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At least 559 records · Page 31Linked to original sources
PubMed1993

Prophylactic radiation therapy for prevention of heterotopic ossification after hip arthroplasty: results in 141 high-risk hips.

In a 4 1/2-year, prospectively randomized study, 137 patients with 141 hips at high risk for heterotopic ossification (HO) received prophylactic radiation therapy (RT). Patients were randomly assigned to a low-dose regimen of five fractions of 2 Gy each (n = 73) or a high-dose regimen of either 10 fractions of 2 Gy each (n = 7) or five fractions of 3.5 Gy each (n = 61). Treatment failure was assessed by comparing immediately postoperative radiographs with radiographs obtained at least 6 months after hip surgery (Brooker grading score). Positive responses (ie, effective prophylaxis of HO) were seen in 129 (91.5%) hips. Treatment failures were observed in 12 (8.5%). Use of a nonsteroidal antiinflammatory drug (NSAID) lowered the failure rate in both RT groups. High RT dose with a short duration (< or = 9 days) and use of an NSAID was significantly (P = .009) correlated with treatment success. RT delivered within a few days after hip surgery is effective in preventing HO, even in high-risk patients, and provides an excellent alternative for patients with contraindications to long-term medication with either NSAIDs or corticosteroids.

Adult↗
PubMed1982

Congenital dislocation of the hip. Review at maturity of 147 hips treated by excision of the limbus and derotation osteotomy.

In 1957 Somerville and Scott presented their principles of management for the older child with congenital hip dislocation. They advocated preliminary traction followed, in those hips which remained dislocated, by excision of the limbus and subsequent derotation varus osteotomy of the femur. As alternative regimes are advocated it becomes increasingly important to subject each method to detailed long-term review. One hundred and forty-seven hips in 121 patients aged between 12 months and three years and treated by the standard Somerville and Scott regime have been reviewed. The age at review ranged from 16 to 31 years. The recall rate was 91 per cent. Each patient was seen regularly in a special clinic where detailed notes, radiographs and records were available. The results have been assessed clinically and radiographically by modifications of Severin's criteria to enable comparisons to be made with other published series. Attention has been focused on the good and the bad prognostic factors and on the long-term complications. The most worrying feature has been the premature onset of degenerative arthritis even in hips which seemed to have been satisfactorily reduced.

Child, Preschool↗
PubMed2002

Dual X-ray absorptiometry of hip, heel ultrasound, and densitometry of fingers can discriminate male patients with hip fracture from control subjects: a comparison of four different methods.

Few studies have examined different bone densitometry techniques to determine male hip fracture risk. We conducted a case-control study of 31 noninstitutionalized men, mean age 77 yr, with a first hip fracture and compared the results with 68 randomly selected age-matched control subjects. The methods used were dual X-ray absorptiometry (DXA) of the proximal femur, quantitative ultrasound (QUS) of the heel and fingers, and radiographic absorptiometry of the fingers. Case patients had significantly lower values (4-17%; p < 0.01) for all methods. The odds ratios for every SD reduction in bone values were 4.8 (95% confidence interval [CI]: 2.3-9.9) for DXA of the femoral neck, 2.2 (95% CI: 1.2-3.9) for QUS of the heel, 2.0 (95% CI: 1.2-3.3) for QUS of the phalanges, and 3.1 (95% CI: 1.5-6.6) for radiographic absorptiometry of the phalanges. The results indicate a strong capability of DXA of the femoral neck to distinguish between men with a first hip fracture and control subjects. Furthermore, ultrasound of the heel and fingers as well as radiographic absorptiometry proved capable of discriminating men with hip fractures from control subjects.

Absorptiometry, Photon↗
PubMed1977

Limitation of abduction of hips in the newborn. Is it a clinical sign or a phenocopy of congenital hip dislocation?

Until recently the possibility of a connection between maternal thyroid disorders and congenital hip pathology in the newborn has not been given any attention. However, from this study it is evident that there is a close relationship between maternal thyroid disorders and limitation of abduction of the hips in the newborn. The histological findings are suggestive of a neonatal thyrotoxic myopathy or periodic paralysis which might give rise to an error in muscle balance around the hips. The high proportion of affected children without a family history of congenital hip dislocation suggests that genetic factors have in the past been overemphasized.

Adult↗
PubMed2000

The pain and function of the hip (PFH) scale: a patient-based instrument for measuring outcome after total hip replacement.

The Pain and Function of the Hip (PFH) scale was developed following the recommendations of the Société International de Chirurgie Orthopedique et Traumatologie to assess the outcomes of total hip replacement (THR). This study evaluated metric properties of the PFH scale and its ability to measure clinical change (responsiveness) in consecutive patients undergoing THR. Patients were evaluated preoperatively and at 3 and at 12 months postoperatively. The PFH scale and the Nottingham Health Profile (NHP) were administered. Complete data were collected for 79 patients. Mean overall preoperative PFH score was 26.5 and mean overall PFH score 12 months postoperatively was 69.8 (P < .01). Correlation with the NHP was high (r = -0.64), and the magnitude of improvement (effect size) as assessed by the PFH scale was large (3.6 compared with 1.7 for the NHP). The PFH scale is simple and valid, and may complement routine clinical evaluation of hip replacement. Residual pain after hip replacement may have been previously underestimated.

Arthroplasty, Replacement, Hip↗
PubMed1993

Technical pitfalls in the use of the sliding hip screw for fixation of intertrochanteric hip fractures.

Two hundred fifty consecutive intertrochanteric fractures treated with a sliding hip screw (SHS) over a three year period were reviewed and specific types of technical pitfalls identified. Most pitfalls were technique dependent and potentially preventable with proper attention to the principles of fracture reduction and insertion of the device. Pitfalls encountered with the use of the SHS occurred as a result of either poor fracture reduction or implant insertion. Problems related to fracture reduction included poor radiographic visualization, posterior sag, varus angulation, and internal rotation of the femoral shaft in relation to the femoral neck. Potential pitfalls encountered during SHS insertion included superior guide wire placement, guide wire breakage or penetration into the hip joint or pelvis, loss of reduction during lag screw insertion, improper screw-barrel relationship, and improper plate application. Finally, the SHS may not be the implant of choice for all extracapsular hip fractures (i.e., the reverse obliquity fracture). This paper identifies the various pitfalls that may occur with the use of the SHS for the fixation of intertrochanteric hip fractures. Illustrative cases are provided and guidelines for avoiding these surgical pitfalls suggested.

Bone Screws↗
PubMed1995

The use of a high-hip center in revision total hip arthroplasty.

In certain cases, primary and revision total hip arthroplasty is complicated by insufficient bone stock and distorted acetabular anatomy such that the craniocaudal dimension of the acetabular recess is greater than the anteroposterior dimension. Acetabular reconstruction in such cases can be carried out by placing the acetabular component more proximally than normal (high-hip center). Recent biomechanical and clinical data suggest that placement of the acetabular component at a higher than normal hip center does not adversely effect the longevity of the component fixation. Proximal placement of the hip center also facilitates the contact between the host bone and the porous coating when uncemented porous coated components are used, and minimizes the need for structural bone grafts. However, femoral components with longer neck lengths and removal of impinging bone are needed when the acetabular components are placed more proximally in order to restore the limb lengths and minimize the chances for dislocation.

Acetabulum↗
PubMed2001

Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator.

Osteolysis and loosening of artificial joints caused by UHMWPE wear debris has prompted renewed interest in metal-on-metal (MOM) hip prostheses. This study investigated the wear and wear debris morphology generated by MOM prostheses in a physiological anatomical hip simulator for different carbon content cobalt chrome alloys. The low carbon pairings demonstrated significantly higher "bedding in" and steady state wear rates than the mixed and high carbon pairings. The in vitro wear rates reported here were up to one or two orders of magnitude lower than the clinical wear rates for first-generation MOM hip prostheses. Two methods for characterising the metal wear debris were developed, involving digestion, scanning electron microscopy and transmission electron microscopy. The metal wear particles characterised by the two methods were similar in size, 25-36 nm, and comparable to particles isolated from periprosthetic tissues from first and second-generation MOM hip prostheses. Due to the small size of the metal particles, the number of particles generated per year for MOM prostheses in vitro was estimated to be up to 100 times higher than the number of polyethylene particles generated per year in vivo. The volumetric wear rates were affected by the carbon content of the cobalt chrome alloy and the material combinations used. However, particle size and morphology was not affected by method of particle characterisation, the carbon content of the alloy or material combination.

Biomechanical Phenomena↗
PubMed2001

Assessment of variations in the measurement of hip ultrasonography by the Graf method in developmental dysplasia of the hip.

The purpose of this study was to assess the variations in the measurement of hip ultrasonography using the Graf method in developmental hip dysplasia. Twenty-two observers independently analyzed 20 hip ultrasonograms on two occasions. Intraobserver and interobserver agreement ratios on the exact Graf classification were 65% and 51%, respectively. Intraobserver and interobserver agreement ratios on the treatment method according to the hip type were 76% and 64%, respectively. Average intraobserver and interobserver differences were 4.0 degrees and 5.1 degrees for the alpha angle, and 5.9 degrees and 10.1 degrees for the beta angle, respectively. It was concluded that having a basic knowledge of the Graf method was the key point, and the observer's previous number of examinations had no effect on the results.

Analysis of Variance↗
PubMed1975

Conversion of the arthrodesed hip to a total hip arthroplasty.

Total hip arthroplasty was done in thirty-three patients who had had previous surgical attempts at arthrodesis of the hip. The arthrodesis had failed in nineteen patients, and the other fourteen patients had fused hips with symptoms in the knee and lower back. Thirty-one of the patients had satisfactory functional ability after total hip arthroplasty after one to three and one-half years' follow-up. The two patients in whom the procedure failed had complicating infections.

Adult↗
PubMed2003

[Drive principles of a triaxial physiological hip joint simulator for wear testing of hip endoprostheses].

The long-term performance of hip joint replacements is a major criterion for quality assessment. Aseptic loosening as a result of wear has a considerable impact on the long-term stability of the prosthesis. Constant improvements in hip joint endoprostheses necessitate the use of hip joint simulator to evaluate and assess the suitability of newly developed materials. In the present paper, a triaxial physiological hip joint simulator is presented, and detailed information provided, on the applied control concepts, adaptation of various hard- and software systems and the accuracy of the kinematic and force parameters achievable.

Biomechanical Phenomena↗
PubMedDate not supplied

Treatment of the painful chronically dislocated and subluxated hip in cerebral palsy with hip arthrodesis.

The purpose of this study was to evaluate 14 painful dislocated hips in patients with spastic cerebral palsy, treated with hip arthrodesis and internal fixation. The mean age at the surgical procedure was 15 years and 5 months. The mean follow-up period was 5 years and 3 months. All patients showed bone union, pain relief, and postural improvement. Hip arthrodesis is a reasonable option in treating painful spastic subluxated and dislocated hips in patients with cerebral palsy, especially if it is unilateral and the patient has weight-bearing function.

Adolescent↗
PubMed2004

[Sonographic assessment of stable hip reposition in newborns and infants with congenital hip dysplasia treated conservatively].

The paper presents a sonographic assessment of dysplastic hip morphology with clinically diagnosed instability after achieving stable reposition. The analysed group comprised 42 dysplastic unstable hips. They were classified according to the Graf classification as type D, III and IV. The analysed group was divided into 2 subgroups according to the child's age at the time treatment was began. Group I comprised children in whom treatment was began at age 2-6 weeks. Group II included children who were 7-12 weeks old at the time treatment was began. The morphology of the dysplastic hip was assessed basing on angle alpha and beta measurements. Stable repositioning of the hip was achieved on average 5 weeks after conservative treatment was started. The average alpha angle was 50 degrees in group I and 48 degrees in group II; accordingly, angle beta was on average 60 degrees and 69 degrees.

Acetabulum↗
PubMed1992

Iliopsoas bursal distension caused by acetabular loosening after total hip arthroplasty. A rare complication of total hip arthroplasty.

In a 58-year-old woman, a cystic mass at the ileocecal region communicated with the loosened hip prosthesis 20 years after total hip arthroplasty (THA). The preoperative arthrogram of the hip and the intraoperative cystogram suggested a one-way communication from the hip to the cystic mass. The mass was diagnosed as an iliopsoas bursitis distended by the influx of the synovial fluid from the loosened THA.

Abdominal Neoplasms↗
PubMed2005

A review of hip arthroscopy and its role in the management of adult hip pain.

The diagnosis and management of patients presenting with hip pain is often challenging. A thorough history and physical examination, imaging studies and selective injections can help define the source of pain in many of these individuals. As technology and technical skills continue to improve, the role for hip arthroscopy will continue to expand. Further well-designed studies will better refine the indications for hip arthroscopy in managing patients with hip pathology.

Arthroscopy↗
PubMedDate not supplied

Function following mega total hip arthroplasty compared with conventional total hip arthroplasty and healthy matched controls.

Total hip arthroplasty (THA) with the use of a Mega prosthesis was a successful surgical procedure in the management of tumors of the hip as well as in revision THA with loss of bone stock. Passive hip motion and strength of hip muscles, walking ability, and activities of daily living in nine such cases compared well with the function following conventional THA. Limp and positive Trendelenburg sign were more common after Mega THA. Dislocation of the prosthesis occurred in 2/14 cases. Fracture of the femoral condyle occurred in one case. Another case had stem fatigue failure of a thin stem.

Adult↗
PubMed1985

[Possibilities, problems and present status of hip sonography of infant hips].

The author reports on hip-joint examinations in 16 000 infants, using sonography (age: 1 day up to 12-15 months). Particular attention is given to the classification of disturbances of maturation of the hip joint described. The use of angles and the possibility of making mistakes during measurement are demonstrated. The ultrasonographic traces are compared with X-rays to demonstrate the accuracy of ultrasonic investigation of infant hip joints. Determination of hip-joint maturity using the "sonometer" is described.

Hip Dislocation, Congenital↗
PubMed1979

Total hip replacement following infection in the opposite hip.

Total hip replacements without ensuing infection were performed in 31 patients in the presence of infection in the contralateral hip. Infection in the opposite hip was proved bacteriologically in the follow-up in 19 cases averaged 5 years (2 years 3 months to 10 years). In another 12 hips in the same circumstances, without positive bacteriological evidence of active infection on the opposite side, healing occurred without infection.

Adult↗