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At least 667 records · Page 37Linked to original sources
PubMed2001

"Tripolar" hip arthroplasty for failed hip resurfacing: nineteen years follow-up.

The authors describe the case of a 37-year-old patient who sustained a subcapital femoral neck fracture six months after ICLH double-cup hip resurfacing. As the polyethylene acetabular resurfacing component was undamaged and well fixed, a standard femoral stem with a bipolar head was inserted. The outer diameter of the bipolar head was chosen to fit the resurfacing socket. The "tripolar" hip arthroplasty has functioned well for 19 years and was revised for aseptic cup loosening. The cemented femoral stem was still well fixed and was not revised. Although the "tripolar" hip has functioned well in our case, we believe it is not indicated for metal on metal bearings. In this case the use of an appropriate modular head with a correct head-socket clearance is preferred.

Adult↗
PubMed1975

[Biomechanics of the hip joint. I. A new model for the calculation of the forces in the hip joint].

After a short review of the theory of the forces acting in the human hip joint we develope a new model for the calculation of the forces R acting on the head of the supporting femur, of their direction phi and of the maximal pressure of the femoral head. The new concept is the determination of a fixed point A, the attachement of the resultant muscle force M at the pelvis, and the insertion T of this muscle force at the trochanter. After determination of this points in a single standard radiography of the pelvis and hips, the model calculate the resultant force R at the hip joint. The pressure in the articulation is calculated also by the same proceeding. The influence of the choice of the point A is discussed.

Biomechanical Phenomena↗
PubMed1976

Total hip replacement in patients with ankylosing spondylitis with involvement of the hip.

Twenty-three patients with ankylosing spondylitis underwent thirty-four total hip arthroplasties with an average follow-up of 42.5 months. The over-all results were rated good in all but two patients. Significant benefit was obtained in posture and function so that these patients could be gainfully employed. Improvement in the sum total range of motion was 96.1 degrees in patients with bone ankylosis and 150 degrees in those with fibrous ankylosis. The preoperative sum total range of motion was maintained or improved in hips with a painful arc of motion. Most of the limited motion in patients with ankylosed hips was due to myositis ossificans.

Adult↗
PubMed1990

[Avascular necrosis of the hip in radiologic images during treatment using the Freyka pillow for congenital hip dislocation].

Radiological picture of 823 hips in 636 children treated with the use of Freyka pillow between 1972 and 1976 was assessed. Avascular necrosis of the proximal end of the femur was found in 113 cases. The older the child was at the beginning of treatment the highest were the chances for developing avascular necrosis, but more serious changes were found in younger children. In the hips with greater initial dislocation changes were more frequent. A comparison between hips treated with Freyka pillow and those treated with different methods as to frequency of avascular necrosis was difficult due to the lack of uniformity in criteria for both diagnosis and assessment of the results.

Child, Preschool↗
PubMed2005

Increased bone mineral content but not bone mineral density in the hip in surgically treated knee and hip osteoarthritis.

OBJECTIVE: The inverse relationship between the occurrence of osteoarthritis (OA) and osteoporosis is controversial. Some investigators have found higher bone mineral density (BMD) in the hips, lumbar spine, and other skeletal sites of patients with OA; others have not. We investigated the relationship between BMD and OA. METHODS: We compared the BMD, bone mineral content (BMC), and projected area of the femoral neck (FN) and trochanter (TR) of 99 women with a validated diagnosis of primary OA from the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort, with 2012 controls. The measurements were made twice in women aged 47-59 years in 1989-91, and then repeated in 1994-98. RESULTS: After correction for age, body mass index (BMI), menopausal status, and hormone replacement therapy use before inclusion, we found no significant difference in femoral BMD of the OA patients compared with controls at baseline and at 5-year followup (FN +2.7%, +4.6%, respectively; nonsignificant). However, the BMC was significantly higher in all regions of interest in OA patients at baseline [FN +8.3% (p = 0.004); TR +13.3% (p = 0.017)]. The projected area of FN was also significantly higher at baseline and followup in OA patients (FN +3.7%, +3.9%, respectively; p < 0.001). The projected area of the bones increased in all subjects over the followup period. The BMD decrease rate was higher in OA patients for all regions of interest during followup. CONCLUSION: Hip BMD of women treated surgically for hip or knee OA was not different from that of healthy controls when measured twice with a 5-year interval. However, at 5-year followup, OA can be accompanied by an increase in bone size or changes in shape, and faster loss of BMD.

Absorptiometry, Photon↗
PubMed1990

One-stage hip reconstruction with Dega's transiliacal osteotomy in the treatment of congenital hip dislocation in children.

Results of surgical treatment of the congenital dislocation of the hip in 40 children (2-5 years) are presented. The mean observation period was 8 years. 80% of very good and good results were obtained in the included material. One-stage hip reposition -reconstruction with Dega's transiliacal osteotomy, applied to children of 2-3 years, gives positive results, adding to further development of the hip joint.

Child, Preschool↗
PubMed1987

[Treatment of congenital dislocation of the hip--follow-up study of cases of bilateral dislocation of the hip].

The treatment of congenital dislocation of the hip in 16 patients (32 hips) older than 9 years of age at the time of this follow-up study was evaluated. Most of the patients were treated at the age between 1 and 3 years. Right and left hips treated by different methods, either conservative treatment, Colonna capsular arthroplasty or open reduction, were examined radiologically and compared. Consistent results were not obtained in the patients who underwent conservative treatment or Colonna capsular arthroplasty. Among the patients of open reduction, better results were obtained in those of "open reduction with total capsulotomy" than those treated by other methods. The patients who underwent such an operation at an earlier age showed the best results. The results of open reduction were not inferior to those of conservative treatment if concentric improvement was observed immediately after the operation. Therefore, a treatment appropriate for each patient should be selected and conservative treatment alone should not be insisted upon.

Child, Preschool↗
PubMed1971

Studies in osteoarthritis of the hip. II. Osteoarthritis of the hip and leg-length disparity.

An x-ray method is described for the determination of leg-length inequality in the standing subject, Its precision is compared to that of other methods in current use. The geometrical considerations which are inherent in any radiographic method of leg-length determination are summarized. Sixty-seven patients with OA hip were studied; 62 were considered to be idiopathic and 36 of these idiopathic cases were superolateral in type. Measurements in these 36 patients showed significant leg-length disparity, most of the diseased hips being found on the side of the longer leg. If allowance is made for shortening due to disease, the frequency and bias of the disparity are highly significant. The strong association between OA hip of this type and a long leg suggests a causal relationship.

Female↗
PubMed1984

The infected hip after total hip arthroplasty.

We studied the cases of fifty-two patients with an infection at the site of a prosthetic total hip replacement, and are reporting the significant clinical features, infecting organisms, methods of treatment, and results at long-term follow-up. Forty-eight per cent of the hips had had an operation prior to the index arthroplasty, and 42 per cent had a wound complication. All patients had pain in the infected hip, but only 54 per cent had an erythrocyte sedimentation rate of more than thirty millimeters per hour, 44 per cent had fever, and 15 per cent had leukocytosis. In 88 per cent of the patients a single organism was grown on culture, and Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli were present in about 75 per cent. When antibiotic therapy alone was the initial treatment, the infection was eradicated in only one patient. Excisional arthroplasty was the definitive surgical procedure in thirty-three patients and the infection was eradicated in twenty-seven of them, but the clinical result was satisfactory in only twenty. Of ten patients who had a true Girdlestone arthroplasty, none had recurrence of the infection and all had a clinically satisfactory outcome.

Adult↗
PubMed1995

Combined realignment procedure (femoral and acetabular) of the hip joint in ambulatory patients with cerebral palsy and secondary hip dislocation.

In a retrospective study we evaluated the results of 11 patients with cerebral palsy and concomitant hip dislocation who were still able to walk. They had been surgically treated with proximal femoral osteotomy (varization and derotation) and acetabular osteotomy (triple osteotomy) in order to achieve stabilization of the hip joint. The patients' mean age was 14.4 +/- 3.7 years. The female:male ratio was 7:4. All 11 hip joints were successfully stabilized. The range of passive abduction significantly increased from 20 degrees preoperatively to 42 degrees postoperatively. The range of flexion slightly decreased from 101 degrees to 92 degrees. Internal rotation significantly decreased from 51 degrees to 37 degrees. External rotation increase from 27 degrees preoperatively to 41 degrees postoperatively. Preoperatively 4 of the 11 patients had been able to walk without any walking aids; 7 had been able to walk with support. Concerning the ambulatory status, mild improvement was achieved postoperatively in 3 patients. The CCD-angle decreased significantly from 138.9 degrees preoperatively to 118.7 degrees postoperatively. The migration index according to Reimers improved significantly from 50.2% preoperatively to 24.2% postoperatively. Prior to surgery 4 cases showed a grade 1 dislocation, 6 cases a grade 2 dislocation, and 1 case a grade 3 dislocation. We succeeded in performing a complete reposition in all patients. Preoperatively the CE- angle was only -3 degrees (+/- 11.3 degrees) and was improved to 27.1 degrees (+/- 5.3 degrees). The ACM-angle measured 45.4 degrees preoperatively and 49.5 degrees postoperatively. The sitting balance was improved in all patients. Furthermore the problem of anal care was reduced.

Acetabulum↗
PubMed1994

A hip wear simulator for the evaluation of biomaterials in hip arthroplasty components.

A multistation (8-station) hip simulator has been designed and tested that provides a practical imitation of the motions and loads seen by the hip joint during a typical walking cycle. A biaxial rocking motion of +/- 23 degrees is synchronized with the respective resultant forces of the extension-flexion (heel-strike to toe-off) movements of the leg. This particular simulator provides a practical engineering in vitro implementation of the walking cycle. It also provides a realistic and practical compromise between general wear screening devices (such as pin-on-disk systems) and the intensive research accomplished through full scale simulation (full 6 degree-of-freedom systems) and modeling. Evaluation of system performance shows that control of rpm (revolutions-per-minute) for the desired axial rotation of 1 Hz was kept to 60 cpm +/- 1 cpm for axial loads (per actuator) as high as 4500 Newtons. Although loading error was 2% in the peak load areas of interest (3000 Newton), station-to-station load control variability was less than .6%. Baseline wear studies with this simulator using ultra-high-molecular-weight polyethylene and Cobalt-Chromium (UHMWPE/CoCr) hip systems indicate an average specimen-to-specimen wear variability of less than 7% range after 5 million test cycles. Testing was performed in a calf serum environment at an equilibrium temperature of 33 degrees C.

Biocompatible Materials↗
PubMedDate not supplied

Conversion of hip joint pseudarthrosis to total hip replacement.

Forth hips in 35 patients were converted from pseudarthrosis to low friction total hip arthroplasty (LFA). Pain, function and range of motion were improved in most cases. Gait was improved and number of walking aids required were reduced in most cases. Abduction against gravity and straight leg raising were also improved. Limb length was restored in all but 9 cases. Two cases dislocated postoperatively. One was reduced and did well; the other had a trochanter avulsion with recurrent subluxation. Improvement of function is a prime indication for converting a pseudarthrosis to LFA whereas pain is not so significant a factor. This is a formidable procedure requiring a complete range of prostheses and instruments and complete familiarity with the technique of total hip replacement but the end results are gratifying.

Adult↗
PubMed1989

A long-term follow-up study of total hip replacement with bone graft. Correlations between roentgenographic measurement and hip mobility.

Fifty total hip replacement treating the acetabular deficiency with autologous bone graft from the femoral head were performed on 44 patients with congenital dislocation of the hip. The average age was 55 years. The average follow-up period was 5 years and 2 months, ranging from 3 years, 8 months to 6 years, 11 months. Solid union was demonstrated in all acetabular grafting. No loosening of either acetabular or femoral components occurred. Roentgenological measurements used as a parameter of good results showed that better results were obtained using the true acetabulum (ideal position) with appropriate bony coverage.

Acetabulum↗
PubMed2000

From the RSNA Refresher Courses. Radiological Society of North America. Chronic adult hip pain: MR arthrography of the hip.

This article describes the technique for performance and interpretation of magnetic resonance arthrography of the hip. A description of normal anatomy of the hip is presented, and the appearance of the abnormal labrum is discussed. Labral detachments and tears are the most common clinically significant abnormalities to be identified. These abnormalities are recognized on the basis of the presence of contrast material at the acetabular-labral interface or within the substance of the labrum. Many varied appearances of the labrum have been identified within the asymptomatic population, and the correlation of these appearances is contrasted with those of the abnormal labrum in symptomatic patients. To date, it is difficult to draw conclusions regarding the significance of an absent labrum or of a sulcus at the acetabular-labral junction. Experience suggests that an absent labrum in a symptomatic individual is pathologic and that a sulcus at the anterosuperior acetabular-labral junction may be a normal variant.

Acetabulum↗
PubMed2007

Effectiveness of computer-navigated minimally invasive total hip surgery compared to conventional total hip arthroplasty: design of a randomized controlled trial.

BACKGROUND: Moderate to severe osteoarthrosis is the most common indication for Total Hip Arthroplasty (THA). Minimally Invasive Total Hip Surgery (MIS) and computer-navigated surgery were introduced several years ago. However, the literature lacks well-designed studies that provide evidence of superiority of computer-navigated MIS over a conventional THA technique. Hence, the purpose of this study is to compare (cost)effectiveness of computer-navigated MIS with a conventional technique for THA. It is our hypothesis that computer-navigated MIS will lead to a quicker recovery during the early postoperative period (3 months), and to an outcome at least as good 6 months postoperatively. We also hypothesize that computer-navigated MIS leads to fewer perioperative complications and better prosthesis positioning. Furthermore, cost advantages of computer-navigated MIS over conventional THA technique are expected. METHODS/DESIGN: A cluster randomized controlled trial will be executed. Patients between the ages of 18 and 75 admitted for primary cementless unilateral THA will be included. Patients will be stratified using the Charnley classification. They will be randomly allocated to have computer-navigated MIS or conventional THA technique. Measurements take place preoperatively, perioperatively, and 6 weeks and 3 and 6 months postoperatively. Degree of limping (gait analysis), self-reported functional status and health-related quality of life (questionnaires) will be assessed preoperatively as well as postoperatively. Perioperative complications will be registered. Radiographic evaluation of prosthesis positioning will take place 6 weeks postoperatively. An evaluation of costs within and outside the healthcare sector will focus on differences in costs between computer-navigated MIS and conventional THA technique. DISCUSSION: Based on studies performed so far, few objective data quantifying the risks and benefits of computer-navigated MIS are available. Therefore, this study has been designed to compare (cost) effectiveness of computer-navigated MIS with a conventional technique for THA. The results of this trial will be presented as soon as they become available.

Adolescent↗
PubMed2006

Constrained components for the unstable hip following total hip arthroplasty: a literature review.

Patients with chronic instability or late dislocation following total hip arthroplasty often require operative management. Unfortunately, there is an increased risk of recurrent dislocation following revision in these patients. Over the past decade the use of constrained devices for patients with chronic instability has gained increased interest; however, there is a paucity of studies available in the literature regarding the use of these devices. The purpose of this study was to analyze the available literature over the past 15 years, focusing on larger, long-term studies, to obtain recommendations from the respective articles for indications and contraindications for the use of constrained devices. Our review of eight reports included 1,199 hips in 1,148 patients with a total mean follow-up of 51 months (range, 24 to 124 months). The mean rate of dislocation following revision with a constrained liner was 10% and the mean re-operation rate for reasons other than dislocation was 4%. We concluded that constrained liners are an option for patients who have failed management of instability with other implants, those with instability of unclear etiology, those with cognitive problems who are unable to follow dislocation precautions, those with deficient abductors, and elderly or low-demand individuals with well-positioned implants requiring revision.

Arthroplasty, Replacement, Hip↗
PubMed2004

Three- to six-year results with the Ultima metal-on-metal hip articulation for primary total hip arthroplasty.

One hundred seventy-one primary total hip arthroplasties were evaluated in a prospective, randomized study. Ninety-five involved a metal-backed cup with an all-metal liner and 76 involved a metal-backed polyethylene cup that was used as the control. All were implanted with an S-ROM cementless femoral component with a 28 mm head. The mean follow-up period was 3.7 years (range, 3.0-5.7). The average postoperative Harris hip score was 95.4 (range, 65-100) for the metal-on-metal group and 96.1 (range, 65-100) for the metal-on-polyethylene group. Radiographic results were not statistically different between the 2 groups. Early results show the metal-on-metal articulation has been successful to date and justify continued clinical use.

Adolescent↗
PubMed1985

Total hip replacement combined with bone grafting for acetabular dysplasia causing severe osteoarthritis of the hip joint.

Over a 10 year period 18 total hip joint arthroplasties (THJA) were performed on 15 patients with disabling osteoarthritis of the hip joint secondary to congenital dislocation or subluxation. In all cases reconstruction of the deficient acetabulum was necessary in order to provide total bony containment of the acetabular prosthesis. This was achieved using a bone graft, fashioned from the femoral head and securing it above the true acetabulum. At follow-up all patients were pain free. Radiographically, there had been no loosening of the acetabular prosthesis and all grafts appear to have united. The operative technique is described in detail.

Acetabulum↗