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At least 829 records · Page 46Linked to original sources
PubMed2005

Comparison of outcomes following uncemented hemiarthroplasty and dynamic hip screw in the treatment of displaced subcapital hip fractures in patients aged greater than 70 years.

As health care costs increase, evaluating treatment methods in femoral neck fractures to determine the most effective treatment paradigm will become increasingly important. The current study compared two methods of treatment in similar cohorts of displaced femoral neck fractures. One hundred and twenty two patients were randomly assigned to two groups: In Group A, 62 patients were treated with a hemiarthroplasty. In group B, 60 patients were treated with dynamic screw fixation. Patients were evaluated at a minimum 3 year follow-up. Using the Matta functional hip score, 42% of group A and 70% of group B had good to excellent results. This difference was significant (p = 0.004). A significant agreement between physician assessment using the Matta score, and patient perception of outcome using the SF-36 scale was demonstrated (r = 0.64). No statistical difference between groups for revision surgery existed. Both physician based and patient based outcome scores favour retention and internal fixation of the femoral head in this cohort of patients at a short-term follow-up.

Aged↗
PubMed1991

Total hip arthroplasty following failed internal fixation of hip fractures.

A retrospective review was performed on 27 consecutive patients with total hip arthroplasty (THA) following failure of internal fixation of fractures of the proximal femur. The results were comparable to primary THA in femoral neck fractures. Considerably less satisfactory results were obtained in THA in intertrochanteric fractures. Bone loss and medial displacement of the femoral shaft led to high incidence of intraoperative complications and postoperative dislocations. Extreme care must be taken to avoid fracture and penetration of the femoral shaft. Autograft, allograft, or head and neck replacement components should be available for reconstruction of the difficult cases.

Adult↗
PubMed1991

[Imaging techniques in the diagnosis and therapy of hip dysplasia and hip dislocation].

With the introduction of sonography and computed and magnetic resonance tomography into the diagnostic procedures of congenital dysplasia and congenital dislocation of the hip more detailed anatomic imaging has become available and has brought new insights and dynamics to the therapy of this frequent orthopedic problem. The techniques are discussed with representative illustrations and compared with each other as well as the 'classic' roentgenogram and arthrogram.

Computer Simulation↗
PubMed1987

[Cement-free implanted total hip endoprosthesis of the Mittelmeier model. Clinical experiences and results following 6 years of use mainly in accident-induced hip changes].

We give a review of the results of 165 implantations in 143 patients. Uncemented endoprostheses (type Mittelmeier) for replacement of hip joints were implanted from September 1979 to December 1985 at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. When we started to implant uncemented prostheses the complication rate was higher than in conventional implantations. Most of the complications could be gradually avoided. The current complication rate is equal in both procedures. Long-term results will be known in a few years' time. We will they also know whether the method is advantageous for younger patients.

Adult↗
PubMed1982

[Treatment of inflammatory hip disease in rheumatoid arthritis with cemented total prostheses. Apropos of 62 total hip prostheses, of which 38 were followed for more than 3 years].

The authors have operated on 62 hips in 43 patients. Thirty-eight were followed for more than three years. Out of 62 cases there were 2 early deaths, 2 instances of pulmonary embolus and 1 of sepsis. Five different types of prosthesis were used. On 11 occasions a border appeared around the cement of the femoral component and in three of these loosening was demonstrated. The number of these appeared to be higher than after total replacement for other etiologies and seemed to be aggravated by technical errors, such as varus positioning and lack of cement. In most cases a remarkable functional improvement was obtained but progressively secondary worsening of walking ability was seen due to involvement of other joints. It is concluded that special precautions should be observed in such cases and that other joints should be replaced earlier when necessary.

Adult↗
PubMed1994

[Bony changes at the femur side after hip joint replacement: radiologic analysis of 80 hip joints].

The authors, according to Amstutz, studied the roentgenographs of 80 postoperation cases of cemented hip joint replacement performed more than two years-ago. There were bone changes in 64 cases (80%), of them, sclerosis of bone in 32 cases (40%), atrophy of bone in 25 cases (31%), absorption of bone in 24 cases (30%), thickness of bone cortex in 18 cases (22%), enlargement of medullary cavity in 12 cases (15%), periosteum reaction in 8 cases (10%), and thinness of bone cortex in 1 case (1.3%). Most of them usually occurred in the sixth month to the second year post-operation and located mainly at the 1, 4, 5 and 7 regions. The authors think that the most important cause is the unbalance of biologic stress, and other factors are elasticity and hardness of prosthesis, frictional force, cemented of the stem, etc.

Adult↗
PubMed1996

[The results of operations for open reduction with capsular hip joint arthroplasty in congenital hip dislocation in children].

The authors make an analysis of results of operations for open setting with capsular arthroplasty of the hip joint, derotational supratrochanteric denticulate osteotomy and resection of the femur with creation of iliofemoral, ischiofemoral and pubofemoral ligaments from the residual proximal part of the capsule in 56 children with congenital dislocation of the femur. Long-term results were studied in 46 children, 35 of them having good results and 8 having satisfactory results.

Anesthesia, Endotracheal↗
PubMed1991

Bone mineral density of the hip measured with dual-energy X-ray absorptiometry in normal elderly women and in patients with hip fracture.

Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA) in 133 normal females on five regions of the femoral site: neck, trochanteric, intertrochanteric, Ward's triangle, and total area of the proximal femur. One hundred and twenty-five women (56 older than 65, range 65-97, and 69 with an age range of 21-65) were also examined for spinal bone mineral density. The mean in vivo precision (CV%) of the measurements with repositioning assessed on five young and eight elderly patients was ranged from 0.7% to 1.7% but lower for Ward's triangle (CV = 2.95% and 3.87%). Between 30 and 90 years, a linear age-related bone mineral decrease was found at all sites with a similar magnitude of bone loss for the femoral neck, total or intertrochanteric regions (-33% to -39%). A greater decrease was found for the Ward's triangle region (-61%). In the subgroup of elderly women (65-97 years old), the lumbar BMD measured with an anteroposterior incidence did not decrease significantly with age, contrasting with an average 27% decrease of the BMD of the hip between 65 and 90 years of age. In addition, 31 patients suffering either from a cervical (n = 12) or pertrochanteric (n = 19) fracture were measured on their contralateral femur 15 to 30 days after the fracture event. The mean calculated BMD values were, depending on the measured area, from 14% to 21% lower than those reported for age-matched controls (z-score from -1.11 to -0.65). A fracture threshold was determined for each site from this population and the elderly controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed2005

Early MRI findings of the acetabulum and femoral head in a dysplastic hip resulting in a rapid destruction of the hip joint.

We documented a case of rapidly destructive arthrosis of the hip joint (RDA), in whom abnormal findings were observed not only in the femoral head but also in the acetabulum on magnetic resonance images (MRI) in the early stage. Radiographs made 1 month after the onset of pain showed a slight narrowing of the joint space. MRI obtained 2 months after the onset detected small foci of low signal intensity in the subchondral area of the femoral head on the T1-weighted images, and a linear pattern of high signal intensity in the lateral side of the acetabulum on the T2-weighted images. During the 17-month follow-up period, this case eventually underwent massive destruction of the femoral head as well as the acetabulum.

Acetabulum↗
PubMed2005

Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice?

UNLABELLED: The aim of this study was to present age references for waist circumference (WC), hip circumference (HC), and waist/hip ratio (WHR) in Dutch children. Cross-sectional data were obtained from 14,500 children of Dutch origin in the age range 0-21 years. National references were constructed with the LMS method. This method summarises the distribution by three smooth curves representing skewness (L curve), the median (M curve), and coefficient of variation (S curve). The correlations between body mass index-standard deviation score (BMI-SDS), the circumferences and their ratio, and demographic variables were assessed by (multiple) regression analysis for three age groups: 0-<5 years (1), 5-<12.5 years (2), and 12.5-<21 years (3). A cut-off for clinical use was suggested based on the International Obesity Task Force criteria for BMI. Mean WC and HC values increased with age. Mean WC was slightly higher in boys than in girls, and this difference was statistically significant from 11 years of age onwards. In contrast, HC was significantly higher in girls than in boys from 9 years onwards. The correlation between WC-SDS and BMI-SDS ( r =0.73, P <0.01) and between HC and BMI-SDS ( r =0.67, P <0.01) increased with age. With regard to WHR-SDS, a low correlation was found for 12.5-20 years of age ( r =0.2, P <0.01). WC-SDS correlated positively with height SDS ( r =0.35, P <0.01). CONCLUSION: Waist circumferences can be used to screen for increased abdominal fat mass in children, whereby a cut-off point of 1.3 standard deviation score seems most suitable.

Adolescent↗
PubMed1988

On the biomechanics of human hip complex in vivo--I. Kinematics for determination of the maximal voluntary hip complex sinus.

In recent years, multisegmented mathematical models of the total human body have gained increasing attention in view of the high cost of experiments with human cadavers and/or anthropometric dummies. While these models can simulate very complicated load-motion situations, their effectiveness depends heavily on the proper biomechanical description and modeling of the major articulating joints of the human body. In a research effort to obtain the in vivo biomechanical joint property data suitable for incorporation into these models, the senior author and his associates recently developed a new kinematic and force data collection methodology by means of sonic emitters. By applying and extending this data collection methodology, this paper in Part I presents kinematics for determination of the maximal voluntary hip complex sinus. An overdeterminate number of sonic emitters is utilized and the 'most accurate' three-dimensional kinematic data set is selected by first establishing a selection criterion. Quantitative results obtained from three male subjects are presented in a functional expansion form relative to a locally-defined joint axis system as well as in the form of globographic representation relative to the torso-fixed axis system.

Biomechanical Phenomena↗
PubMed1988

On the biomechanics of human hip complex in vivo--II. Passive resistive properties beyond the hip complex sinus.

In multisegmented mathematical models of the total human body, the resistive force properties of the major articulating joints play a direct and significant role in determining the relative motion between two body segments and in the understanding of injury mechanisms. This paper presents three-dimensional passive resistive properties beyond the maximal voluntary hip complex sinus by applying the kinematic data collection methodology developed in Part I together with a recently developed force data collection technique with sonic emitters (previously reported elsewhere by the senior author and his associates). The same three male subjects as in Part I of this paper were tested. Quantitative results were displayed by establishing the constant resistive force (moment) contours on a modified local joint axis system.

Biomechanical Phenomena↗
PubMed2004

Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: a biomechanical study.

The radiographs of a sample of patients who had canulated hip screw fixation for intracapsular femoral neck fractures were reviewed in our region. There were six different types of configurations used in these fixations which are divided into two groups: (I) triangular configurations, consisting of two parallel screws with a third screw placed either superiorly, inferiorly, anteriorly or posteriorly; and (II) linear configurations with two or three screws in a vertical line. In our study, we tested the relative strength of each configuration in a laboratory setting using synthetic bone models. Statistical analysis, at 5% significance level, using two-way ANOVA and post-hoc test was carried out to test the differences of the results between the configurations.Our results clearly show that the triangular configurations had a higher peak load, higher ultimate load, less displacement and more energy absorption before failure than other configurations.

Biomechanical Phenomena↗
PubMed1992

Total hip arthroplasty for treatment of canine hip dysplasia.

Cemented THA is an established procedure for treating arthropathies of the hip in large, healthy mature dogs. CHD with secondary osteoarthritis is the most common indication. Although comparative studies between THA and excision arthroplasty have not been reported, our experience with both procedures and studies in the literature support THA as the best available treatment for crippling degenerative joint disease secondary to CHD in large, mature dogs. Negative aspects of the procedure include high cost, the potential of significant complications, and the sophisticated surgical technique required. Improvements in patient selection, design of implants, surgical technique, and postoperative care have decreased the incidence of complications and improved the success rate to over 90%. However, concerns in human applications about cement disease and the desire to increase the functional life of the prosthesis have renewed interest in cementless systems. Advantages of cementless THA are fixation via bony ingrowth and avoidance of problems associated with PMMA. Important technical aspects of cementless THA relate to optimal fit and fill so that the prosthesis is stable, bone ingrowth is promoted, and weight-bearing forces are transferred to the proximal femur physiologically. Problems recognized with cementless systems include fissure fracture, bone resorption, and excessive motion between the implant and bone. Currently, investigations are being conducted to develop prosthetic materials that more closely match the stiffness of bone, stem designs that provide optimal fit and maintain normal strain patterns in the bone, and coating materials that promote permanent fixation by bone ingrowth. Early clinical results in humans and research results in dogs have been encouraging but have not withstood the test of time. Results of cementless techniques must be compared to the standards set by cemented THA over the last 20 years in humans and the last 10 years in dogs.

Animals↗
PubMed1997

Comparison of general anesthesia with and without lumbar epidural for total hip arthroplasty: effects of epidural block on hip arthroplasty.

STUDY OBJECTIVES: To determine whether lumbar epidural anesthesia, when combined with general anesthesia, decreases perioperative blood loss, the incidence of postoperative deep vein thrombosis (DVT), cardiac dysrhythmias, and ischemia in patients undergoing total hip arthroplasty (THA). DESIGN: Randomized, controlled study. SETTING: A university hospital. PATIENTS: 37 ASA physical status I, II, and III patients, undergoing elective THA. INTERVENTION: Patients were divided into two statistically comparable groups: Group GA = general anesthesia; Group CEGA = general anesthesia plus lumbar epidural anesthesia. All patients had 48-hour perioperative Holter monitoring, applied on admission, the day prior to surgery. In both groups, general anesthesia was induced with thiopental sodium and muscle relaxant, and maintained with oxygen, nitrous oxide, isoflurane, opioid, and muscle relaxant. Group B received lumbar epidural anesthesia with 10 ml 0.5% bupivacaine with 1:200,000 epinephrine prior to anesthesia induction. Blood loss was measured by suction bottle contents, sponge weights, and collection drainage. DVT was assessed with postoperative leg scanning, plethysmography, and venogram. MEASUREMENTS AND MAIN RESULTS: Intraoperative blood loss was less after combined epidural-general anesthesia (663.8 ml +/- 299.0 ml) than after general anesthesia alone (1,259.2 ml +/- 366.0 ml). The difference was found to be statistically significant (p < 0.00005). No difference was found between the two groups in postoperative blood loss, incidence of DVT, cardiac dysrhythmias, or ischemia. CONCLUSION: Combined regional-general anesthesia decreases intraoperative blood loss in THA, and thereby offers an advantage over general anesthesia alone.

Aged↗
PubMed2001

Dissociation of modular total hip arthroplasty at the femoral head-neck interface after loosening of the acetabular shell following hip dislocation.

Modular component dissociation is a potential problem of current modular total hip arthroplasty (THA) systems. We describe a case of dissociation of the modular THA at the femoral head-neck interface after loosening of the acetabular shell during closed reduction for posterior dislocation of THA. The causes of this dissociation and acetabular shell loosening are discussed. Successful treatment was provided with surgical revision of the acetabular and the femoral head components. The present case serves as a graphic reminder that the acetabular shell overhanging the acetabular bone must be avoided when implanting modular THA components.

Biomechanical Phenomena↗
PubMed1975

[Nerve lesions following total hip replacement and other hip-joint operations].

Nerve lesions occurred in 17 patients who had undergone hip-joint operations (especially total replacement). The femoral nerve was most commonly affected, followed by sciatic and gluteal nerves, with combined pareses in six. As differential diagnosis from pseudoparesis is not always possible, electromyography should be performed in all cases. Stretching and/or squeezing are the most important causes. The operation results are significantly impaired by such nerve lesions. However, long-term results are usually satisfactory in the majority of cases. Early diagnosis and treatment are important in ensuring good therapeutic results.

Adult↗
PubMedDate not supplied

[Macerated human hip bone preparation as a substitute for fresh frozen preparations for testing the primary stability and frictional torques of cementless hip cups].

AIM: The aim of the study was to validate macerated human acetabuli as replacement for fresh frozen preparations for testing primary stability and the screwing in moments of cementless threaded hip cups. METHOD: Three fresh frozen human pelvis were tested. One half of each pelvis was macerated whereas the other half was preserved as fresh frozen preparation. In the side of every pelvis the moments of screwing-in, the micromotions, the maximum expressing force and the maximum pull-out torque were determined. RESULTS: The screwing in moments, the maximum expressing forces and the maximum pull-out torques did not change. The micromotions were reduced to half. CONCLUSION: Considering the reduction of the micromotions, macerated human acetabuli are valid replacements for fresh frozen preparations for testing the primary stability and the screwing-in behaviour of screwed pans.

Cementation↗