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At least 1,009 records · Page 56Linked to original sources
PubMed1991

Intraoperative autotransfusion in reconstructive hip joint surgery of patients with rheumatoid arthritis and ankylosing spondylitis.

The efficacy of a simple, low-cost device designed for intraoperative blood salvage and reinfusion, known as the Sorensen system, was studied during 24 hip joint operations in adult patients suffering from rheumatoid arthritis or ankylosing spondylitis. The total need for homologous blood was reduced to 28%, compared with a matched control group of patients who had previously undergone hip surgery by homologous blood replacement. In primary hip-replacement operations, the need for blood was met either completely by autotransfused blood or by the addition of 1 or 2 units of homologous blood. In revision arthroplasties, the maximal need for homologous blood was 6 units owing to a greater blood loss during operation. Postoperative changes in several hematologic variables measured were all very small. The autotransfusion system proved easy and safe to operate. No patients manifested complications. In our experience, the system may be considered an underutilized resource in rheumatological surgery.

Adolescent↗
PubMed1985

Direct measurement of local pressures in the cadaveric human hip joint during simulated level walking.

Eleven piezoelectric pressure transducers, each supporting an area of articular cartilage about 3 mm in diameter, were inserted through the bone of the acetabulum. Nine cadaveric hip joints, thus instrumented, were subjected to forces representing six instants in a typical level walking cycle, including the highest and lowest force. Under the highest force, the maximum pressure measured ranged from 4.93 to 9.57 MN m-2. The transducer positions which were subjected to the highest pressures were subjected at some other instant in the cycle to pressures which were an order of magnitude lower, or to zero pressure.

Adult↗
PubMedDate not supplied

[Effect of superimposed stress of hip joints in the sagittal plane on the fatigue properties].

The testing position for hip-joint prostheses proposed in DIN 58840 was compared with a testing position better adapted to the real stress situation, and possible effects studied. A load and movement analysis was carried out, and the respective position at which maximum impact loads occur was analysed. After the dynamic test, the results of the loads to be borne are presented for the testing position in accordance with DIN 58840 and that adapted to the real load in the case of two types of prostheses on the basis of Wöhler diagrams. The lateral stem stresses were then determined analytically. In the statistical assessment of the fracture analysis of prostheses broken in vivo, the directions of crack propagation were found to be in accordance with those of prostheses broken under dynamic loading, in particular in the case of the testing position adapted to the real stress situation.

Biomechanical Phenomena↗
PubMed2005

Development of a novel type of shoe to improve the efficiency of knee-ankle-foot orthoses with a medial single hip joint (Primewalk orthoses): a novel type of shoe for Primewalk orthosis.

The purpose of the study was to develop and evaluate a new heel cushion in shoes for use with knee-ankle-foot orthoses having a medial single hip joint (Primewalk orthoses) in order to improve walking velocity and efficiency. Primewalk orthoses and shoes were made for a 24-year-old man having paraplegia with flaccid paresis (level T-7; grade A, ASIA impairment scale) of 2 years' duration. Walking exercises were assigned. Shoes were modified with the sole made of hard rubber and the addition of soft rubber heel cushions. The walking speed, centre of foot pressure during walking, and ground reaction force were evaluated. The patient also subjectively assessed the devices. The modifications to the shoes resulted in a 1.94-fold increase in walking speed (8.6 to 16.7 m/min), a 1.87-fold increase in step length (16.7 to 31.3 cm) and a 54.8% decrease in the physiological cost index (7.7 to 3.48 beats/min). The centre of foot pressure during walking was found to deviate towards the lateral margin of the foot. The horizontal rotation of the pelvis increased simultaneously. The patient reported increased amplitude of flail motion of the trunk and decreased burden to the upper limbs. It was concluded that the modified new heel cushion of the shoe provided freedom to the lower legs and thereby increased walking efficiency.

Adult↗
PubMed1999

Matrix metalloproteinases and tissue inhibitors of metalloproteinases in joint fluid of the patients with loose artificial hip joints.

The pseudojoint cavity formed in patients undergoing total hip arthroplasty (THA) is later remodeled to synovial membrane-like tissue, which produces pseudosynovial fluid. This pseudosynovium also is an important source of matrix metalloproteinases (MMPs). As it is widely speculated that synovial fluid MMPs may contribute to local tissue degradation in rheumatoid arthritis (RA) and osteoarthritis (OA), we hypothesize that locally produced MMPs are found in the pseudosynovial fluid, via which they have access to the implant-host interface, and that if they retain their proteolytic potential, they might contribute to aseptic loosening. Enzyme-linked immunosorbent assay (ELISA), immunoblotting, and zymography were used to analyze MMPs and tissue inhibitors of metalloproteinases (TIMPs) in synovial fluid in aseptic loosening, which was compared to RA and OA. Pseudosynovial THA fluid was characterized using low levels of MMP-1 but moderate levels of MMP-13 and MT1-MMP (MMP-14). Due to the lack of an appropriate assay, MMP-13 and MT1-MMP were not similarly assessed, but the immunoblotting indicated that they were in the 56 kD intermediate proteolytically processed forms. The MMP-9 level was intermediate between RA and OA. MMP-2 was on a significant level, but there were no differences among study groups. The THA group also was characterized using relatively high levels of TIMP-1 and TIMP-2. Accordingly, MMP-9 and MMP-2 were found to occur in the 92 kD and 72 kD proenzyme form, respectively, with full activity retained in all study groups. The data suggest that proMMP-2-TIMP-2 and proMMP-9-TIMP-1 complexes are formed in the pseudosynovial fluid due to the excess of TIMPs over MMPs in aseptic loosening of THA. TIMP-complexed MMPs are resistant to MMP-mediated proteolytic activation, which may explain their latency and proenzyme zymogen form. Thus, formation of stabilizing proMMP-TIMP complexes enable transportation of proMMPs far from their original site of production. Due to motion-associated cyclic changes of the intra-articular pressure, fluid-phase MMPs stabilized by TIMPs might be absorbed to implant surfaces and interface tissues and help to dissect the implant/cement-to-bone interface in situ. Consequently, they may contribute to local proteolytic/tissue destructive events and aseptic loosening.

Aged↗
PubMed1995

Primary psoas abscess due to methicillin-resistant Staphylococcus aureus concurrent with septic arthritis of the hip joint.

We report an unusual case of a primary psoas abscess due to community acquired methicillin-resistant Staphylococcus aureus in an immunocompetent man. The course of the disease was indolent, expressed as septic arthritis of the hip joint. When the diagnosis was made, 3 months after symptoms began, the patient was treated by surgical evacuation of the abscess and appropriate antibiotics. Full recovery and return to his usual activity followed total hip replacement.

Arthritis, Infectious↗
PubMed1989

Performance of noncountermovement jump with both knee and hip joints fully extended.

The relationships between neuromuscular performance and biomechanical variables were studied in maximum vertical jumps to examine the factors influencing the performance of a noncountermovement jump. Keeping their knee and hip joint fully extended, five healthy subjects performed four kinds of noncountermovement jumps and one countermovement jump, during which ankle joint angle, platform force, and surface electromyograms of a triceps surae muscle were recorded. In the four noncountermovement jumps, the magnitude of activation and force at the onset of a shortening contraction of the triceps surae muscle were controlled at four different levels. Performance parameters of the noncountermovement jumps, maximum angular velocity of the ankle angle and flight time, correlated with the platform force at the onset of the plantar flexion. Furthermore the integrated electromyograms of the triceps surae muscle before the plantar flexion were correlated with the maximum angular velocity of the ankle angle and the force at the plantar flexion onset. The findings suggest that the efficient utilization of the muscle characteristic contributes to an enhancement of the noncountermovement jump.

Adult↗