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At least 1,225 records · Page 68Linked to original sources
PubMed1995

Heterotopic bone formation affecting the hip joint is preventable in high risk patients by post-operative radiation.

Between 1984 and 1993, 40 high risk patients (45 hips) received postoperative irradiation as prophylaxis against heterotopic ossification (HO). Radiotherapy was commenced within 5 days of the surgery in 43 of 45 hips. The development of HO was assessed by comparison of radiographic films prior to irradiation and at least 2 months after treatment (median interval 12 months). Progression of HO was observed in only two of 45 hips (4.3%) and of clinical significance in one (2.2%). Treatment was well tolerated with no acute complications or loosening of prosthetic components attributable to irradiation. During the study period, the treatment programme changed from 20 Gy in 10 fractions to 6-8 Gy in a single fraction, without loss of treatment efficacy. As well as improving resource utilization, single fraction techniques allow fewer patient transfers thereby reducing patient discomfort and risk of hip dislocation. This procedure is uncomplicated and should be considered more widely in the management of this disabling non-malignant condition.

Adult↗
PubMed2001

A novel low wearing differential hardness, ceramic-on-metal hip joint prosthesis.

Osteolysis and loosening of artificial joints caused by polyethylene wear debris has prompted renewed interest in alternative bearing materials for hip prosthesis designs. Lower wearing metal-on-metal (MOM) and ceramic-on-ceramic prostheses are being used more extensively, and there is considerable interest in further improving on their performance. This study investigated the wear properties and debris morphology of a novel differential hardness ceramic-on-metal (COM) prosthesis, in comparison with MOM articulations in a physiological anatomical hip joint simulator. The COM pairings were found to have wear rates approximately 100-fold lower than the MOM pairings. The MOM pairings showed a higher "bedding in" wear rate (3.09+/-0.46mm(3)/10(6) cycles) in the first million cycles, which then reduced to a steady state wear rate of 1.23+/-0.5mm(3)/10(6) cycles. The wear rate of the COM pairings over the duration of the test was approximately 0.01mm(3)/10(6) cycles with very little wear detected on the surface of the prosthesis components. The wear particles from both articulations were oval to round in shape and in the nanometer size range. After one million cycles the mean maximum diameter of the MOM and COM wear particles were 30+/-2.25 and 17.57+/-1.37nm, respectively. After five million cycles the wear particles were statistically significantly smaller than at one million cycles, 13.9+/-0.72nm for the MOM pairings and 6.11+/-0.40nm for the COM pairings. The wear rates of the MOM prostheses were representative of clinical values. The use of differential hardness COM pairings dramatically reduced the wear rate compared to MOM hip prostheses. The wear particles from the MOM articulation were similar to particles found in retrieved tissues from around MOM prostheses. The extremely low wearing differential hardness COM bearings presented in this study produced far smaller volumetric particle loads compared to MOM prostheses currently used clinically.

Biocompatible Materials↗
PubMed1977

New prospects for a prolonged functional life-span of artificial hip joints by using the material combination polyethylene/aluminium oxide ceramin/metal.

Investigations over the years have shown that the mirror-finished Al2O3 ceramic is a much more suitable frictional counterpart to ultrahigh molecular weight (UHMW) polyethylene than metal. Despite the extremely gread hardness difference between polyethylene and Al2O3 ceramic, a considerable lower wear rate is obtained for the polyethylene socked with this new low-friction material combination. The unexpectedly favorable tribological behavior of this ceramic material in contact with polyethylene may be attributed to the following factors: better values for corrosion resistance characteristics, wettability with liquids, surfact gloss, hardness, and scratch resistance of the ceramic material in comparison with those of the hitherto used metallic implant materials (AISI-316L steel or cast Co-Cr-Mo alloy). It appears that, by using this new combination of materials for the socket and the ball, it will be possible to prolong the service life of artificial hip joints considerably without having effecy any fundamental changes in the present design and implantation principle retaining the hitherto used anchorage shaft made of wrought Co-Ni-Cr-Mo-Ti alloy Protasul-10 of extremely high corrosion fatigue strength.

Alloys↗
PubMedDate not supplied

[The early diagnosis of postoperative suppuration in endoprosthesis of the hip joint].

The authors describe the method of control of the course of an early wound process in patients with endoprosthesis of the hip joint in early postoperative period, which is based on determination of the level of lysozyme in the wound. The method allows detection of the development of suppuration and start of antibacterial therapy in the early postoperative period, before the appearance of the clinical symptoms.

Clinical Enzyme Tests↗
PubMed1995

[Primary total endoprosthetic hip joint replacement in acetabulum fractures].

Conservative treatment of acetabular fractures mean a long period with immobilisation followed by quite a few of complications that are life-threatening to old patients. Besides that these fractures often cause painful posttraumatic osteoarthritis of the hip joint. Open reduction and osteosynthesis is favored more and more, but the complications described cannot be avoided absolutely by surgical treatment. The sequelae are risky reoperations and the necessity for implantation of total joint prosthesis. As shown in the enclosed case reports, total hip replacement can be emphasized as first step and as definitive surgery. Implantation of an artificial joint allows postoperative remobilisation with full weight bearing and long lasting immobilisation can be avoided. Therefore this kind of therapy is justified for treatment of old and polymorbid patients as an out of rule therapy.

Acetabulum↗
PubMed1986

Dislocation and fracture dislocation of hip joints treated by traditional bone setters in Jos, Plateau State, Nigeria.

Two patients who sustained respectively dislocation and fracture dislocation of the hip joint as a result of traffic accidents and who initially went to traditional bone setters for treatment are reported. The native and modern orthodox treatment given to them are compared and analysed. It is suggested that certain types of fracture cases should not be managed by traditional bone setters; and that a careful assessment of the practice of traditional bone setting be made before a marriage between orthodox and traditional medicine is advocated.

Adult↗
PubMed2005

Angular orientation of trabecular bone in the femoral head and its relationship to hip joint loads in leaping primates.

The elastic properties and mechanical behavior of trabecular bone are largely determined by its three-dimensional (3D) fabric structure. Recent work demonstrating a correlation between the primary mechanical and material axes in trabecular bone specimens suggests that fabric orientation may be used to infer directional components of the material strength and, by extension, the hypothetical loading regime. Here we quantify the principal orientation of trabecular bone in the femoral head and relate these principal fabric directions to loading patterns during various locomotor behaviors. The proximal femora of a diverse sample of prosimians were scanned using a high-resolution X-ray computed tomography scanner with resolution of better than 50 mum. Spherical volumes of interest were defined within the femoral heads and the 3D fabric anisotropy was calculated using the mean intercept length and star volume distribution methods. In addition to differences in bone volume and anisotropy, significant differences were found in the spatial orientation of the principal trabecular axes depending on locomotor behavior. The principal orientations for leapers (Galago, Tarsius, Avahi) are relatively tightly clustered (alpha(95) confidence limit: 8.2; angular variance s: 18.2 degrees ) and oriented in a superoanterior direction, while those of nonleapers are more variable across a range of directions (alpha(95): 16.8; s: 42.0 degrees ). The mean principal directions are significantly different for leaping vs. nonleaping taxa. These results further suggest a relationship between bone microstructure in the hip joint and locomotor behavior and indicate a similarity of loading across leapers despite differences in kinematics and phylogeny.

Animals↗
PubMed1993

Soft-tissue window to enhance visualization of entrapped osteocartilaginous fragments in the hip joint.

The thin-section computed tomographic (CT) scans of 11 patients with entrapped intra-articular fragments secondary to dislocation or fracture dislocation of the hip are studied. The effects of CT bone and soft-tissue contrast manipulation on the visibility of the intra-articular fragments are demonstrated in both patients and in vitro. When the mechanism of injury and clinical features raise the possibility of entrapped fragments, as in hip dislocation and fracture dislocation, special magnification and image-enhancement techniques are available for re-examining the acetabulum, especially when raw CT data are saved. Thus, index of suspicion and appropriate CT planning can ensure prompt diagnosis and treatment of entrapped intraarticular fragments in the hip joint.

Cartilage, Articular↗
PubMed1997

Prevalence of heterotopic ossification in cemented versus noncemented total hip joint replacement in patients with osteoarthrosis: a randomized clinical trial.

OBJECTIVE: To determine the prevalence of heterotopic bone formation in cemented versus noncemented total hip joint replacement. DESIGN: A prospective randomized controlled trial. Follow-up ranged from 2 to 6 years (mean 4 years). SETTING: A university hospital. PATIENTS: Two hundred and twenty-six patients who had primary or secondary osteoarthrosis of the hip were stratified according to type of fixation, surgeon and age. Patients were randomized within strata: 112 received noncemented total hip prostheses and 114 received cemented prostheses. The 2 groups were similar with respect to age and sex. INTERVENTION: Primary total hip arthroplasty. A cemented (methylmethacrylate) or noncemented prosthesis was inserted by a lateral surgical approach. MAIN OUTCOME MEASURE: The Brooker classification was used to grade heterotopic bone formation from postoperative radiographs. RESULTS: Overall, 148 (66%) hips had no heterotopic ossification, 56 (25%) were Brooker class I, 14 (6%) were class II, 8 (3%) were class III and none were class IV. In the noncemented group of patients, 76 (68%) hips had no heterotopic ossification, 25 (22%) were Brooker class I, 7 (6%) were class II, 4 (4%) were class III and none were class IV. In the cemented group of patients, 72 (63%) hips had no heterotopic ossification, 31 (27%) hips were Brooker class I, 7 (6%) were class II, 4 (4%) were class III and none were class IV. CONCLUSION: There was no significant difference in the prevalence of heterotopic ossification between cemented and noncemented total hip replacements in patients with osteoarthrosis.

Aged↗
PubMed1983

Total hip joint arthroplasty with gentamicin-impregnated cement. A clinical study of gentamicin excretion kinetics.

The excretion pharmacokinetics of gentamicin (GM) following total hip joint arthroplasty with GM-impregnated bone cement were studied in ten patients. The patients received 0.5-1.1 g of GM. Twenty-four-hour portions of urine were collected for up to 60 days after operation. GM concentrations in urine were initially 8-25 mg/l, and during the first four days the excretion ranged from 0.7 to 25 mg/day. On the 30th day drug levels in the urine were 0.5-1.0 mg/l, and the excretion was 0.5-1.0 mg/day. The GM excretion-time curve consisted of an initial rapid phase that terminated four to six days after operation, with a half-life of 0.65 days, and a slow phase with a half-life of 7.5-73.0 days (mean, 16 days). From the area under the excretion-time curve and from extrapolation of the registered terminal phase, it was calculated that 5%-18% (mean, 13%) of the GM administered was accounted for. Thus, a major portion of the drug was unaccounted for. Data obtained two years after operation suggested that the half-life of the terminal phase is much longer (greater than 240 days) than that calculated from data obtained during the first two months after operation. It was calculated that the surface area of the cement would be in excess of 150 cm2 and that the volume of an interface tissue layer 1 mm thick would be approximately 15 cm3. Thus, at three weeks, when the daily excretion was approximately 1 mg/24 hours, 67 micrograms/cm3/day of GM would be available for antimicrobial action at a tissue--cement interface 1 mm thick.

Adult↗
PubMed1992

[A systemic approach to the surgical treatment of degenerative-dystrophic diseases of the hip joint].

Based on the experience gained with the surgical treatment of over 900 patients with different forms of degenerative dystrophic diseases of the hip joint the current principles of the choice of different types of surgical interventions were defined. As far as the patients with aseptic necrosis of the head of the femur are concerned, the main problem in this case lies in the early diagnosis of osteonecrosis. The surgical treatment is specified by the leading factor of the pathogenesis at every stage of the development of the process (vascular disorders, changes in the biomechanism of the joint). The planning of operations in patients with dysplastic coxarthrosis rests on the consideration of 8 basic factors that influence the disease by means of factorial analysis and determination of the prognostic estimations of the treatment efficacy.

Femur Head Necrosis↗
PubMed1992

A simulator study of friction in total replacement hip joints.

Frictional behaviour of 22 different femoral head-acetabular cup combinations was studied on a new servo-hydraulic microcomputer-controlled hip joint simulator using various flexion-extension angle and superior-inferior load set value waveforms and using distilled water at 37 +/- 1 degrees C as lubricant. Six different head materials were included in the study, whereas all cups were ultra-high molecular weight polyethylene (UHMWPE). Most head-cup combinations studied are commercially available. No distinctly superior joint design can be pointed out, but the frictional behaviour of alumina ceramic against UHMWPE proved overall most favourable (mu min was 0.02), whereas that of non-ion-implanted titanium alloy Ti-6Al-4V against UHMWPE proved strikingly poor (mu max was 0.15). The lowest frictional torque was in 22 mm joints, but frictional torque did not always increase straightforwardly with increasing diameter of the femoral head. The measurements form an extensive comparison between a wide variety of head-cup combinations. The simulator is apparently a useful instrument in the study of frictional behaviour of new designs, materials, surface treatments and coatings that are frequently introduced.

Friction↗
PubMed1976

Traumatic dislocation of the hip joint in children.

Between 1949 and 1972, 24 children under the age of 16 years were admitted to Middlemore Hospital with traumatic dislocation of a hip. Half of these were between 12 and 15 years of age, and there was a predominance of boys in the ratio of 7:1. A survey of these children supports the view that the hip joint of a child becomes dislocated more readily than that of an adult.

Adolescent↗