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At least 721 records · Page 40Linked to original sources
PubMed2003

Relationship between outcome and annual surgical experience for the charnley total hip replacement. Results from a regional hip register.

Using a regional arthroplasty register, we assessed the outcome, at five years, of 1198 primary Charnley total hip replacements (THRs) undertaken across a single health region in England in 1990. An independent clinical and radiological assessment was completed for 497 operations, carried out in 18 different hospitals, under the care of 56 consultants and by differing grades of surgeon. The overall number of failures in this group was 44 (8.9%). We found that the risk of failure in patients operated on by a consultant whose firm carried out 60 or more THRs in 1990 was 25% of that of patients under the care of a consultant whose firm undertook less than 30, adjusting for a number of patient, surgeon and hospital characteristics (16% v 4%; p < 0.001 for linear trend). Our study shows that the early outcome of hip replacement surgery varies with the number of replacements undertaken by the consultant firm. A national arthroplasty register would be a convenient source for such data.

Aged↗
PubMed2005

Early results of primary Birmingham hip resurfacings. An independent prospective study of the first 230 hips.

We describe the experience with the first consecutive 230 Birmingham hip resurfacings at our centre. At a mean follow-up of three years (25 to 52 months) survivorship was 99.14% with revision in one patient for a loose acetabular component and one death from unrelated causes. One patient developed a fracture of the femoral neck at six weeks which united unremarkably after a period of non-weight-bearing. The Harris hip score improved from a mean of 62.54 (8 to 92) to 97.74 (61 to 100). The mean flexion improved from 91.52 degrees (25 to 140) to 110.41 degrees (80 to 145). Most patients (97%) considered the outcome to be good or excellent. Our preliminary experience with this implant is encouraging and the results are superior to the earlier generation of resurfacings for the same length of follow-up.

Adolescent↗
PubMed2005

The Oxford hip scores for primary and revision hip replacement.

We have used the Oxford hip score to monitor the progress of 1908 primary and 279 revision hip replacements undertaken since the start of 1995. Our review programme began in early 1999 and has generated 3900 assessments. The mean pre-operative scores for primary and revision cases were 40.95 and 40.11, respectively. The mean annual score for primary replacement at between 12 and 84 months ranged between 20.60 and 22.57. A comparison of cross-sectional and longitudinal data showed no significant differences. All post-operative reviews showed a significant improvement (p < or = 0.0001). The 50- to 60-year-old group scored significantly better than the patients over 80 years of age up to 48 months (p < 0.01). A subgroup of 826 National Health Service (NHS) and 397 private patients, treated by the senior author (2292 Oxford assessments), had a higher (i.e. worse) mean pre-operative score for the NHS patients (p < or = 0.001). The private patients scored better than the NHS group up to 84 months (p < 0.05). Patients treated by a surgeon performing more than 100 replacements each year had a significantly better outcome up to five years than those operated on by surgeons performing fewer than 20 replacements each year. The age of the patients at the time of operation, and their pre-operative level of disability, have both been identified as affecting the long-term outcome. Awareness of the influence of these factors should assist surgeons to provide balanced advice.

Aged↗
PubMed2005

Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip.

Recently, femoroacetabular impingement has been recognised as a cause of early osteoarthritis. There are two mechanisms of impingement: 1) cam impingement caused by a non-spherical head and 2) pincer impingement caused by excessive acetabular cover. We hypothesised that both mechanisms result in different patterns of articular damage. Of 302 analysed hips only 26 had an isolated cam and 16 an isolated pincer impingement. Cam impingement caused damage to the anterosuperior acetabular cartilage with separation between the labrum and cartilage. During flexion, the cartilage was sheared off the bone by the non-spherical femoral head while the labrum remained untouched. In pincer impingement, the cartilage damage was located circumferentially and included only a narrow strip. During movement the labrum is crushed between the acetabular rim and the femoral neck causing degeneration and ossification. Both cam and pincer impingement lead to osteoarthritis of the hip. Labral damage indicates ongoing impingement and rarely occurs alone.

Acetabulum↗
PubMed1993

Revision of cemented hip arthroplasties. 101 hips followed for 5 (4-9) years.

101 hips were revised with cemented Lubinus prostheses after failed primary cemented arthroplasty, and followed for 5 (4-9) years. Radiographically, 41 hips (36 femoral stems and 13 acetabular components) had become loose. The use of an intramedullary plug at the revision did not prevent sinking of the prosthesis. No difference was found between conventional or pressure-injection cementation techniques. In cases where the stem was inserted in varus or the acetabular component was in malposition there was increased loosening. Patients below 50 years of age had oftener more than 5 mm sinking of the stem and more prosthesis loosenings.

Adult↗
PubMed1995

Ultrasound measurements in hips of children above 2 years of age. Normal variations in 232 hips.

In order to find the limits of normal variation of ultrasound measurements in children over 2 years of age, we examined 116 children and adolescents with normal hip joints. The children had been referred for various complaints from their lower extremities. Longitudinal ultrasound scanning from the lateral and anterior aspects was performed by the orthopedic surgeon as an integral part of the clinical examination. The most relevant parameters regarding hip dysplasia are those assessing the coverage of the femoral head: the lateral head distance (LHD, the distance from the lateral tangent of the bony epiphysis to the lateral bony acetabular rim) and the anterior head distance (AHD, measured as LHD, but from the anterior scan). The LHD increased with age; the upper normal limit (mean + 2 SD) increased from 4 mm at age 2-3 years to 7 mm at age 12-16 years. The AHD was larger in adolescents 12-16 years of age than in younger patients. The upper normal limit was 1 mm in the youngest and 2 mm in the oldest children. The mean (SD) differences (right minus left) in LHD and AHD were 0.3 (1.1) mm and 0.2 (1.0) mm, respectively. Radiographs were available in 15 of the patients and confirmed the ultrasound findings regarding femoral head coverage. Our findings should be of value in interpreting ultrasound measurements in older children.

Adolescent↗
PubMed1998

A-W glass ceramic as a bone substitute in cemented hip arthroplasty: 15 hips followed 2-10 years.

We retrospectively reviewed hip arthroplasties in 13 patients (15 hips), in whom we had used apatite-wollastonite (A-W) glass ceramic together with auto- or allograft for augmentation of severe bone deficiency. 11 cemented sockets and 4 stem revisions were included and followed for 2-9.6 years. There were no radiolucent lines between A-W glass ceramic and surrounding bone, and remodeling of the bone graft containing A-W glass ceramic was observed. No migration of cemented sockets was seen except in 1 case, which was revised. In this case, direct bonding between bone and A-W glass ceramic granules was present histologically. In 4 stem revisions, 5 mm subsidence occurred in 1 case. However, the stem became stable and remodeling of the grafted bone occurred. An artificial bone material, such as A-W glass ceramic, can be used under high-load conditions, because of its good mechanical properties.

Adult↗
PubMed1999

Poor survival of cementless Biomet total hip: a report on 1,047 hips from the Finnish Arthroplasty Register.

In Finland, almost 50% of all hip replacements done after 1989 have been inserted without cement. Biomet components have been the most commonly used implants in cementless arthroplasties. Between 1985 and 1997, 4,300 prostheses were implanted because of primary osteoarthrosis. 4 different acetabular component designs have been identified as Biomet implants (Mallory-Head, Romanus, T-TAP, Universal) and were used in 1,047 hips. The 9-year survival of all arthroplasties using Biomet cups was only 65 (95% CI 61-69)% while that of arthroplasties using T-TAP-cups was only 58 (52-65)%. In contrast, the 7.5-year survival of arthroplasties using Romanus cups was 85 (79-91)%. The 98 (96-99)% 5-year survival of arthroplasties with Mallory-Head cups should be interpreted cautiously, since similar results of arthroplasties using the Universal cup with the same type of liner decline sharply to 93 (88-98)% only 1 year later. The poor survival of Biomet cementless prostheses in our series seems to be related to the poor survival of the cup. This finding was common to all metal shell designs using Hexloc liners. We recommend that Biomet cups with Hexloc liners should not be used and patients who have had them inserted should undergo regular clinical and radiographic follow-ups.

Adult↗
PubMed2001

Mid-term results in total hip arthroplasty with the basic noncemented hip prosthesis.

The Basic (IQL-Biomet, Valencia, Spain) hip prosthesis was used in 430 implant procedures, of which 417 had mean follow-up of 6 years. Radiographic follow-up was performed at 1, 3, 6, and 12 months postoperatively, and annually thereafter. The average Harris hip score improved from 35.7 preoperatively to 90.9 postoperatively. Clinical results after 2 years of follow-up showed 6% thigh pain, which decreased to 2% at 6 years. Radiographic evaluation demonstrated 22 cases of calcar resorption, 14% of which had distal pedestal formation. Heterotopic ossification was noted radiographically in 36%. These mid-term results obtained with the Basic prosthesis are similar to the findings of other series and warrant its use.

Adult↗
PubMed1997

[Sonographic measures of the hip joint of 1328 newborns of Han and Uygur nationalities-relative factors of congenital dislocation of hip].

The four sonographic methods (Engesaeter, Terjesen, Graf, Morin-Harcke) were used for examining the hip joint of 1328 newborns of Han and Uygur nationalities. The difference between Han and Uygur newborns was not statistical significant, but some literatures reported that in our country, the incidence of different nationalities in different regions varied. Our conclusion is that there is no obvious relationship between the depth of the acetabulum and the percentage of the femoral head covered by the acetabulum. It is caused by other factors, inherent or acquired. The value of the hip joint of the male and female has significant difference (P < 0.0005). The incidence of CDH in girls is much higher than that in boys. This may be related to the different depth of the acetabulum and different percentage of the femoral head covered by the acetabulum. In the period of newborn, girl's depth of the acetabulum is smaller than that of boys.

Anthropometry↗
PubMed2002

Revision total hip arthroplasty using a cementless modular femoral hip design.

The difficulty in selecting the "ideal" components for revision total hip arthroplasty is one factor leading to poor outcomes. For femoral hip components, loosening rates of femoral revision have been reported with different types of designs. Because of improved rates with more porous components, the use of cementless femoral revision is highly attractive. This article describes a cementless femoral revision component, the ZMR system, which addresses the challenges and design goals of revision as well as surgical philosophy: off-the-shelf flexibility, proximal-distal extensive fixation, restoration of kinematics (offset, let lengths, anteversion, and muscle tensioning), and implant integrity.

Arthroplasty, Replacement, Hip↗
PubMed1976

Total hip arthroplasty in Paget's disease of the hip.

For thirty-two patients with Paget's disease of the pelvis, mechanical disruption of the hip joint caused sufficient pain and disability to require total hip-replacement arthroplasty. Three of the patients had had fractures of the femoral neck. No unusual complications were encountered and the results were excellent.

Aged↗
PubMed1991

[Basic study of cementless hip prosthesis design--analysis of the proximal femur in Japanese patients with osteoarthritis of the hip].

By CT scan, the author analyzed morphologically the proximal medullary canal of the femur in 52 cases of osteoarthritis of the hip. The purpose is to determine the stem shape of an artificial hip joint suitable for Japanese patients. The results were as follows: 1) The femoral head diameter indicated positive correlation with the height, the femoral length, the femoral shaft transverse diameter, and the medullary canal diameter. The proportionality of the femur was found in Japanese patients with osteoarthritis. 2) The femoral head offset indicated no correlation with any results obtained by various measurement. 3) The medullary canal diameter of the diaphysial portion as well as the ratio of the medullary canal to the femur increased with age. 4) The taper angle*, 3.8 degree on the average was positively correlated only with the medullary canal diameter. *"Taper angle" indicates the degree of tapering of the medullary canal.

Adolescent↗
PubMed1989

[Initial experience with the Steel triple osteotomy in the treatment of arthrosis of the hip joint as a result of congenital hip dysplasia].

The age of the patients was 18 to 40 years (mean age 32 years), the interval after operation was 5 months to 3 years (mean 17 months). In all 8 patients proper covering of the head was achieved, CE angle 25-45 degrees, mean gain of CE angle 35 degrees. The X-ray picture revealed widening of the articular space and reabsorption of arthritic pseudocysts. As regards the clinical picture, marked regression of complaints was recorded. Osteotomy of the pelvis according to Steele prolongs the vitality of the hip joint: a) by increasing the contact surface in the hip joint, b) by shifting the till then minimally burdened and thus minimally usurated cartilage into the zone of the main burdening, c) the usurated cartilage, on the other hand, is shifted beyond this zone. Moreover, osteotomy of the pelvis prepares a bed for anchoring of the cup of a possible future prosthesis. The above facts are advantages, as compared with different types of osteotomies of the femur, which moreover may in future cause further complications of the implantation of the femoral component of the artificial joint.

Adolescent↗
PubMed1988

[Arthroplasty of the hip joint in children and adolescents with congenital hip dislocation].

The work is devoted to operative treatment of children with repeated dislocations and ankyloses of the hip joint after operative treatment of congenital dislocation of the hip. The dura mater, demineralized allocups and polymer self-resolving film were used as interlayers. Best results were obtained in arthroplasty with using demineralized allocups, polymer self-resolving film or their combinations.

Acetabulum↗
PubMed1986

Hip arthroplasty in quiescent mycobacterial infection of hip.

Three patients underwent hip arthroplasty--one total hip replacement and two, Thompson's hemiarthroplasty. The diagnosis was degenerative joint disease and subcapital fracture of the femur, respectively. Histologic and bacteriologic examination revealed mycobacterial infection. None of the patients had a past history of mycobacterial infection. In one instance, there was a reactivation of the infection eight months following surgery, which was treated successfully by antituberculosis drugs.

Aged↗
PubMed1988

Unstable intertrochanteric fractures of the hip. Treatment with Ender pins compared with a compression hip-screw.

In a prospective, consecutive, randomized study of the treatment of unstable intertrochanteric fractures of the hip, the use of Ender pins was compared with the use of the compression hip-screw. There were more than 100 patients in each treatment group. The patients who were alive six months postoperatively were evaluated. The number of secondary operations was much higher in the patients who were treated with Ender pins, and a considerably higher number of those patients had loss of fixation. The use of Ender pins that were too long and a history of a fracture before the operation in which Ender pins were used were statistically significant predictors of secondary operations.

Aged↗