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PubMed1985

[Quantitative assessment of bone scintigraphy in hip joint disease].

Quantitative assessment of bone scintigraphy was performed in fifty-six patients with hip joint disease including femoral neck fracture, aseptic necrosis of the femoral head, traumatic dislocation of the hip, Perthes disease, and transient synovitis of the hip. In the static study, bone scintigraphy was obtained 3 hours after injection of 99mTc-MDP by gamma camera equipped with a computer and uptake ratios were calculated. In the dynamic study, bone scintigraphy was performed in one, 3 and 5 hours after injection of radionuclide. Femoral head uptake ratio was markedly decreased in osteonecrosis following femoral neck fracture and characteristically increased in aseptic necrosis of the femoral head but prolonged retention of 99mTc-MDP could be observed. Uptake ratios of epiphysis were decreased in Perthes disease but normal in transient synovitis of the hip. Static and dynamic study of bone scintigraphy may be useful for early diagnosis and treatment in the hip joint disease.

Adult↗
PubMed1999

Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs.

OBJECTIVE: To assess the efficacy of etodolac in improving hind limb function in dogs with osteoarthritis of the hip joint. DESIGN: Prospective study. ANIMALS: 100 client-owned dogs with clinical signs of osteoarthritis of the hip joint. PROCEDURE: Baseline ground reaction forces and subjective assessment scores were collected twice at a 7- to 10-day interval. After meeting entrance criteria, dogs were randomly assigned to the following 3 treatment groups: control group (0 mg of etodolac), low-dosage group (135 mg of etodolac), or high-dosage group (450 mg of etodolac). Dogs were treated once daily for 8 days, and gait analysis was repeated on day 8. RESULTS: On day 8 of treatment, vertical impulse and vertical peak force values for low- and high-dosage groups were significantly greater than baseline values within each group. On day 8, vertical impulse values from the high-dosage group were significantly greater than values from the low-dosage group. Vertical peak forces for the low- and high-dosage groups were significantly greater at 8 days than that of the control group. Analysis of the effect of evaluation center (site) on treatment outcome did not reveal a significant effect. CLINICAL IMPLICATIONS: Etodolac administration for 8 days improved ground reaction forces in dogs with osteoarthritis of the hip joint. Improvement in force transmission was dosage dependent for the primary outcome measurement (vertical impulse). Results of the study indicate that etodolac is well tolerated by dogs, with minimal adverse effects during an 8-day treatment period.

Animals↗
PubMed1992

[The effect of verticalization of the resulting force (R) of weight bearing in the hip joint on morphologic characteristics of the medullary canal in the femoral shaft in patients with coxarthrosis].

An influence of verticalization of the resulting force of weight-bearing on the hip joint "R" on the morphological characteristics of the medullar canal on the proximal edge of the shaft of femur was researched. Progressive degenerative changes of the hip joint with a consequent sideways limping or changes of the collodiaphysial angle (ccd angle) were the cause of the verticalization of the resulting force "R". The analysis of patients treated and operated on The Orthopaedic Department of the General Hospital Osijek and The Orthopaedic Clinic of The Medical Faculty of The University of Zagreb. The research, undoubtedly, proved that the patients with coxarthrosis and side-ways in the hip or with changed collodiaphysial angle experienced verticalization of the resulting force of weigh-bearing of the hip joint and the proximal edge of femur which caused morphological changes of the medular canal of the shaft of femur.

Female↗
PubMed1993

[A radiological study of the hip joint in cerebral palsy].

In cerebral palsy (CP), abnormal posture, contracture of the hip and dislocation occur during a long period of the course. In order to clarify the factors of tendency to dislocation, radiological survey was undertaken for the patients of CP. These data were analyzed from the respects of weight bearing, position of leg and developed deformity at the neck of the femur. One hundred seventy eight hips of 90 patients with an average of 26 years of age and 64 hips of normal individual as a control. Kai's method was used for measuring angles of tilting at neck and anteversion. The incidence of dislocations of the hip joints was more frequent in patients who were incapable of weight bearing than in patients who were capable of weight bearing (p < 0.01). However, there was no difference between spastic type and athetotic type of CP. In patients who were incapable of weight bearing inclination (the neck-shaft angle), anteversion of the femoral neck to the shaft showed larger than in patients who were capable of weight bearing (p < 0.01). Anteversion of patients who were capable of weight bearing of CP was larger than that of the normal control (p < 0.01), but extent of inclination was the same. From these findings the present investigator has concluded that femoral neck becomes valgus with an increased anteversion in longstanding CP patients who are especially unable to stand or walk. Furthermore, such hip joints are found to dislocate easily if adducted.

Adolescent↗
PubMed1979

Localized regressive articular cartilage changes in the hip joint of the rabbit following an induced synovitis.

A talcum induced synovitis in the hip joint of the rabbit, which is known to cause articular cartilage hyperplasia followed by femoral head protrusion and joint incongruency, has in the present experiment also been shown to lead to localized regressive articular cartilage changes. The articular cartilage of the hip joints in 40 rabbits was examined histologically, at intervals, following induction of such a talcum synovitis. Regressive changes in the form of loss of surface chondrocytes and glycosaminoglycans sometimes accompanied by fibrillation, were found in the area of the femoral head articular cartilage which had become flattened following the head protrusion. Chondrocyte cloning facilitated subsequent cartilage repair. The biomechanical disturbance in the joint following the induced synovitis is felt to have caused the regressive changes. The experiment is considered to have some significance in connection with Legg-Calvé-Perthes' Syndrome (L.C.P.S.) in children.

Animals↗
PubMed1996

[Hip joint arthrodesis using the cobra plate. Indication, technique, outcome].

In the era of successful total hip replacement, hip arthrodesis has become an infrequent surgical procedure. Current indications are severe deterioration of the hip joint with a painful, reduced range of motion in young patients, such as disorders subsequent to sepsis of the hip joint, slipped capital epiphysis, Perthes' disease and trauma with contraindications for a total joint replacement. Another important indication is paralysis or musculature loss. From 1980 to 1990, 20 consecutive patients underwent a hip arthrodesis with a cobra plate and were evaluated. None of the patients was lost for follow-up; complications occurred in 5 out of 25 cases (20%). All patients had radiographic evidence of union, 2 patients required re-osteosynthesis and bone grafting. In two cases infection occurred. In one case the position of the fused join went into abduction. Thirteen patients were able to walk free of pain; however, 5 patients were disappointed with the arthrodesis result because of the handicap involved with a fused hip. Hip arthrodesis using the cobra plate is a technically demanding operation, but immediate mobilization and partial weight bearing are facilitated. There is little risk of non-union compared to other surgical procedures. If the technique is correct functional problems will be rare.

Adolescent↗
PubMed1995

[The biomechanical characteristics of the hip joint during endoprosthesis].

Under consideration was the interaction of the hip joint endoprosthesis pedicle with the femur. Causes of shaking the prosthesis pedicle, fracture of the femur, progressing deforming arthrosis were analyzed. Formulas for calculating the character of interactions of the prosthesis pedicle with the femur are presented, as well as risk factors and recommendations for practical use. The article is illustrated with a clinical case.

Aged↗
PubMed1978

[Sciatic nerve: special topography and possibility of injuries in surgery of the hip joint (author's transl)].

The minimal distance between the dorsal acetabulum and the sciatic nerve can be 1.5 cm. This topographic situation is extremely important for surgery of the hip and dorsal pelvis (for e.g.: total hip prothesis, osteosynthesis of dorsal acetabulum-fractures). Various operative approaches to the hip joint lead to different intraoperative aspects including the danger of iatrogen sciatic nerve-lesions. In most cases the nerve cannot be seen but only be palpated during operation. If the stem of the sciatic nerve is injured intraoperatively, lesions can be found in the whole field of its innervation. For this reason specimen operations were performed in human cadavers using various approaches to the hip joint. We systematically investigated the topography of this region--layer by layer--cutting sections in horizontal and sagittal plains. Based on our findings the course of the sciatic nerve is described with special emphasis on the danger of lesions during surgery of the hip joint and dorsal pelvis.

Hip Joint↗
PubMed2005

The painful bone marrow edema syndrome of the hip joint.

In this issue of the WKW, Aigner et al have published that, for the first time, a conservative approach with iloprost has shown to be equally successful as the well-documented core decompression surgical approach in patients with BMES of the hip joint. The BME pattern on MR-imaging of the hip joint represents a common but unspecific finding, which may be associated with several diseases requiring different therapeutic strategies (Table 1). It is still controversial, whether BMES of the hip represents a distinct self-limiting disease also known as transient osteoporosis, transient marrow edema, or algodystrophy, or merely reflects a subtype of ON. Since prognosis and therapeutic consequences vary significantly, differential diagnosis between BMES, CRPS and ON is of clinical interest (Table 2). Both, BMES and ON show similar ON risk factors and a male prevalence, while classical CRPS has a history of trauma and a prevalence among females. Clinical presentation of BMES and ON is similar with typical mechanical pain and prevalence of the hip joint. In contrast, classical CRPS shows a diffuse and burning pain in combination with trophic and vasomotor signs, mainly in the hands and feet. Imaging patterns of BMES are more diffuse, across the entire femoral head, while focal and subchondral in ON. In both, the patterns are limited to the femoral head. In contrast to classical CRPS, the imaging changes are located in all periarticular bones, and the soft tissues are always affected. The histological bone marrow changes are similar in all three diseases, but with abundant new bone formation in BMES and CRPS, whereas in ON only limited new bone formation surrounds the focal necrosis with a sclerotic rim. Protected weight-bearing and treatment with iloprost for BMES, but operative treatment for ON, and a sophisticated physiotherapy for CRPS in combination with iloprost are the preferred treatment strategies in our institution.

Arthralgia↗
PubMed2004

The choice of arthroplasty for secondary osteoarthritis of the hip joint following avascular necrosis of the femoral head in sicklers.

Secondary osteoarthritis of the hip joint often complicates avascular necrosis of the femoral head in young adults suffering from sickle cell anemia. These patients, particularly in our environment, are usually reluctant to use walking aids like crutches to alleviate the pain since they believe that these devices are temporary measures. They often demand long-term solutions which border on surgery. The surgical procedures carried out in these patients range from osteotomies to arthroplasties. With the advent of various forms of hip implants, osteotomies are not as popular in modern-day orthopedic practice. In this series, we treated five patients with secondary osteoarthritis in six hip joints (bilateral in one patient) using cementless bipolar arthroplasty with good outcome. This implant is available and affordable in Nigeria, and the use of a cementless implant obviates damage to the acetabulum and may make revision surgeries less hazardous both for the surgeon and the patient.

Adult↗
PubMed1980

[Pressure on the bearing surface of the hip joint (author's transl)].

The 3-dimensional geometry of the articular surface of the hip joint was reconstructed using data obtained from ap radiograms of the pelvis. Combining the results of this calculation with data published on the weight distribution of adult persons, the mean and the standard deviation of the pressure on the articular surface of the hip joint are calculated.

Adolescent↗
PubMedDate not supplied

[Strength of muscles surrounding the hip joint and gait in patients following implantation of a cementless hip endoprosthesis].

There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprotheses. The aim of this study was to examine the pre- and postoperative course of strength deficits in this musculature compared to clinical parameters and the uninvolved side. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip protheses were implanted were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strength of abductors, flexors, and rotator muscles as well as maximum isokinetic strength of the extensors and flexor musculature at 60% and 120%/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months (90-124%). By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 6 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of capsule pattern.

Adult↗
PubMed2005

An artificial neural network that utilizes hip joint actuations to control bifurcations and chaos in a passive dynamic bipedal walking model.

Chaos is a central feature of human locomotion and has been suggested to be a window to the control mechanisms of locomotion. In this investigation, we explored how the principles of chaos can be used to control locomotion with a passive dynamic bipedal walking model that has a chaotic gait pattern. Our control scheme was based on the scientific evidence that slight perturbations to the unstable manifolds of points in a chaotic system will promote the transition to new stable behaviors embedded in the rich chaotic attractor. Here we demonstrate that hip joint actuations during the swing phase can provide such perturbations for the control of bifurcations and chaos in a locomotive pattern. Our simulations indicated that systematic alterations of the hip joint actuations resulted in rapid transitions to any stable locomotive pattern available in the chaotic locomotive attractor. Based on these insights, we further explored the benefits of having a chaotic gait with a biologically inspired artificial neural network (ANN) that employed this chaotic control scheme. Remarkably, the ANN was quite robust and capable of selecting a hip joint actuation that rapidly transitioned the passive dynamic bipedal model to a stable gait embedded in the chaotic attractor. Additionally, the ANN was capable of using hip joint actuations to accommodate unstable environments and to overcome unforeseen perturbations. Our simulations provide insight on the advantage of having a chaotic locomotive system and provide evidence as to how chaos can be used as an advantageous control scheme for the nervous system.

Computer Simulation↗
PubMed2000

Simplified motion and loading compared to physiological motion and loading in a hip joint simulator.

Two wear tests were conducted using the Durham Hip Joint Wear Simulator to investigate the effects of simplified motion and loading on ultra-high molecular weight polyethylene (UHMWPE) acetabular cup wear rates. Bovine serum was used as a lubricant and a gravimetric technique was used to measure wear. The first wear test duration was 7.1 x 10(6) cycles and investigated the effect of simplified loading. This was achieved by using full physiological motion and loading for the first 5 x 10(6) cycles of the test, then physiological motion with simplified loading for the final 2.1 x 10(6) cycles of the wear test. The UHMWPE acetabular cup wear rates using full physiological motion and loading were 32.2 and 51.7 mm3/10(6) cycles against zirconia and CoCrMo femoral heads respectively. Using simplified loading the cup wear rates were 30.1 and 49.2 mm3/10(6) cycles against zirconia and CoCrMo respectively which was not significantly different from wear rates with physiological loading. The effect of simplified motion was investigated in a second wear test of 5.0 x 10(6) cycles duration. Physiological loading was applied across the prosthesis with physiological motion in the flexion/extension plane only. Mean wear of the acetabular component dropped to 0.197 mm3/10(6) cycles. The surfaces of all the acetabular cups were subject to gross examination, optical microscopy and scanning electron microscopy. No notable difference was observed between the cups subjected to physiological motion and loading and those subjected to simplified loading. The cups worn with a single plane of motion had a much smaller worn area and a notable difference in surface features to the other cups. Simplifed loading is therefore an acceptable simplification in simulator testing but simplifying motion to the flexion/extension plane axis only is unacceptable.

Acetabulum↗
PubMed2003

Evaluation of multiple radiographic predictors of cartilage lesions in the hip joints of eight-month-old dogs.

OBJECTIVE: To determine the radiographic methods that best predict the development of osteoarthritis in the hip joints of a cohort of dogs with hip dysplasia and unaffected dogs. ANIMALS: 205 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbred dogs. PROCEDURE: Pelvic radiography was performed when the dogs were 8 months old. Ventrodorsal extended-hip, distraction, and dorsolateral subluxation (DLS) radiographs were obtained. An Orthopedic Foundation for Animals-like hip score, distraction index, dorsolateral subluxation score, and Norberg angle were derived from examination of radiographs. Osteoarthritis was diagnosed at the time of necropsy in dogs > or = 8 months of age on the basis of detection of articular cartilage lesions. Multiple logistic regression was used to determine the radiographic technique or techniques that best predicted development of osteoarthritis. RESULTS: A combination of 2 radiographic methods was better than any single method in predicting a cartilage lesion or a normal joint, but adding a third radiographic method did not improve that prediction. A combination of the DLS score and Norberg angle best predicted osteoarthritis of the hip joint or an unaffected hip joint. All models that excluded the DLS score were inferior to those that included it. CONCLUSIONS AND CLINICAL RELEVANCE: A combination of the DLS score and Norberg angle was the best predictor of radiographic measures in 8-month-old dogs to determine whether a dog would have normal or osteoarthritic hip joints.

Animals↗
PubMed2003

[Endoprosthesis of the hip joint in progressive and chronic destructive tuberculous arthritis: problems and prospects].

The paper presents the results of endoprosthesis of the hip joint in 6 patients with destructive tuberculous coxitis. In 2 patients, the process was bilateral. All the patients received preoperative antituberculous therapy with 3-4 drugs (isoniazid, rifampicin, pyrazinamide, streptomycin) for 14-12 weeks. Within the first 6 weeks, isoniazid and rifampicin were given intravenously. A clinical stabilization was achieved in all cases, which permitted total endoprosthesis of the hip joint. In postoperative period, the patients began to be active on days 10-12 of antituberculous therapy that lasted as long as 6 months in their local dispensary. The follow-ups of the patients ranged from 1 to 5 years. The support capacity and function of the joint operated on were recovered in all cases. There was no recurrence of a tuberculous process at the site of endoprosthesis. Thus, the developed tactics of preoperative preparation and post-operative management permits endoprosthesis of the hip joint in patients with destructive tuberculous coxitis and recovery of articular support capacity and function. At the same time it is necessary to define clinical indications for this operation in each specific case.

Arthritis↗
PubMed1995

Influence of shoes and heel strike on the loading of the hip joint.

The forces and moments acting at the hip joint influence the long-term stability of the fixation of endoprostheses and the course of coxarthrosis. These loads may depend on the kind of footwear and the walking or running style. These factors were investigated in a patient with instrumented hip implants. He wore different sports shoes, normal leather shoes, hiking boots and clogs and walked barefoot with soft, normal and hard heel strikes. The loads were lowest while walking and jogging without shoes. All shoes increased the joint force and the bending moment at the implant slightly but the torsional moment rose by up to 50%. No relation was found between the different type of shoes and the load increase, only shoes with very hard soles were clearly disadvantageous. Soft heels, soles or insoles did not offer advantages. Gait stability seems to play the most important role in increasing the joint loading and should be the criterion for the choice of footwear. Smooth gait patterns with soft heel strikes are the only means to reduce joint loading during slow jogging.

Aged↗
PubMed1985

Experimental temperature rise in human hip joint in vitro in simulated walking.

Although reported frictional coefficients in synovial joints are very low, a computer model of the human hip joint in simulated walking predicted a temperature rise of several degrees Celsius. To confirm this prediction, physical experiments were conducted in vitro on intact human hip joints dynamically loaded and articulated as in walking. Thermisters were placed in subchondral bone in both the acetabulum and femoral head, just below the cartilage layers. The surrounding saline bath was maintained at 37 degrees C. Measured temperatures as high as 2.5 degrees C above the 37 degrees C were recorded in the subchondral bone. Loading that simulated the stance/swing phases of gait but without articulation produced no significant increase in temperature; thus fluid flow per se is not significantly energy dissipative; the prime source is friction at the articulating surfaces.

Hip Joint↗