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At least 469 records · Page 26Linked to original sources
PubMed1996

[Quality assurance in hip prosthesis surgery. New type hip prostheses, review of a 3-year material].

This article deals with the short-term results of prosthetic replacement of the hip joint. The investigation was carried out three years after the introduction of a new hip prosthesis - the ITH (" International Total Hip") prosthesis. Our results were analysed retrospectively, the primary goal being quality assessment of the results of our hip surgery. We found that the results of hip prosthetic surgery with the ITH-prosthesis were satisfying, although the frequency of complications was rather high: 185 implantations of the ITH-prosthesis gave 13 cases of deep venous thrombosis; one case of deep infection and subsequent revision surgery; four cases of dislocation of the prosthesis, of which two cases have been subsequently revised; one case of perforation of the femur with later revision; and one case of permanent paralysis of the femoral nerve. The overall rate of revisions was 2.7%. The overall survival of the prosthesis according to Kaplan Meier was 97% after three years.

Adult↗
PubMed1997

Septic arthritis of adult hip treated by total hip replacement--a case report.

Septic arthritis is usually seen in children as an acute febrile illness induced by septicemia, local inoculation of a joint caused by trauma or adjacent osteomyelitis. It also occurs in adults particulary those with debilitating disease or sepsis at other sites. It normally happens in knee joints, but rarely in hip joints. A 65-year-old patient suffered from hip pain and febrile episodes intermittently for two months. Diagnostic hip aspiration was performed with 60 ml pus drained. The aspirate grew Staphylococcus aureus. Hip arthrotomy was performed with extensive debridement. Eighteen months later, this patient received total hip replacement and he has remained well for 8 years, with no evidence of infection or of implants loosening.

Aged↗
PubMed1995

Total hip replacement with solid autologous femoral head graft for hip dysplasia.

Acetabuloplasty with solid autologous femoral head graft for the treatment of hip dysplasia is an established method which creates the contained cavity needed to accommodate the artificial cup. In order to evaluate the medium- and long-term results of this method using a cementless hemispheric cup, 34 patients (39 hips) operated on between 1979 and 1986 were clinically and radiologically reviewed. The minimal follow-up was 5 years (average 7.6 years). The Harris hip score increased from 36 points preoperatively to 89 points 1 year postoperatively and to 85.1 at the last follow-up. On roentgenographic evaluation, all grafts had been incorporated and appeared to have tolerated the mechanical loading well. Partial resorption of the graft occurred in 22 of the 39 hips, mainly in the lateral non-loaded zone. Twenty-nine of the 39 acetabular components showed migration, on average 4.2 mm cranially and 1.8 mm medially; 92% occurred during the first 2 years, and thereafter it was not progressive. Smaller cups migrated consistently more than larger cups. A significant correlation was found between cup migration and the degree of bone coverage of the cup, and extensive migration occurred in most cases with cup coverage by the host bone of less than 40%-50% of the weight-bearing surface of the cup. Only one acetabular component was altered significantly, and another appears to have become loose. The use of the normal-sized cups and cementless fixation medially in the primary acetabulum are thought to have contributed to our favorable mid- to long-term results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Study of hip joint dislocation after total hip arthroplasty.

The present study was undertaken to identify the factors responsible for hip joint dislocation after total hip arthroplasty, laying emphasis on analysis of the background variables of the patients. Of the 317 hips included in the study, ten (3.2%) dislocated. Only the anteversion angle of the cup differed significantly between the dislocation group and the dislocation-free group. The safe zone of the anteversion angle seems to be between 20 and 30 degrees. but it is also essential to set the antetorsion angle of the stem to match the shape of individual bones to create a more stable hip joint. This safe zone may be expanded by the additive effect of antetorsion angle of the stem.

Adult↗
PubMed2002

Total hip arthroplasty in patients younger than 30 years of age following developmental dysplasia of hip (DDH) in infancy.

Total hip arthroplasty (THA) in young patients is a controversial subject, due to the high failure rates reported in the literature, and even more so in patients with a history of developmental dysplasia of the hip (DDH). A group of 11 patients, all under the age of 30 years at the time of surgery, underwent THA due to congenital dislocation of the hip. Mean age at the time of operation was 23.3 years (range 16-30 years). The mean follow-up period was 9 years (range 3-14 years). The mean preoperative Harris' hip score (HHS) was 56.9 compared with the postoperative HHS of 90.6. Due to aseptic loosening of the cup, 4 patients underwent successful revision arthroplasty. These encouraging medium-term results in our patients suggest that THA may be a good solution for young patients suffering from coxarthrosis due to DDH, at least temporarily, especially when other alternatives, such as arthrodesis or resection arthroplasty, are considered.

Adolescent↗
PubMed2006

Short-term outcomes of total hip arthroplasty after complications of open reduction internal fixation for hip fracture.

Failed open reduction internal fixation (ORIF) of the proximal femur can render patients severely disabled. This study analyzed the short-term functional results and complications of total hip arthroplasty (THA) for complications of ORIF after hip fracture. A retrospective arthroplasty database review identified 36 patients treated with a THA for complications of ORIF of the hip. These patients were matched to a cohort of 36 patients who underwent primary unilateral THA for osteoarthritis. Study results indicate that THA for failed ORIF of the hip is a successful procedure despite concerns of increased intraoperative difficulty and risk of fracture.

Aged↗
PubMed1999

The Charnley versus the Spectron hip prosthesis: radiographic evaluation of a randomized, prospective study of 2 different hip implants.

A total of 410 hips were randomized to treatment with either a Charnley (206 hips) or a Spectron (204 hips) total hip arthroplasty. The patients were operated on by a standardized procedure using a contemporary cementing technique and were followed after 1, 3, 5 to 6, and 10 years. The postoperative radiographs showed a significantly increased rate of malalignment and consequently low grade of cement mantle quality of the Charnley stem compared to the Spectron. No differences concerning cement mantle quality or positioning were found between the Charnley ogee cup and the metal-backed Spectron. Evaluation of the follow-up radiographs revealed 10 loose Charnley stems and 1 loose Spectron stem and 4 loose Charnley ogee cups and 23 loose Spectron metal-backed cups. The differences of revision rate for the femoral and acetabular components of the 2 prostheses were significant (P = .03, Charnley femoral component more frequent; P = .03, Spectron acetabular component more frequent). The radiographic evaluation strengthened this disparity. Poor wear characteristics of the metal-backed Spectron cup are perhaps the main reason for the highly significant difference in mechanical failure rate between the 2 cups. We therefore propose that metal-backing of cemented cups should be avoided, at least when combined with larger femoral heads. The difficulty in positioning the Charnley stem with an adequate cement mantle, especially in the absence of trochanteric osteotomy, might explain the inferior Charnley stem longevity in this study.

Aged↗
PubMed1999

Polyethylene wear and synovitis in total hip arthroplasty: a sonographic study of 48 hips.

Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined radiographically and sonographically at 10-year follow-up. Polyethylene wear of acetabular cups was measured on conventional non-weight-bearing pelvic radiographs, and the volume of polyethylene debris was calculated. Radiographic signs of loosening were identified. The capsular distance (ie, thickness of the synovium or synovial contents) was measured sonographically. We found a significant correlation between increased volumetric wear and increased capsular distance. Hips with radiographically loose acetabular components had significantly greater volumetric wear and capsular distance than those without signs of acetabular loosening. This relationship was not observed in hips with radiographically loose femoral components. In cemented THA, the volume of polyethylene wear debris and the thickness of the synovium and the synovial contents are related. In the event of radiographic loosening of the acetabular component, they are both increased.

Aged↗
PubMed2004

Increased risk of dislocation after primary total hip arthroplasty in inflammatory arthritis: a prospective observational study of 410 hips.

BACKGROUND: It is unclear whether patients with inflammatory arthritis have a higher risk of dislocation after hip replacement. PATIENTS AND MATERIAL: We carried out a prospective study assessing the incidence of dislocation within 2 years after surgery for patients diagnosed with inflammatory arthritis (IA) and osteoarthrosis (OA). One single type of prosthesis was implanted using a lateral approach. Both diagnostic groups were compared by univariate analysis with respect to dislocation, sex, age, diagnosis, prior hip surgery, experience of the surgeon and malposition of the acetabular component. In a multivariate logistic regression approach, the difference in dislocation incidence was assessed after adjusting for the effect of the potential confounders given above. Between 1996 and 1999, 410 THA were performed: 70 in IA and 340 in OA. After 2 years no patients were lost to follow-up, but 12 patients had died, and 5 revisions were carried out for reasons other than dislocation. RESULTS: The dislocation rate in patients with IA was higher than in patients with OA: 10% (7 hips) in the IA group and 3% (10 hips) in the OA group (p = 0.006). No significant differences were found among the risk factors for dislocation between the two groups. Multivariate logistic regression analysis showed that IA is an independent risk factor for dislocation (odds ratio (OR) 3.7, 95% CI 1.3-11), together with malposition of the cup in more than 55 degrees abduction (OR 7.7, CI 2.3-26) and increased anteversion (OR 7.6, CI 1.4-42.4). INTERPRETATION: Our findings clearly suggest that inflammatory arthritis has to be considered as an independent risk factor for dislocation after primary THA.

Adult↗
PubMed2004

High survival rate of hydroxyapatite-coated hip prostheses: 100 consecutive hips followed for 10 years.

We followed 100 consecutive primary total hip replacements with a proximal hydroxyapatite coating for 10 years. No patient was lost to follow-up. 29 patients (32 hips) died before the 10-year follow-up was done; none of their hips had been revised. Thigh pain on activity occurred in 3 hips. We found no radiographic signs of loosening of the femoral components. In course of time the location of dense bone around the femoral stem, which would suggest implant/bone stress transfer, moved distally in 51 of 67 stems after 10 years. No linear or distal osteolysis occurred around the stem. Revision of 1 stem was performed because of thigh pain, but it was found fixed to bone proximally, while 3 cups were revised because of acetabular osteolysis. The 10-year survival of the stem and cup, using revision or pending revision as endpoint, was 100% (95% CI: 99-100) and 97% (95% CI: 94-99), respectively.

Aged↗
PubMed2006

High wear rates and extensive osteolysis in 3 types of uncemented total hip arthroplasty: a review of the PCA, the Harris Galante and the Profile/Tri-Lock Plus arthroplasties with a minimum of 12 years median follow-up in 96 hips.

BACKGROUND: High wear rates and femoral and acetabular osteolysis have been-and still are-the main problems in uncemented total hip replacement. We reviewed 96 consecutive cementless total hip replacements of 4 different designs. PATIENTS AND METHODS: 21 PCA, 25 Harris Galante Porous/Harris Galante I (stem/cup), 25 Profile pressfit/ Tri-Lock Plus (stem/cup) and 25 Profile HA-coated/Tri-Lock Plus (stem/cup) prostheses were included. The operations were performed in the period 1984-1991. Median follow-up ranged from 12-16 years. Wear and osteolysis were measured. RESULTS: Mean linear wear rates ranged from 0.17 to 0.21 mm/year in the 4 groups, and there were no statistically significant differences between the groups (p = 0.9, ANOVA). Moderate or extensive osteolysis was found in 46 of the 96 hips included. The association between high and low wear rates (more or less than 0.20 mm/ year) and extent of osteolysis was statistically significant (p < 0.001, t-test). We found poor 12-year survival of the primary prostheses in all 4 groups (50-70%), mainly due to revisions because of wear of the polyethylene liner and/or osteolysis. The infrequently documented Profile/Tri-Lock Plus systems did not perform differently from the PCA and the HG. INTERPRETATION: The poor long-term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner failure, which are both generally asymptomatic until catastrophic failure appears.

Adult↗
PubMed2006

Standardized incidence rates of total hip replacement for primary hip osteoarthritis in the 5 Nordic countries: similarities and differences.

BACKGROUND: The national hip registers of the Nordic countries provide an opportunity to compare age- and sex-standardized annual incidence of primary total hip replacement (THR) and types of implants used for primary hip osteoarthritis (OA) in Denmark, Finland, Iceland, Norway and Sweden. METHODS: The data on THR were from the national total hip replacement registries, and population data were from the national statistics agencies. Annual incidence density per 100,000 was calculated for each 5-year age group and it was age-standardized using the WHO European standard population. RESULTS: Crude country-specific annual incidence (all ages) for 1996-2000 varied between 73 and 90. WHO age-standardized annual incidence (all ages) varied between 61 (Finland) and 84 (Iceland). For the ages 50-89, comprising 94-98% of all THRs for OA, annual incidence varied between 217 (Finland) and 309 (Iceland). For Norway, the sex incidence ratio (women/men) was 2, and for the other countries it was between 1.1 and 1.3. The use of uncemented and hybrid replacements was considerably higher in Finland and Denmark than in the other countries. INTERPRETATION: We found overall similarity in THR incidence between the 5 Nordic countries, but substantial differences between women and men, and in the use of different types of implant. Population-based, age-standardized and disease-specific information on THR incidence is required in order to properly explore the causes of differences in provision and practice of THR in different countries, regions and groups, and it will aid in projecting future needs.

Aged↗
PubMed2002

[Hip metallosis caused by wear of a TT-1 stem on a ceramic modular head hip prosthesis --case report].

The author presents a case of metal stem cone wear caused by a ceramic head. During revision hip arthroplasty procedure a new modular ceramic head was implanted in combination with a stable cemented TT-1 stem. 13 months after surgery the hip became symptomatic and 20 months after the procedure total loosening of the cup was observed. Wear of the stem cone was visible. During the next revision procedure all hip prosthesis elements were removed, soft tissue debridement was performed and a new cemented prosthesis was implanted. One year post-op the hip is pain free.

Ceramics↗
PubMed1985

Total hip arthroplasty and acetabular bone grafting for unreduced fracture-dislocation of the hip.

Functional restoration after chronic persistent fracture-dislocation of the hip was achieved by total hip arthroplasty (THA) in two patients with history of severe multiple injuries. Acetabular deficiency was corrected by use of the femoral head as an autologous bone graft. A 24-year-old man and a 42-year-old woman were treated for persistent fracture-dislocation of the hip two years and one year, respectively, after the accidents. In both, total hip arthroplasty in combination with acetabular bone grafts, with the femoral head, produced satisfactory clinical results at follow-up periods of 59 and 55 months.

Acetabulum↗
PubMed1983

Traction radiography of the hip and fluid in the hip joint.

Applying traction to the hip joint normally creates a 'vacuum phenomenon' between the femoral head and the acetabulum. With the presence of fluid in the hip joint, this effect does not occur. Traction radiography thus gives the clinician and radiologist an easy and noninvasive method for detecting fluid in the hip joint. The subsequent article illustrates the potentialities of traction radiography in several hip diseases.

Adolescent↗
PubMed1999

Waist and hip circumferences, and waist-hip ratio in 19 populations of the WHO MONICA Project.

OBJECTIVE: To assess differences in waist and hip circumferences and waist-to-hip ratio (WHR) measured using a standard protocol among populations with different prevalences of overweight. In addition, to quantify the associations of these anthropometric measures with age and degree of overweight. DESIGN: Cross-sectional study of random population samples. SUBJECTS: More than 32000 men and women aged 25-64y from 19 (18 in women) populations participating in the second MONItoring trends and determinants in CArdiovascular disease (MONICA) survey from 1987-1992. RESULTS: Age standardized mean waist circumference range between populations from 83-98 cm in men and from 78-91cm in women. Mean hip circumference ranged from 94-105cm and from 97-108cm in men and women, respectively, and mean WHR from 0.87-0.99 and from 0.76-0.84, respectively. Together, height, body mass index (BMI), age group and population explained about 80% of the variance in waist circumference. BMI was the predominant determinant (77% in men, 75% women). Similar results were obtained for hip circumference. However, height, BMI, age group and population, accounted only for 49% (men) and 30% (women) the variation in WHR. CONCLUSION: Considerable variation in waist and hip circumferences and WHR were observed among the study populations. Waist circumference and WHR, both of which are used as indicators of abdominal obesity, seem to measure different aspects of the human body: waist circumference reflects mainly the degree of overweight whereas WHR does not.

Adult↗
PubMed2006

Operative and non-operative treatment options for dislocation of the hip following total hip arthroplasty.

BACKGROUND: Dislocation following hip replacement is associated with significant morbidity and functional cost. The cause is usually multifactorial. A variety of treatment options are available which can broadly be classified into operative and non-operative. OBJECTIVES: To determine the best methods of treatment of recurrent dislocation following total hip replacement. SEARCH STRATEGY: The following databases were searched until August 2006: MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), Health Technology Assessment database (HTA), Database of Abstracts of Reviews of Effectiveness (DARE), International Standard Randomised Controlled Trial Number Register (ISRCTN), and MetaRegister of Controlled Trials (mRCT). SELECTION CRITERIA: Randomised and quasi-randomised trials comparing operative and non-operative treatments for recurrent dislocation following total hip replacement. DATA COLLECTION AND ANALYSIS: Two independent reviewers applied the inclusion criteria to identified studies. MAIN RESULTS: Searches identified 269 studies. None fulfilled the inclusion criteria. AUTHORS' CONCLUSIONS: The authors invite researchers to perform RCTs comparing different treatment options for recurrent dislocation of the hip. The heterogeneity of the population and variety of underlying causes would favour a multi-centre study to achieve an adequate sample size.

Arthroplasty, Replacement, Hip↗
PubMed2001

Evaluation of the structure-modifying effects of diacerein in hip osteoarthritis: ECHODIAH, a three-year, placebo-controlled trial. Evaluation of the Chondromodulating Effect of Diacerein in OA of the Hip.

OBJECTIVE: To evaluate the ability of diacerein, an interleukin-1beta inhibitor, to slow the progressive decrease in joint space width observed in patients with hip osteoarthritis (OA). METHODS: In this randomized, double-blind, placebo-controlled 3-year study, 507 patients with primary OA of the hip (by the American College of Rheumatology criteria) received diacerein (50 mg twice a day) or placebo. The minimal hip joint space width was measured by a central reader on yearly pelvic radiographs, using a 0.1-mm-graduated magnifying glass. RESULTS: Baseline characteristics were comparable in the 2 treatment groups (255 patients receiving diacerein, 252 receiving placebo); 238 patients (47%) discontinued the study, mainly because of adverse events in the diacerein group (25% versus 12% with placebo) and because of inefficacy in the placebo group (14% versus 7% with diacerein). The percentage of patients with radiographic progression, defined by a joint space loss of at least 0.5 mm, was significantly lower in patients receiving diacerein than in patients receiving placebo, both in the intent-to-treat analysis and in the completer analysis (50.7% versus 60.4% [P = 0.036] and 47.3% versus 62.3% [P = 0.007], respectively). In those patients who completed 3 years of treatment, the rate of joint space narrowing was significantly lower with diacerein (mean +/- SD 0.18 +/- 0.25 mm/year versus 0.23 +/- 0.23 mm/year with placebo; P = 0.042). Diacerein had no evident effect on the symptoms of OA in this study. However, a post hoc covariate analysis that took into account the use of analgesics and antiinflammatory drugs showed an effect of diacerein on the Lequesne functional index. Diacerein was well tolerated during the 3-year study. The most frequent adverse events were transient changes in bowel habits. CONCLUSION: This study confirms previous clinical findings indicating that the demonstration of a structure-modifying effect in hip OA is feasible, and shows, for the first time, that treatment with diacerein for 3 years has a significant structure-modifying effect as compared with placebo, coupled with a good safety profile. The clinical relevance of these findings requires further investigation.

Anthraquinones↗