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PubMedDate not supplied

Clinical benefit of reconstruction of dislocated or subluxated hip joints in patients with spastic cerebral palsy.

Sixty-four dislocated hip joints in 47 patients with spastic cerebral palsy were reconstructed surgically for pain or physical impairment. The procedure included a femoral and pelvic osteotomy, an anterior iliopsoas transfer, and further soft-tissue surgery. The study was based on a research questionnaire (mean follow-up 6.8 years) and radiographs (3.0 years). Upon review of radiographs, it was discovered that three hips had redislocated and that 23 were insufficiently covered. Four complications (one deep infection, three femoral fractures) occurred. Pain was relieved fully in 28 of 37 patients and eased in 9 of 37. Weight-bearing improved sitting problems in 22 of 26 patients and enabled nine of 36 nonwalkers to take at least a few steps.

Adolescent↗
PubMed1988

A critique of the methodologies used in clinical studies of hip-joint arthroplasty published in the English-language orthopaedic literature.

In a search of the English-language orthopaedic literature that was published from 1960 through 1986, only four papers that reported on prospective studies of hip-joint arthroplasty were found. In the study presented here, the standard epidemiological methods that are applicable to the design and performance of prospective clinical trials in medicine were reviewed, and the identified papers were evaluated with respect to the use of these methods. In all four papers, grave deficiencies were identified. Finally, the effects of some controlled clinical trials in other surgical disciplines were briefly reviewed. On the basis of the findings in this study, it was concluded that adequate surgical trials should be completed before new procedures or new designs of prostheses, such as those used in hip-joint arthroplasty, are made available for general use.

Clinical Trials as Topic↗
PubMed1991

A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint.

Quality of life before and one year after total hip arthroplasty was evaluated in fifty-six patients who had arthrosis of the hip joint. There were twenty-one men and thirty-five women, and the median age was sixty-five years (range, thirty to seventy-nine years). Before and after total hip arthroplasty, a functional assessment was done with the Charnley-Merle d'Aubigné scoring system. The patients assessed quality of life using the Nottingham Health Profile. In the comparison of quality of life before and after the arthroplasty, significant improvement was observed regarding pain (p less than 0.0001), energy (p less than 0.0001), sleep (p less than 0.0001), and social isolation (p = 0.001). Similarly, there was a significant reduction in the frequency of health-related problems pertaining to housework (p less than 0.0001), holidays (p less than 0.0001), hobbies (p = 0.0001), social life (p less than 0.0001), sexual function (p = 0.001), and family life (p = 0.0005), and among patients who were sixty-five years old or less and who worked at paid employment (p = 0.04). Quality of life after total hip arthroplasty was in close agreement with that of a healthy reference group of similar age and sex distribution. It was concluded that quality of life after total hip arthroplasty is improved considerably. The Nottingham Health Profile is a valuable tool in the evaluation of the result of, as well as the indicators for, total hip arthroplasty.

Activities of Daily Living↗
PubMed1990

[Results of ceramoplasty of the supra-acetabular area in dysplasia of the hip joint].

The authors present their results of using ceramic implants for the reconstruction of the supraacetabular area in 43 patients of various age groups. On the basis of a biomechanical investigation the results of positive effect of the acetabular vault reconstruction with ceramic implants on the statics and kinematics of the hip joint are acknowledge.

Acetabulum↗
PubMed2006

Balance lower limb loads and 3D spine modifications after total hip joint replacement: effects of leg length discrepancy correction.

Following total hip joint replacement (THJR), the durability of a prosthesis is limited by: wearing of frictional surfaces and loosening and migration of the prosthesis-cement-bone system. Literature review witnesses biomechanical studies focused mainly/only on hip functional state while none of them approached leg length discrepancy (LLD), posture unbalancing or spine related problems after THJR. Conversely, these latter could be critical elements for surgery and rehabilitation success, given the possible induction of asymmetric loading patterns. This study presents the results obtained by using a recently proposed methodology, to measure 3D subject posture balance and spine morphology and to evaluate its usefulness in individual therapy tuning/follow up. 3D subject's posture has been measured by means of 3D opto-electronic device, force platform and baropodography. 90 subjects after THJR have been included in this study. The subjects have been evaluated in two different epochs: 3 weeks after surgical intervention and after 3 months. 77/90 patients presented a LLD, pelvic obliquity and posture unbalancing. More than 90% of this group showed an overall postural re-balancing induced by the use of simple underfoot wedge. 70/77 patients needed wedge under the healthy side showing the surgical intervention produced a leg lengthening. 60/90 (52 LLD) patients underwent up to now to control and patients who wore the suggested wedge (63.4%) presented an improvement over all the considered quantitative parameters. Patients who wore a shorter than suggested wedge (23.1%), or that did not wear the suggested wedge (13.5%) presented a moderate or significant worsening of their postural balancing respectively.

Adult↗
PubMed2003

Recovery after total hip joint arthroplasty in elderly patients with osteoarthritis: positive effect of upper limb interval-training.

OBJECTIVE: To evaluate the influence of an interval training program for the upper limbs on cardiorespiratory fitness and walking ability in elderly patients after total hip joint arthroplasty. DESIGN: A randomized controlled trial. After surgery, control and training groups started general rehabilitation. Training group combined it with an arm-interval exercise program (3 sessions of 30 minutes per week, for 6 weeks). SUBJECTS: Patients were assigned randomly to control (n = 7) and training groups (n = 7). METHODS: Incremental exercise tests were carried out until exhaustion on an arm crank ergometer 1 month before and 2 months after surgery. A 6-minute walk test was also performed 2 months after surgery. RESULTS: VO2 peak increased significantly in the training group (p = 0.0424) and did not change in the control group. The difference in VO2 peak change between the groups was significant (p = 0.0362, +19.2% in the training group and -3.5% in the control group). In the walking test the training group covered a significantly longer distance than did the control group (p = 0.0055, 396.4 metres and 268.1 metres, respectively). CONCLUSION: These results stress the importance of physical training in a rehabilitation program after total hip joint arthroplasty and this should be considered for improving the current practices in rehabilitation.

Aged↗
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↗
PubMed1987

Revision arthroplasty of the hip joint. A retrospective analysis.

During the period 1974-1983, 768 total hip arthroplasties were performed at the Surgical Hospital, University Central Hospital in Helsinki. Brunswik prostheses were used until 1980, and after this the operations were routinely performed with Lubinus prostheses. Additionally, from 1977 to 1981 Wagner and Freeman resurfacing prostheses were used in 107 cases. Of all these patients, 44 (5.7%) needed revision arthroplasty. The average interval between the primary operation and revision arthroplasty was 3.7 years and the follow-up period after the second operation averaged 2.9 years. The patients who underwent revision arthroplasty were compared with a matched control group. In the revision group, radiographs revealed that the medial cement packing was complete in 28% of the hips, this being the case in 78% of the controls (P less than 0.001). Also, the cement tip packing was more often incomplete in the revision hips than in the controls (P less than 0.01). Regarding the lateral cement packing there was no statistical difference between the two groups. The revision rate of the resurfacing prostheses was 14.9%, compared with 7.8% of the Brunswik prostheses which were inserted at the same time. At the follow-up, the patients with revised hips had less pain than before the primary operation (P less than 0.001) and their mobility was similarly improved. We conclude that adequate medial and tip cement packing must be emphasized in the primary arthroplasty. Resurfacing prostheses have a relatively high loosening tendency. Revision arthroplasty is the treatment of aseptic loosening after total hip replacement and it gives good clinical results. Aseptic loosening is the most common long-term complication after total hip replacement surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1979

[The creeping post-operative hip joint empyema (author's transl)].

The case histories of 10 patients with chronic empyema of the hip joint following nailing of the femoral neck, respectively following intertrochanteric osteotomy are being described. With only a few exceptions their post-operative course showed no signs of infection. After an interval of between 5 weeks and 2 years their condition deteriorated rapidly. By the time the patients returned to hospital, usually, the joint was already destroyed or septic luxation had occurred. Because of their poor general condition only resection of the femoral head was possible. As an alternative to continuous suction drainage, the implantation of PMMA chains seems to have advantages.

Adult↗
PubMed1976

[Traumatic ostearthritis of the hip joint and its treatment (author's transl)].

The author describes the various origins of osteoarthrosis following hip joint injuries. Since beginning osteoarthrosis can't be stoped, he emphasizes the surgical treatment of joint fractures including accurate reduction and stabilization of the fragments. In respect of this, intracapsular fractures of the neck of the femur always require a stabile fixation. In all cases the micro-injuries of the articular cartilage should be considered. The different possibilities of post-traumatic degenerative arthritis are discussed and the methods of operative procedures presented.

Bandages↗
PubMed2001

Measurement of the radiological hip joint space width. An evaluation of various methods of measurement.

OBJECTIVE: To determine the most relevant method of measurement of the radiographic hip joint space width (JSW). DESIGN: Seventy hips were examined from 36 patients of the ECHODIAH study having had one to four X-rays of the pelvis during the 3-year course of the study. Minimum interbone distance (MIDc), mean width of both the whole joint space (MJSWL) and a region of interest of the joint space (MJSWroi) were measured using computerized analysis of digitized radiographs. MID was also measured using a graduated eyepiece (MIDge). Reproducibility of the measurement was assessed by the intraclass coefficient of correlation. Sensitivity to change was evaluated by the standardized response mean. RESULTS: The intraobserver intraclass coefficient of correlation of MIDc and MJSWroi was 0.98 and 0.94, respectively. The mean value degrees S.D. of MJSWL, MJSWroi, MIDc and MIDge was 3.3 degrees 0.9, 2.6 degrees 0.9, 2.4 degrees 0.9 and 2.6 degrees 1.2 mm, respectively. MIDge was significantly larger than MIDc (mean difference: 0.21 degrees 0.62 mm, P<0.001), in both normal and osteoarthritic hips. However, the difference between MIDge and MIDc varied largely when considering topography of femoral head migration. Whatever the method was, a significant (P<0.001) mean decrease of nearly 0.5 mm was found in osteoarthritic hips over the 3 year follow-up. The standardized response mean for MJSWL, MJSWroi, MIDge and MIDc was 0.73, 0.75, 0.79 and 0.85, respectively. Superiority of MIDc, in term of sensitivity to change, was mainly seen in osteoarthritic hips showing a superomedial or a concentric migration of the femoral head. CONCLUSION: Minimum interbone distance measured with a computer assisted method is suggested as the most suitable method for the evaluation of hip osteoarthritis (OA) progression.

Female↗
PubMed1986

An unusual ganglion communicating with hip joint resembling a femoral hernia. Case report.

A rare case of a ganglion communicating with the hip joint was encountered in a 72-year-old man who presented a reducible soft mass over the left femoral triangle. This mass, clinically considered to be a femoral hernia, proved to be a ganglion after excision. We report the clinical course of this case with the suggestion that caution should be given to the patient's subtle symptoms while herniography may be helpful for differential diagnosis of this rare condition.

Aged↗
PubMed1999

Ganglion of the hip joint--we present a logical approach to the exploration of a mass in the femoral triangle.

Hip joint ganglion is a rare cause of a mass in the femoral triangle. Our patient presented with a swelling in the groin and a history of femoral hernia repair 5 years previously. Pre-operative assessment with ultrasound suggested a possible femoral artery aneurysm. We propose that safe exploration of a mass closely related to the femoral vessels must include vascular control.

Aged↗
PubMed1975

[Clinical and experimental experiences of important factors concerning the permanent anchorage of hip-joint-prostheses (author's transl)].

Amomg a lot of conditions influencing the permanent anchorage of hip-joint-prostheses the following factors are very important: form and surface conditions of the material, in addition to a valgus position of the prostheses. The importance of these parameters in changed biomechanics after arthroplastic replacement is confirmed by measurements of spherical shape, morphology of the surface and diameter of the material. Furthermore, the vectorial distribution of weight by the different varus and valgus positions were examined. The experimental results were confirmed by clinical studies on 1407 prostheses during the course of 5 years.

Alloys↗
PubMed1990

[Surgical treatment of residual congenital dysplasia with dislocation of the hip joint after treatment with the Frejka pillow].

The characteristics of patients and the radiological condition of hip joints that required surgery because of residual dysplasia in the course of growth after treatment by the Frejka pillow have been presented. That treatment was employed in 4 per cent of the treated hips. The operations consisted in inspection of the joint, transiliac osteotomy after Dega with subtrochanteric osteotomy with detorsion of the femur, of the same type of operation without opening of the joint, performance of only transiliac osteotomy or only subtrochanteric osteotomy. Because late evaluation at over 10 years of life revealed 5 per cent of hips with poor rebuilding that should be treated surgically, it has been determined that the total number of cases requiring surgery after treatment by the Frejka pillow is 9 per cent.

Adolescent↗
PubMed2005

Digital correction of magnification in pelvic x rays for preoperative planning of hip joint replacements: theoretical development and clinical results of a new protocol.

The introduction of digital radiological facilities leads to the necessity of digital preoperative planning, which is an essential part of joint replacement surgery. To avoid errors in the preparation and execution of hip surgery, reliable correction of the magnification of the projected hip is a prerequisite. So far, no validated method exists to accomplish this. We present validated geometrical models of the x-ray projection of spheres, relevant for the calibration procedure to correct for the radiographic magnification. With help of these models a new calibration protocol was developed. The validity and precision of this procedure was determined in clinical practice. Magnification factors could be predicted with a maximal margin of error of 1.5%. The new calibration protocol is valid and reliable. The clinical tests revealed that correction of magnification has a 95% margin of error of -3% to +3%. Future research might clarify if a strict calibration protocol, as presented in this study, results in more accurate preoperative planning of hip joint replacements.

Algorithms↗