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PubMed2000

Recurrent traumatic dislocation of the hip joint at the age of 13 and 17 years. A case report.

We report a case of a recurrent traumatic dislocation of the hip joint in a young man at the age of 13 and 17. The patient had retroversion of the femoral neck, instead of a physiological anteversion. We found no consensus about the management of a recurrent traumatic dislocation of the hip joint in the literature. The various therapeutic options are discussed. We advised posterior capsulorraphy with femoral rotation osteotomy. The patient refused surgery.

Adolescent↗
PubMed1983

Comparison of normal and abnormal human fetal hip joints: a quantitative study with significance to congenital hip disease.

The presence, extent of abnormality, and measurement data in hips from six fetuses with congenital deformities and seven normal fetuses with 12 aberrant hips were compared with similar data from 140 normal fetuses. Six hips were abnormal on naked eye examination in fetuses with polycystic kidneys, multiple deformities, or cyclopia. Hips graded normal in two fetuses with cardiac defects were found to have dysplasia, greater on the left side, when measurement data were compared. Aberrant features observed resembled that reported in congenital hip disease. Although no joints were frankly dislocated, six hips were subluxated with marked deformity. Only two assessed abnormal hips did not have values outside normal limits for their comparison age group, and joints from six fetuses had some values that exceeded normal limits by 2 SD. In only two fetuses were the femoral angle values outside normal limits indicating that femoral angles alone may be poor criteria of hip dysplasia. Quantitative data for normal fetuses permit more precise evaluation of morphologically abnormal joints and enable detection of dysplasia not apparent on naked eye examination.

Diseases in Twins↗
PubMed2005

Clinical applicability of using spherical fitting to find hip joint centers.

The functional or sphere-fitting method has been proposed as an alternative to the traditional predictive approach to locating hip centers based on inter-ASIS breadth. In the functional approach, the movement of a marker on the thigh is fit to a sphere whose center coincides with the hip joint center. The first objective of this study was to determine the required parameters that allow an accurate application of a sphere-fitting method. The parameters examined in this study included: (1) the range of motion in flexion-extension and abduction-adduction, (2) the specific algorithm used to fit a sphere to the data, (3) the method of placing markers on the thigh, and (4) the type of motion used to generate points, either walking or a standing leg motion (SLM) trial. This objective was addressed with a computer simulation and clinical data. The second objective was to compare the accuracy of the functional method to the traditional predictive approach in a group of nine human subjects. The location of the hip center estimates from both methods were compared to an ultrasound-determined hip center standard, and linear errors and errors along each axis were compared. Results from the computer simulation indicated that an iterative algorithm is needed, with a method using the derivative yielding slightly more accurate results. Clinical results indicated that the functional method with a standing leg motion trial produced significantly smaller errors in hip joint center estimates (1.34 cm) versus the predictive method (2.16 cm). In addition, the range of error across hips was smaller for the functional method. If high joint center accuracy is needed or in populations characterized by obesity or pelvic asymmetries, the subject specificity and independence from anatomical landmarks characteristic of the functional method would likely provide more accurate results.

Adult↗
PubMed1988

[Indications for hip joint replacement. Early and late results].

Marked advances have been made in the application of hip joint endoprostheses since their extensive dissemination in the early 70's. Implantation material, surface structure, design of the prosthesis and surgical techniques have been better adapted to the biological and biomechanical conditions. Nevertheless, the long-term prognosis remains uncertain, and joint-saving interventions continue to take priority. The possibilities for the application of endoprostheses in cases of degenerative, posttraumatic and congenital changes and tumourous destructions have been improved by extended prostheses and additional measures. Whereas the indication for a prosthesis to save the mobility of the patient is established more frequently for older patients suffering from basic diseases with a limited life expectancy, osteolysis due to bone tumours or metastases, hip-joint replacement in younger patients should always be performed as a last resort, even if the prognosis is better.

Femoral Neck Fractures↗
PubMed2001

Biomechanical analysis of suture anchors and suture materials used for toggle pin stabilization of hip joint luxation in dogs.

OBJECTIVE: To compare in vitro mechanical properties of toggle pins and toggle rods used as suture anchors and of 3 suture materials (50-lb monofilament polybutester, No. 5 braided polyester, and 5-mm woven polyester) commonly used as prosthetic ligaments in the repair of hip joint luxation in dogs. SAMPLE POPULATION: Femoropelvic specimens from the cadavers of 18 dogs. PROCEDURE: Suture anchors were compared by use of pullout tests. Suture materials were compared by use of monotonic and cyclic tensile tests; cyclic tensile tests were performed with the suture placed over the edge of an aluminum bar to simulate the edge of the femoral bone tunnel. In vitro mechanical properties of the ligament of the femoral head were determined by use of monotonic tensile tests, using bone-ligament-bone cadaveric specimens. The in vitro mechanical properties of the acetabulum-ligament-femur complex and of this complex following rupture of the ligament and stabilization with a toggle rod and 5-mm woven polyester were determined by use of compression tests that simulated weight-bearing. RESULTS: Mechanical properties of the toggle rod were not significantly different from those of the toggle pin. Woven polyester had the longest fatigue life in cyclic testing. Hip joints stabilized with a toggle rod and woven polyester had less than half the strength in vitro of intact joints. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a toggle rod or toggle pin can be used for stabilization of hip joint luxations in dogs. Of the materials tested, braided polyester had the best in vitro mechanical properties.

Animals↗
PubMed1991

[Non-cemented alloplasty of the hip joint].

The authors present a review of the contemporary problem of non-cemented alloplasty of the hip joint. They compare the advantages and disadvantages of cemented and non-cemented endoprostheses of the hip joint in relation to possible loosening and possible re-operation and with regard to the surgical technique. The negative action of bone cement is divided into two groups: 1. immediate effects which act on surrounding tissues and the patient's organism during operation. 2. late effects which involve abrasion and the phagocytic response to small cement fragments and the formation of osteoaggressive granulations. These late effects are demonstrated on histological material. The authors emphasize that non-cemented alloplasty has also some pitfalls which involve in particular higher demands on the accuracy of the surgical technique and, no doubt, more severe haemorrhage. The main advantages are according to the authors the elimination of negative effects of bone cement, in particular late effects. The authors tried to classify the contemporary spectrum of available non-cemented implants with regard to their design, materials and surface finish.

Bone Cements↗
PubMed1999

[Direct communication between the lower urinary tract and the hip joint complicating acetabular fracture. A case report].

INTRODUCTION: Urinary complications are rare in acetabular fractures (3.5 p. 100). They can lead to immediate, secondary or late complications. CASE REPORT: The authors report the case of an uretro-acetabular fistula in a complex acetabular fracture. Intravenous urography showed the fistula with opacification of the hip joint. Surgical treatment of the fracture was contra-indicated due to the septic risk. Post traumatic degenerative joint disease appeared in our patient and a total hip arthroplasty was performed at 18 months post injury. At 6 months follow-up, clinical biological and radiographical status was good. DISCUSSION AND CONCLUSION: Hip joint contamination with urines due to uretroacetabular fistula could be responsible for septic hip arthritis and late joint deterioration. Urine drainage using a cystocatheter as in our observation is recommended. Primary and secondary treatment of the acetabular fracture remains difficult.

Acetabulum↗
PubMed1995

[Ultrasound anatomy of the fetal hip joint with special reference to the blood supply].

AIM: Study of the anatomy of the fetal hip joint in 115 pregnancies between 13. to 40.th weeks of gestation by ultrasound. METHOD: Sonoanatomy was studied by high resolution ultrasound (Acuson 128). For investigation of vascular supply of the fetal hip, colour-coded Doppler sonography was performed. In-vivo studies on vascular supply were correlated with histological sections of 34 fetal hip specimens, according to the conceptional age of 13-35 weeks. RESULTS: Vascular studies of the proximal end of the human femur showed a supply by the lateral and medial femoral circumflex arteries branched from the femoral artery or the deep femoral artery. After 22 weeks of gestation the acetabular artery supplied by the obturator artery was visible by means of Doppler sonography. At the end of pregnancy, large numbers of intraosseous blood vessels are demonstrable within the femoral head and neck. CONCLUSION: The basic arterial pattern of the hip joint is established at birth. Proximal end of the growing femur, acetabulum, os ilium and labrum acetabulare are clearly visible by ultrasound.

Acetabulum↗
PubMed1976

Traumatic dislocation of hip joint with fracture of shaft of femur on the same side.

Four cases of traumatic dislocation of the hip joint with fracture of the shaft of femur on the same side, and one case of bilateral hip joint dislocation with a fracture of shaft of femur on one side are reported. Pitfalls in diagnosis and hazards of delayed treatment are emphasized. Methods of treatment are outlined. Complications such as avascular necrosis of the head of the femur and sciatic nerve palsy are discussed. Avascular necrosis of the head of the femur is not inevitable even after reduction of the joint has been delayed for several days.

Adolescent↗
PubMed1991

Ultrasound in the diagnosis of congenital dysplasia and dislocation of the hip joints in children older than two years.

To evaluate the use of ultrasound in the diagnosis to congenital dysplasia and dislocation of the hip (CDH) in children older than two years of age, 64 patients with normal hip joints and 47 patients with present or previous CDH were examined. Lateral and anterior ultrasound scanning was employed, and the coverage of the femoral head by the acetabular roof was assessed. The ultrasound measurements were compared with standard roentgenography, and a good accordance between the methods was found. A lateral projection of the femoral head in relation to the bony acetabular rim of more than 8 mm in children younger than ten years of age indicated subluxation and more than 15 mm at age two to four years indicated dislocation. Reliable images were obtained by ultrasound at any age between two and 18 years. Ultrasound is recommended as the primary imaging technique in the evaluation of hip joints, even in older children, and ultrasound should replace roentgenography in most of the follow-up examinations of children with previous CDH.

Adolescent↗
PubMed1992

[Postoperative treatment, rehabilitation and expert assessment of patients with endoprostheses of the hip joint].

The main demands on a total hip replacement are to reduce pain or achieve painlessness and to recover or improve mobility and walking ability. Today more younger patients were operated replacing a destroyed hip joint: the reintegration in professional and sportive activities is a major part of the rehabilitation process. The postoperative management especially in physical therapy can be standardized inspite of the use of various models. Usually full weight bearing is accepted after 3 months. A review of consecutive treatment methods and professional and sportive rehabilitation measures are presented. Hip replacement leads to restrictions in activity in general. The evaluation, in relation to the different indemnifying, is differentiated.

Disability Evaluation↗
PubMed1999

[Antibiotic prophylaxis in hip joint surgery].

Nosocomial deep wound infections are serious complications after hip joint surgery. Our aim was to determine whether there is a difference in rates of nosocomial infections between group of patients after elective surgery of hip replacement and group of patients with hip replacement after trauma. Both groups of patients had perioperative prophylaxis with amoxycillin. We found that the overall trauma patients infection rate was 0.9 per cent compared with 1.5 per cent for elective surgery infections. In both groups of patients a postsurgery stress was documented according to increase of acute phase proteins (C-reactive protein, orosomucoid and fibrinogen) in plasma for a minimum 10 days after surgery. We conclude, that both groups of patients had benefit from amoxycillin prophylaxis therapy.

Acute-Phase Proteins↗
PubMed2006

Toggle rod stabilization for treatment of hip joint luxation in dogs: 62 cases (2000-2005).

OBJECTIVE: To determine outcome of open toggle rod stabilization in dogs with luxation of the hip joint. Design-Retrospective case series. ANIMALS: 62 dogs. PROCEDURES: Information on signalment, surgical procedure, and postoperative care was obtained from the medical records. A questionnaire was sent to all owners to solicit follow-up information. RESULTS: The distribution for time between luxation and surgery was bimodal, with 24 (39%) dogs examined < or = 2 days after injury and 23 (37%) examined > 7 days after injury. Postoperative complications developed in 16 of the 62 (26%) dogs, with complications developing within 1 week after surgery in 10 of the 16. The most common complication was reluxation, which occurred in 7 dogs. Dogs in which surgery time was < 2 hours were significantly less likely to have a reluxation (2/40 [5%]) than were dogs in which surgery time was > or = 2 hours (5/22 [23%]). When asked to rate current limb function (0 = no lameness and 5 = non-weightbearing lame) a minimum of 6 months after surgery, 23 of 27 (85%) owners indicated a score of 0 or 1. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggest that toggle rod stabilization is an effective treatment for hip joint luxation in dogs. However, complications, particularly reluxation, were common.

Animals↗
PubMed2002

Surface characterization and debris analysis of ceramic pairings after ten million cycles on a hip joint simulator.

This study was aimed at characterizing the ceramic wear particles produced during tests on a hip joint wear simulator of up to 10 million cycles. Alumina and alumina-zirconia composites were studied as commercial or potential hip joint products respectively. No ceramic particles could be observed, even after a careful isolation procedure. This confirms the low wear rate found for these materials in previous works (of the order of tenths of milligrams per million cycles). Surface characterization was conducted by means of scanning electron microscopy. It confirms the low wear regime of ceramic pairings and allows ceramic wear debris morphology to be defined. The effect of microstructure on surface wear is discussed.

Aluminum Oxide↗
PubMed2004

A general elastohydrodynamic lubrication analysis of artificial hip joints employing a compliant layered socket under steady state rotation.

A general numerical methodology was developed in the present study to analyse the elastohydrodynamic lubrication problem of a compliant layered socket against a rigid ball under steady state rotation representing flexion and extension during walking, with particular reference to artificial hip joint replacements. The general numerical methodology consisted of using the Newton-Raphson method to solve the Reynolds equation, simultaneously with the full elasticity equation using the finite element method in combination with the fast Fourier transform technique. Two specific types of acetabular cup were considered, one with ultra-high molecular weight polyethylene used in current total hip joint replacements, and one with polyurethane proposed for compliant layered 'cushion form bearings' for future developments. The film thickness and the pressure distribution for both cups were obtained under a wide range of operating conditions. The predicted central or average film thicknesses within the contact conjunction were compared with those estimated from various simplified theories available in the literature. A simple analytical methodology was consequently established to estimate the lubricating film thickness in a compliant layered socket, based on the corresponding ball-on-plane model and the consideration of the curvature effect.

Computer Simulation↗
PubMed2002

Relationship between radiographic measurements of reconstructed hip joint position and the Trendelenburg sign.

We evaluated 60 limbs, including 34 primary total hip arthroplasties in 30 patients (mean age, 56 years) at a minimum of 2 years postoperatively. Femoral offset ratio (%FO) was calculated by dividing the femoral offset by the distance between the centers of the bilateral femoral heads on radiographs. The tilt angle of the pelvis by the Trendelenburg test was measured using the magnetic sensor system. In the limbs having a negative Trendelenburg sign after reconstruction, the %FO averaged 20.1% (range, 14.7% to 24.7%), and the tilt angle of the pelvis averaged +0.8 degrees (range, -1.0 degrees to +5.0 degrees ). The tilt angle of the pelvis correlated positively with %FO (P=.0160, r=0.407). The reconstructed hip joint position is crucial to improve hip abductor function.

Adolescent↗