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Intra-articular pressure of the hip joint outside and inside the limbus.

The intra-articular pressure of the hip joint of a hemipelvectomized limb was measured outside and inside the limbus. The negative pressure inside the limbus was not sufficient to hold the weight of a leg. The pressure inside the limbus changed chiefly in flexion, extension and internal rotation, however, the pressure outside the limbus changed primarily in abduction, adduction and external rotation. From these pressure changes, it was considered that the limbus was not an airtight valve. Moreover, there seemed to be an air leakage through valve of the limbus.

Extremities↗

Comparative study of the wear of UHMWPE with zirconia ceramic and stainless steel femoral heads in artificial hip joints.

The wear of ultra high molecular weight polyethylene (UHMWPE) when sliding against zirconia ceramic and stainless steel counterfaces has been compared in a pin-on-plate reciprocator and in a hip joint simulator. A lower wear factor was found for the UHMWPE when sliding on the zirconia ceramic counterfaces in the pin-on-plate tests. In the hip joint simulator test, the acetabular cups articulating on zirconia heads showed consistently lower volume changes than the cups articulating on stainless steel heads. The higher volume changes found with the stainless steel heads were associated with an increased roughness of the femoral heads during the tests. This roughening was caused by the adherence of a rough polymer transfer film.

Biocompatible Materials↗

[The hip joint in arthrogryposis].

In a retrospective review of 70 hips in 35 patients with arthrogryposis 56 of all hips studied were affected by the disorder. Clinically 4 types of arthrogrypotic hip deformity could be distinguished. In 19 hip joints not only a deformity and a restriction of movement but also a dislocation was found. Based on the results of this study a one-stage open reduction combined with a varus shortening, femoral derotation osteotomy for unilateral hip dislocations is recommended. In cases of bilateral dislocations the above mentioned surgical procedure is indicated only if there is a less severe generalized involvement of AMC. For correction of hip deformities type II during neonatal period conservative treatment by traction or by plaster cast redression has proved be successful. The authors experience is compared with reports of other authors and guidelines for clinical classification and treatment are presented.

Arthrogryposis↗

[Biomechanics of the hip joint in children].

Based on the data derived from the examination of 16 infantile and juvenile anatomical hip specimens as well as the radiological examination of 1350 hip joints of healthy children, a biomechanical model of the developing hip was computed. This two-dimensional vector model describes the forces acting on the growth plates of the head and the greater trochanter during the one-legged stance. It could be proven that the apophysis of the greater trochanter is subject to compressive stress by lateral-cranial traction bands and therefore corresponds with a "pressure apophysis". The muscle forces acting on the trochanter apophysis can be combined as a trochanteric resultant RT. This stimulates a lateral-cranial growth of the trochanter apophysis. The direction of the hip abductors and, as a result, also the direction and the length of Pauwels' hip resultant R are influenced by this mechanism.

Adolescent↗

Biomechanics of the normal and abnormal hip joint.

Static analysis of the canine hip has given some insight to the nature and trend of the force and subsequent stress that is normally applied to the joint. Using the static model, the magnitude and direction of force and stress worsens in the hip with the anatomic and stability changes associated with CHD. More sophisticated dynamic models that take into account unbalanced forces and moments with the resultant motion are needed to better understand the mechanics of the hip joint.

Animals↗

Metal-on-metal articulation for artificial hip joints: laboratory study and clinical results.

As wear is inevitable with artificial joint replacement, it has to be minimized to avoid possible aseptic loosening following osteolysis due to particle-initiated foreign body reaction. Co-Cr-Mo-C alloys have a long history with only minimum wear when articulating with themselves. This investigation shows that the choice of the alloy has an effect on the wear rate of this articulation couple. Tribological studies in a screening device, a pendulum apparatus and a hip joint simulator showed a marked influence of the environment as well as the diameter of the implants with metal-on-metal articulation. A wear-resistant combination with low friction characteristics has been developed by using a wrought Co-Cr-Mo-C alloy and reducing the implant diameter to 28 mm. Clinical wear rates are comparable with laboratory data and demonstrate the potential of the metal-on-metal articulation to solve the problem of wear-induced osteolysis of hip joint endoprostheses.

Bone Cements↗

[Contribution to the etiology of coxarthrosis. Radiographic and clinical evaluation of 976 arthrotic hip joints (author's transl)].

Radiograms and case histories of 654 randomized patients with 976 arthrotic hip joints have been reviewed in an attempt to make an etiological diagnosis. 98.3% of the patients and 98.8% of arthrotic hips, respectively, could be determined as to their underlying praearthrotic deformities according to Hackenbroch sen. The respective mean value gained from 6556 patients published in the world literature is 74.2% with marked individual variations. Most frequent praearthrotic condition was found to be congenital hip dislocation, followed by epiphyseolysis capitis femoris juvenilis, trauma, coxitis, M. Perthes, coxa vara, protrusio acetabuli, idiopathic femoral head necrosis, ankylosing spondylitis and several more rare basic conditions.--The most important reasons for differing results are discussed: Specific composition of clinic cases, completeness of documentation, experience of the reviewer and considerable space for personal interpretation. Relevant epidemiological data are also mentioned; they are in agreement with clinical experience and published data.--Finally it is stated that present diagnostic methods are not able to detect all praearthrotic conditions.

Adolescent↗