless THA in this patient group is sparse. The study demonstrates encouraging clinical results for cementless THA in steroid-induced AVN. Reliable femoral component fixation occurred if a good initial component fit was achieved; however, long-term acetabular loosening and wear remain serious concerns.

Acetabulum↗
PubMed1990

Treatment of osteoarthrosis secondary to congenital dislocation of the hip. Primary cemented surface replacement compared with conventional total hip replacement.

Seventy-four cemented conventional total hip arthroplasties (in fifty-five patients) and thirty-seven cemented surface replacements (in thirty-two patients) were done between 1971 and 1984 for treatment of osteoarthrosis secondary to congenital dislocation of the hip. The patients in the first group were older and had more severe dysplasia. In all patients, we tried to position the acetabular component at the level of the true acetabulum. In both groups, the operation relieved pain and improved the function of the hip in the short term. There were fewer and less severe early postoperative complications in the surface-replacement group, but the rate of long-term failure (revision or resection) was substantially higher. Survivorship analysis demonstrated that neither type of operation yielded durable results in younger patients; all revisions were in patients who were less than sixty years old. However, in older patients who had cemented conventional total hip arthroplasty, survivorship was excellent, regardless of the amount of dysplasia.

Adult↗
PubMed2005

Acetabular reconstruction using a roof reinforcement ring with hook for total hip arthroplasty in developmental dysplasia of the hip-osteoarthritis minimum 10-year follow-up results.

The outcome of 33 total hip arthroplasties using an acetabular reinforcement ring with hook for osteoarthritis associated with developmental dysplasia of the hip was reevaluated after a minimal follow-up of 10 years (average, 10.8 years). Most cases comprised Crowe type II (22 hips) and type III (7 hips) dysplasia. The mean D'Aubigné score increased from 7 to 15 points. Three revisions (9%) were performed for aseptic loosening, 2 of them had a structural autograft. None of the unrevised 30 acetabular reconstructions showed definite radiographic signs of loosening. These results compare favorably with the literature and the acetabular reinforcement ring with hook presents a versatile tool for acetabular bone stock deficiencies.

Acetabulum↗
PubMed1998

Cumulative revision rate with the Scan Hip Classic I total hip prosthesis. 1,660 cases followed for 2-12 years.

We analyzed the cumulative revision rate in 1,474 patients (1,660 hips) operated on with a cemented Scan Hip Classic I prosthesis from November 1983 to January 1994 at Lund University Hospital. The revision rate was analyzed for 3 diagnoses--arthrosis, rheumatoid arthritis and complication after a hip fracture--and for 2 head diameters--22 and 32 mm. Until January 1996, 36 hips were revised: 31 because of aseptic loosening, 3 because of dislocation and 2 because of infection. The overall revision rate was 5.6% after 10 years and was similar in arthrosis, rheumatoid arthritis and fracture cases. Due to revisions because of dislocation in the 22 mm group, the total revision rate was lower in the 32 mm group (p = 0.03).

Adult↗
PubMed1998

Analysis of the kinematics of different hip simulators used to study wear of candidate materials for the articulation of total hip arthroplasties.

We developed an analytical technique to determine the paths traced by specific points on the femoral head against the acetabulum in the human hip joint during gait. The purpose of the study was to apply this technique to the mechanical hip simulators chosen to conduct wear tests on polymeric acetabular liners used in total hip replacements. These simulators differ from one another in the type of motion produced, apart from other variables such as type of lubricant and head position. Due to the variation in the kinematics between the machines, the paths traced by the points on the femoral head against the acetabular liner ranged from simple linear traces to figure-8 loops and quasi-elliptical paths during a single simulator cycle. The distances traveled by these points during the same period also varied appreciably among the different hip simulator designs. These results are important when combined with other studies that have shown that kinematics can play an important role in the outcome of in vitro wear experiments. The kinematic differences quantified in this study can partially explain the substantial differences in wear data reported from different simulator designs and also underscore the usefulness of the technique described in this study in judging the results from different hip simulator experiments.

Acetabulum↗
PubMed2003

Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement results of a prospective study in 462 hips.

BACKGROUND: The effectiveness of pre- or postoperative radiotherapy for prevention of heterotopic ossification (HO) following total hip replacement (THR) has already been demonstrated in the past. Thereby, in most studies using preoperative radiotherapy patients were irradiated < 6 h before surgery. The purpose of this prospective study was to analyze the effectiveness of preoperative irradiation on the evening before surgery and to identify risk factors for HO in a homogeneous collective of patients. PATIENTS AND METHODS: From July 1997 to July 2001, 416 patients (462 hips; 235 males, 227 females) received preoperative radiotherapy of the hip on the evening before surgery with a 7-Gy single fraction. The patients' median age was 67.1 years. The most frequent indication for radiotherapy was hypertrophic osteoarthritis (383 hips, 82.9%). Treatment results were assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). The analysis of radiographs was performed according to the Brooker score. RESULTS: The overall incidence of HO was 18.1% (n = 84), Brooker score 1 12.3% (n = 57), score 2 3.9% (n = 18), score 3 1.5% (n = 7), and score 4 0.4% (n = 2). Sex, body height, hypertrophic osteoarthritis of higher degree, size of the femoral component of the prosthesis, previous ipsi- or contralateral HO, and short course of nonsteroidal anti-inflammatory drug (diclofenac) therapy significantly influenced the HO rate in univariate analysis. In multivariate analysis, an interdependence of prosthesis size, sex and patient's height was found. From these three variables, only prosthesis size was statistically significant in multivariate analysis. The cumulative dose of diclofenac (< or = 300 mg or > 300 mg) within the first 7 postoperative days and previous ipsi- or contralateral HO influenced the incidence of HO in multivariate analysis. CONCLUSION: Preoperative radiotherapy on the evening before surgery is an effective treatment modality to reduce overall (Brooker 1-4) and clinically relevant, severe HOs (Brooker 3-4), and includes several advantages compared to postoperative irradiation. Previous ipsi- and contralateral HOs were identified as high risk factors for HO in this study. In patients with these risk factors, the incidence of HO increased.

Adult↗
PubMed1985

In vivo moment arm lengths for hip extensor muscles at different angles of hip flexion.

Moment arm lengths of three hip extensor muscles, the gluteus maximus, the hamstrings and the adductor magnus, were determined at hip flexion angles from 0 degrees to 90 degrees by combining data from ten autopsy specimens and from twenty patients, the latter examined by computed tomography. A straight-line muscle model for muscle force was used for the hamstrings and adductor magnus, and for the gluteus maximus a two-segment straight-line muscle force model was used. With the joint in its anatomical position the moment arm of the gluteus maximus to the bilateral motion axis averaged 79 mm, for the hamstrings 61 mm and for the adductor magnus 15 mm. The moment arm of gluteus maximus decreased with increasing hip flexion angle. The hamstrings showed an increase in moment arm length up to an average of 35 degrees hip flexion and then a decrease with increasing hip flexion angle. The corresponding figures for the adductor magnus moment arm showed an increase up to 75 degrees and then a decrease. Statistical analysis revealed significant differences in moment arm length between men and women.

Aged↗