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[Artificial contrasting of the hip joint in children and adolescents: X-ray anatomic study].

The diagnostic capacities of currently available radiation diagnostic techniques in imaging some anatomic structures of the hip joint (HJ) were determined on the basis of studies of 70 sectional sets of HJs in children and adolescents aged 0 to 13 years through X-ray and anatomic comparisons. Magnetic resonance imaging (MRI) is the method of choice in visualizing the cartilaginous and soft-tissue structures of HJ in children and adolescents. MR-arthrography extends the capacities of the technique in imaging the articular surfaces and intraarticular structures of the joint. Contrast enhancement of the HJ cavity during X-ray study and computed tomography may be an alternative to MRI as it makes it possible to well visualize the cartilaginous head of the femur, the cartilaginous borders of the cotyloid cavity, the limbus, etc. Double contrasting enhances the capacities of detailed imaging of the articular surfaces, intraarticular structures, capsules, and ligamentous apparatus of HJ. The studies performed have specified the time course of anatomic changes during HJ growth and defined the method of choice or an alternative procedure of radiation techniques in the diagnosis of these changes, which is of great importance for early detection of pathological changes and for choice of therapeutic and diagnostic policy.

Adolescent↗

Hip joint center location from palpable bony landmarks--a cadaver study.

An anatomical anthropometric study of adult human cadaveric pelves was performed to investigate the relationship between hip joint center (HJC) and selected aspects of pelvic geometry. Sixty-five pelves (35 female and 30 male) were examined. Measurements of pelvic geometry and HJC (center of bony acetabular rim) were taken from bony landmarks of de-fleshed pelves. Correlation analysis revealed that HJC cannot be accurately located as a function of pelvic width alone, but requires estimation as a function of pelvic height and depth as well. HJC was optimally located relative to the respective ASIS: 14% of pelvic width medial (mean error 0.58 cm), 34% of pelvic depth posterior (mean error 0.30 cm), and 79% of pelvic height inferior (mean error 0.35 cm). No significant differences were found between males and females in HJC estimation.

Aged↗

[Hip joint arthrodesis with vascularized bone autotransplant on fixed neurovascular pedicle].

The surgical technique, clinical and anatomic explanation of the osteoplastic part of the compression arthrodesis of a hip joint has been demonstrated. The spongiform vascularized transplant from the upper flaring portion of the illeum was used for the operation. The basis for the transplant flap is a front part of musculus gluteus medius with arteries, veins and a nerve.

Arthrodesis↗

Cement-free bioceramic double-cup endoprosthesis of the hip-joint.

A cement-free bioceramic aluminum oxide double cup endoprosthesis is under investigation as an alternative to the cemented stem endoprosthesis. Nine patients with 11 operated hips are without complaints after an average of 20.8 months (range 8--28 months). Early loosening of 2 femoral components occurred because of technical mistakes during operation. In 3 patients loosening of the femoral component was seen 5--7 months after surgery. Mobilization of the hip joint and walking capacity are similar to the usually implanted stem endoprosthesis. Stable long-lasting anchorage is possible if the femoral component is implanted in valgus position and in contact with living bone. Failures are treated by a traditional type of endoprosthesis.

Adult↗

[Rehabilitation treatment of children with rheumatoid arthritis after operations on the hip joint].

The authors present their experience in the recovery treatment of 37 children suffering from rheumatoid arthritis after 40 treatment-and-prophylactic and reconstructive operations on the hip joint. The peculiarities++ of drug therapy and hormonal protection during the postoperative period are reflected. The terms of starting the performance of passive and active movements in the operated joint are given, as well as the terms of partial and complete loading of the extremity with regard to the state of the muscle function, the bone structure and the function of the operated and other affected joints. The sequence of using the methods of physiotherapy and therapeutic physical training is pointed out. The necessity of complex use of these means of treatment is stressed.

Arthritis, Juvenile↗

Health-related quality of life and appropriateness of knee or hip joint replacement.

BACKGROUND: We studied the association between explicit appropriateness criteria for total hip joint replacement (THR) and total knee replacement (TKR) with changes in health-related quality of life of patients undergoing these procedures. METHODS: Prospective observational study of 1576 consecutive patients with diagnoses of osteoarthritis on waiting lists to undergo THR or TKR. Explicit appropriateness criteria using the RAND appropriateness method were applied. Patients completed 2 questionnaires that measured health-related quality of life, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), before the procedure and 6 months afterward. RESULTS: Patients who were considered appropriate candidates for these procedures had greater improvements than those who were considered inappropriate candidates in all 3 WOMAC domains (pain, functional limitation, and stiffness; THR: 43.0, 40.6, and 40.4 vs 14.7, 19.1, and 15.9; TKR: 34.9, 32.5, and 30.2 vs 23.2, 18.9, and 17.1; P<.001 for all comparisons). Patients who underwent THR and were judged to be appropriate candidates had greater improvements in the physical function, role-physical, bodily pain, and social function domains of the SF-36 than those judged to be inappropriate candidates (34.4, 35.1, 33.1, and 26.6 vs 19.6, 9.2, 5.7, and 7.0; P = .04, P = .03, P < .001, and P < .001, respectively). Appropriate candidates for TKR demonstrated greater improvement in the social function domain of the SF-36 after the procedure than those deemed inappropriate candidates (19.9 vs 7.9; P = .004) but not in the other domains of functional status. CONCLUSIONS: These results suggest a direct relationship between explicit appropriateness criteria and better health-related quality-of-life outcomes after THR and TKR surgery. Our results support the use of these criteria for clinical guidelines or evaluation purposes.

Activities of Daily Living↗

A posterior approach to the hip joint with complete posterior capsular and muscular repair.

A posterior approach to the hip is described, which preserves the posterior hip capsule and short external rotators. These structures are reflected during exposure and are securely repaired to bone as a single capsulomuscular flap during wound closure. This approach has been used exclusively since December 1986 for uncomplicated primary hip arthroplasty. In 259 consecutive cases, there have been only two dislocations, both associated with significant trauma.

Adult↗

[Regional blood circulation in the area of the hip joint in patients with various inflammatory rheumatic diseases].

An analysis of the results of a study of the regional blood circulation in 36 patients with marked pathology of the hip joints of inflammatory nature (rheumatoid arthritis, Bechterew's disease, Reiter's disease) showed a statistically significant increase in transcutaneous oxygen pressure in the projection of the affected joints in unilateral as well as in bilateral pathology. In unilateral pathology there was a significant increase in transcutaneous oxygen pressure, on the surface of the contralateral joint, where pathology was undetectable by routine clinical methods. In the authors' opinion, it could be indicative either of an early stage of the joint involvement or the general reaction of a region under study to an inflammatory process.

Adult↗

Chondrolysis of the hip joint in a patient receiving long-term hemodialysis: histologic and biochemical evaluation.

We describe a patient undergoing long-term hemodialysis, in whom severe chondrolysis of the hip joint developed. The chondrolysis evolved in the absence of synovial inflammation and articular chondrocalcinosis. Biochemical studies of articular cartilage retained at surgery revealed deposition of exclusively small proteoglycans in the matrix. This may have been an important factor leading to the rapid chondrolysis in this patient.

Cartilage Diseases↗

Repeatability of gait data using a functional hip joint centre and a mean helical knee axis.

Repeatability of traditional kinematic and kinetic models is affected by the ability to accurately locate anatomical landmarks (ALs) to define joint centres and anatomical coordinate systems. Numerical methods that define joint centres and axes of rotation independent of ALs may also improve the repeatability of kinematic and kinetic data. The purpose of this paper was to compare the repeatability of gait data obtained from two models, one based on ALs (AL model), and the other incorporating a functional method to define hip joint centres and a mean helical axis to define knee joint flexion/extension axes (FUN model). A foot calibration rig was also developed to define the foot segment independent of ALs. The FUN model produced slightly more repeatable hip and knee joint kinematic and kinetic data than the AL model, with the advantage of not having to accurately locate ALs. Repeatability of the models was similar comparing within-tester sessions to between-tester sessions. The FUN model may also produce more repeatable data than the AL model in subject populations where location of ALs is difficult. The foot calibration rig employed in both the AL and FUN model provided an easy alternative to define the foot segment and obtain repeatable data, without accurately locating ALs on the foot.

Ankle Joint↗

[The new rotatory hip-joint endoprosthesis according to the unit construction system after Weber. Experience and results of follow-up checks after five years (author's transl)].

The new rotatory hip-joint total prosthesis after Weber with rotating metal head and polyethylene socket has yielded a very high percentage of good results to date, according to experience collected in the course of five years and a comprehensive followup study. It was possible to prove that the metallic rotatory joint does not entail any disadvantages, and that it is extremely resistant to wear. The almost complete absence of shaft fractures is remarkable (two cases after 2,500 operations) as well as the low incidence of loosening after primary operation. Complications occur much more frequently following exchange operations. The unit construction principle on which this type of prosthesis is based, offers great advantages in respect of surgical technique. It appears that the rotatory prosthesis is superior to other concepts with regard to wear and to stability of fixation.

Biomechanical Phenomena↗

Relationships between body mass indices and surgical replacements of knee and hip joints.

BACKGROUND: Osteoarthritis is both the most common form of arthritis and the most common reason for joint replacement surgery. Obese persons are believed to be more likely to develop generalized osteoarthritis that leads not only to knee but also to hip joint replacement surgeries. We hypothesized that obesity is also a risk for partial joint replacements and surgical revisions. METHODS: A frequency-matched case-control study was conducted in Utah. Between 1992 and 2000, 840 hip and 911 knee joint replacement surgery patients, aged 55 to 74 years, were included in this study. Cases were randomly matched to 5578 controls, defined as Utah residents enrolled in a cancer screening trial. Odds ratios (ORs) were calculated using ICD-9 (International Classification of Diseases, 9th revision) procedural codes and body mass index (BMI) groups. RESULTS: There was a strong association between increasing BMI and both total hip and knee replacement procedures. In males, the highest OR was for those weighing 37.50 to 39.99 kg/m(2) (total hip: OR=9.37, 95% confidence interval [CI] 2.64-33.31; total knee: OR=16.40; 95% CI 5, 19-51.86). In females, the highest OR was for those weighing > or =40 kg/m(2) (total hip: OR=4.47; 95% CI, 2.13-9.37; total knee: OR=19.05; 95% CI, 9.79-37.08). There were slight gender-specific differences in risk found for partial hip replacement procedures. Unexpectedly, no statistically significant association was found between obesity and the risk for hip or knee revision procedures. CONCLUSIONS: While there is an association between obesity and hip and knee joint replacement surgeries, obesity does not appear to confer an independent risk for hip or knee revision procedures.

Age Distribution↗