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PubMed1989

[Reconstructive operations in the supra-acetabular region of the dysplastic hip joint in children using a migrating osteo-muscular tissue complex].

The paper is devoted to the surgical treatment of children with dysplastic pre- and coxarthroses, particularly to reconstruction of the supra-acetabular++ area of the hip joint using a migrating osteo-muscular+ tissue complex, i.e. a graft taken from the upper flaring portion of the ilium together with the growth area and the tailor's muscle attached to it, which allows to reduce the terms of the treatment, to exclude a further recurrence of the deformation and to interrupt the present phenomena of arthrosis. In all the 52 operated patients aged 5 to 12 years with the follow-up periods up to 6 years the anatomical and the functional results were good. The mean rating according to the Central Institute of Traumatology and Orthopaedics was 4.8 points.

Acetabulum↗
PubMed1994

Recent advances in adult hip joint surgery.

This article is a summary of the information published in the field of hip surgery in adults over the past year. It reviews the epidemiology and economic aspects of total hip replacement, which dominates adult hip surgery, and examines the long-term results and complications that occur with both cemented and uncemented arthroplasty of the hip. Aseptic loosening is a major problem in the long-term outcome of total hip replacement. Wear of the bearings with production of particulate debris induces a local inflammatory response, activating the bone resorbing cells. Accordingly, revision surgery has become a frequent procedure that raises difficult problems. Strategy, methods, implant design, grafting, and indication for cemented or noncemented total hip replacements are discussed.

Adult↗
PubMed2006

Ochronotic arthropathy: pathological evidence of acute destruction of the hip joint.

Alcaptonuria is a hereditary disease, also known as black hip, where there is an accumulation of homogentisic acid pigmentation in joint cartilages. We describe a 74-year-old woman who showed acute destruction of her left hip joint. She received a total hip arthroplasty on her right side in July 2000, and was diagnosed with ochronosis. Her postoperative follow-up was at our institutions outpatient department. She first complained of increasing groin pain in July 2005, after which she had a left total hip arthroplasty in October 2005. Histopathologically, samples from this patient showed "fragmentation and cleft formation" in the cartilage of the femoral head. In addition, the samples revealed a remarkable degradation of proteoglycan, which is the secondary most abundant constituent of extra cellular matrix. These findings suggested that "cleft formation", where cracks develop toward the center, caused an acute destructive arthropathy with morphological fragility suggestive of ochronosis.

Acute Disease↗
PubMed1982

Autonomic hyperreflexia following passive stretching to the hip joint.

Autonomic hyperreflexia may occur in patients with severe upper thoracic and cervical spinal cord lesions. This syndrome, consisting of episodic hypertension, bradycardia, diaphoresis, and headaches, is an autonomic reflex evoked by a variety of stimuli applied below the level of injury. This article describes three cases in which autonomic hyperreflexia was provoked by passive hip joint stretching.

Adult↗
PubMedDate not supplied

[Total endoprosthetic management of the hip joint after failed osteosynthesis of para-articular hip fracture].

OBJECTIVE: Treatment of fractures of the proximal femur by open reduction and internal fixation is prone to complications and frequently requiring secondary joint replacement. The aim of the present study was to examine the results of total hip arthroplasty as a salvage procedure for failed internal fixation of femoral or acetabular fractures. PATIENTS AND METHODS: We retrospectively studied 145 patients who had undergone 146 total hip arthroplasties for failed internal fixation of femoral (n = 135) or acetabular fractures (n = 11). Mean follow-up time after insertion of the hip endoprosthesis was 7.1 years (1.5-14.7 years). Patient evaluation included a history, clinical examination, and standard radiographs. RESULTS: Twenty-eight patients had died, and 18 patients were lost to follow-up. Kaplan-Meier analysis with revision of the implants as the end-point demonstrated 85 percent survival after ten years. Using the Merle d'Aubigné rating system, we found good or excellent results in 85 percent of the cases. However, only 73.9 percent of the patients were satisfied with their result, and 40.9 percent still showed a positive Trendelenburg gait at follow-up. The perioperative mortality was 2.7 percent. Surgery-related femoral fractures or fissures were observed in 18 cases, and deep infections in four. CONCLUSIONS: In comparison with data of patients who had undergone primary total hip arthroplasty for osteoarthritis in our department, the results reported here after secondary hip replacement are clearly inferior. Nonetheless, alloarthroplasty of the hip still is the most effective procedure after failed internal fixation for acetabular or proximal femoral fractures.

Adult↗
PubMed1990

Spinal lesions simulating hip joint disorders.

In three patients pain in the groin and thigh which was initially attributed to either a malfunctioning hip prosthesis or osteoarthritic hip, was shown to arise in the spine. All patients had positive myelograms and one had electromyographic evidence of nerve root compression. Referred pain from the spine must always be considered in the differential diagnosis of pain thought to be arising from a hip replacement.

Aged↗
PubMed1995

Quantitative assessment of radiographic normal and osteoarthritic hip joint space.

Radiographic joint space narrowing (JSN) is the hallmark of progression in osteoarthritis (OA). We developed a technique of measuring joint space of the hip by computer analysis of digitally stored pelvic radiographs. The interobserver coefficient of variation was 3.3%. Mean joint space width (MJSW) and joint space surface were more sensitive to change than interbone distance. In a retrospective analysis of 69 OA hips, MJSW decreased 0.43 +/- 0.43 mm per year and was lower in patients with the hypertrophic form of OA. Limitations were due to radiograph quality. This computerized measurement method is applicable to monitor progression of hip OA and appears to be of value in the evaluation of disease-modifying therapies for OA.

Adolescent↗
PubMed2004

Comparable ultrasound measurements of ten anatomical specimens of infant hip joints by the methods of Graf and Terjesen.

PURPOSE: To define which sonographic section planes relative to the acetabular inlet plane will produce analyzable images with the methods of Graf and Terjesen. MATERIAL AND METHODS: Anatomical specimens of infant hip joints were investigated in a water bath using the methods of Graf and Terjesen. Acetabular position was varied in defined increments with respect to the ultrasound beam. The alpha angles and the femoral head coverage (FHC) were measured. RESULTS: To obtain images analyzable by the two methods, the ultrasound beam had to intersect with the acetabular inlet plane at defined angles. The acetabular notch had to be anteriorly rotated from the ultrasound beam plane by at least 20 degrees. Beam entry within a 50 degrees sector posterior to the perpendicular on the inlet plane resulted in analyzable images. The stepwise multiple linear regression analysis showed that alpha angles and FHC were much affected by the coronal-plane transducer tilt. CONCLUSION: The fact that caudal tilts of the transducer are associated with reduced alpha angles and FHC values should be kept in mind in clinical ultrasound investigations. It is recommended that the transducer should be put on the greater trochanter perpendicular to the transverse axis of the body.

Cadaver↗
PubMed1999

Development of a ten-station, multi-axis hip joint simulator.

Joint simulators are now used extensively to evaluate the performance of materials and designs of total replacement hip and knee joints. In this Technical Note a new ten-station hip joint simulator with biaxial rotational articulation synchronized to a physiological loading cycle is described. The current simulator manufactured by ProSim Limited (Manchester, UK) is a development of a first generation machine designed and built in-house at DePuy International Limited (Leeds, UK). The use of this new form of ten-station hip simulator to evaluate the performance of 22 mm zirconia femoral heads and ultra-high molecular weight polyethylene acetabular cups over some 7 million loading cycles is described elsewhere [1].

Biomechanical Phenomena↗
PubMed1991

Radiographic personal identification with characteristic features in the hip joint.

This case demonstrates a radiographic personal identification. A body was found but no positive results were obtained from the remains regarding the cause of death, the manner of death, or precise identification. At the autopsy, a characteristic radiographic deformity was found in the hip joints. After searching the registry of persons with congenital acetabular dysplasia and super-imposing the postmortem radiograph on the films of the registry, the identification was successful.

Adolescent↗
PubMed1988

Pitfalls of early diagnosis and treatment of congenital dislocation of the hip joint.

The efficiency of the routines for early diagnosis and treatment of congenital dislocation of the hip joint (CDH) practiced in the 1960s in the city of Göteborg were reviewed. Between 1961 and 1970 there were 65,875 live births in Göteborg. Eighty-five percent of the estimated number of cases of CDH were diagnosed during the first month of life. Of the children "missed" at the primary screening on the maternity wards, 75% (15/20) were premature babies and/or had been delivered during weekends. In all, 475 newborn children were judged to have unstable hips (dislocated or dislocatable hips), corresponding to an incidence of 7.2 per thousand live births. In 19 children, abduction treatment with braces commenced during the first 10 days of life failed to prevent dislocation. Eighteen of these children were treated primarily with a Frejka pillow and one with a von Rosen splint. A history of CDH among relatives was obtained in 47% of these 19 children including four of five children who had developed pathological hips after supplementary treatment with a hip spica cast and/or surgery. Radiological examination at the age of 1-4 months was helpful in revealing failure of early abduction treatment to prevent dislocation, which in most cases was difficult to detect by clinical examination at this early age.

Female↗