[Prevention of degenerative-dystrophic changes in the hip joint after individualized prosthesis].
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Hip Fractures↗
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[Surgical approach in alloplasty of the hip joint (anatomic observations)].
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Hip Joint↗
[Functional improvement after total hip joint prosthesis].
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Aged↗
[Semicircular incomplete osteotomy of the supra-acetabular area of the hip joint and its outcome].
The paper is devoted to the surgical treatment of the children with dysplastic pre- and coxarthroses, namely to the reconstruction of the supraacetabular area of the hip joint by means of incomplete semicircular osteotomy, which has allowed to reduce the terms of the treatment, to exclude a further recurrence of the deformation and to interrupt the phenomena of arthrosis that are present. In all the cases of the 50 patients who had been operated (aged 3 to 14 years with the follow-up period up to 10 years) there were good anatomical and functional results. The average mark according to the CITO scale was 4.6.
Acetabulum↗
[Total endoprosthesis of the hip joint. Experience with 931 cases (April 1969-April 1976) in a general surgery department (author's transl)].
The total artificial replacement of the hip joint in dislocated medial fracture of the neck of the femur in elderly people and in coxarthrosis is the standard method today. While there is no better method at the present time for the older patient, loosening and infections in particular compel strict indication and a search for other solutions for younger persons. Taking these criteria into consideration, the operation has proved thoroughly reliable up to the present and it is also worth recommending for use in a suitably experienced general surgery department. In the 6 years, 193 medial fractures of the neck of the femur with sequelae and 704 coxarthroses were operated on and 34 prosthesis exchanges were also undertaken. In medial fracture of the neck of the femur in the elderly as an acute and life-threatening disturbance of function, the mortality was 15%, whereas in coxarthrosis patients it was 0,3%. The early and late complications lie within justifiable limits.
Age Factors↗
A hip joint simulator study using new and physiologically scratched femoral heads with ultra-high molecular weight polyethylene acetabular cups.
This study validates a hip joint simulator configuration as compared with other machines and clinical wear rates using smooth metal and ceramic femoral heads and ultra-high molecular weight polyethylene (UHMWPE) acetabular cups. Secondly the wear rate of UHMWPE cups is measured in the simulator with deliberately scratched cobalt-chrome heads to represent the type of mild and severe scratch damage found on retrieved heads. Finally, the scratching processes are described and the resulting scratches compared with those found in retrieved cobalt-chrome heads. For smooth cobalt-chrome and zirconia heads the wear rates were found to be statistically similar to other simulator machines and within the normal range found from clinical studies. An increased wear rate was found with cobalt-chrome heads scratched using either the diamond stylus or the bead cobalt-chrome but the greatest increase was with the diamond scratched heads which generated scratches of similar dimensions to those on retrieved heads. A greater than twofold increase in wear rate is reported for these heads when compared with smooth heads. This increased wear rate is, however, still within the limits of data from clinical wear studies.
Acetabulum↗
A method for calculating acetabular anteversion, femur anteversion and the instability index of the hip joint.
A method of calculating the degree of anteversion of the acetabular fossa and femoral neck with computed tomography is described. The instability index of the hip joint can be measured directly with this method.
Acetabulum↗
Physiological response to phlebotomies for autologous transfusion at elective hip-joint surgery.
In order to study the physiological response to phlebotomies for autotransfusion, an autotransfusion program was designed for 10 patients undergoing hip-joint replacement surgery for arthrosis. 4 phlebotomies of 450 ml each were performed within 12 days. Blood samples were taken immediately before phlebotomy for blood hemoglobin (Hb), serum erythropoietin (Epo), reticulocyte count (ret) and erythrocyte 2,3-diphosphoglycerate (DPG). All 4 phlebotomies could be performed in 9/10 patients, and only 1 patient had significant symptoms (fatigue). The operation was performed 2 weeks after the last phlebotomy. None of the patients had recovered the initial Hb level at operation (24.8 +/- 9 per liter lower than initially), and they were all even more anemic after the operation (36.8 +/- 16.9 g/l lower than initially). Serum Epo increased from 13.6 +/- 7.2 IU to 30.6 +/- 12.2 (SD) IU per liter, and reticulocyte counts increased to a maximum of 3.68 +/- 1.69%. DPG increased in all patients except the one who had significant fatigue. It is concluded that the patients tolerated the phlebotomy program well but that a significant anemia developed. The compensatory increase in erythropoietin and reticulocyte count, adequate for this degree of anemia, was small compared to the increase seen at more severe anemia, indicating that there may be a role for pharmacological stimulation of erythropoiesis in blood predeposit programs.
Adult↗
Statically equivalent load and support conditions produce different hip joint contact pressures and periacetabular strains.
The hip is a common site of orthopaedic trauma and disease, and considerable research has been directed toward understanding the development of contact pressures within the joint. Virtually all experimental studies to date have employed proximal femurs compressed along the joint reaction force vector into acetabulae explanted from cadaver pelves. This approach presumes that deformations of the acetabulum are highly localized, and that the pelvis is functionally a rigid body. We have developed a methodology that uses intact pelves loaded through simulation of the abductor mechanism. A direct comparison of the two techniques revealed significantly different joint contact characteristics and periacetabular strains. Fuji film measurements of contact area and pressure were more widely distributed across the acetabulum for the intact pelvis, with significant pressure development in anterior and posterior regions. Contact patterns in the explanted acetabulae were concentrated in the superior portion of the joint. Principal strains from three rosette gages placed near the acetabular rim were also significantly different for the two testing techniques, but were not substantially altered by the presence of Fuji film within the joint. The results indicate that deformation of the entire pelvis and the manner in which loads are applied significantly affect development of contact pressures within the hip joint, and that Fuji film is a suitable technique for recording those patterns.
Acetabulum↗
The insertion of the iliopsoas as a design favouring lateral rather than medial rotation at the hip joint.
A study of cadaveric material undertaken to investigate a possible anatomical basis for the nature of rotary influence of the iliopsoas at the hip joint shows that the winding course around the femoral neck with extension of tendon insertion towards the greater trochanter, and the spiralling course of the tendon both appear to be a design for causing external rotation during muscular contraction by a process of unwinding around the neck and untwisting of the spiral tendon under tension.
Aged↗
Effect of effusion on hip joint stability in the newborn. A postmortal study.
In a postmortal study we found that 1 mL fluid injected through the triradiate cartilage into the hip joint of a newborn child was enough to cause instability. This instability persisted even after aspiration of the fluid. The findings were confirmed by ultrasonography.
Edema↗
[Development of the normal infantile hip joints assessed by MRI].
The paper provides an overview of the time of appearance of the secondary ossification centers and closure of the growth plates of the acetabulum and proximal epiphysis of the femur: the triradiate cartilage, the acetabular roof growth cartilage, the subcapital growth cartilage, the growth cartilage of the major trochanter, the growth cartilage of the minor trochanter. The study is based upon 62 MRI scans of healthy hips in 45 patients aged 3-21. The examined hips showed no pathologic traits--neither in the MRI scan nor in X-ray investigation. In Spin Echo and Turbo Spin Echo sequential imaging all obtained slices were used, on GRADIENT ECHO: FISP 3D, FLASH 2D, and FLASH 3D FAT SAT only chosen slices were included in the study. This way the following results were obtained: the ossification center of the major trochanter appears at the age of 3 in girls and at the age of 6 in boys, while the ossification center of the minor trochanter appears at the age of 6 in both sexes. The times of complete ossification of following growth cartilages were observed: for the triradiate cartilage ossification was observed at age 12-15 in girls and 15-16 in boys; for the cartilage of the acetabular roof ossification was noted at age 12-15 in girls and 15-18 in boys; ossification in the subcapital growth cartilage occurred at age 15-17 in girls and 16-18 in boys; the major trochanter growth cartilage ossifies at age 15-16 in girls and 16-18 in boys; for the minor trochanter ossification of the growth cartilage occurs at age 14-16 in girls and at age 16-18 in boys. The secondary ossification center of the pubic bone appears at age 9-11 in girls and 13-16 in boys and the secondary ossification center of the acetabular roof appears at age 13-17 in girls and boys. This study expand our knowledge on the development of the hip joint and facilitate the assessment of hip pathology.
Adolescent↗
Telemeterized in vivo hip joint force data: a report on two patients after total hip surgery.
Two telemeterized femoral components were implanted in two patients as part of normal total hip replacement procedures. The two components were instrumented to measure the three force components directed along: (a) the neck axis, (b) transverse to the neck axis and in the plane of the prosthesis, and (c) transverse to the neck axis and perpendicular to the plane of the prosthesis. Data were collected at multiple sessions during the early postoperative period for a number of standard activities, including gait, stair climbing, rising from a chair, single leg stance, double leg stance, ipsilateral and contralateral straight leg lifts while supine, ipsilateral flexion and extension while standing, and ipsilateral abduction while standing and lying on the contralateral side. These data are summarized and compared with the published results from analytic studies and with the results from previous studies using instrumented femoral components. Peak loads for gait during the period of study were roughly 2.7 body weights (BW) when the patients walked at their normal pace. Contact forces at the hip during stationary single leg stance approximated the peak loads during gait with values ranging from 2.1 to 2.8 BW. The highest forces recorded reached values approaching 5.5 BW and occurred during periods of instability while the patient engaged in stationary single leg stance. Our in vivo data indicate that forces generated during the above activities increase in magnitude quite rapidly during the early postoperative period and that during this period the patients have the ability to perform the activities of daily living without generating the high amplitude joint contact forces suggested by the results of dynamic studies. Joint contact forces during gait were found to depend on speed, but the high absolute magnitudes predicted by model studies were not supported by the in vivo data.
Aged↗
Cartilage thickness in the hip joint measured by MRI and stereology--a methodological study.
OBJECTIVE: The purpose of this study was to develop a precise and efficient method for estimating the thickness of the articular cartilage in the hip joint and hence three different stereologic methods were tested based on Magnetic Resonance Imaging. DESIGN: Twenty two females and four males with hip dysplasia underwent MRI. The thickness of the femoral and acetabular cartilage was estimated. RESULTS: The results for all three methods showed that the observed total variance on cartilage thickness is small. The mean thickness of the acetabular cartilage measured by the three different methods ranged between 1.15 mm and 1.46 mm. The mean thickness for the femoral cartilage measured by the three different methods ranged between 1.18 mm and 1.78 mm. The measurements took 15-20 min per hip to carry out. CONCLUSION: Methods 1 and 3 are as precise but we favour method 3 because the measurements are done on images obtained through the center of the femoral head which means that the cartilage surface is intersected perpendicular and partial volume effect avoided. We suggest that this method can be advantageous for assessing the progression of osteoarthritis in dysplastic hips after periacetabular osteotomy.
Adult↗
Repair of cartilage defects and torn acetabular labrum in hip joints after conventional osteotomy: evaluation by follow-up arthroscopy.
The purpose of this study was to evaluate recovery from cartilage damage and labral lesions after osteotomy of hip joints. Conventional osteotomy for dysplastic hips was performed on 38 hips. Hip arthroscopy preceded the osteotomy, which in turn was followed up 18.9 months later on average by arthroscopy. We assessed the Harris hip score (HHS) and radiological and arthroscopic findings before and after osteotomy. The average HHS was improved from 64.9 to 88.5. Cartilage repair was observed on the acetabular side of five hips (13.2%) and on the femoral side of four (10.5%). At follow-up arthroscopy, the acetabular labrum had adhered to the capsule in 11 hips. Acetabular adhesion may increase stability of the joint. We conclude that the effects of conventional osteotomy are limited, and additional surgery might be needed in the future.
Acetabulum↗
Acute bursitis calcarea trochanterica in an infant, with perforation into the hip joint demonstrated by arthrogram.
A case of bursitis calcarea trochanterica acuta is reported in a boy aged four months. The calcification was amorphous, and arthrography revealed extension into the hip joint. The lesion was treated surgically.
Acute Disease↗
[Therapeutic approach in degenerative-dystrophic diseases of the hip joint in relation to the immunologic status].
In the process of study of the immunological status peculiarities of 202 patients with some degenerative-dystrophic diseases of hip joint has been revealed that the hyperimmune reactions to tissular antigens of the joint components (bone, cartilage, synovial membrane) are more often observed in case of non-specific arthritis, asephic necrosis of the head of the femur and dysplastic coxarthrosis. These were precisely the states with more frequent postoperative complications, provoking the process development, joint ankylosing or formation of ossificates. Preoperative immunocorrection therapy of 20 patients by means of a course of low-dose injections of plasma substitutes (polyglukine, hemodesis or reopolyglukine), individually selected by RIML and lymphocytotoxic test, allowed to arrest the lryperimmune manifestations. After reconstructive-restorative operations there was observed positive clinical and roentgenologic dynamics in the operated joint of the patients.
Antigen-Antibody Reactions↗