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At least 703 records · Page 39Linked to original sources
PubMed1997

Biomechanics of the hip joint capsule -- a mathematical model and clinical implications.

OBJECTIVE: Our aim was to develop a mathematical model to calculate forces, tension and stretching in the hip joint capsule, under conditions caused by the joint effusion usually accompanying hip disease. DESIGN: A mathematical model was developed, based on experimental data from cadaver studies. BACKGROUND: Intracapsular pressure is important with respect to the degree of painless movement in the hip. Previously, we established the relations between the rotation around the axis of the neck of the femur, joint effusion, intracapsular pressure and joint stability. METHODS: In six cadaver adult hips the joint distraction, the traction force along and the rotation around the axis of the neck of the femur and the intracapsular pressure, were simultaneously monitored as the volume of intracapsularly infused saline was increased. The elasticity-constants included in the extracted formula for the fluid pressure were calculated in a designed computer software based on these experimental data. RESULTS: Presented in Figures 3-12. CONCLUSIONS: In the normal joint there is no increase in intracapsular pressure, nor any tension in the hyperboloid shape capsule within the normal range of rotation around the axis of the neck of the femur. This shape is distorted in a hip with effusion, rotation then resulting in an increased intracapsular pressure and tension in the capsule, with potential risk of ruptures.

Journal Article↗
PubMed1996

Physical modelling of hip joint forces in stair climbing.

A test device has been developed and validated to simulate physiologic loading of the hip during stair climbing. Forces about the hip joint were measured in static simulations of stair climbing using simulated extensor, abductor and adductor muscle groups to support the joint. Femoral flexion angle (to model step length and height) and applied hip flexion moment (to model trunk lean) were varied to examine the effects of different loading conditions on the hip. In stair climbing the maximum total joint force was six times body weight at 34 degrees of femoral flexion and 60 N m of hip flexion moment. Joint forces increased with hip flexion moment and varied little with femoral flexion angle, except for the posteriorly directed force. This component, which twists implants about the femoral shaft, increased with femoral flexion angle but changed little with hip flexion moment.

Biomechanical Phenomena↗
PubMed1990

Ultrasonography may reveal synovitis in a clinically silent hip joint.

The usefulness of ultrasonography in detecting intra-articular effusion of the hip joint is discussed in the light of three cases. In all these patients, effusion was demonstrated by ultrasonography and confirmed by aspiration of inflammatory synovial fluid from the joint, though the joint was clinically symptomless. It is recommended that all rheumatologists use ultrasonography.

Adult↗
PubMed2006

Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage: better cartilage delineation after intra-articular than intravenous gadolinium injection.

PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. RESULTS Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images (P < 0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA (P < 0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. CONCLUSION: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.

Adult↗
PubMed1996

Effects of leg length discrepancies on the forces at the hip joint.

The authors questioned whether leg length discrepancies of the magnitude ordinarily seen after total hip reconstruction (<2 cm) would substantially alter hip joint forces. Using conventional gait analysis techniques to ascertain intersegmental resultant hip forces and moments, the authors used lifts to simulate leg length discrepancies of 2.3, 3.5, and 6.5 cm in 7 normal subjects. The 2.3-cm lift produced no changes. On the side of the lift (long limb), the 3.5- and 6.5-cm lifts modestly decreased mean peak intersegmental resultant hip forces by 6% and 12%, respectively, but not moments. The changes were, however, variable, with a few subjects showing increases and the rest showing decreases in selected forces or moments. On the side opposite to the lift (short limb), the 3.5- and 6.5-cm lifts increased mean peak intersegmental resultant hip forces by 2% to 12%, but not moments except in 1 case (8%). It is concluded that leg length discrepancies of the sort commonly seen after total hip reconstruction would likely cause no substantial changes in hip forces.

Adult↗
PubMed2005

[Specific features of hemodialysis patients and recipients of allogenic kidney determining requirements for the operation of endoprosthesis of the hip joint].

The authors consider specific general status of 23 patients aged from 26 through 63 years who underwent operations of total endoprosthesis of the hip joint for aseptic necrosis of the femoral bone head (18 cases) and pathological fracture of the femur neck (5 cases). Out of 23 patients 11 were given dialysis treatment and 12 underwent allotransplantation of the kidney. A technique of complex preoperative management is described that allowed avoidance of general peri- and postoperative complications.

Adult↗
PubMed1994

[Early changes in the hip joint following epiphysiolysis of the femoral head. Results of an MRT study].

With the aim of detecting patients at risk of developing coxarthritis, 34 patients were investigated prospectively by MRI 6-14 years after epiphysiolysis for slipped capital femoral head. In particular, cartilage changes were analysed by gradient-echo sequences. In 40% of the hip joints investigated cartilaginous lesions were present, detectable as irregularity and flattening of contour and more rarely as changes in signal intensity. In contrast, only 18% of the radiographs available revealed any pathology. When pelvic X-rays are normal or reveal slight sclerosis, cartilaginous lesions on MRI are considered early signs of coxarthrosis. This combination was seen especially often in patients with a primarily high angle of dislocation and in those who needed treatment by reposition or osteotomy. Only in 8 of the 17 hip joints showing sclerosis on conventional radiograms, sclerosis was also diagnosed by MRI, possibly because of partial volume and susceptibility effects at high field strength. Even with limited spatial resolution, cartilage examination is warranted in young patients in whom early osteoarthritis can be expected.

Adult↗
PubMed1999

Shortening of a unit rod protruding into the hip joint: case report and description of a surgical technique.

A unit rod is a well-accepted method of posterior spinal instrumentation in patients with cerebral palsy (CP). Several types of complications after the use of a unit rod were reported, including penetration through the medial wall of the pelvis. A patient who underwent anterior and posterior spinal fusion with unit-rod instrumentation was found to have penetration of the unit rod into a dysplastic hip joint. The pelvic limb of the rod was shortened with a burr through an anterolateral approach to the iliac bone. This procedure was associated with a lower blood loss than was previously reported for revisions of unit rods. There was no need for hardware removal and therefore no loss of correction. The unit rod may be shortened before surgery to prevent this problem. The described procedure is a simple way of correcting penetration of a unit-rod limb into the hip joint.

Adolescent↗
PubMed1987

[Sonography of the hip joint in skeletal dysplasias and chromosome disorders].

The preliminary results of ultrasound of the hip in patients with skeletal dysplasias and chromosomal aberrations are described. Pathology of the hip joint can be demonstrated by ultrasound; especially the entities with abundant cartilage can be visualized by sonography. Ultrasound of the hip is a valuable method in the diagnosis of skeletal dysplasias complementary to plain x-ray surveys.

Bone Diseases, Developmental↗
PubMed2004

Protein expression of MMP-13, uPA, and PAI-1 in pseudocapsular and interface tissue around implants of loose artificial hip joints and in osteoarthritis.

Matrix metalloproteinase 13 (MMP-13), urokinase type plasminogen activator (uPA), and plasminogen activator inhibitor type-1 (PAI-1) have been reported to be involved in aseptic loosening of artificial hip joints. This study for the first time presents the protein levels of all of these factors in synovial-like interfaces between bone and prosthesis and in pseudocapsular tissues surrounding the artificial joint in patients with aseptic loosening (n=17) measured by ELISA. No differences were observed in the antigen expression of MMP-13, uPA, and PAI-1, comparing interface and pseudocapsular tissue. Also, no significant correlation between the protein expression of these factors and years from arthroplasty to revision or to type of fixation (cemented vs. cementless) was observed. As control, MMP-13, uPA, and PAI-1 antigen levels were also determined in the synovium of patients with osteoarthritis (n=10). Yet, the antigen levels of MMP-13, uPA, and PAI-1 in tissue specimens from patients with aseptic loosening of artificial hip joints were significantly higher compared to their expression in synovial capsular tissues obtained from patients with osteoarthritis. In conclusion, this study shows that elevated protein levels of uPA, PAI-1, and MMP-13 in periprosthetic pseudocapsular and interface tissues from patients after total hip replacement due to aseptic loosening seem not to be associated with the patient outcome.

Adult↗
PubMed1978

[Compression tests on the human hip joint (author's transl)].

Three human pelvises were subjected to static loading in the course of the experiments. The values determined for the elasticity modules lie between 2 and 4.5 kp/min2. The values range between 5 and 14 kp/mm2 if only the compacta is considered. The experiments show that the elasticity modules obtained at cross sections through the Os coxae are higher than those for sections through the hip joint and its immediate surroundings. Here the elasticity module reaches the minimum value of 0.77 kp/cm2 (Fig. 1, cross section No.2, Table 3). The highest breaking strain was 1045 kp (Pelvis II). The longitudinal contraction of the three pelvis was 26.6 mm on average. For the mean height of 27.2 cm for the specimens used, this means that the pelvis, as a system (with hip joint) can be reduced in length by about 10% before a fracture occurs under static load conditions.

Biomechanical Phenomena↗
PubMed2001

Pelvis and hip joint injuries as a reconstructive factors in car-to-pedestrian accidents.

The pelvic girdles of 371 pedestrian victims of road traffic accidents were evaluated during postmortem examinations. Additionally, 144 hip joints were opened. The pelvic injuries were found in 28% of the pedestrians hit exclusively in their upright position and 52% of the victims run over by a vehicle. The side of the body hit by a car was determined on the basis of the location of blood suffusions within the subcutaneous tissues and muscles of lower limbs as well as the character of injuries found in the knee and upper ankle joints. The findings were verified with the data from court records. It was shown that the injuries of the sacroiliac joints or vertical fractures of the posterior parts of iliac bones were useful parameters for determining the side (left or right) of the body hit by a vehicle. Moreover, it was found that a direct impact on the hip region was evidenced by the ipsilaterally localized fractures of the iliac ala, central hip fractures and intraosseous blood suffusions within the greater trochanter of the femur. The external dislocations of the hip joints (always) and bilateral injuries to the sacroiliac joints (usually) were observed in the victims run over by vehicles.

Accidents, Traffic↗
PubMed1990

[99mTc-MDP abnormal uptake in the femur shaft in hemi-lateral hip joint disorders].

During the past 4 years, three-phase bone scintigraphy using 99mTc-MDP has been studied in 68 patients suffering from hemi-lateral hip-joint disorders. We were impressed on abnormal uptake of the shaft of femur on the involved side. 99mTc-MDP uptake in the shaft of femur is compared with between involved leg and normal leg of 68 cases with hemi-lateral hip-joint disorders (76 examinations). We excluded cases of osteomyelitis, cases of malignant tumor, and post-operative cases. In early images, the 99mTc-MDP uptake is not always increased in involved side. But in delayed images, there are no patients whose normal side's 99mTc-MDP uptake is increased. The 99mTc-MDP uptake in early image is not related only with blood flow of the thigh but with the amount of soft tissue of the thigh. And the 99mTc-MDP uptake in delayed image is related with disuse osteoporosis.

Adult↗
PubMed2001

Synovial osteochondromatosis of the hip joint. Etiology, diagnostic investigation and therapy.

Synovial osteochondromatosis (Reichel's syndrome) of the hip joint is an unusual entity that is difficult to diagnose in the initial stages. In the beginning the condition is characterized by recurrent pain in the affected joint with negative radiographic and MR findings. The first stage shows only synovial reaction without loose bodies. In the second stage radiography is negative because of cartilaginous bodies, and even in the third stage radiography is negative in one third of cases although osseous bodies are present. After diagnosis surgery is indicated to prevent damage to the joint. We review the etiology, clinical findings and differential diagnosis especially types of secondary synovial chondromatosis and discuss ultrasound, radiologic, MR and scintigraphic features and laboratory findings. We describe the surgical treatment and postoperative treatment of patients with synovial osteochondromatosis with moderate signs of secondary osteoarthritis.

Chondromatosis, Synovial↗
PubMed1978

[Experience in 77 changes of hip-joint prostheses (author's transl)].

The article reports on 77 changes of hip-joint prostheses. The main indications are deep infections and loosening. The surgical procedure and complications are described. Results are encouraging. Even in cases of changes of prostheses on account of fistulating, deep infection, the infections can be controlled in 75% of the cases. Long-term results must be awaited.

Accidents↗
PubMedDate not supplied

[Hip joint replacement in young patients].

The recent standard of hip-joint replacement after Charnley with metal-polyethylene combination and fixation by bone cement is charged with long term problems by wear (with foreign body reaction) and cement destruction by fatigue. Therefore the indication was limited to old patients with short life expectancy and left the problem of joint replacement in younger patients unresolved. By the use of highly wear resistant alumina ceramic and return to cementless anchorage, according to the principle of surface increase, a new technique of joint replacement by means of selflocking ceramic-autophor-prosthesis was created. The clinical experience is now 9 years. It shows that after some problems in the beginning mostly good results can be achieved. Therefore an extension of the indication for joint replacement for younger patients is justified.

Adolescent↗
PubMed1994

Autosomal dominant (Beukes) premature degenerative osteoarthropathy of the hip joint unlinked to COL2A1.

Molecular investigations have been undertaken in several separate large South African families with autosomal dominant skeletal dysplasias in which premature degenerative osteoarthropathy of the hip joint was the major manifestation. There are sometimes additional minor changes in the spine and these conditions fall into the general spondyloepiphyseal dysplasia (SED) nosological category. In some kindreds, linkage between phenotype and the type II collagen gene (COL2A1) has been established, while in others there is no linkage. We have now completed molecular linkage investigations in an Afrikaner family named Beukes, in which 47 members in 6 generations have premature osteoarthropathy of the hip joint. A LOD score of minus infinity indicates that this condition is not the result of a defect of the COL2A1 gene.

Chromosome Aberrations↗