Science.gov

Sample records for hip joint diseases

  1. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  2. Hip joint replacement - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: the ...

  3. Hip joint injection

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007633.htm Hip joint injection To use the sharing features on this ... injection is a shot of medicine into the hip joint. The medicine helps relieve pain and inflammation. It ...

  4. Hip joint replacement

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002975.htm Hip joint replacement To use the sharing features on this page, please enable JavaScript. Hip joint replacement is surgery to replace all or part ...

  5. Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in dogs.

    PubMed

    Smith, G K; Popovitch, C A; Gregor, T P; Shofer, F S

    1995-03-01

    Passive coxofemoral joint laxity of dogs, as quantitated by a distraction-stress radiographic method, may have important prognostic value in determining susceptibility to hip dysplasia. Data from 151 dogs, representing 13 breeds, were included in a logistic regression model to evaluate the contribution of factors such as age, breed, weight, sex, distraction index, and Norberg angle to the risk of developing degenerative joint disease (DJD) of the coxofemoral joint. Of the factors studied, the amount of passive hip laxity, as quantitated by the distraction index, was the most significant (P < 0.0001) determinant of the risk to develop DJD of the coxofemoral joint. In the longitudinal and cross-sectional components of the study, distraction index was a significant (P < 0.001) risk factor for DJD, irrespective of age at evaluation (4, 12, or 24 months). The strength of the hip laxity:DJD correlation increased with the age of dog. In contrast, the Norberg angle, a measure of hip laxity on the standard hip-extended radiograph, was not found to be a significant risk factor for DJD, either in the longitudinal or cross-sectional analyses. Breed-specific probability curves of DJD susceptibility indicated that German Shepherd Dogs had a significantly (P < 0.05) greater risk of developing DJD than did the pool of non-German Shepherd Dogs. The information derived from this statistical model will help to scientifically characterize the role of passive hip laxity as a component in the pathogenesis of DJD of the coxofemoral joint. PMID:7744684

  6. Hip joint replacement

    MedlinePlus

    Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthopolasty: Evidence-based guideline and evidence report. American Association of Orthopaedic Surgeons. 2011. Harkess JW, Crockarell JR. Arthroplasty of ...

  7. Radiographic changes in the hip joint in children suffering from Perthes disease.

    PubMed

    Froberg, Lonnie; Christensen, Finn; Pedersen, Niels Wisbech; Overgaard, Søren

    2012-05-01

    The purpose was to compare radiographic parameters with a sex-matched and age-matched control group at the onset of disease and at skeletal maturity. The study comprised 143 patients with Legg-Calvé-Perthes disease, treated using a Thomas splint. Wiberg's centre-edge angle and the acetabular index angle were applied. The age at diagnosis was 6.6 years with no difference between boys and girls. At the time of diagnosis, the centre-edge angle was decreased from 18° in the control group to 10° in the affected hip. The age at follow-up was 16 (SD 2) years for the boys and 15 (SD 3) years for the girls. At the time of skeletal maturity, the centre-edge angle was decreased and the acetabular index angle increased in the affected hip and the nonaffected hip in Stulberg class III/IV/V hips compared with the control group. Initially radiographic changes only occur on the affected hip. At skeletal maturity both hips show radiographic changes. PMID:22186707

  8. High Spatial Resolution MRI of Cystic Adventitial Disease of the Iliofemoral Vein Communicating with the Hip Joint

    SciTech Connect

    Michaelides, Michael; Pantziara, Maria Ioannidis, Kleanthis

    2013-05-14

    Venous cystic adventitial disease (CAD) is an extremely rare entity, and so far less than 20 cases have been described in the literature. Herein, we describe the imaging findings of CAD of iliofemoral vein in a 51-year-old woman who presented with leg swelling with special emphasis on high spatial resolution MRI, which demonstrated communication of the cyst with the hip joint. To our knowledge, this is the first description of high spatial resolution MRI findings in venous CAD supporting a new theory about the pathogenesis of venous CAD.

  9. [An assistant artificial hip joint].

    PubMed

    Shi, Zhen-man; Chen, Jian-chang; Shi, Jiang; Chen, Wenhong; Zhang, Chunhao

    2002-01-01

    The assistant artificial hip joint (AAHJ) is a new impermanent hip support implanted in the body. It is used for treatment of ischemic necrosis of the femoral head at the early stage. It reserves the natural femoral head, increases its containment and decreases its load, thus makes the recovery of the necrosed femoral head. The AAHJ's moving axis center is the same as that of the femoral head. Therefore, the moving range of the hip joint is very close to the normal postoperatively. The patient can walk with loading in 3 weeks after the surgical operation, and can regain his (or her) daily work and life in 2 to 3 months of the operation. The AAHJ's structure is simple and the price is cheap. PMID:16104164

  10. Mild to Moderate Hip OA: Joint Preservation or Total Hip Arthroplasty?

    PubMed

    Peters, Christopher L

    2015-07-01

    Treatment of structural hip disease such as FAI and acetabular dysplasia has increased dramatically over the past decade with the goal of preservation of the native hip joint. A number of patient and disease specific parameters including the amount of underlying hip osteoarthrosis can help predict success with joint preservation surgery. Total hip arthroplasty remains a very good option in young patients who are not ideal candidates for joint preservation surgery. Future developments will help to better identify ideal surgical candidates and improve understanding of the disease processes. PMID:25842248

  11. Biotribology of artificial hip joints

    PubMed Central

    Di Puccio, Francesca; Mattei, Lorenza

    2015-01-01

    Hip arthroplasty can be considered one of the major successes of orthopedic surgery, with more than 350000 replacements performed every year in the United States with a constantly increasing rate. The main limitations to the lifespan of these devices are due to tribological aspects, in particular the wear of mating surfaces, which implies a loss of matter and modification of surface geometry. However, wear is a complex phenomenon, also involving lubrication and friction. The present paper deals with the tribological performance of hip implants and is organized in to three main sections. Firstly, the basic elements of tribology are presented, from contact mechanics of ball-in-socket joints to ultra high molecular weight polyethylene wear laws. Some fundamental equations are also reported, with the aim of providing the reader with some simple tools for tribological investigations. In the second section, the focus moves to artificial hip joints, defining materials and geometrical properties and discussing their friction, lubrication and wear characteristics. In particular, the features of different couplings, from metal-on-plastic to metal-on-metal and ceramic-on-ceramic, are discussed as well as the role of the head radius and clearance. How friction, lubrication and wear are interconnected and most of all how they are specific for each loading and kinematic condition is highlighted. Thus, the significant differences in patients and their lifestyles account for the high dispersion of clinical data. Furthermore, such consideration has raised a new discussion on the most suitable in vitro tests for hip implants as simplified gait cycles can be too far from effective implant working conditions. In the third section, the trends of hip implants in the years from 2003 to 2012 provided by the National Joint Registry of England, Wales and Northern Ireland are summarized and commented on in a discussion. PMID:25621213

  12. Eponymous hip joint approaches.

    PubMed

    Somford, Matthijs P; Hoornenborg, Daniël; Wiegerinck, Johannes I; Bolder, Stefan B T; Schreurs, Berend W

    2016-07-01

    After the low friction arthroplasty by John Charnley was no longer confined to specialized hospitals but commonplace in the general orthopedic practice, the issue remained how to most optimally reach the hip. The names of the authors of these approaches remain in a lot of cases connected to the approach. By evaluating the original articles in which the approaches are described we ascertain the original description and technique. By various sources we obtained the (short) biography of the people whose name is connected to the approach. Our research covers the biographies of colleagues Smith-Petersen, Watson-Jones, Hardinge, Charnley, Moore and Ludloff. The eponymous approaches are shown and described after the short biography on each individual. This study shows that without the work of our colleagues we cannot proceed in our profession. An understanding and knowledge of the people who dedicated themselves to developing the orthopedic surgery to the high standard it has today is the least honour we should give them. PMID:27139185

  13. Life Estimation of Hip Joint Prosthesis

    NASA Astrophysics Data System (ADS)

    Desai, C.; Hirani, H.; Chawla, A.

    2014-11-01

    Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

  14. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  15. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  16. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  17. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  18. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  19. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  20. Hip joint replacement - series (image)

    MedlinePlus

    ... hip socket. The socket is usually made of metal. A liner that fits inside the socket. It ... usually plastic, but some surgeons use ceramic and metal. The liner allows the hip to move smoothly. ...

  1. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  2. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  3. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  4. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  5. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  6. Anterior Hip Joint Force Increases with Hip Extension, Decreased Gluteal Force, or Decreased Iliopsoas Force

    PubMed Central

    Lewis, Cara L.; Sahrmann, Shirley A.; Moran, Daniel W.

    2008-01-01

    Abnormal or excessive force on the anterior hip joint may cause anterior hip pain, subtle hip instability and a tear of the acetabular labrum. We propose that both the pattern of muscle force and hip joint position can affect the magnitude of anterior joint force and thus possibly lead to excessive force and injury. The purpose of this study was to determine the effect of hip joint position and of weakness of the gluteal and iliopsoas muscles on anterior hip joint force. We used a musculoskeletal model to estimate hip joint forces during simulated prone hip extension and supine hip flexion under 4 different muscle force conditions and across a range of hip extension and flexion positions. Weakness of specified muscles was simulated by decreasing the modeled maximum force value for the gluteal muscles during hip extension and the iliopsoas muscle during hip flexion. We found that decreased force contribution from the gluteal muscles during hip extension and the iliopsoas muscle during hip flexion resulted in an increase in the anterior hip joint force. The anterior hip joint force was greater when the hip was in extension than when the hip was in flexion. Further studies are warranted to determine if increased utilization of the gluteal muscles during hip extension and of the iliopsoas muscle during hip flexion, and avoidance of hip extension beyond neutral would be beneficial for people with anterior hip pain, subtle hip instability, or an anterior acetabular labral tear. PMID:17707385

  7. Effect of Hip Angle on Anterior Hip Joint Force during Gait

    PubMed Central

    Lewis, Cara L.; Sahrmann, Shirley A.; Moran, Daniel W.

    2010-01-01

    Anterior hip or groin pain is a common complaint for which people are referred for physical therapy. We have observed that people with anterior hip pain often walk in greater hip extension than people without anterior hip pain, and that the pain is reduced when they walk in less hip extension. Therefore, we investigated anterior hip joint forces which may contribute to anterior hip pain and examined the effect of end range hip extension on the anterior hip joint force during gait. To do this, we used a 6 degree of freedom, 3-dimensional musculoskeletal model to estimate hip joint forces during gait. Within subjects, the maximum anterior hip joint force for gait trials with the most hip extension was compared to the anterior hip joint force for gait trials with the least hip extension. The musculoskeletal model indicated that increasing the maximum end range hip extension when walking results in an increase in the anterior hip joint force when compared to walking in less hip extension. Walking in greater hip extension may result in an increase in the anterior hip joint force, and thereby contribute to anterior hip pain. The findings of this study provide some evidence supporting the use of gait modification to reduce anterior hip force when treating people with anterior hip pain. PMID:20934338

  8. Atraumatic Anterior Dislocation of the Hip Joint

    PubMed Central

    Ohtsuru, Tadahiko; Morita, Yasuyuki; Murata, Yasuaki; Itou, Junya; Morita, Yuji; Munakata, Yutaro; Kato, Yoshiharu

    2015-01-01

    Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case. PMID:26819791

  9. Imaging the hip joint in osteoarthritis: A place for ultrasound?

    PubMed

    Sudula, S N

    2016-05-01

    Osteoarthritis has traditionally been imaged with conventional radiographs; this has been regarded as the reference technique in osteoarthritis for a long time. However, in recent years, innovative imaging techniques such as ultrasonography have been used to obtain a better understanding of this disease. This is mainly due to tremendous technical advances and progressive developments of ultrasound equipment occurring over the past decade. Ultrasonography has been demonstrated to be a valuable imaging technique in the diagnosis and management of osteoarthritis of the hip joint. Application of this imaging methodology for osteoarthritis has improved the understanding of the disease process and may aid in the assessment of the efficacy of future therapies. The execution of ultrasound-guided procedures with safety and reliability has a relevant significance in patient management of osteoarthritis of the hip joint. This paper reviews the use of ultrasound as an imaging technique for the evaluation and treatment of osteoarthritis hip joint. PMID:27482280

  10. Coxofemoral joint laxity from distraction radiography and its contemporaneous and prospective correlation with laxity, subjective score, and evidence of degenerative joint disease from conventional hip-extended radiography in dogs.

    PubMed

    Smith, G K; Gregor, T P; Rhodes, W H; Biery, D N

    1993-07-01

    A 3-year prospective study of large-breed dogs (4 months to 3 years of age) was conducted to evaluate the influence of radiographic positioning and age on coxofemoral joint (hip) laxity, subjective hip score, and development of degenerative joint disease (DJD). The dogs (n = 142) were breeder- or client-owned and represented 14 breeds. With dogs under heavy sedation, hips were radiographed in the standard hip-extended position and in the new compression/distraction position at 4, 6, 12, 24, and 36 months of age. The standard hip-extended radiographic view was evaluated by 3 methods: subjective evaluation by a board-certified veterinary radiologist (WHR), according to the standard 7-point Orthopedic Foundation for Animals (OFA) scoring scheme (OFA/WHR); joint laxity quantitation, using the Norberg angle (NA) method; and subjective scoring by a veterinary orthopedic surgeon for radiographic evidence of DJD. The hips in the distraction radiographic view were evaluated for passive hip laxity, as measured by use of a unitless distraction index (DI). Results of the study indicated that at a specific age (4, 6, 12, 24, or 36 months), all methods of hip evaluation correlated with each other at a moderate level (P < 0.05). The strength of contemporaneous correlation tended to increase with age of evaluation. Longitudinally, the between-method correlations were usually significant (P < 0.05), but not at a sufficiently high level to permit reliable between-method prediction. Prospective intraclass (within-method) statistical analysis of the various hip-scoring methods indicated that DI was superior to NA and OFA/WHR in comparability of score over time. The intraclass correlation coefficient ranged from 0.55 to 0.91 for DI in contrast to 0.40 to 0.78 for NA, and 0.06 to 0.39 for OFA/WHR over the age intervals of the study. For reference, the highest Kappa of 0.39 for the subjective OFA/WHR scoring reflected a maximal level of agreement between time intervals, only slightly

  11. The hip joint as a conchoid shape.

    PubMed

    Menschik, F

    1997-09-01

    The hip joint is not an exact ball and socket joint. In a meridian section, the mean deviation from a conchoid shape is quite small, so that this shape might better describe the joint's shape. This conclusion was reached by measuring the cartilaginous and osseous shapes of eight normal hip joints (multiorgan donors with average of age 33 yr, range 19-46 yr) using a CNC coordinate measuring machine (CMM). On two additional hip joints, only the osseous shape was determined. A rotational axis was first determined by finding parallels of latitude at the femoral head and acetabulum. At the meridian sections, the best-fitting circle or conchoid was determined from the scanned measuring points, using least-squares regression. Two perpendicular meridians were then measured for each sample and used to evaluate the three-dimensional shape. The medium squared deviation showed a better fit for a conchoid shape compared to a sphere for all samples tested. Furthermore, the equation of the conchoid for the femoral head (r = a + b cos phi) and that for the acetabulum (r' = a' + b' cos phi) were related in that a = b' and b = a' within mean deviation factors of 4%. Their special shape makes the joint less likely to sublux compared to a ball and socket joint. In addition, the rolling and gliding mechanisms between the two shapes may result in less wear. PMID:9302622

  12. Celiac Disease in Women with Hip Fractures

    PubMed Central

    LeBoff, Meryl S.; Cobb, Haley; Gao, Lisa Y.; Hawkes, William; Yu-Yahiro, Janet; Kolatkar, Nikheel S.; Magaziner, Jay

    2014-01-01

    Objective Celiac disease is associated with decreased bone density, however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels. Methods Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and the control group (n=51), all of whom were from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone. Results Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.61%, respectively). Conclusion Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not prove useful, although larger prospective studies among hip fracture subjects are needed. PMID:23732553

  13. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  14. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  15. Magnetic resonance imaging of hip joint cartilage and labrum

    PubMed Central

    Zilkens, Christoph; Miese, Falk; Jäger, Marcus; Bittersohl, Bernd; Krauspe, Rüdiger

    2011-01-01

    Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage. PMID:22053256

  16. [An endoapparatus for restoration of hip joint].

    PubMed

    Lapinskaia, V S; Gatiatulin, R R; Trubnikov, V I; Velichko, M V; Froliakin, T V; Kovalenko, A E; Froliakina, L A

    2008-01-01

    The possibility of prolonging the anatomic and functional longevity of joints in young patients with coxarthrosis deformans under conditions of long-term unloading using a submersible distraction device is considered. A submersible endoapparatus for restoration of hip joint is described. Its functional capabilities as an unloading device were corroborated by experimental testing. Clinical examples illustrated with X-ray photographs demonstrate the possibility of long-term unloading of the injured joint and postponement of endoprosthesis replacement in young patients by 20-25 years. It is suggested to use the developed method for organ-sparing surgery in young working-age patients. PMID:18688939

  17. Cystic lesion around the hip joint.

    PubMed

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-Ichi

    2015-10-18

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  18. Cystic lesion around the hip joint

    PubMed Central

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

    2015-01-01

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  19. Articular capsule repair in initial artificial hip replacement via anterolateral approach to the hip joint.

    PubMed

    Zhang, B L; Wang, F; Tian, M B; Yin, W L; You, X Y; Li, D; Ma, L G; Xing, L Q

    2016-01-01

    This study was carried out to explore articular capsule repair in first artificial hip replacement (AHR) via anterolateral approach and its influence on postoperative dislocation. A total of 292 patients who received AHR via anterolateral approach and had the articular capsule repaired in People’s Hospital of Zhengzhou (Henan, China) from February 2008 to February 2014 were selected and divided into total hip replacement (THR) group (group A1) and artificial femoral head replacement (AFHR) group (group A2). Five hundred and five cases in the control group treated using the same approach but receiving no articular capsule repair were divided into THR group (group B1) and AFHR group (group B2). Condition of postoperative dislocation was compared between the two groups. All cases were followed up for 6 months to 5 years (average: 3.75 years); it was noted that the difference in average age, gender, disease constitution and follow-up time in the two groups was not significant (P>0.05). Moreover, groups A1 and B1 were found with 1 case of early hip joint dislocation (0.73%) and 13 cases of hip joint dislocation (5.24%) respectively post-operatively, and the comparison between the two groups was statistically significant (P less than 0.05). One case of hip joint dislocation (0.65%) was found in group A2 and 5 cases (1.95%) in group B2 in early post operation and the difference between two groups had no statistical significance (P>0.05). Neither the repair group nor the control group developed late-onset dislocation after the operation. Thus, we can state that articular capsule repair is feasible during the first AHR via anterolateral approach, which decreases the occurrence of early hip joint dislocation after operation and proves that repairing articular capsule during AFHR via anterolateral approach is unnecessary. PMID:27358130

  20. Management of Periprosthetic Hip Joint Infection

    PubMed Central

    Lee, Hee Dong; Prashant, Kumar

    2015-01-01

    Total hip joint replacement offers dramatic improvement in the quality of life but periprosthetic joint infection (PJI) is the most devastating complication of this procedure. The infection threatens the function of the joint, the preservation of the limb, and occasionally even the life of the patient due to long term hospitalization and high cost. For the surgeon it is a disastrous burden, which requires repeated, complicated procedures to eradicate infection and to provide a mobile joint without pain. Yet in the absence of a true gold standard, the diagnosis of PJI can be elusive. Synovial fluid aspiration, diagnostic imaging, traditional culture, peripheral serum inflammatory markers, and intraoperative frozen sections each have their limitations but continue to be the mainstay for diagnosis of PJI. Treatment options mainly include thorough irrigation and debridement with prosthesis retention, or a two-stage prosthesis exchange with intervening placement of an antibiotic-loaded spacer. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic PJI. Debridement, antibiotics and implant retention is the obvious choice for treatment of acute PJI, with good success rates in selected patients. This article presents an overview of recent management concepts for PJI of the hip emphasizing diagnosis and the clinical approach, and also share own experience at our institution.

  1. Development of gait performance and dynamic hip and knee joint loading after containment improving surgery in patients with Legg-Calvé-Perthes disease.

    PubMed

    Stief, Felix; Schmidt, André; Adolf, Stefanie; Kremer, Laura; Brkic, Moamer; Meurer, Andrea

    2016-06-01

    Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study. Instrumented gait analysis was performed preoperatively, 13.4 (±1.7), and 28.0 (±4.4) months postoperatively. At final follow-up, the mean leg length of the involved side was reduced by 1.10 (±0.53)cm compared to the non-involved side. In addition, a significant reduction in maximum knee flexion (-26%, p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still present in the patient group compared to controls indicating a "stiff knee gait pattern". In contrast, the sagittal plane hip parameters, the ipsilateral trunk lean toward the involved stance limb, and the knee and hip joint loading during gait normalized during the postoperative period. The results of the present study should motivate further exploration if patients with LCPD stiffen their knees to compensate for leg length discrepancy. Besides the standard radiological evaluation of the surgery outcome, instrumented gait analysis is a valuable method of recording functional deficits and early recognition of the need for physiotherapeutic treatment or insole supply in patients with LCPD. PMID:27264403

  2. Clinical and genetic assessments of hip joint laxity in the Boykin spaniel

    PubMed Central

    Tsai, Kate L.

    2006-01-01

    Abstract Canine hip dysplasia (CHD) is characterized by a malformation of the hip joint that leads to joint laxity and consequential degenerative joint disease. The most widely used method for diagnosis of CHD is the ventrodorsal hip-extended radiologic view, commonly referred to as the Orthopedic Foundation for Animals (OFA) method. The method of the University of Pennsylvania Hip Improvement Program (PennHIP), an alternative technique that is based on hip joint laxity, provides a quantitative assessment, the distraction index (DI), of the likelihood of the development of CHD because of increased laxity in the hip joint. Linear regression analysis showed that, across many breeds of dog, the incidence of CHD, as defined by the OFA, is positively correlated with the mean DI, the determination coefficient (r2) being 26%. We used families of Boykin spaniels (BSs) to determine the level of joint laxity in the breed and to conduct an initial whole-genome screening to identify markers that co-segregate with increased joint laxity. Although there was a positive correlation between the incidence of hip dysplasia and increased joint laxity, we did not find significant linkage in the 28 BSs that underwent genotyping, likely owing to the small size of the pedigree. PMID:16639948

  3. Modes of lubrication in human hip joints.

    PubMed Central

    Roberts, B J; Unsworth, A; Mian, N

    1982-01-01

    Cadaveric hip joints were tested in a hip function simulator which subjected the femoral head to a cycle of loading and oscillation similar to that experienced during walking and measured the frictional torque transmitted to the acetabulum. Silicone fluids with viscosities from 10-2 Pa s (pascal second) to 30 Pa s were used as lubricants and the transition from mixed to full fluid film lubrication was observed around 5 x 10(-2) Pa s. Sodium carboxymethylcellulose solutions were also tested at the lower viscosities. Hyaluronidase digestion of samples of synovial fluid caused a significant increase in friction over the control samples. Trypsin digestion had no significant effect. No correlation between compliance of the cartilage and the frictional values was observed. PMID:7092334

  4. The innervation of canine hip joint capsule: an anatomic study.

    PubMed

    Huang, C H; Hou, S M; Yeh, L S

    2013-12-01

    To clarify the contributions of the nerves supplying the canine hip joint capsule for clinical application, cadaver study of six healthy mongrel dogs was performed. The pelvises and hindlimbs of cadavers were dissected and fixed in formaldehyde. Innervation of the joint capsule was investigated with the aid of an operative microscope. As a result, the canine hip joint capsule receives multiple innervations from articular branches of four nerves. They are articular nerve fibres of femoral, obturator, cranial gluteal and sciatic nerves from the cranioventral, caudoventral, craniolateral and dorsolateral directions of the joint, respectively. No branch originating from the caudal gluteal nerve was observed innervating the hip joint capsule. Our data provides useful information for research on the canine hip joint, including pain analysis with hip disorders and surgical nerve blockade to relieve pain. PMID:23410229

  5. The evolution and concepts of joint-preserving surgery of the hip.

    PubMed

    Leunig, M; Ganz, R

    2014-01-01

    The use of joint-preserving surgery of the hip has been largely abandoned since the introduction of total hip replacement. However, with the modification of such techniques as pelvic osteotomy, and the introduction of intracapsular procedures such as surgical hip dislocation and arthroscopy, previously unexpected options for the surgical treatment of sequelae of childhood conditions, including developmental dysplasia of the hip, slipped upper femoral epiphysis and Perthes' disease, have become available. Moreover, femoroacetabular impingement has been identified as a significant aetiological factor in the development of osteoarthritis in many hips previously considered to suffer from primary osteoarthritis. As mechanical causes of degenerative joint disease are now recognised earlier in the disease process, these techniques may be used to decelerate or even prevent progression to osteoarthritis. We review the recent development of these concepts and the associated surgical techniques. PMID:24395304

  6. Radiographic identification of loose bodies in the traumatized hip joint

    SciTech Connect

    Baird, R.A.; Schobert, W.E.; Pais, M.J.; Ahmed, M.; Wilson, W.J.; Farjalla, G.L.; Imray, T.J.

    1982-12-01

    Acrylic spacers and cubes of cortical bone of known dimensions were placed in predetermined locations in cadaver hip joints, which were then studied with plain radiography and linear, hypocycloidal, and computed tomography (CT). Joint space widening was not measurable on plain radiographs of the pelvis when 2-mm spacers were placed anywhere within the hip joint. When 4-mm spacers were used, widening measured 2 mm in the axis of measurement corresponding to the location of the spacer. Linear tomography did not permit identification of the 2-mm cubes; however, hypocycloidal tomography and CT consistently showed them anywhere within the hip joint. Radiation dose and clinical recommendations are discussed.

  7. Differential diagnosis of pain around the hip joint.

    PubMed

    Tibor, Lisa M; Sekiya, Jon K

    2008-12-01

    The differential diagnosis of hip pain is broad and includes intra-articular pathology, extra-articular pathology, and mimickers, including the joints of the pelvic ring. With the current advancements in hip arthroscopy, more patients are being evaluated for hip pain. In recent years, our understanding of the functional anatomy around the hip has improved. In addition, because of advancements in magnetic resonance imaging, the diagnosis of soft tissue causes of hip pain has improved. All of these advances have broadened the differential diagnosis of pain around the hip joint and improved the treatment of these problems. In this review, we discuss the causes of intra-articular hip pain that can be addressed arthroscopically: labral tears, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres, and chondral damage. Extra-articular diagnoses that can be managed arthroscopically are also discussed, including: iliopsoas tendonitis, "internal" snapping hip, "external" snapping hip, iliotibial band and greater trochanteric bursitis, and gluteal tendon injury. Finally, we discuss extra-articular causes of hip pain that are often managed nonoperatively or in an open fashion: femoral neck stress fracture, adductor strain, piriformis syndrome, sacroiliac joint pain, athletic pubalgia, "sports hernia," "Gilmore's groin," and osteitis pubis. PMID:19038713

  8. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of...

  9. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  10. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of...

  11. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  12. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  13. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of...

  14. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of...

  15. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of...

  16. Influence of Different Hip Joint Centre Locations on Hip and Knee Joint Kinetics and Kinematics During the Squat

    PubMed Central

    Sinclair, Jonathan; Atkins, Stephen; Vincent, Hayley

    2014-01-01

    Identification of the hip joint centre (HJC) is important in the biomechanical examination of human movement. However, there is yet to be any published information regarding the influence of different HJC locations on hip and knee joint kinetics during functional tasks. This study aimed to examine the influence of four different HJC techniques on 3-D hip and knee joint kinetics/kinematics during the squat. Hip and knee joint kinetics/kinematics of the squat were obtained from fifteen male participants using an eight camera motion capture system. The 3-D kinetics/kinematics of the squat were quantified using four hip joint centre estimation techniques. Repeated measures ANOVAs were used to compare the discrete parameters as a function of each HJC location. The results show that significant differences in joint angles and moment parameters were evident at both the hip and knee joint in the coronal and transverse planes. These observations indicate that when calculating non-sagittal joint kinetics/kinematics during the squat, researchers should carefully consider their HJC method as it may significantly affect the interpretation of their data. PMID:25713661

  17. Radiographic Hip Joint Phenotype of the Pembroke Welsh Corgi

    PubMed Central

    Karbe, Georga T.; Biery, Darryl N.; Gregor, Thomas P.; Giger, Urs; Smith, Gail K.

    2013-01-01

    Objective To investigate the radiographic hip joint phenotype of the Pembroke Welsh Corgi. Study Design Prospective and retrospective cross-sectional study. Animals Pembroke Welsh Corgis (n = 399). Methods Ventrodorsal, hip-extended radiographs were evaluated for subluxation, osteoarthritis (OA), caudolateral curvilinear osteophytes (CCO), and circumferential femoral head osteophytes (CFHO) of PennHIP evaluated Corgis. Joint laxity was measured by distraction index (DI). Results All Corgis had DI > 0.30 (mean, 0.66), 6.8% had OA, 18% had subluxation, 22.3% had CCO, and 74.4% had CFHO. Higher DI increased the odds for subluxation and canine hip dysplasia (CHD) but not for OA, CCO, or CFHO. The presence of CCO increased the odds for OA by 4.6 times (P = .002) and 2.2 times (P = .01) for hip dysplasia. All dogs with OA had CFHO. The presence of CFHO increased the odds for subluxation by 8.7 times (p < .001) and 8.9 times (P < .001) for hip dysplasia. Subluxation increased the odds for OA by 15.4 times (P < .001). Conclusion Corgis had a low frequency of conventional OA despite having hip laxity that has been shown to correlate with hip OA and hip dysplasia in large-breed dogs. The relationship between CCO and OA was similar to published findings in nonchondrodystrophic large-breed dogs and the CFHO was significantly associated with subluxation. Both CCO and CFHO are associated with hip dysplasia in this small chondrodystrophic breed. PMID:23253037

  18. Kinematic radiography of the hip joint after hip resurfacing arthroplasty.

    PubMed

    Kawashima, Hiroki; Kajino, Yoshitomo; Kabata, Tamon; Tsuchiya, Hiroyuki; Sanada, Shigeru; Ichikawa, Katsuhiro

    2016-07-01

    This study aimed to evaluate the usefulness of dynamic radiography using a dynamic flat-panel detector (FPD) system after hip resurfacing arthroplasty (HRA). A total of 32 hips of 26 patients who underwent HRA were included. Sequential images of active abduction in the supine position and flexion in the 45° semilateral position were obtained using the FPD system. We examined the imaging findings of impingement between the acetabular component and femoral neck with cooperative motion at maximal exercise. Moreover, the central component coordinate of the acetabulum and femoral head sides was measured. For abduction motion, impingement was detected in two (6.3 %) hips between the superior portion of the femoral neck and acetabular component. For flexion motion, impingement was detected in 19 (59.4 %) hips. There were no findings of subluxation between the acetabular component and femoral neck after impingement, but cooperative motion of lumbar and pelvic flexion was observed. There was no significant difference in the center-to-center distance regardless of the presence or absence of impingement. Detailed postoperative kinematics of the hips after HRA showed that the proposed dynamic FPD system could reveal acquired impingement and cooperative motion as dynamic images and possibly reveal findings that would be unobservable using static images. PMID:27207072

  19. Ultrasonographic Features of Hip Joints in Mucopolysaccharidoses Type I and II

    PubMed Central

    Żuber, Zbigniew; Jurecka, Agnieszka; Różdżyńska-Świątkowska, Agnieszka; Migas-Majoch, Agata; Lembas, Agnieszka; Kieć-Wilk, Beata; Tylki-Szymańska, Anna

    2015-01-01

    Objectives The primary aim of this study was to assess the ultrasonographic features of hip joints in patients with mucopolysaccharidosis (MPS) type I and II in comparison with healthy population. The secondary aims were to correlate these features with clinical measures and to evaluate the utility of ultrasound in the diagnosis of MPS disease. Materials and Methods Sixteen MPS I (n = 3) and II (n = 13) patients were enrolled in the present study and underwent clinical and radiological evaluation, and bilateral high-resolution ultrasonography (US) of hip joints. The distance from the femoral neck to joint capsule (synovial joint space, SJS), joint effusion, synovial hyperthrophy, and local pathological vascularization were evaluated. The results were compared to the healthy population and correlated with clinical and radiological measures. Results 1. There was a difference in US SJS between children with MPS disease and the normative value for healthy population (7mm). Mean values of SJS were 15.81 ± 4.08 cm (right hip joints) and 15.69 ± 4.19 cm (left joints). 2. No inflammatory joint abnormalities were detected in MPS patients. 3. There was a clear correlation between US SJS and patients’ age and height, while no clear correlation was observed between SJS and disease severity. Conclusions 1. Patients with MPS I and II present specific features in hip joint ultrasonography. 2. The data suggests that ultrasonography might be effective in the evaluation of hip joint involvement in patients with MPS and might present a valuable tool in facilitating the diagnosis and follow up of the disease. PMID:25922936

  20. [Old age and joint disease].

    PubMed

    d'Harcourt, G; Meignan-Debray, S; Mémin, Y

    1987-01-01

    The seriousness of articular diseases in old persons is related to the loss of function and the rapid way this can lead to them being bed ridden. Rheumatoid polyarthritis is often difficult to distinguish from rhizomelic pseudopolyarthritis, these two diseases resemble each other at this age with the asthenia and loss of general health, the inflammatory pains which are peripheral and of nerve root origin. Among the metabolic arthropathies, articular chondrocalcinosis is frequent, and often latent, but sometimes it is destructive in particular in the hips and knees; septic arthritis today mainly occurs in the elderly, and the algoneurodystrophies are more frequent in old persons than in young subjects, following trauma or a hemiplegia. Arthrosis is obviously the main articular disease of senescence especially involving the joints of the lower limb, hip disease being less incapacitating than knee disease where surgical treatment is less often considered. The arthroses of the upper limbs especially of the shoulder are well tolerated. Osteochondromatosis, osteonecrosis of the internal condyle of the knee, the rapidly destructive arthropathies and hemarthrosis can develop as a complication of a simple arthrosis. In the spine vertebral hyperostosis is especially a disease of the elderly, it can occur alone or with an arthrosis of the posterior vertebral joints, a narrow spinal canal straight or narrowed. Medical treatment, physiotherapy, and finally surgery can give very satisfactory results in an old patient, avoiding loss of function, a miserable existence and becoming bed ridden. PMID:3496925

  1. Patient-adapted treatment for prosthetic hip joint infection.

    PubMed

    Baker, Richard P; Furustrand Tafin, Ulrika; Borens, Olivier

    2015-01-01

    Hip joint replacement is 1 of the most successful surgical procedures of the last century and the number of replacements implanted is steadily growing. An infected hip arthroplasty is a disaster, it leads to patient suffering, surgeon's frustration and significant costs to the health system. The treatment of an infected hip replacement is challenging, healing rates can be low, functional results poor with decreased patient satisfaction. However, if a patient-adapted treatment of infected hip joints is used a success rate of above 90% can be obtained.Patient-adapted treatment is based on 5 important concepts: teamwork; understanding the biofilm; diagnostic accuracy; correct definition and classification of PJI; and patient-tailored treatment.This review presents a patient-adapted treatment strategy to prosthetic hip infection. It incorporates the best aspects of the single and staged surgical strategies and promotes the short interval philosophy for the 2-stage approach. PMID:26044528

  2. [Squatting cast for biomechanical treatment of decentred hip joints].

    PubMed

    Mühlbacher, E; Lick-Schiffer, W; Lojpur, M; Baumgartner, F; Spieß, T; Tschauner, C

    2014-12-01

    The so-called "congenital" luxation of the hip joint is endemic in Central Europe and occurs in about 1% of all newborn infants. By the means of ultrasonographic diagnosis according to the Graf method an early detection instantly after birth has become a good clinical routine in the German-speaking countries. Sonography-based conservative treatment has become the gold standard. The cast in squatting ("human") position is a standard procedure in order to retain the originally decentred or unstable hip joints in the reduced position: 100° flexion and 50° abduction are necessary to fix the hip joint in the reduced position without the risk of avascular necrosis. After the fixation in a squatting-cast, a period of functional bracing in flexed position enhances bony maturation. This two-phase functional conservative treatment can avoid later osteotomies or even early total hip replacement. PMID:25531512

  3. Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement.

    PubMed

    Foucher, Kharma C; Hurwitz, Debra E; Wimmer, Markus A

    2009-12-01

    Implant loosening is a common indication for total hip replacement (THR) revision. High contact forces and implant twisting moments are thought to be associated with implant loosening. Relationships between joint positioning and hip forces, or outcomes, have been investigated through in vivo and in vitro modalities. Relationships between hip forces and gait are less understood, despite repeated findings that gait following a THR does not fully return to normal. We tested the hypothesis that gait parameters would be better predictors of implant force (peak contact forces and peak twisting moment during walking) than joint positioning parameters. Subjects underwent gait analysis, hip force modeling, and measurement of clinical radiographs 1 year after successful THR surgery. Gait parameters were consistently more influential in determining hip forces. Alone, gait explained as much as 67% of the variation in force, compared to a maximum of 33% by joint geometry. Combinations of gait and joint positioning parameters together explained up to 86% of the variation in hip force parameters. Results suggest that gait may provide a valuable postoperatively modifiable target to improve hip loads and potentially reduce the risk for implant loosening. PMID:19514072

  4. [Hip arthroscopy].

    PubMed

    Gollwitzer, H; Banke, I J; Schauwecker, J

    2016-02-01

    Hip arthroscopy represents an important component in the treatment of diseases of the hip joint and is nowadays an indispensible tool in modern hip-preserving surgery. This article provides a review of the basic technical principles, typical indications and complications of hip arthroscopy. Furthermore, current developments as well as possibilities and limitations of the arthroscopic technique are reviewed. PMID:26781702

  5. Ankle and hip postural strategies defined by joint torques.

    PubMed

    Runge, C F; Shupert, C L; Horak, F B; Zajac, F E

    1999-10-01

    Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control

  6. Ankle and hip postural strategies defined by joint torques

    NASA Technical Reports Server (NTRS)

    Runge, C. F.; Shupert, C. L.; Horak, F. B.; Zajac, F. E.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control

  7. Effect of increased pushoff during gait on hip joint forces.

    PubMed

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to "push more with your foot when you walk". We collected motion data of markers placed on the subjects' trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to "push more with your foot when you walk" reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  8. Effect of increased pushoff during gait on hip joint forces

    PubMed Central

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to “push more with your foot when you walk”. We collected motion data of markers placed on the subjects’ trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual 3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to “push more with your foot when you walk” reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces was 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  9. Taking care of your new hip joint

    MedlinePlus

    ... Cabrera AL. Total hip replacement. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine ... Groomes TE. Total knee replacement. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine ...

  10. Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints.

    PubMed

    Umer, Masood; Rashid, Haroon; Umer, Hafiz Muhammad; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  11. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    PubMed Central

    Umer, Masood; Rashid, Haroon; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  12. Loads in the hip joint during physically demanding occupational tasks: A motion analysis study.

    PubMed

    Varady, Patrick Aljoscha; Glitsch, Ulrich; Augat, Peter

    2015-09-18

    Epidemiologic studies of osteoarthritis of the hip indicate a possible connection between work related activities and the pathogenesis of the disease. This study investigated the hip joint contact forces for physically demanding occupational tasks (lifting, carrying, transferring of a weight (mass: 25 kg, 40 kg and 50 kg); stair climbing without and with additional load of 25 kg; ladder climbing) and compared these with everyday activities (level gait, sitting down and getting up). The hip joint contact force was calculated with the human multibody simulation software AnyBody employing motion capture and ground reaction force measurements by force plates and an instrumented staircase and ladder. Although the results for 11 male test subjects showed individual variations, a general trend could be observed in regards of force curves' characteristics and maxima. The largest joint contact forces calculated were (637 ± 148)%-body weight for horizontal transfer of a 50 kg weight. For several of the occupational activities the computed hip joint contact forces were significantly larger compared to the investigated examples of activities of daily living. This study provides original data of simulated hip joint contact forces for physically demanding activities. PMID:26187677

  13. A patterned microtexture to reduce friction and increase longevity of prosthetic hip joints

    PubMed Central

    Chyr, Anthony; Qiu, Mingfeng; Speltz, Jared; Jacobsen, Ronald L.; Sanders, Anthony P.; Raeymaekers, Bart

    2014-01-01

    More than 285,000 total hip replacement surgeries are performed in the US each year. Most prosthetic hip joints consist of a cobalt-chromium (CoCr) femoral head that articulates with a polyethylene acetabular component, lubricated with synovial fluid. The statistical survivorship of these metal-on-polyethylene prosthetic hip joints declines significantly after 10 to 15 years of use, primarily as a result of polyethylene wear and wear debris incited disease. The current engineering paradigm to increase the longevity of prosthetic hip joints is to improve the mechanical properties of the polyethylene component, and to manufacture ultra-smooth articulating surfaces. In contrast, we show that adding a patterned microtexture to the ultra-smooth CoCr femoral head reduces friction when articulating with the polyethylene acetabular liner. The microtexture increases the load-carrying capacity and the thickness of the joint lubricant film, which reduces contact between the articulating surfaces. As a result, friction and wear is reduced. We have used a lubrication model to design the geometry of the patterned microtexture, and experimentally demonstrate reduced friction for the microtextured compared to conventional smooth surrogate prosthetic hip joints. PMID:25013240

  14. [Dynamics of hip joint biomechanics in patients with coxarthrosis at the time of hippotherapy].

    PubMed

    Nareklishvili, T M

    2008-02-01

    The problems of degenerative-dystrophic abnormalities stimulate the development of new skills and methods of treatment and rehabilitation of the diseases. The goal of the study was to determine the efficacy of hippotherapy in patients with coxarthrosis, according to functional and biomechanical parameters. Hippotherapy involves the utilization of horseback riding to stimulate the patient's normal reactions and locomotion; to improve the balance and coordination of movement, normalize muscle tension, and eliminate pathological reflexes. The advantage of the hippotherapy is in the specific posture, which is adopted by hip joint at the time of riding and in movement, which is accomplished by rider, at different paces of the horse. 10 female patients from 14 to 32 years old with coxarthrosis were under the observation. The rehabilitation of the patients was carried out by means of hippotherapy, which consisted of three months riding three times a week. To evaluate the efficacy of treatment, a new method of biomechanical registration of hip joint movement during hippotherapy on pacing horse was developed. The dynamics of biomechanical curves before and after the treatment, as well as the clinical and functional parameters of the patients allowed the authors to conclude: hippotherapy improves a hip joint functional state in patients with coxarthrosis; improves the muscle-tendineous component of hip joint movement. Hippotherapy may be considered as the pathogenetic method of treatment of coxarthrosis. Drawing the biomechanical curve of hip joint movement at the time of riding is the objective method of studying its function. PMID:18401052

  15. Characterisation of alumina hip-joint wear by FIB Microscopy

    NASA Astrophysics Data System (ADS)

    Zeng, Peng; Inkson, Beverley J.; Rainforth, W. Mark

    2006-02-01

    The wear of hip-joints is a significant clinical problem, which causes adverse tissue reactions leading to bone absorption and consequent loosening of the fixation. Artificial hip joints retrieved after use and tested on simulators typically exhibit a 'stripe' wear area on the surface of the alumina bearing components. Focused Ion Beam (FIB) microscopy has been used to investigate the sub-surface damage mechanisms in worn alumina hip-joints for the first time. The alumina acetabular cup, both inside and outside the 'stripe' wear trace, has been cross-sectioned by FIB milling. The sub-surface microstructures revealed by the FIB machining, outside, inside and at the edge of the 'stripe' have been imaged by SEM and FIB and are compared with the microstructure of unworn bulk material. The advantage of this technique is that it enables site specific selected areas of the worn surface to be analysed.

  16. Grading and quantification of hip osteoarthritis severity by analyzing the spectral energy distribution of radiographic hip joint space

    NASA Astrophysics Data System (ADS)

    Boniatis, I.; Costaridou, L.; Panagiotopoulos, E.; Panayiotakis, G.

    2009-08-01

    An image analysis system is proposed for the assessment of hip osteoarthritis (OA) severity. Sixty four hips (18 normal, 46 osteoarthritic), corresponding to 32 patients of unilateral or bilateral hip OA were studied. Employing custom developed software, 64 Region Of Interest (ROI) images of Hip Joint Spaces (HJSs) were delineated on patients' digitized radiographs. The Fourier spectrum of each HJS-ROI was computed and expressed in polar coordinates. Spectral signatures, quantifying the radial and angular distribution of HJS spectral energy were formed. Signature descriptors were generated and utilized in the design of a two-level hierarchical decision tree, used for the grading of the severity of the disease. Accordingly, at Level 1, implemented by a multiple classifier system, the discrimination between normal and osteoarthritic hips was performed. At Level 2, the hips that had been successfully characterized as osteoarthritic at Level 1, were further characterized as of ``Mild / Moderate'' or ``Severe'' OA, by the Bayes classifier. A signature descriptors based regression model was designed, so as to quantify OA-severity. The system graded OA reliably, given that the accomplished classification accuracies for Level 1 and Level 2 were 98.4% and 100%, respectively. OA-severity values, expressed by HJS-narrowing, correlated highly (r = 0.9, p < 0.001) with values predicted by the model. The system may contribute to OA-patient management.

  17. Technical Note on Modified Posterior Approach to the Hip Joint

    PubMed Central

    Iyer, Krishna Mohan

    2015-01-01

    Introduction: The posterior approach is the most commonly and relatively easy to be used to expose the hip joint. Posterior approaches allow excellent visualization of the entire acetabulum and the upper femoral shaft, and thus they are popular for revision joint replacement surgery particularly in cases where only the femoral component needs to be replaced. There may be a higher dislocation rate with minimal movement as compared to anterior approaches if the posterior approach is used in fractured neck of femur surgery in demented or elderly bedridden patients who often lie crouched in bed with their hips in a flexed and adducted position. The expected purpose of this modification of the Posterior Approach to the Hip Joint is to overcome the fear of dislocation and hence combine the advantages of the Posterior route with greater stability. Technique: The author’s original paper written 30 years ago (Iyer, 1981) presented an original technique devised to confer greater stability to the hip joint posteriorly to minimize the greater incidence of dislocation which has been reported extensively in literature. The technique involves an osteotomy of the posterior overhanging part of the greater trochanter to include the insertions of the short lateral rotators along with the posterior third of the gluteus medius, which can then be turned back in one piece like the page of a book to include the capsule of the hip joint. This gives wide exposure of the posterior lip of the acetabulum and is relatively bloodless in its exposure. This approach is very useful in the elderly particularly demented patients requiring a hemiarthroplasty and also in primary and revision total hip replacement. This approach has been tested in cadavers to conclude the greater stability given as compared to the routine resuture or reattachment of the short lateral rotators. Conclusion: The modified technique provides for greater stability as compared to the Southern Approach. PMID:27299026

  18. Contact pressures in the human hip joint measured in vivo.

    PubMed Central

    Hodge, W A; Fijan, R S; Carlson, K L; Burgess, R G; Harris, W H; Mann, R W

    1986-01-01

    The pressures on human articular cartilage have been measured in vivo. An instrumented femoral head prosthesis that telemeters interarticular pressure at 10 discrete locations 253 times per second was implanted in apposition to natural acetabular cartilage. Data were acquired during surgery, recovery, rehabilitation, and normal activity, for longer than 1 year after surgery. Pressure magnitudes were synchronized with body-segment kinematic data and foot-floor force measurements so as to locate transduced pressure areas on the natural acetabulum and correlate movement kinematics and dynamics with local cartilage pressures. The data reveal very high local (up to 18 MPa) and nonuniform pressures, with abrupt spatial and temporal gradients, that correlate well both in magnitude and distribution with in vitro data and computer simulations of synovial joint mechanics. Peak pressures in vivo are, however, considerably higher than pressures measured in vitro under the putative forces experienced by the joint in life, particularly in normal movements where cocontraction occurs in agonist and antagonist muscles across the hip joint. Thus, extant gait-analysis studies which apply inverse Newtonian calculations to infer joint forces establish the lower limit on such forces, since such analyses include only the net muscular torques about the joint and cannot account for the contribution of the increment in joint force due to muscular cocontraction. Our data also contribute to the understanding of normal synovial joint tribology and the possible role of mechanical factors in the deterioration evident in osteoarthritis. Further, design criteria for both partial and total hip replacement prostheses and specific aspects of rehabilitation protocols following hip surgery (e.g., the extent to which crutches and canes unload the hip joint) warrant reconsideration in light of the extraordinary high pressures measured during the activities of daily living. Images PMID:3458248

  19. Total Hip Joint Replacement Biotelemetry System

    NASA Technical Reports Server (NTRS)

    Boreham, J. F.; Postal, R. B.; Luntz, R. A.

    1981-01-01

    The development of a biotelemetry system that is hermetically sealed within a total hip replacement implant is reported. The telemetry system transmits six channels of stress data to reconstruct the major forces acting on the neck of the prosthesis and uses an induction power coupling technique to eliminate the need for internal batteries. The activities associated with the telemetry microminiaturization, data recovery console, hardware fabrications, power induction systems, electrical and mechanical testing and hermetic sealing test results are discussed.

  20. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/polymer semi-constrained cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3350 Hip joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer...

  1. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal constrained cemented or uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3300 Hip joint metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal...

  2. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal constrained cemented or uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3300 Hip joint metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal...

  3. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/polymer semi-constrained cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3350 Hip joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer...

  4. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal constrained cemented or uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3300 Hip joint metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal...

  5. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/polymer semi-constrained cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3350 Hip joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer...

  6. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted...

  7. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted...

  8. Hip joint arthrosis: an occupational disorder among farmers.

    PubMed

    Thelin, A

    1990-01-01

    Observations among Swedish farmers indicate that coxarthrosis is a common disorder in farming populations. In this case-referent study, we describe relationships between farming and hip joint arthrosis. The case-group consisted of 105 persons who have had surgery because of coxarthrosis and the referents consisted of 222 randomly selected persons. Non-responders totaled 9%. Farming was significantly more common in the case group. The ratio varied between 2.1 and 3.2, varying with the length of time in farming. Longer exposure did not seem to result in greater risk. There was no risk elevation related to forestry or transportation work. Nor was there any over-representation of accidents with injuries to the lower extremities in the case group. Heavy work load did not seem to be related to the genesis of coxarthrosis. Farming is an amalgamation of different types of work. However, we develop the hypothesis from this study that tractor driving may be related to hip arthrosis. Unfavorable angles in the hip joints may occur during tractor driving. Other studies support this hypothesis, as it has been found that unsuitable conditions for the hip joints may be related to arthrosis. PMID:2220841

  9. Design and Dynamic Analysis of a Novel Biomimetic Robotics Hip Joint.

    PubMed

    Cui, Bingyan; Chen, Liwen; Wang, Zhijun; Zhao, Yuanhao; Li, Zhanxian; Jin, Zhenlin

    2015-01-01

    In order to increase the workspace and the carrying capacity of biomimetic robotics hip joint, a novel biomimetic robotics hip joint was developed. The biomimetic robotics hip joint is mainly composed of a moving platform, frame, and 3-RRR orthogonal spherical parallel mechanism branched chains, and has the characteristics of compact structure, large bearing capacity, high positioning accuracy, and good controllability. The functions of the biomimetic robotics hip joint are introduced, such as the technical parameters, the structure and the driving mode. The biomimetic robotics hip joint model of the robot is established, the kinematics equation is described, and then the dynamics are analyzed and simulated with ADAMS software. The proposed analysis methodology can be provided a theoretical base for biomimetic robotics hip joint of the servo motor selection and structural design. The designed hip joint can be applied in serial and parallel robots or any other mechanisms. PMID:27018226

  10. Design and Dynamic Analysis of a Novel Biomimetic Robotics Hip Joint

    PubMed Central

    Cui, Bingyan; Chen, Liwen; Wang, Zhijun; Zhao, Yuanhao; Li, Zhanxian; Jin, Zhenlin

    2015-01-01

    In order to increase the workspace and the carrying capacity of biomimetic robotics hip joint, a novel biomimetic robotics hip joint was developed. The biomimetic robotics hip joint is mainly composed of a moving platform, frame, and 3-RRR orthogonal spherical parallel mechanism branched chains, and has the characteristics of compact structure, large bearing capacity, high positioning accuracy, and good controllability. The functions of the biomimetic robotics hip joint are introduced, such as the technical parameters, the structure and the driving mode. The biomimetic robotics hip joint model of the robot is established, the kinematics equation is described, and then the dynamics are analyzed and simulated with ADAMS software. The proposed analysis methodology can be provided a theoretical base for biomimetic robotics hip joint of the servo motor selection and structural design. The designed hip joint can be applied in serial and parallel robots or any other mechanisms. PMID:27018226

  11. The effects of taping, stretching, and joint exercise on hip joint flexibility and range of motion

    PubMed Central

    Choi, Jung-Hyun; Yoo, Kyung-Tae; An, Ho-Jung; Choi, Wan-Suk; Koo, Ja-Pung; Kim, Jae-Ic; Kim, Nyeon-Jun

    2016-01-01

    [Purpose] This study aimed to examine the effects of joint exercise, taping, and stretching on hip joint flexion, flexibility, and range of motion. [Subjects and Methods] Forty-five college students in their 20s were randomly assigned and equally divided into three groups, as follows: a stretching group, a taping and exercise group, and an exercise group. Changes in trunk range of motion and hip joint flexibility of the three groups were measured before and after the intervention. [Results] Comparison between flexibility before and after the intervention revealed statistically significant changes in all three groups. Moreover, the evaluation of joint range of motion after the intervention showed that there were statistically significant changes in all three groups. [Conclusion] Taping, stretching, and joint exercise are considered effective for the increase in flexibility and joint range of motion. PMID:27313394

  12. Development of a hip joint model for finite volume simulations.

    PubMed

    Cardiff, P; Karač, A; FitzPatrick, D; Ivanković, A

    2014-01-01

    This paper establishes a procedure for numerical analysis of a hip joint using the finite volume method. Patient-specific hip joint geometry is segmented directly from computed tomography and magnetic resonance imaging datasets and the resulting bone surfaces are processed into a form suitable for volume meshing. A high resolution continuum tetrahedral mesh has been generated, where a sandwich model approach is adopted; the bones are represented as a stiffer cortical shells surrounding more flexible cancellous cores. Cartilage is included as a uniform thickness extruded layer and the effect of layer thickness is investigated. To realistically position the bones, gait analysis has been performed giving the 3D positions of the bones for the full gait cycle. Three phases of the gait cycle are examined using a finite volume based custom structural contact solver implemented in open-source software OpenFOAM. PMID:24141555

  13. The Arterial Folding Point During Flexion of the Hip Joint

    SciTech Connect

    Park, Sung Il; Won, Je Hwan Kim, Byung Moon; Kim, Jae Keun; Lee, Do Yun

    2005-04-15

    Purpose: Endovascular stents placed in periarticular vessels may be at a greater risk of neointimal hyperplasia and eventual occlusion than those placed in non-periarticular vessels. The purpose of this study was to investigate the location of maximal conformational change along the iliac and femoral artery, the folding point, during flexion of the hip joint and its location relative to the hip joint and the inguinal ligament. Methods: Seventy patients undergoing femoral artery catheterization were evaluated. The patients were 47 men and 23 women and ranged in age from 26 to 75 years (mean 54 years). The arteries (right:left = 34:36) were measured using a marked catheter for sizing vessels. Fluoroscopic images were obtained in anteroposterior and lateral projections in neutral position, and in the lateral projection in flexed position of the hip joint. The folding point was determined by comparing the lateral projection images in the neutral and flexed positions. The distance from the acetabular roof to the folding point and the distance from the inguinal ligament to the folding point was evaluated. Results: : The folding point was located 42.8 {+-} 28.6 mm cranial to the acetabular roof and 35.1 {+-} 30.1 mm cranial to the inguinal ligament. As the patient's age increased, the folding point was located more cranially (p < 0.001). Conclusions: The folding point during flexion of the hip joint was located 42.8 {+-} 28.6 mm cranial to the acetabular roof and 35.1 {+-} 30.1 mm cranial to the inguinal ligament. As the patient's age increased, the folding point was located more cranially. When a stent is inserted over this region, more attention may be needed during follow-up to monitor possible occlusion and stent failure.

  14. Diagnosis of Periprosthetic Joint Infection Following Hip and Knee Arthroplasty.

    PubMed

    Parvizi, Javad; Fassihi, Safa Cyrus; Enayatollahi, Mohammad A

    2016-07-01

    The diagnosis of periprosthetic joint infection (PJI) following total hip arthroplasty and total knee arthroplasty has been one of the major challenges in orthopedic surgery. As there is no single absolute test for diagnosis of PJI, diagnostic criteria for PJI have been proposed that include using several diagnostic modalities. Focused history, physical examination, plain radiographs, and initial serologic tests should be followed by joint aspiration and synovial analysis. Newer diagnostic techniques, such as alpha-defensin and interleukin-6, hold great promise in the future diagnosis of equivocal infections. PMID:27241375

  15. Prosthetic hip joint infection caused by Rothia dentocariosa

    PubMed Central

    Ozan, Fırat; Öncel, Eyyüp Sabri; Duygulu, Fuat; Çelik, İlhami; Altay, Taşkın

    2015-01-01

    Rothia dentocariosa is an aerobic, pleomorphic, catalase-positive, non-motile, gram-positive bacteria that is a part of the normal flora in the oral cavity and respiratory tract. Although it is a rare cause of systemic infection, it may be observed in immunosuppressed individuals. Here we report the case of an 85-year old man who developed prosthetic joint infection that was caused by R. dentocariosa after hemiarthroplasty. This is the first case report of a prosthetic hip joint infection caused by R. dentocariosa in the literature. PMID:26379996

  16. Interobserver Repeatability of Measurements on Computed Tomography Images of Lax Canine Hip Joints from Youth to Maturity

    PubMed Central

    Lopez, Mandi J.; Davis, Kechia M.; Jeffrey-Borger, Susan L.; Markel, Mark D.; Rettenmund, Christy

    2013-01-01

    Objectives To determine interobserver repeatability of measurements on computed tomography (CT) images of lax canine hip joints at different ages and in the presence of degenerative joint disease at maturity. Study Design Longitudinal observational investigation. Animals Sibling crossbreed hounds. Methods Pelvic CT was performed at 20, 24, 32, 48, 68, and 104 weeks of age. Measures were performed on 3 contiguous two-dimensional (2D) transverse CT images of both hips at each time point by 3 investigators. Center-edge angle (CEA), horizontal toit externe angle (HTEA), ventral (VASA), dorsal (DASA), and horizontal (HASA) acetabular sector angles, acetabular index (AI), and percent femoral head coverage (CPC) were measured. Interobserver repeatability was quantified with the intraclass correlation coefficient (ICC). Satisfactory repeatability was considered when ICC ≥ 0.75. Results DASA, CEA, and CPC were repeatable in all age groups. HASA and HTEA were repeatable for all but 1 time point. At 20 weeks of age, all measures but AI were repeatable, and at 104 weeks of age, DASA, CEA, CPC, and HASA were repeatable. Measures were repeatable in hips with and without degenerative changes with the exceptions of AI and HASA in normal hips and VASA and HTEA in osteoarthritic hips. Conclusions Most 2D CT measurements examined were repeatable regardless of age or joint disease. Clinical Relevance Two-dimensional CT measures may augment current techniques for assessing joint changes in lax canine hips. PMID:20017848

  17. Bone scintigraphy of hip joint effusions in children

    SciTech Connect

    Kloiber, R.; Pavlosky, W.; Portner, O.; Gartke, K.

    1983-05-01

    Thirty-eight children with hip pain of acute onset were studied by bone scintigraphy. Nine patients had diminished radiotracer deposition involving the entire proximal femoral ossification center. This could be related to infarction or compression of blood supply by a tense joint effusion. Eight of these patients had joint aspiration confirming the presence of an effusion. Five patients had follow-up studies after aspiration, and femoral-head uptake reverted to normal in all but one which subsequently proved to be infarcted. A photopenic zone was seen on blood pool images in 10 patients, many of whom were also aspirated of fluid. Bone scintigraphy is useful in the diagnosis of joint effusions and can give information as to the state of perfusion of the femoral head. Follow-up studies after aspiration can differentiate infarction from reversible ischemia.

  18. Progressive hip joint subluxation in Saul-Wilson syndrome.

    PubMed

    Chinen, Yasutsugu; Kaneshi, Takuya; Kamiya, Takeshi; Hata, Kenichiro; Nishimura, Gen; Kaname, Tadashi

    2015-11-01

    Saul-Wilson syndrome (SWS) is a rare congenital skeletal syndrome characterized by postnatal onset of short stature, relative microcephaly, frontal bossing, prominent eyes with shallow orbits, midface hypoplasia, cataract, and generalized skeletal changes, including spondylar dysplasia, overtubulation of the long bones with metaphyseal flaring and megaepiphyses, coxa valga, elbow deformity, and brachydactyly. We describe a boy with the overall clinical and radiological features fitting the characteristics of SWS, although cataract, elbow deformity, and overt brachydactyly were not seen. He presented with painful hip joint due to hip subluxation in late childhood, which exacerbated with age and ultimately, required surgical intervention. Awareness of this orthopedic complication in SWS is essential in the management of patients with SWS. PMID:26239279

  19. An open source lower limb model: Hip joint validation.

    PubMed

    Modenese, L; Phillips, A T M; Bull, A M J

    2011-08-11

    Musculoskeletal lower limb models have been shown to be able to predict hip contact forces (HCFs) that are comparable to in vivo measurements obtained from instrumented prostheses. However, the muscle recruitment predicted by these models does not necessarily compare well to measured electromyographic (EMG) signals. In order to verify if it is possible to accurately estimate HCFs from muscle force patterns consistent with EMG measurements, a lower limb model based on a published anatomical dataset (Klein Horsman et al., 2007. Clinical Biomechanics. 22, 239-247) has been implemented in the open source software OpenSim. A cycle-to-cycle hip joint validation was conducted against HCFs recorded during gait and stair climbing trials of four arthroplasty patients (Bergmann et al., 2001. Journal of Biomechanics. 34, 859-871). Hip joint muscle tensions were estimated by minimizing a polynomial function of the muscle forces. The resulting muscle activation patterns obtained by assessing multiple powers of the objective function were compared against EMG profiles from the literature. Calculated HCFs denoted a tendency to monotonically increase their magnitude when raising the power of the objective function; the best estimation obtained from muscle forces consistent with experimental EMG profiles was found when a quadratic objective function was minimized (average overestimation at experimental peak frame: 10.1% for walking, 7.8% for stair climbing). The lower limb model can produce appropriate balanced sets of muscle forces and joint contact forces that can be used in a range of applications requiring accurate quantification of both. The developed model is available at the website https://simtk.org/home/low_limb_london. PMID:21742331

  20. Prevention of Periprosthetic Joint Infections of the Hip and Knee.

    PubMed

    Levy, David M; Wetters, Nathan G; Levine, Brett R

    2016-01-01

    Periprosthetic joint infection (PJI) is a rare but devastating complication of arthroplasty. Research has been dedicated to minimizing the incidence of PJI, leading to the development of a comprehensive perioperative approach. Multiple preoperative, intraoperative, and postoperative factors can increase patient risk. From medical management and skin sterilization to wound sterility and blood management, multiple issues must be considered in a well-rounded prevention protocol. In this literature review, we consolidate the current information that orthopedic surgeons can use to minimize PJI after total knee arthroplasty and total hip arthroplasty. PMID:27552468

  1. Late arthroscopic retrieval of a bullet from hip joint

    PubMed Central

    Gupta, Ravi K; Aggarwal, Varun

    2009-01-01

    We describe a case of arthroscopic retrieval of a bullet from the hip joint of an 18-year-old boy, who sustained the injury four months back, accidentally, while bird hunting with a country made shotgun. The surgery was performed with the standard ordinary instrumentation of knee arthroscopy. The patient became pain-free the same evening and started partial weight bearing on the next day of surgery. At 13 months follow-up, the patient had returned to normal activity without any functional limitations. PMID:19838396

  2. Canine intersegmental hip joint forces and moments before and after cemented total hip replacement.

    PubMed

    Dogan, S; Manley, P A; Vanderby, R; Kohles, S S; Hartman, L M; McBeath, A A

    1991-01-01

    Intersegmental forces and moments (i.e. resultant free body forces and moments computed at the joint centers) were studied in canine hindlimbs before and after cemented total hip replacement (THR). Five large, adult, mixed-breed dogs were selected. Their gait was recorded (while leash-walked) before surgery using high-speed cinematography and a force plate. Cemented total hip replacement was unilaterally performed on each dog. Gait was again recorded at one and four months after surgery. Segmental properties (mass, center of mass, and mass moment of inertia) of the hindlimbs were experimentally determined, and an inverse dynamics approach was used to compute intersegmental forces and moments in the sagittal plane. Significant reductions in intersegmental joint forces and moments were observed in the operated hindlimb one month after surgery, although kinematic gait parameters were unaltered. Decreases of 77.0% for vertical forces, 61.9% for craniocaudal forces, and 66.2% for extension moments were determined. Four months after surgery, the joint forces and moments had returned to their preoperative values. This experiment demonstrates that the dynamics of normal walking can be restored in a canine model by four months after THR. It also shows that kinetic (rather than kinematic) parameters are more descriptive of antalgic gait in the canine. PMID:1856240

  3. Effects of osteoarthritis on radiographic measures of laxity and congruence in hip joints of Labrador Retrievers.

    PubMed

    Gold, Randi M; Gregor, Thomas P; Huck, Jennifer L; McKelvie, Pamela J; Smith, Gail K

    2009-06-15

    OBJECTIVE- To determine effects of hip joint osteoarthritis on radiographic measures of hip joint laxity and congruence. DESIGN- Longitudinal study. ANIMALS- 40 Labrador Retrievers. PROCEDURES- Dogs were assigned to 2 groups based on radiographic evidence of osteoarthritis. Dogs in the osteoarthritis group were free of osteoarthritis at initial radiographic evaluation (t(1)) and developed osteoarthritis by a subsequent radiographic evaluation (t(2)). Dogs in the nonosteoarthritis group had no radiographic osteoarthritis at either evaluation. Hip joint laxity was quantified by use of the distraction index (DI) from a distraction radiographic view and use of the Norberg angle (NA) from a ventrodorsal hip-extended radiographic view. The compression index (CI) from a compression radiographic view was used as a measure of joint congruence (concentricity). RESULTS- Hip joint laxity (NA or DI) did not change over time in the nonosteoarthritis group. Mean hip joint laxity (NA and DI) for the osteoarthritis group was greater at t(1) than for the nonosteoarthritis group. With the onset of osteoarthritis, mean NA decreased significantly and mean CI increased significantly, but mean DI remained unchanged. CONCLUSIONS AND CLINICAL RELEVANCE- No radiographic evidence for compensatory hip joint tightening associated with osteoarthritis was detected. Hip-extended radiography revealed that hip joints got looser with osteoarthritis and NA decreased. Hip joint laxity (DI) on distraction radiographs was unchanged by the onset of osteoarthritis and remained constant in the osteoarthritis and nonosteoarthritis groups at both evaluations. However, the CI increased with osteoarthritis, as reflected in nonzero indices (incongruence). The CI may be a valid marker for early hip joint osteoarthritis. PMID:19527128

  4. Simultaneous bilateral hip joint imaging at 7 Tesla using fast transmit B₁ shimming methods and multichannel transmission - a feasibility study.

    PubMed

    Ellermann, J; Goerke, U; Morgan, P; Ugurbil, K; Tian, J; Schmitter, S; Vaughan, T; Van De Moortele, P-F

    2012-10-01

    The objective of this study was to demonstrate the feasibility of simultaneous bilateral hip imaging at 7 Tesla. Hip joint MRI becomes clinically critical since recent advances have made hip arthroscopy an efficacious approach to treat a variety of early hip diseases. The success of these treatments requires a reliable and accurate diagnosis of intraarticular abnormalities at an early stage. Articular cartilage assessment is especially important to guide surgical decisions but is difficult to achieve with current MR methods. Because of gains in tissue contrast and spatial resolution reported at ultra high magnetic fields, there are strong expectations that imaging the hip joint at 7 Tesla will improve diagnostic accuracy. Furthermore, there is growing evidence that the majority of these hip abnormalities occur bilaterally, emphasizing the need for bilateral imaging. However, obtaining high quality images in the human torso, in particular of both hips simultaneously, must overcome a major challenge arising from the damped traveling wave behaviour of RF waves at 7 Tesla that leads to severe inhomogeneities in transmit B1 (B(1) (+) ) phase and magnitude, typically resulting in areas of low signal and contrast, and consequently impairing use for clinical applications. To overcome this problem, a 16-channel stripline transceiver RF coil was used, together with a B1 shimming algorithm aiming at maximizing B(1) (+) in six regions of interest over the hips that were identified on axial scout images. Our successful results demonstrate that this approach effectively reduces inhomogeneities observed before B1 shimming and provides high joint tissue contrast in both hips while reducing the required RF power. Critical to this success was a fast small flip angle B(1) (+) calibration scan that permitted the computation of subject-specific B1 shimming solutions, a necessary step to account for large spatial variations in B(1) (+) phase observed in different subjects. PMID:22311346

  5. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer semi-constrained cemented prosthesis. 888.3350 Section 888.3350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer...

  6. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/polymer semi-constrained cemented prosthesis. 888.3350 Section 888.3350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer...

  7. A frictional study of total hip joint replacements

    NASA Astrophysics Data System (ADS)

    Scholes, S. C.; Unsworth, A.; Goldsmith, A. A. J.

    2000-12-01

    Polymeric wear debris produced by articulation of the femoral head against the ultra-high-molecular-weight polyethylene socket of a total hip replacement has been implicated as the main cause of osteolysis and subsequent failure of these implants. Potential solutions to this problem are to employ hard bearing surface combinations such as metal-on-metal or ceramic-on-ceramic prostheses. The aim of this study was to investigate the difference in lubrication modes and friction of a range of material combinations using synthetic and biological fluids as the lubricants. The experimental results were compared with theoretical predictions of film thicknesses and lubrication modes. A strong correlation was observed between experiment and theory when employing carboxy methyl cellulose (CMC) fluids as the lubricant. Under these conditions the ceramic-on-ceramic joints showed full fluid film lubrication while the metal-on-metal, metal-on-plastic, diamond-like carbon-coated stainless steel (DLC)-on-plastic and ceramic-on-plastic prostheses operated under a mixed lubrication regime. With bovine serum as the lubricant in the all ceramic joints, however, the full fluid film lubrication was inhibited due to adsorbed proteins. In the metal-on-metal joints this adsorbed protein layer acted to reduce the friction while in the ceramic coupling the friction was increased. The use of bovine serum as the lubricant also significantly increased the friction in both the metal-on-plastic and ceramic-on-plastic joints. The friction produced by the DLC-on-plastic joints depended on the quality of the coating. Those joints with a less consistent coating and therefore a higher surface roughness gave significantly higher friction than the smoother, more consistently coated heads.

  8. Prevention of congenital dislocation of the hip. The Swedish experience of neonatal treatment of hip joint instability.

    PubMed

    Palmén, K

    1984-01-01

    The extensive work on early diagnosis and treatment of CDH (in the broad sense of this term) in Sweden has formed the basis of our present organization of prevention of hip dislocation. Practically all children are born in hospital, at present about 93,000 per year (1980). Routine examination of the hip joints has been included in the check-ups of newborns since the beginning of the 1950's. The centralization of obstetrics, especially during the last decade, has facilitated the organization of these examinations by paediatric consultants in all obstetric departments. All cases of hip joint instability are recorded, and during the last few years the frequency has been about 12 per thousand, probably with some over-diagnosis due to registration of uncertain cases. All definite cases of hip instability have been treated immediately at the orthopaedic departments. A study of a series of untreated newborns with transient instability has shown that the majority, but not all, will develop normal hip joints without treatment. This has been one reason for the recommendation to treat all unequivocal cases of hip instability. The present organization of examination and treatment is described. Detailed and practical instructions for the examination and treatment are given. Follow-ups of children treated for hip instability in the neonatal period are reported. It has been found that in practically all these patients anatomically normal hip joints are achieved by means of correct and carefully followed up treatment. The findings in 65 patients with neonatal hip instability in whom the treatment was unsuccessful or inadequate have underlined the importance of a strict treatment schedule, experienced doctors and detailed information to the parents. The effect of diagnosis and treatment of hip instability neonatally on the frequency of late-diagnosed cases of CDH was studied by recording all late-diagnosed cases at all orthopaedic departments. It was clear from the latter study

  9. A model of flexion-extension movement in hip joint using polynomial interpolation

    NASA Astrophysics Data System (ADS)

    Toth-Taşcǎu, Mirela; Pater, Flavius; Stoia, Dan Ioan

    2013-10-01

    The study proposes a mathematical model of flexion-extension movement in hip joint based on Lagrange polynomial interpolation. In order to develop and validate the proposed model the angle of flexion-extension (F-E) in hip joint was analyzed. The two main reasons of this option rely on the importance of the hip joint in human locomotion and the fact that flexion-extension movement is developed in most of the human joints. The mathematical model of joint movement allows developing a more detailed kinematic analysis of the joint movements. The raw data representing the variation of the flexion-extension angle in hip joint was achieved by experimental kinematic analysis of a lot of ten young healthy subjects.

  10. Characterization of the Neural Anatomy in the Hip Joint to Optimize Periarticular Regional Anesthesia in Total Hip Arthroplasty.

    PubMed

    Simons, Matthew J; Amin, Nirav H; Cushner, Fred D; Scuderi, Giles R

    2015-01-01

    The purpose of the current study was to identify and map the periarticular neural anatomy of the hip to optimize periarticular injection techniques in total hip arthroplasty. A literature review of common search engines was performed using terms associated with hip innervation and 17 met the inclusion criteria. The studies addressed both gross and microscopic neural anatomy of the human hip joint, and the findings summarize key areas of hip mechanoreceptors and free nerve endings to provide a framework for targeted periarticular hip infiltration. Grossly, the hip joint is supplied by the femoral, obturator, sciatic, and superior gluteal nerves, as well as the nerve to the quadratus femoris. The greatest concentration of sensory nerve endings and mechanoreceptors is found at the anterior hip capsule, especially superiorly. The labrum is most highly innervated from the 10 to 2 o'clock position. After the cup and liner are placed, periarticular injections should be infiltrated toward the remnant labrum from 10 to 2 o'clock. Before stem insertion, the visible periosteum may then be injected circumferentially about the femur. The anterior and superior capsular tissue, if retained, is routinely infiltrated at the time of capsular repair. Depending on surgical approach, the fascia and incised soft tissue are infiltrated before final closure. PMID:26731384

  11. Shoulder and hip joint for hard space suits

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    Shoulder and hip joints for hard space suits are disclosed which are comprised of three serially connected truncated spherical sections, the ends of which converge. Ball bearings between the sections permit relative rotation. The proximal end of the first section is connected to the torso covering by a ball bearing and the distal end of the outermost section is connected to the elbow or thigh covering by a ball bearing. The sections are equi-angular and this alleviates lockup, the condition where the distal end of the joint leaves the plane in which the user is attempting to flex. The axes of rotation of the bearings and the bearing mid planes are arranged to intersect in a particular manner that provides the joint with a minimum envelope. In one embodiment, the races of the bearing between the innermost section and the second section is partially within the inner race of the bearing between the torso and the innermost spherical section further to reduce bulk.

  12. Is running associated with degenerative joint disease

    SciTech Connect

    Panush, R.S.; Schmidt, C.; Caldwell, J.R.; Edwards, N.L.; Longley, S.; Yonker, R.; Webster, E.; Nauman, J.; Stork, J.; Pettersson, H.

    1986-03-07

    Little information is available regarding the long-term effects, if any, of running on the musculoskeletal system. The authors compared the prevalence of degenerative joint disease among 17 male runners with 18 male nonrunners. Running subjects (53% marathoners) ran a mean of 44.8 km (28 miles)/wk for 12 years. Pain and swelling of hips, knees, ankles and feet and other musculoskeletal complaints among runners were comparable with those among nonrunners. Radiologic examinations (for osteophytes, cartilage thickness, and grade of degeneration) also were without notable differences among groups. They did not find an increased prevalence of osteoarthritis among the runners. Our observations suggest that long-duration, high-mileage running need to be associated with premature degenerative joint disease in the lower extremities.

  13. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  14. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  15. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  16. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  17. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/ceramic/polymer semi-constrained... Devices § 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or...

  18. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/ceramic/polymer semi-constrained... Devices § 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or...

  19. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/polymer or ceramic/polymer... Devices § 888.3410 Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained...

  20. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/polymer or ceramic/polymer... Devices § 888.3410 Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained...

  1. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  2. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  3. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  4. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/ceramic/polymer semi-constrained... Devices § 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or...

  5. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/polymer or ceramic/polymer... Devices § 888.3410 Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained...

  6. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  7. 21 CFR 888.3358 - Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer/metal semi-constrained... Devices § 888.3358 Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis. (a) Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a...

  8. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/ceramic/polymer semi-constrained... Devices § 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or...

  9. 21 CFR 888.3358 - Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/polymer/metal semi-constrained... Devices § 888.3358 Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis. (a) Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a...

  10. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/ceramic/polymer semi-constrained... Devices § 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or...

  11. [Metal spongiosa endoprostheses for surgical revision of the hip joint].

    PubMed

    Lütten, C; Lorenz, H; Thomas, W

    1990-01-01

    On the basis of 60 revision operations which were carried out on hip joints with mainly aseptic loosened cemented endoprosthesis and which also had, to some extent, distinct macrophagic induced osteolysis zones, it could be shown that implants with a metal spongiosa surface structure offer a good chance of an enduring revitalisation in the anchorage position and, thereby, are able to achieve a permanently stable endoprosthesis fixation. The expansion defects could be filled by means of homologous or autologous spongiosa transplantation. The post-operative X-ray check-up showed a vital inward-growing healing. All the endoprosthesis remained in situ during the follow-up examination period of, on average, 12.1 months. In accordance with the Merle D'Aubigne hip evaluation scheme, 43.3% showed an excellent result; 40% a good one; 13.3% were satisfactory; and only 3.4% showed a bad result. Major complications which occurred were: two intra-operative femoral stem fractures which had to be taken care of osteosynthetically; a repeat operation which had to take place during the first post-operative week because of a dislocation of the socket cup; and a luxation which was revised under narcosis. In spite of an increased periarticular ossification's ratio in revision operations, second-class ossification only occurred in 16.7% of all cases and third-class ossification did not occur at all. PMID:2140646

  12. Imaging of the hip joint. Computed tomography versus magnetic resonance imaging

    NASA Technical Reports Server (NTRS)

    Lang, P.; Genant, H. K.; Jergesen, H. E.; Murray, W. R.

    1992-01-01

    The authors reviewed the applications and limitations of computed tomography (CT) and magnetic resonance (MR) imaging in the assessment of the most common hip disorders. Magnetic resonance imaging is the most sensitive technique in detecting osteonecrosis of the femoral head. Magnetic resonance reflects the histologic changes associated with osteonecrosis very well, which may ultimately help to improve staging. Computed tomography can more accurately identify subchondral fractures than MR imaging and thus remains important for staging. In congenital dysplasia of the hip, the position of the nonossified femoral head in children less than six months of age can only be inferred by indirect signs on CT. Magnetic resonance imaging demonstrates the cartilaginous femoral head directly without ionizing radiation. Computed tomography remains the imaging modality of choice for evaluating fractures of the hip joint. In some patients, MR imaging demonstrates the fracture even when it is not apparent on radiography. In neoplasm, CT provides better assessment of calcification, ossification, and periosteal reaction than MR imaging. Magnetic resonance imaging, however, represents the most accurate imaging modality for evaluating intramedullary and soft-tissue extent of the tumor and identifying involvement of neurovascular bundles. Magnetic resonance imaging can also be used to monitor response to chemotherapy. In osteoarthrosis and rheumatoid arthritis of the hip, both CT and MR provide more detailed assessment of the severity of disease than conventional radiography because of their tomographic nature. Magnetic resonance imaging is unique in evaluating cartilage degeneration and loss, and in demonstrating soft-tissue alterations such as inflammatory synovial proliferation.

  13. Bilaterally asymmetric effects of quantitative trait loci (QTLs): QTLs that affect laxity in the right versus left coxofemoral (hip) joints of the dog (Canis familiaris).

    PubMed

    Chase, Kevin; Lawler, Dennis F; Adler, Fred R; Ostrander, Elaine A; Lark, Karl G

    2004-01-30

    In dogs hip joint laxity that can lead to degenerative joint disease (DJD) is frequent and heritable, providing a genetic model for some aspects of the human disease. We have used Portuguese water dogs (PWDs) to identify Quantitative trait loci (QTLs) that regulate laxity in the hip joint. A population of 286 PWDs, each characterized by ca. 500 molecular genetic markers, was analyzed for subluxation of the hip joint as measured by the Norberg angle, a quantitative radiographic measure of laxity. A significant directed asymmetry was observed, such that greater laxity was observed in the left than the right hip. This asymmetry was not heritable. However, the average Norberg angle was highly heritable as were the Norberg angles of either the right or left hips. After correction for pedigree effects, two QTLs were identified using the metrics of the left and right hips as separate data sets. Both are on canine chromosome 1 (CFA1), separated by about 95 Mb. One QTL, associated with the SSR marker FH2524 was significant for the left, but not the right hip. The other, associated with FH2598, was significant for the right but not the left hip. For both QTLs, some extreme phenotypes were best explained by specific interactions between haplotypes. PMID:14708095

  14. Bilaterally Asymmetric Effects of Quantitative Trait Loci (QTLs): QTLs That Affect Laxity in the Right Versus Left Coxofemoral (Hip) Joints of the Dog (Canis familiaris)

    PubMed Central

    Chase, Kevin; Lawler, Dennis F.; Adler, Fred R.; Ostrander, Elaine A.; Lark, Karl G.

    2009-01-01

    In dogs hip joint laxity that can lead to degenerative joint disease (DJD) is frequent and heritable, providing a genetic model for some aspects of the human disease. We have used Portuguese water dogs (PWDs) to identify Quantitative trait loci (QTLs) that regulate laxity in the hip joint.A population of 286 PWDs, each characterized by ca. 500 molecular genetic markers, was analyzed for subluxation of the hip joint as measured by the Norberg angle, a quantitative radiographic measure of laxity. A significant directed asymmetry was observed, such that greater laxity was observed in the left than the right hip. This asymmetry was not heritable. However, the average Norberg angle was highly heritable as were the Norberg angles of either the right or left hips. After correction for pedigree effects, two QTLs were identified using the metrics of the left and right hips as separate data sets. Both are on canine chromosome 1 (CFA1), separated by about 95 Mb. One QTL, associated with the SSR marker FH2524 was significant for the left, but not the right hip. The other, associated with FH2598, was significant for the right but not the left hip. For both QTLs, some extreme phenotypes were best explained by specific interactions between haplotypes. PMID:14708095

  15. Amyloid Arthropathy of the Hip Joint Associated with Multiple Myeloma: A Case Report

    PubMed Central

    Chun, Young Soo; Rhyu, Kee Hyung; Park, Yong Koo; Ryu, Kyung Nam; Park, Ji Seon; Liang, Huo; Jung, Gwang Young; Shin, Won Ju

    2016-01-01

    Amyloidosis is a disease characterized by the deposition of non-soluble fibrous protein in multiple tissues with a number of possible causes. This protein deposition can occur in any tissue, yet is most commonly seen in kidneys, heart, and gastrointestinal tracts. However, invasion to bone tissues is not often reported. The deposition of amyloid proteins in bone tissues may result in joint pain and pathological fractures; it is important to elucidate the causes and detect early to determine prognosis and treat optimally. In the present case report, with relevant literature review, the authors report a case of total hip arthroplasty in an amyloidosis patient. PMID:27536655

  16. Amyloid Arthropathy of the Hip Joint Associated with Multiple Myeloma: A Case Report.

    PubMed

    Cho, Yoon Je; Chun, Young Soo; Rhyu, Kee Hyung; Park, Yong Koo; Ryu, Kyung Nam; Park, Ji Seon; Liang, Huo; Jung, Gwang Young; Shin, Won Ju

    2016-06-01

    Amyloidosis is a disease characterized by the deposition of non-soluble fibrous protein in multiple tissues with a number of possible causes. This protein deposition can occur in any tissue, yet is most commonly seen in kidneys, heart, and gastrointestinal tracts. However, invasion to bone tissues is not often reported. The deposition of amyloid proteins in bone tissues may result in joint pain and pathological fractures; it is important to elucidate the causes and detect early to determine prognosis and treat optimally. In the present case report, with relevant literature review, the authors report a case of total hip arthroplasty in an amyloidosis patient. PMID:27536655

  17. Investigation and macroscopic anatomical study of referred pain in patients with hip disease.

    PubMed

    Sakamoto, Junya; Morimoto, Yosuke; Ishii, Shun; Nakano, Jiro; Manabe, Yoshitaka; Okita, Minoru; Tsurumoto, Toshiyuki

    2014-02-01

    [Purpose] The aim of this study was to examine the incidence and patterns of referred pain in patients with hip disease, as well as the nerve distribution in the hip and knee joints of 2 cadavers. [Subjects and Methods] A total of 113 patients with hip joint disease were included in the investigation. The incidence of regional pain and referred pain patterns were evaluated before and after arthroplasty. Two cadavers were macroscopically observed to verify the nerve innervation of the hip and knee joints. [Results] Anterior knee pain was observed preoperatively in 13.3% (in resting) and 33.6% (in motion) of the patients, which was comparable with the incidence of greater trochanter pain. In addition, the preoperative incidence rates of knee pain in resting and motion markedly decreased postoperatively. Of note is the remarkable incidence of pain radiating to the ventral lower limb. An anteromedial innervation was determined in the cadavers by the articular branches of the obturator and femoral nerve, which supply small branches to the knee joints. [Conclusion] Our results suggest that the distribution of the incidence of pain among the patients with hip disease is diverse owing to the sensory distribution of the femoral and obturator nerves. PMID:24648632

  18. Effects of Nordic walking on pelvis motion and muscle activities around the hip joints of adults with hip osteoarthritis

    PubMed Central

    Homma, Daisuke; Jigami, Hirofumi; Sato, Naritoshi

    2016-01-01

    [Purpose] Increased compensatory pelvic movement is remarkable in limping patients with hip osteoarthritis (OA). However, a method of improving limping has not been established. The purpose of this study was to identify the effects of two types of Nordic walking by analyzing the pelvic movement and muscle activities of adults with hip OA. [Subjects and Methods] Ten patients with OA of the hip performed Japanese-style Nordic walking (JS NW), European-style Nordic walking (ES NW), and Ordinary walking (OW), and the muscle activities around the hip joint and pelvic movements were analyzed. [Results] The pelvic rotation angle was significantly larger in ES NW than in JS NW. In the stance phase, hip abductor muscle activity was significantly decreased in JS NW compared to both OW and ES NW. In the swing phase, rectus abdominis muscle activity was significantly increased in both JS NW and ES NW compared to OW and lumbar erector spinae activity was significantly lower in JS NW than in OW. [Conclusion] JS NW style may reduce the compensatory pelvic rotation in patients with hip OA. JS NW might be better for joint protection and prevention of secondary disorders of the hip in OA patients. PMID:27190455

  19. New concept in durability improvement of hip total joint endoprostheses.

    PubMed

    Capitanu, Lucian; Florescu, Virgil; Badita, Liliana-Laura

    2014-01-01

    Starting from the well-known fact that the rolling movement always has a lower friction compared to sliding friction, the authors have conceived and realized a pivoting movement joint on a "layer of balls" with "compensation space", placed between the acetabular cup and the femoral head. This technical solution allows free self-directed migration of the balls, depending on the resistance opposed, with successive occupation of the "compensation space". As a concept, the proposed technical solution excludes the existence of a cage for maintaining the relative positions of the spheres. It can be observed that the smallest values of the force and of the friction coefficient are obtained for the prostheses with balls and self-directed movement (approximately 5 times smaller than the values obtained for a classical prosthesis). For all the couples tested, the friction force grows with the growth of the normal load and of the oscillation speed. Changing the contact mechanism for the artificial hip joint from one sliding contact between two large surfaces, to a multitude of rolling contacts, could lead to some problems regarding functionality and durability of the active prosthesis elements. The key to an accurate evaluation of damaging mechanisms acting on THP with self directed rolling balls is a clear and complete picture of the load transfer mechanism. PMID:24707822

  20. Note: Application of a novel 2(3HUS+S) parallel manipulator for simulation of hip joint motion

    NASA Astrophysics Data System (ADS)

    Shan, X. L.; Cheng, G.; Liu, X. Z.

    2016-07-01

    In the paper, a novel 2(3HUS+S) parallel manipulator, which has two moving platforms, is proposed. The parallel manipulator is adopted to simulate hip joint motion and can conduct an experiment for two hip joints simultaneously. Motion experiments are conducted in the paper, and the recommended hip joint motion curves from ISO14242 and actual hip joint motions during jogging and walking are selected as the simulated motions. The experimental results indicate that the 2(3HUS+S) parallel manipulator can realize the simulation of many kinds of hip joint motions without changing the structure size.

  1. Note: Application of a novel 2(3HUS+S) parallel manipulator for simulation of hip joint motion.

    PubMed

    Shan, X L; Cheng, G; Liu, X Z

    2016-07-01

    In the paper, a novel 2(3HUS+S) parallel manipulator, which has two moving platforms, is proposed. The parallel manipulator is adopted to simulate hip joint motion and can conduct an experiment for two hip joints simultaneously. Motion experiments are conducted in the paper, and the recommended hip joint motion curves from ISO14242 and actual hip joint motions during jogging and walking are selected as the simulated motions. The experimental results indicate that the 2(3HUS+S) parallel manipulator can realize the simulation of many kinds of hip joint motions without changing the structure size. PMID:27475608

  2. Arthroscopic Bullet Removal From the Central and Peripheral Compartments of the Hip Joint.

    PubMed

    Howse, Elizabeth A; Rogers, Jason P; Stone, Austin V; Mannava, Sandeep; Stubbs, Allston J

    2016-04-01

    Recent advances in hip arthroscopy offer an approach for treating an uncommon but highly disabling injury from intra-articular missile injury to the hip. Hip arthroscopy affords the patient the benefit of minimally invasive surgery while allowing for the diagnosis and treatment of concomitant pathology, which may be either acute, from the trauma of the missile, or chronic. We present a technique for the removal of projectiles from the central and peripheral compartments of the hip joint. Through a surgical series of a variety of gunshot wounds, we detail the unique aspects of retrieval for the various missile endpoints. We describe this technique for bullets or pieces of bullets lodged within the hip joint space, bone of the acetabulum, or femoral head. Furthermore, we provide an example in which hip arthroscopy is not a suitable option for treatment because of the resulting fracture pattern, which necessitates open reduction along with internal fixation. PMID:27489755

  3. Inter-joint coordination between hips and trunk during downswings: Effects on the clubhead speed.

    PubMed

    Choi, Ahnryul; Lee, In-Kwang; Choi, Mun-Taek; Mun, Joung Hwan

    2016-10-01

    Understanding of the inter-joint coordination between rotational movement of each hip and trunk in golf would provide basic knowledge regarding how the neuromuscular system organises the related joints to perform a successful swing motion. In this study, we evaluated the inter-joint coordination characteristics between rotational movement of the hips and trunk during golf downswings. Twenty-one right-handed male professional golfers were recruited for this study. Infrared cameras were installed to capture the swing motion. The axial rotation angle, angular velocity and inter-joint coordination were calculated by the Euler angle, numerical difference method and continuous relative phase, respectively. A more typical inter-joint coordination demonstrated in the leading hip/trunk than trailing hip/trunk. Three coordination characteristics of the leading hip/trunk reported a significant relationship with clubhead speed at impact (r < -0.5) in male professional golfers. The increased rotation difference between the leading hip and trunk in the overall downswing phase as well as the faster rotation of the leading hip compared to that of the trunk in the early downswing play important roles in increasing clubhead speed. These novel inter-joint coordination strategies have the great potential to use a biomechanical guideline to improve the golf swing performance of unskilled golfers. PMID:26911704

  4. Does surgical approach or prosthesis type affect hip joint loading one year after surgery?

    PubMed

    Wesseling, Mariska; Meyer, Christophe; Corten, Kristoff; Simon, Jean-Pierre; Desloovere, Kaat; Jonkers, Ilse

    2016-02-01

    Several approaches may be used for hip replacement surgery either in combination with conventional total hip arthroplasty (THA) or resurfacing hip arthroplasty (RHA). This study investigates the differences in hip loading during gait one year or more after surgery in three cohorts presenting different surgical procedures, more specific RHA placed using the direct lateral (RHA-DLA, n=8) and posterolateral (RHA-PLA, n=14) approach as well as THA placed using the direct anterior (THA-DAA, n=12) approach. For the DAA and control subjects, hip loading was also evaluated during stair ascent and descent to evaluate whether these motions can better discriminate between patients and controls compared to gait. Musculoskeletal modelling in OpenSim was used to calculate in vivo joint loading. Results showed that for all operated patients, regardless the surgical procedure, hip loading was decreased compared to control subjects, while no differences were found between patient groups. This indicates that THA via DAA results in similar hip loading as a RHA via DLA or PLA. Stair climbing did not result in more distinct differences in hip contact force magnitude between patients and controls, although differences in orientation were more distinct. However, patients after hip surgery did adjust their motion pattern to decrease the magnitude of loading on the hip joint compared to control subjects. PMID:27004636

  5. Properties of copper?stainless steel HIP joints before and after neutron irradiation

    NASA Astrophysics Data System (ADS)

    Tähtinen, S.; Laukkanen, A.; Singh, B. N.; Toft, P.

    2002-12-01

    The tensile and fracture behaviour of CuCrZr and CuAl25 IG0 alloys joint to 316L(N) stainless steel by hot isostatic pressing (HIP) have been determined in unirradiated and neutron-irradiated conditions. The tensile and fracture behaviour of copper alloy HIP joint specimens are dominated by the properties of the copper alloys, and particularly, by the strength mismatch and mismatch in strain hardening capacities between copper alloys and stainless steel. The test temperature, neutron irradiation and thermal cycles primarily affect the copper alloy HIP joint properties through changing the strength mismatch between the base alloys. Changes in the loading conditions i.e. tensile, bend ( JI) and mixed-mode bend ( JI/ JII) lead to different fracture modes in the copper alloy HIP joint specimens.

  6. Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia.

    PubMed

    Giorgi, Mario; Carriero, Alessandra; Shefelbine, Sandra J; Nowlan, Niamh C

    2015-09-18

    Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH. PMID:26163754

  7. Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia

    PubMed Central

    Giorgi, Mario; Carriero, Alessandra; Shefelbine, Sandra J.; Nowlan, Niamh C.

    2015-01-01

    Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH. PMID:26163754

  8. Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population.

    PubMed

    Lian, Fan; Yang, Xiuyan; Liang, Liuqin; Xu, Hanshi; Zhan, Zhongping; Qiu, Qian; Ye, Yujin

    2012-06-01

    To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P < 0.05), Bath AS Functional Activity Index (BASFI) (P < 0.05), and Harris hip score (P < 0.05) was demonstrated. Radiographic progression was recorded as no exacerbation or alleviated. Larger interval between two etanercept administrations would provide similar advantages to standard method and possibly less adverse events if MTX was combined. Etanercept and MTX combination therapy was beneficial to ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing. PMID:21387110

  9. Articular cartilage friction increases in hip joints after the removal of acetabular labrum.

    PubMed

    Song, Yongnam; Ito, Hiroshi; Kourtis, Lampros; Safran, Marc R; Carter, Dennis R; Giori, Nicholas J

    2012-02-01

    The acetabular labrum is believed to have a sealing function. However, a torn labrum may not effectively prevent joint fluid from escaping a compressed joint, resulting in impaired lubrication. We aimed to understand the role of the acetabular labrum in maintaining a low friction environment in the hip joint. We did this by measuring the resistance to rotation (RTR) of the hip, which reflects the friction of the articular cartilage surface, following focal and complete labrectomy. Five cadaveric hips without evidence of osteoarthritis and impingement were tested. We measured resistance to rotation of the hip joint during 0.5, 1, 2, and 3 times body weight (BW) cyclic loading in the intact hip, and after focal and complete labrectomy. Resistance to rotation, which reflects articular cartilage friction in an intact hip was significantly increased following focal labrectomy at 1-3 BW loading, and following complete labrectomy at all load levels. The acetabular labrum appears to maintain a low friction environment, possibly by sealing the joint from fluid exudation. Even focal labrectomy may result in increased joint friction, a condition that may be detrimental to articular cartilage and lead to osteoarthritis. PMID:22176711

  10. Tantalum as a buffer layer in diamond-like carbon coated artificial hip joints.

    PubMed

    Kiuru, Mirjami; Alakoski, Esa; Tiainen, Veli-Matti; Lappalainen, Reijo; Anttila, Asko

    2003-07-15

    The acid resistance of tantalum coated and uncoated human hip joint prostheses was studied with commercial CrCoMo acetabular cups. The samples were exposed to 10% HCl solution and the quantities of dissolved Cr, Co, and Mo were measured with proton-induced X-ray emission (PIXE). The absolute quantities were obtained with the use of Cr and Se solution standards. Tantalum coatings (thicknesses 4-6 microm) were prepared in vacuum with magnetron sputtering. Tantalum coating decreased the corrosion rate by a factor of 10(6). As a spinoff from recent wear tests on artificial hip joints it was shown that tantalum has excellent mechanical properties as an intermediate layer of diamond-like carbon (DLC) coatings. When tantalum was tested together with DLC on three metal-on-metal hip joint pairs in a hip simulator, no observable defects occurred during 15 million walking cycles with a periodic 50-300-kg load (Paul curve). PMID:12808604

  11. Hip Replacement

    MedlinePlus

    ... surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts. A hip replacement can Relieve pain Help your hip joint work better Improve walking and other movements The ...

  12. Efficacy of Debridement for Early Periprosthetic Joint Infection after Hip Arthroplasty

    PubMed Central

    Kim, Jong Hoon; Chun, Sung Kwang; Yoon, Yong Cheol; Lakhotia, Devendra

    2014-01-01

    Purpose In early prosthetic joint infection after hip arthroplasty, debridement with prosthesis retention may be performed for implant salvage, but the reported success rates are highly variable. Hence we reviewed the outcome of radical debridement and retention of prosthesis using established diagnostic criteria and surgical procedures in relation to significant variables including clinical characteristics, pathogenicity, and antibiotic treatment. Materials and Methods We retrospectively reviewed 20 patients (11 men and 9 women) with early prosthetic joint infection after unilateral hip arthroplasty, treated by radical debridement with retention of prosthesis from January 2000 to May 2011. Average follow-up period was 55 months (12-178 months). The outcome was evaluated and analyzed based on recurrence of infection and clinical (Harris hip score) and radiological criteria. Results Pathogens were isolated from 11 hips (methicillin-resistant Staphylococcus aureus [MRSA] in three, methicillin-resistant Staphylococcus epidermidis [MRSE] in two, methicillin-sensitive Staphylococcus aureus [MSSA] in one, Acinetobacter baumannii in two, Enterococcus faecalis in two patients, and Enterococcus, Citrobacter species in one). The mean duration of antibiotic administration was 43.5 days. Recurrence of infection was not observed in any case. Average Harris hip score was 91 points at the last follow-up. Revision surgery was not required for any reason including implant failure. Dislocation occurred in two hips after debridement and was treated conservatively. Conclusion Radical debridement with prosthesis retention is an effective procedure for early prosthetic joint infection after hip arthroplasty in carefully selected patients and with early diagnosis.

  13. "In vivo" determination of hip joint separation and the forces generated due to impact loading conditions.

    PubMed

    Dennis, D A; Komistek, R D; Northcut, E J; Ochoa, J A; Ritchie, A

    2001-05-01

    Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening. PMID:11311703

  14. Neuromuscular exercise prior to joint arthroplasty in patients with osteoarthritis of the hip or knee.

    PubMed

    Villadsen, Allan

    2016-04-01

    Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint and peri-articular structures like the muscles. The hallmark of OA is cartilage loss. The main symptoms are pain and decreased physical function leading to a reduced quality of life. OA ranks eight in leading causes of disability worldwide and it generates a heavy economic burden for society. The prevalence of OA increases with age and 10-18% aged above 60 years are affected. Currently there is no cure for OA and the various treatment modalities aim at addressing symptoms, i.e. reducing pain, improving physical function and preventing further progression of the disease. Exercise has proven to be a viable treatment option with regard to reducing pain and improving physical function in patients with mild to moderate knee OA and is today regarded a cornerstone in the treatment. The documentation is less clear for hip OA. Patients with severe OA of the hip or knee are treated with total joint arthroplasty (TJA). Although, in general, it is a very successful procedure, there are still challenges to overcome in this patient group, as approximately 10% of those having hip arthroplasty and 20% of those having knee arthroplasty have persistent symptoms. The evidence on the efficacy of exercise prior to TJA is sparse. It is based on insufficiently powered trials and with interventions of questionable validity. Two recent systematic reviews and meta-analyses reach conflicting conclusions and highlight the need for high quality trials with sufficient sample sizes. In this dissertation, I wanted to evaluate the effects of an individualised neuromuscular exercise programme (NEMEX-TJR) when administered prior to joint arthroplasty in patients with severe OA of the hip or knee joint. This intervention was previously found to be feasible with regard to pain level during exercise and it was possible to progress the training level in this patient group. The main question asked was: Does the addition of

  15. Effect of neutron irradiation on mechanical properties of Cu/SS joints after single and multiple HIP cycles

    NASA Astrophysics Data System (ADS)

    Tähtinen, S.; Singh, B. N.; Toft, P.

    2000-12-01

    The present design of the ITER plasma facing components consists of a copper alloy heat sink layer between plasma facing materials and stainless steel structure. The main option for manufacturing these components is hot isostatic pressing (HIP) method and several HIP thermal cycles are foreseen for manufacturing of the complete blanket module. Mechanical characterisation of HIP joints between dissimilar metals is a complicated issue, where information on mechanical properties of base alloys, metallurgy of the HIP joints and mechanical testing methods will be required. The tensile and three point bend tests produced different fracture modes, depending on test temperature, applied HIP thermal cycles and neutron irradiation. The fracture mode was either ductile fracture of copper alloy or joint interface fracture. The mechanical properties of the HIP joint specimens were dominated by strength mismatch of the base alloys which was affected by HIP thermal cycles and neutron irradiation.

  16. Repeatability and reproducibility of distraction indices in PennHIP examinations of the hip joint in dogs.

    PubMed

    Ginja, M M D; Ferreira, A J A; Silvestre, M; Gonzalo-Orden, J M; Llorens-Pena, M P

    2006-09-01

    Repeatability and reproducibility of Distraction Index (DI) measurements in the PennHIP method were evaluated in 100 dogs. The PennHIP distraction views sent to the PennHIP Analysis Center (PAC) were duplicated, digitalised, and identified with a code, and an adequate computer software was used for DI measurements. One examiner performed two DI measurement sessions, evaluating individually 200 hip joints. The scoring repeatability and reproducibility were estimated calculating the Intraclass Correlation Coefficient (ICC) between the two DI measurement sessions and between the second DI measurement session and the DI in PAC reports, respectively. The ICC for repeatability was 0.97 [95% confidence interval (CI), 0.96 to 0.98], and the ICC for reproducibility was 0.95 (95% CI, 0.93 to 0.96). The results suggest that the DI measurement method described is repeatable and can reproduce the PAC reports with confidence. Distraction indices measured in different PennHIP studies, using this DI measurement method and performed by trained researchers, can be considered interchangeable. PMID:17020141

  17. The effect of angle and moment of the hip and knee joint on iliotibial band hardness.

    PubMed

    Tateuchi, Hiroshige; Shiratori, Sakiko; Ichihashi, Noriaki

    2015-02-01

    Although several studies have described kinematic deviations such as excessive hip adduction in patients with iliotibial band (ITB) syndrome, the factors contributing to increased ITB hardness remains undetermined, owing to lack of direct in vivo measurement. The purpose of this study was to clarify the factors contributing to an increase in ITB hardness by comparing the ITB hardness between the conditions in which the angle, moment, and muscle activity of the hip and knee joint are changed. Sixteen healthy individuals performed the one-leg standing under five conditions in which the pelvic and trunk inclination were changed in the frontal plane. The shear elastic modulus in the ITB was measured as an indicator of the ITB hardness using shear wave elastography. The three-dimensional joint angle and external joint moment in the hip and knee joints, and muscle activities of the gluteus maximus, gluteus medius, tensor fasciae latae, and vastus lateralis, which anatomically connect to the ITB, were also measured. ITB hardness was significantly increased in the posture with pelvic and trunk inclination toward the contralateral side of the standing leg compared with that in all other conditions (increase of approximately 32% compared with that during normal one-leg standing). This posture increased both the hip adduction angle and external adduction moment at the hip and knee joint, although muscle activities were not increased. Our findings suggest that coexistence of an increased adduction moment at the hip and knee joints with an excessive hip adduction angle lead to an increase in ITB hardness. PMID:25542398

  18. A computer-based image analysis method for assessing the severity of hip joint osteoarthritis

    NASA Astrophysics Data System (ADS)

    Boniatis, Ioannis; Costaridou, Lena; Cavouras, Dionisis; Panagiotopoulos, Elias; Panayiotakis, George

    2006-12-01

    A computer-based image analysis method was developed for assessing the severity of hip osteoarthritis (OA). Eighteen pelvic radiographs of patients with verified unilateral hip OA, were digitized and enhanced employing custom developed software. Two ROIs corresponding to osteoarthritic and contralateral-physiological radiographic Hip Joint Spaces (HJSs) were determined on each radiograph. Textural features were extracted from the HJS-ROIs utilizing the run-length matrices and Laws textural measures. A k-Nearest Neighbour based hierarchical tree structure was designed for classifying hips into three OA severity categories labeled as "Normal", "Mild/Moderate", and "Severe". Employing the run-length features, the overall classification accuracy of the hierarchical tree structure was 86.1%. The utilization of Laws' textural measures improved the system classification performance, providing an overall classification accuracy of 94.4%. The proposed method maybe of value to physicians in assessing the severity of hip OA.

  19. No evidence hip joint angle modulates intrinsically produced stretch reflex in human hopping.

    PubMed

    Gibson, W; Campbell, A; Allison, G

    2013-09-01

    Motor output in activities such as walking and hopping is suggested to be mediated neurally by purported stretch reflex augmentation of muscle output. Reflex EMG activity during these tasks has been frequently investigated in the soleus muscle; with alterations in reflex amplitude being associated with changes in hip joint angle/phase of the gait cycle. Previous work has focussed on reflex activity induced by an artificial perturbation or by induction of H-reflexes. As such, it is currently unknown if stretch reflex activity induced intrinsically (as part of the task) is modulated by changes in hip joint angle. This study investigated whether hip joint angle modulated reflex EMG 'burst' activity during a hopping task performed on a custom-built partially reclined sleigh. Ten subjects participated; EMG and kinematic data (VICON motor capture system) was collected for each hop cycle. Participants completed 5 sets of 30s of self-paced hopping in (1) hip neutral and (2) hip 60° flexion conditions. There was no difference in EMG 'burst' activity or in sagittal plane kinematics (knee/ankle) in the hopping task between the two conditions. The results indicate that during a functional task such as hopping, changes in hip angle do not alter the stretch reflex-like activity associated with landing. PMID:23791780

  20. Hip Replacement

    MedlinePlus

    ... replacement is an operation in which a damaged hip joint is removed and replaced with an artificial joint. ... are many medical conditions that can damage the hip joint. (Watch the video to learn about what goes ...

  1. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

    PubMed

    Tsai, Henry P; Holliday, Casey M

    2015-06-01

    Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

  2. Identification of the contribution of the ankle and hip joints to multi-segmental balance control

    PubMed Central

    2013-01-01

    Background Human stance involves multiple segments, including the legs and trunk, and requires coordinated actions of both. A novel method was developed that reliably estimates the contribution of the left and right leg (i.e., the ankle and hip joints) to the balance control of individual subjects. Methods The method was evaluated using simulations of a double-inverted pendulum model and the applicability was demonstrated with an experiment with seven healthy and one Parkinsonian participant. Model simulations indicated that two perturbations are required to reliably estimate the dynamics of a double-inverted pendulum balance control system. In the experiment, two multisine perturbation signals were applied simultaneously. The balance control system dynamic behaviour of the participants was estimated by Frequency Response Functions (FRFs), which relate ankle and hip joint angles to joint torques, using a multivariate closed-loop system identification technique. Results In the model simulations, the FRFs were reliably estimated, also in the presence of realistic levels of noise. In the experiment, the participants responded consistently to the perturbations, indicated by low noise-to-signal ratios of the ankle angle (0.24), hip angle (0.28), ankle torque (0.07), and hip torque (0.33). The developed method could detect that the Parkinson patient controlled his balance asymmetrically, that is, the right ankle and hip joints produced more corrective torque. Conclusion The method allows for a reliable estimate of the multisegmental feedback mechanism that stabilizes stance, of individual participants and of separate legs. PMID:23433148

  3. Iranian Joint Registry (Iranian National Hip and Knee Arthroplasty Registry)

    PubMed Central

    Aslani, Hamidreza; Nourbakhsh, Seyed Taghi; Lahiji, Farivar A.; Heydarian, Keykavoos; Jabalameli, Mahmood; Ghazavi, Mohammad Taghi; Tahmasebi, Mohammad Naghi; Fayyaz, Mahmoud Reza; Sazegari, Mohammad Ali; Mohaddes, Maziar; Rajabpour, Mojtaba; Emami, Mohammad; Jazayeri, Seyyed Mohammad; Madadi, Firooz; Farahini, Hossein; Mirzatoloee, Fardin; Gharahdaghi, Mohammad; Ebrahimzadeh, Mohammad Hossein; Ebrahimian, Mohammadreza; Mirvakili, Hossein; Bashti, Kaveh; Almasizadeh, Mohtasham; Abolghasemian, Mansour; Taheriazam, Afshin; Motififard, Mehdi; Yazdi, Hamidreza; Mobarakeh, Mahmood Karimi; Shayestehazar, Masoud; Moghtadae, Mehdi; Siavashi, Babak; Sajjadi, Mohammadreza M.; Rasi, Alireza Manafi; Chabok, Seyyed Kazem; Zafarani, Zohreh; Salehi, Shahin; Ahmadi, Monireh; Mohammadi, Amin; Shahsavand, Mohammad Ebrahim

    2016-01-01

    Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran’s Ministry of Health and Education. PMID:27200403

  4. Osteoarthritis of the hip: an occupational disease in farmers.

    PubMed Central

    Croft, P.; Coggon, D.; Cruddas, M.; Cooper, C.

    1992-01-01

    OBJECTIVE--To test the hypothesis that farmers are at high risk of hip osteoarthritis and to investigate possible causes for such a hazard. DESIGN--Cross sectional survey. SETTING--Five rural general practices. SUBJECTS--167 male farmers aged 60-76 and 83 controls from mainly sedentary jobs. All those without previous hip replacement underwent radiography of the hip. MAIN OUTCOME MEASURES--Hip replacement for osteoarthritis or radiological evidence of hip osteoarthritis. RESULTS--Prevalence of hip osteoarthritis was higher in farmers than controls and especially in those who had farmed for over 10 years (odds ratio 9.3, 95% confidence interval 1.9 to 44.5). The excess could not be attributed to any one type of farming, and heavy lifting seems the likely explanation. CONCLUSIONS--Manual handling in agriculture should be limited where possible. Consideration should be given to making hip osteoarthritis a prescribed industrial disease in farmers. There may be wider implications for the prevention of hip osteoarthritis in the general population. PMID:1606427

  5. Compressive and shear hip joint contact forces are affected by pediatric obesity during walking.

    PubMed

    Lerner, Zachary F; Browning, Raymond C

    2016-06-14

    Obese children exhibit altered gait mechanics compared to healthy-weight children and have an increased prevalence of hip pain and pathology. This study sought to determine the relationships between body mass and compressive and shear hip joint contact forces during walking. Kinematic and kinetic data were collected during treadmill walking at 1ms(-1) in 10 obese and 10 healthy-weight 8-12 year-olds. We estimated body composition, segment masses, lower-extremity alignment, and femoral neck angle via radiographic images, created personalized musculoskeletal models in OpenSim, and computed muscle forces and hip joint contact forces. Hip extension at mid-stance was 9° less, on average, in the obese children (p<0.001). Hip abduction, knee flexion, and body-weight normalized peak hip moments were similar between groups. Normalized to body-weight, peak contact forces were similar at the first peak and slightly lower at the second peak between the obese and healthy-weight participants. Total body mass explained a greater proportion of contact force variance compared to lean body mass in the compressive (r(2)=0.89) and vertical shear (perpendicular to the physis acting superior-to-inferior) (r(2)=0.84) directions; lean body mass explained a greater proportion in the posterior shear direction (r(2)=0.54). Stance-average contact forces in the compressive and vertical shear directions increased by 41N and 48N, respectively, for every kilogram of body mass. Age explained less than 27% of the hip loading variance. No effect of sex was found. The proportionality between hip loads and body-weight may be implicated in an obese child׳s increased risk of hip pain and pathology. PMID:27040390

  6. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  7. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  8. Growth characteristics of the fetal ligament of the head of femur: significance in congenital hip disease.

    PubMed Central

    Walker, J. M.

    1980-01-01

    Measurement of the length and width of the ligament of the head of femur (ligamentum teres) in 140 normal human fetuses between 12 weeks and term provides limits for growth changes in this structure. These observations provide no morphological evidence of a significant difference between males and females, or between the right and left sides, to explain the female and left hip preponderance reported in congenital hip disease. The ligament is shown to be variable in length, width, and shape, and it is not a distinctly linear structure through linearity may increase with age. Tests of femoral head mobility support the opinion that this ligament must play a role in fetal and neonatal hip joint stability. Weak correlation only was demonstrated between the ligament variables and acetabular depth, which suggests that ligament shape and socket shape are not closely related. Comparison of measurements from normal and 12 dysplastic or subluxated joints provides no evidence to support previous observations that this structure is unusually long in abnormal hip joints which are not frankly dislocated. Images FIG. 1 PMID:7445537

  9. Visualization of a newborn's hip joint using 3D ultrasound and automatic image processing

    NASA Astrophysics Data System (ADS)

    Overhoff, Heinrich M.; Lazovic, Djordje; von Jan, Ute

    1999-05-01

    Graf's method is a successful procedure for the diagnostic screening of developmental dysplasia of the hip. In a defined 2-D ultrasound (US) scan, which virtually cuts the hip joint, landmarks are interactively identified to derive congruence indicators. As the indicators do not reflect the spatial joint structure, and the femoral head is not clearly visible in the US scan, here 3-D US is used to gain insight to the hip joint in its spatial form. Hip joints of newborns were free-hand scanned using a conventional ultrasound transducer and a localizer system fixed on the scanhead. To overcome examiner- dependent findings the landmarks were detected by automatic segmentation of the image volume. The landmark image volumes and an automatically determined virtual sphere approximating the femoral head were visualized color-coded on a computer screen. The visualization was found to be intuitive and to simplify the diagnostic substantially. By the visualization of the 3-D relations between acetabulum and femoral head the reliability of diagnostics is improved by finding the entire joint geometry.

  10. Effects of Idealized Joint Geometry on Finite Element Predictions of Cartilage Contact Stresses in the Hip

    PubMed Central

    Anderson, Andrew E.; Ellis, Benjamin J.; Maas, Steve A.; Weiss, Jeffrey A.

    2010-01-01

    Computational models may have the ability to quantify the relationship between hip morphology, cartilage mechanics and osteoarthritis. Most models have assumed the hip joint to be a perfect ball and socket joint and have neglected deformation at the interface between bone/cartilage. The objective of this study was to analyze finite element (FE) models of hip cartilage mechanics with varying degrees of simplified geometry and a model with a rigid bone material assumption to elucidate the effects on predictions of cartilage stress. A previously validated subject-specific FE model of a cadaveric hip joint was used as the basis for the models. Geometry for the bone/cartilage interface was either: 1) subject-specific (i.e. irregular), 2) spherical, or 3) a rotational conchoid. Cartilage was assigned either a varying (irregular) or constant thickness (smoothed). Loading conditions simulated walking, stair climbing and descending stairs. FE predictions of contact stress for the simplified models were compared with predictions from the subject-specific model. Both spheres and conchoids provided a good approximation of native hip joint geometry (average fitting error ~0.5 mm). However, models with spherical/conchoid bone geometry and smoothed articulating cartilage surfaces grossly underestimated peak and average contact pressures (50% and 25% lower, respectively) and overestimated contact area when compared to the subject-specific FE model. Models incorporating subject-specific bone geometry with smoothed articulating cartilage also underestimated pressures and predicted evenly distributed patterns of contact. The model with rigid bones predicted much higher pressures than the subject-specific model with deformable bones. The results demonstrate that simplifications to the geometry of the bone/cartilage interface, cartilage surface and bone material properties can have a dramatic effect on the predicted magnitude and distribution of cartilage contact pressures in the hip

  11. Loss of range of motion of the hip joint: a hypothesis for etiology of sports hernia

    PubMed Central

    Rambani, Rohit; Hackney, Roger

    2015-01-01

    Summary Background: sports hernia is a well-recognized cause of groin pain in athletes involved in sports, especially football and rugby. Loss of range of motion of the hip joint is a possible contributory factor to stress across the symphysis pubis leading to the instability. Methods: twenty-five athletes presenting with sports hernia were matched to age, sex, physical/sports activity and co-morbidities with twenty-five athletes without sports hernia. The range of movement of both the hips was compared in athletes of both the groups. Results: there was marked restriction of internal rotation with the hip flexed to 90 degrees (average 17 degrees) and external rotation (average 26 degrees) in sports hernia group compared to the control group. Other movements of the hip were comparable in both the groups. Conclusion: the study highlights observation of limitation of hip rotation with the hip flexed to 90 degrees as a possible factor in the aetiology of sports hernia. There may be an association with other pathologies of the hip such as impingement that requires further investigation. Though this study has its limitation in being a small number and a case control study, it does helps in understanding the possible mechanism of development of this condition. PMID:25878984

  12. Changes in hip joint muscle-tendon lengths with mode of locomotion.

    PubMed

    Riley, Patrick O; Franz, Jason; Dicharry, Jay; Kerrigan, D Casey

    2010-02-01

    We have reported that peak hip extension is nearly identical in walking and running, suggesting that anatomical constraints, such as flexor muscle tightness may limit the range of hip extension. To obtain a more mechanistic insight into mobility at the hip and pelvis we examined the lengths of the muscle-tendons units crossing the hip joint. Data defining the three-dimensional kinematics of 26 healthy runners at self-selected walking and running speeds were obtained. These data were used to scale and drive musculoskeletal models using OpenSIM. Muscle-tendon unit (MTU) lengths were calculated for the trailing limb illiacus, rectus femoris, gluteus maximus, and biceps femoris long head and the advancing limb biceps femoris and gluteus maximus. The magnitude and timing of MTU length peaks were each compared between walking and running. The peak length of the right (trailing limb) illiacus MTU, a pure hip flexor, was nearly identical between walking and running, while the maximum length of the rectus femoris MTU, a hip flexor and knee extensor, increased during running. The maximum length of the left (leading limb) biceps femoris was also unchanged between walking and running. Further, the timing of peak illiacus MTU length and peak contralateral biceps femoris MTU length occurred essentially simultaneously during running, at a time during gait when the hamstrings are most vulnerable to stretch injury. This latter finding suggests exploring the role for hip flexor stretching in combination with hamstring stretching to treat and/or prevent running related hamstring injury. PMID:20022251

  13. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for use with bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the... metal (hemi-hip) acetabular metal cemented prosthesis shall have an approved PMA or a declared...

  14. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for use with bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the... metal (hemi-hip) acetabular metal cemented prosthesis shall have an approved PMA or a declared...

  15. Tribological measurements on a Charnley-type artificial hip joint

    NASA Technical Reports Server (NTRS)

    Jones, W. R., Jr.

    1983-01-01

    A total hip simulator was used to determine the friction and wear properties of Charnley-type (316L stainless steel balls and sterile ultrahigh molecular weight polyethylene cups) hip prostheses. Three different sets of specimens were tested to 395,000, 101,500 and 233,000 walking cycles, respectively. All tests were run unlubricated, at ambient conditions (22 to 26 C, 30 to 50 percent relative humidity), at 30 walking cycles per minute, under a dynamic load simulating walking. Polyethylene cup wear rates ranged from 1.4 to 39 ten billions cu m which corresponds to dimensional losses of 4.0 to 11 microns per year. Although these wear rates are lower than those obtained from other hip simulators and from in vivo X-ray measurements, they are comparable when taking run-in and plastic deformation into account. Maximum tangential friction forces ranged from 93 to 129 N under variable load (267 to 3090 N range) and from 93 to 143 N under a static load of 3090 N. A portion of one test 250,000 walking cycles) run under dry air ( 1 percent relative humidity) yielded a wear rate almost 6 times greater than that obtained under wet air ( 70 percent relative humidity) conditions.

  16. Hip Implant Systems

    MedlinePlus

    ... hip replacement surgery, the damaged portions of the hip joint are removed. The ball (femoral head) is removed ... hip or leg Swelling at or near the hip joint A limp or change in walking ability Noise ( ...

  17. An appraisal of the short lateral rotators of the hip joint.

    PubMed

    Yoo, Sarang; Dedova, Irina; Pather, Nalini

    2015-09-01

    The short lateral rotators (piriformis, obturator internus, superior and inferior gemelli, obturator internus, and quadratus femoris) are functionally important muscles, significantly contributing to hip joint stability. They act as "postural muscles", holding the femoral head in the acetabulum during hip movements, thus are frequently monitored in gait analysis and for muscle rehabilitation post-injury. Despite the need to precisely identify and repair these muscles for stability postoperatively, clinical complications have resulted from the inadequate and inconsistent understanding of their morphological and functional anatomy. Furthermore, the short lateral rotators have complex entheses (osteotendinous insertions on bone) and may be subject to overuse injury in sport. This study aims to review the reported morphology of the short lateral rotators in order to ascertain whether discrepancies exist in our understanding of these muscles, and if further investigation is required to aid in gait analysis, clinical management of hip pathologies, and prevention of overuse injuries. Following a literature search strategy, 59 primary references were retrieved from three databases, with additional 26 anatomical textbooks selected for critical evaluation. Numerous inaccuracies and inconsistencies in the anatomical descriptions of the attachments, patterns of innervation and actions exist, and often insufficiently supported by primary findings. There is also a paucity of information regarding the architectural pattern of the muscles, which would be useful in clarifying the function of these dynamic stabilizers of the hip joint. A better anatomical understanding of these muscles will better inform hip reconstruction and lead to improved surgical outcomes by reducing post-operative complications. PMID:26032283

  18. Morphometric assessment of the canine hip joint using the acetabular angle of retrotorsion.

    PubMed

    Doskarova, B; Kyllar, M; Paral, V

    2010-01-01

    Morphometric assessment of the canine hip joint using acetabular angle of retrotorsion was used in this study. The aim of our study was to compare the acetabular angle of retrotorsion (AAR) with values of the Norberg angle (NA) and the hip score (HS) in the Leonberger dog breed and to determine the cut-off point of AAR that distinguish between normal and dysplastic hip status on the basis of Fédération Cynologique Internationale (FCI) hip evaluation. Retrospective analysis of NA and AAR was measured from standard ventrodorsal pelvic radiographs with extended femurs in 387 Leonberger dogs (141 males and 246 females) from 18 to 63 months of age, which were then divided into five age-groups. Through analysis of these radiographs, it was determined that the cut-off point for NA was 105°, AAR was 15°, and the acetabular angle of retrotorsion was positively correlated with Norberg angle and negatively correlated with hip score. The results of our study indicate that the acetabular angle of retrotorsion may represent a reliable morphometric assessment tool in evaluating acetabular cup conformation, and values of AAR may help to assess the FCI grade of canine hip dysplasia. PMID:20740259

  19. Hip Joint Replacement Using Monofilament Polypropylene Surgical Mesh: An Animal Model

    PubMed Central

    Białecki, Jacek; Klimowicz-Bodys, Małgorzata Dorota; Wierzchoś, Edward; Kołomecki, Krzysztof

    2014-01-01

    Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur) leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS), triple pelvic osteotomy (TPO), total hip replacement (THR), and femoral head and neck resection (FHNE). The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform. PMID:24987672

  20. Hip joint replacement using monofilament polypropylene surgical mesh: an animal model.

    PubMed

    Białecki, Jacek; Majchrzycki, Marian; Szymczak, Antoni; Klimowicz-Bodys, Małgorzata Dorota; Wierzchoś, Edward; Kołomecki, Krzysztof

    2014-01-01

    Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur) leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS), triple pelvic osteotomy (TPO), total hip replacement (THR), and femoral head and neck resection (FHNE). The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform. PMID:24987672

  1. Optical measurement system for preparation and after-OP-check of a hip joint endoprothetic implantation

    NASA Astrophysics Data System (ADS)

    Maschke, R.; Lempe, B.; Taudt, Ch.; Rudek, F.; Baselt, T.; Basan, F.; Grunert, R.; Hartmann, P.

    2014-02-01

    With 332,000 operations carried out every year, the implantation of an artificial hip joint is one of the most common surgical operations performed in the US. According to prognosis which takes the demographical change into account, the number of these operations will increase in the coming years. One of the essential requirements is the perfect reconstruction of the biomechanical functions, especially the knowledge about the center of the hip rotation and the length of the leg. Based on this information it is possible to ensure the right position of the newly set leg during surgery. The aim of this work is to present and evaluate an optical measurement method in order to gather information about the center of the hip joint and the leg length. An appropriate laboratory setup has been designed and implemented in order to evaluate two different approaches: a structured light-method consisting of a DLP-Beamer or a laser source which projects defined patterns onto the patient and a marker-based system. Together with this both methods are combined with custom software to determine the hip joint center and the leg length with an accuracy of around +/- 0.2 inches. The clinical use of the tested approaches would give the surgeon the opportunity to reset the implant-parameters in the course of the surgery. In this way subsequent illnesses such as scoliotic pelvis can be prevented.

  2. Role of the Acetabular Labrum in Load Support Across the Hip Joint

    PubMed Central

    Henak, Corinne R.; Ellis, Benjamin J.; Harris, Michael D.; Anderson, Andrew E.; Peters, Christopher L.; Weiss, Jeffrey A.

    2011-01-01

    The relatively high incidence of labral tears among patients presenting with hip pain suggests that the acetabular labrum is often subjected to injurious loading in vivo. However, it is unclear whether the labrum participates in load transfer across the joint during activities of daily living. This study examined the role of the acetabular labrum in load transfer for hips with normal acetabular geometry and acetabular dysplasia using subject-specific finite element analysis. Models were generated from volumetric CT data and analyzed with and without the labrum during activities of daily living. The labrum in the dysplastic model supported 4-11% of the total load transferred across the joint, while the labrum in the normal model supported only 1-2% of the total load. Despite the increased load transferred to the acetabular cartilage in simulations without the labrum, there were minimal differences in cartilage contact stresses. This was because the load supported by the cartilage correlated to the cartilage contact area. A higher percentage of load was transferred to the labrum in the dysplastic model because the femoral head achieved equilibrium near the lateral edge of the acetabulum. The results of this study suggest that the labrum plays a larger role in load transfer and joint stability in hips with acetabular dysplasia than in hips with normal acetabular geometry. PMID:21757198

  3. [Experimental research of the influences on the development of the hip joints with excavated acetabula].

    PubMed

    Sun, D; Chen, X; Tang, C

    1996-12-01

    There are still arguments about the operation excavated acetabula treatments for the congenital dislocation of the hip. To inquire into the influences on the development of the hip joints with excavated acetabula size, we divided 60 two-month-old chickens into three groups which were given incised dislocation and then reduction partly excavated the cartilages of the acetabula and excavated them totally to the left hips respectively. Contrasting observation of all the experimental chickens was taken on the right ones of their own. The second group achieved a fair function of the joint movement. Limited and slight adhesion was not affecting the development of the joints seriously. The third group had, on the contrary, poor functions because of the comprehensive adhesion in the acetabula. The surfaces of the acetabula were replaced by fabric tissue. The remaining or regenerating cartilage cells vary obviously under the light scope and the electronic scope. The heads of the femurs had changed similarly. It is suggested that in dealing with the congenital dislocation of the hip, excavating the acetabola cartilage is not advisable. Partly excavating is permitted when a limited bony process existing in the bottom of the acetabula. PMID:9590781

  4. Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review

    PubMed Central

    Santaguida, Pasqualina L.; Hawker, Gillian A.; Hudak, Pamela L.; Glazier, Richard; Mahomed, Nizar N.; Kreder†, Hans J.; Coyte, Peter C.; Wright, James G.

    2008-01-01

    Background Total joint arthroplasty is a highly efficacious and cost-effective procedure for moderate to severe arthritis in the hip and knee. Although patient characteristics are considered to be important determinants of who receives total joint arthroplasty, no systematic review has addressed how they affect the outcomes of total joint arthroplasty. This study addresses how patient characteristics influence the outcomes of hip and knee arthroplasty in patients with osteoarthritis. Methods We searched 4 bibliographic databases (MEDLINE 1980–2001, CINAHL 1982–2001, EMBASE 1980–2001, HealthStar 1998–1999) for studies involving more than 500 patients with osteoarthritis and 1 or more of the following outcomes after total joint arthroplasty: pain, physical function, postoperative complications (short-and long-term) and time to revision. Prognostic patient characteristics of interest included age, sex, race, body weight, socioeconomic status and work status. Results Sixty-four of 14 276 studies were eligible for inclusion and had extractable data. Younger age (variably defined) and male sex increased the risk of revision 3-fold to 5-fold for hip and knee arthroplasty. The influence of weight on the risk of revision was contradictory. Mortality was greatest in the oldest age group and among men. Function for older patients was worse after hip arthroplasty (particularly in women). Function after knee arthroplasty was worse for obese patients. Conclusion Although further research is required, our findings suggest that, after total joint arthroplasty, younger age and male sex are associated with increased risk of revision, older age and male sex are associated with increased risk of mortality, older age is related to worse function (particularly among women), and age and sex do not influence the outcome of pain. Despite these findings, all subgroups derived benefit from total joint arthroplasty, suggesting that surgeons should not restrict access to these

  5. Hip ultrasound.

    PubMed

    Martinoli, Carlo; Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa; Valle, Maura; Tagliafico, Alberto

    2012-12-01

    In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up. PMID:21571471

  6. Retrospective Analysis for Genetic Improvement of Hip Joints of Cohort Labrador Retrievers in the United States: 1970–2007

    PubMed Central

    Lust, George; Zhu, Lan; Zhang, Zhiwu; Todhunter, Rory J.

    2010-01-01

    Background Canine Hip Dysplasia (CHD) is a common inherited disease that affects dog wellbeing and causes a heavy financial and emotional burden to dog owners and breeders due to secondary hip osteoarthritis. The Orthopedic Foundation for Animals (OFA) initiated a program in the 1960's to radiograph hip and elbow joints and release the OFA scores to the public for breeding dogs against CHD. Over last four decades, more than one million radiographic scores have been released. Methodology/Principal Findings The pedigrees in the OFA database consisted of 258,851 Labrador retrievers, the major breed scored by the OFA (25% of total records). Of these, 154,352 dogs had an OFA hip score reported between 1970 and 2007. The rest of the dogs (104,499) were the ancestors of the 154,352 dogs to link the pedigree relationships. The OFA hip score is based on a 7-point scale with the best ranked as 1 (excellent) and the worst hip dysplasia as 7. A mixed linear model was used to estimate the effects of age, sex, and test year period and to predict the breeding value for each dog. Additive genetic and residual variances were estimated using the average information restricted maximum likelihood procedure. The analysis also provided an inbreeding coefficient for each dog. The hip scores averaged 1.93 (±SD = 0.59) and the heritability was 0.21. A steady genetic improvement has accrued over the four decades. The breeding values decreased (improved) linearly. By the end of 2005, the total genetic improvement was 0.1 units, which is equivalent to 17% of the total phenotypic standard deviation. Conclusion/Significance A steady genetic improvement has been achieved through the selection based on the raw phenotype released by the OFA. As the heritability of the hip score was on the low end (0.21) of reported ranges, we propose that selection based on breeding values will result in more rapid genetic improvement than breeding based on phenotypic selection alone. PMID:20195372

  7. Influence of electrical stimulation on hip joint adductor muscle activity during maximum effort

    PubMed Central

    Nakano, Sota; Wada, Chikamune

    2016-01-01

    [Purpose] This study investigated whether hip adductor activity was influenced by electrical stimulation of the tensor fascia lata muscle. [Subjects and Methods] The subjects were 16 nondisabled males. Each subject was asked to adduct the hip joint with maximum effort. The electromyogram of the adductor longus was recorded under two experimental conditions, with and without electrical stimulation of the tensor fascia lata. [Results] In the presence of electrical stimulation, muscle activity decreased to 72.9% (57.8–89.3%) of that without stimulation. [Conclusion] These results suggested that inactivation of the adductor group was promoted by electrical stimulation of the tensor fascia lata. PMID:27313387

  8. Hip rotation angle is associated with frontal plane knee joint mechanics during running.

    PubMed

    Sakaguchi, Masanori; Shimizu, Norifumi; Yanai, Toshimasa; Stefanyshyn, Darren J; Kawakami, Yasuo

    2015-02-01

    Inability to control lower extremity segments in the frontal and transverse planes resulting in large knee abduction angle and increased internal knee abduction impulse has been associated with patellofemoral pain (PFP). However, the influence of hip rotation angles on frontal plane knee joint kinematics and kinetics remains unclear. The purpose of this study was to explore how hip rotation angles are related to frontal plane knee joint kinematics and kinetics during running. Seventy runners participated in this study. Three-dimensional marker positions and ground reaction forces were recorded with an 8-camera motion analysis system and a force plate while subjects ran along a 25-m runway at a speed of 4m/s. Knee abduction, hip rotation and toe-out angles, frontal plane lever arm at the knee, internal knee abduction moment and impulse, ground reaction forces and the medio-lateral distance from the ankle joint center to the center of pressure (AJC-CoP) were quantified. The findings of this study indicate that greater hip external rotation angles were associated with greater toe-out angles, longer AJC-CoP distances, smaller internal knee abduction impulses with shorter frontal plane lever arms and greater knee abduction angles. Thus, there appears to exist a conflict between kinematic and kinetic risk factors of PFP, and hip external rotation angle may be a key factor to control frontal plane knee joint kinematics and kinetics. These results may help provide an appropriate manipulation and/or intervention on running style to reduce the risk of PFP. PMID:25572723

  9. In vivo baseline measurements of hip joint range of motion in suspensory and non-suspensory anthropoids

    PubMed Central

    Hammond, Ashley S.

    2014-01-01

    Hominoids and atelines are known to use suspensory behaviors and are assumed to possess greater hip joint mobility than non-suspensory monkeys, particularly for range of abduction. This assumption has greatly influenced how extant and fossil primate hip joint morphology has been interpreted, despite the fact that there are no data available on hip mobility in hominoids or Ateles. This study uses in vivo measurements to test the hypothesis that suspensory anthropoids have significantly greater ranges of hip joint mobility than non-suspensory anthropoids. Passive hip joint mobility was measured on a large sample of anesthetized captive anthropoids (non-human hominids=43, hylobatids=6, cercopithecids=43, Ateles=6, Cebus=6). Angular and linear data were collected using goniometers and tape measures. Range of motion data were analyzed for significant differences by locomotor group using ANOVA and phylogenetic regression. The data demonstrate that suspensory anthropoids are capable of significantly greater hip abduction and external rotation. Degree of flexion and internal rotation were not larger in the suspensory primates, indicating that suspension is not associated with a global increase in hip mobility. Future work should consider the role of external rotation in abduction ability, how the physical position of the distal limb segments are influenced by differences in range of motion proximally, as well as focus on bony and soft tissue differences that enable or restrict abduction and external rotation at the anthropoid hip joint. PMID:24288178

  10. Feasibility of Arthroscopic Placement of Autologous Matrix-Induced Chondrogenesis Grafts in the Cadaver Hip Joint

    PubMed Central

    Thorey, Fritz; Budde, Stefan; Ezechieli, Marco; Albrecht, Urs Vito; Ettinger, Max

    2013-01-01

    An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC) for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i) the feasibility of placing the AMIC in the different zones of the hip joint and ii) check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm) and 2/24 showed major displacement (>3 mm). None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone. PMID:24191186

  11. [Fatigue property analysis of prosthesis of hip joint with two different materials].

    PubMed

    Tang, Gang; Wang, Jiange; Luo, Hongxia

    2015-02-01

    Total hip replacement (THR) is replacing the prosthesis stem similar to human bone that takes advantage of the material with both good mechanical properties and biocompatibility to the damaged articular surface. Thus it can not only alleviate or even eliminate the pain but also effectively maintain the joint stability and freedom and restore its normal performance. Finite element analysis was used in this study to establish a 3D model of artificial hip stem, and explore its fatigue properties of different materials to ensure the safety and reliability. The calculating obtained two results of different metal hip prosthesis, including lifetime and deformation. The minimum service life of titanium prosthesis reaches 568 million times, which satisfies ISO standards, while the stainless steel does not suit to be a prosthesis material. PMID:25997269

  12. A Case of Legg-Calvé-Perthes Disease due to Transient Synovitis of the Hip

    PubMed Central

    Murata, Yasuaki; Morita, Yuji; Munakata, Yutaro; Kato, Yoshiharu

    2016-01-01

    Transient synovitis (TS) of the hip develops spontaneously in childhood; it usually has a good prognosis and is a self-limiting disease. However, its pathology is not well known. We describe a case of Legg-Calvé-Perthes disease (LCPD) that seemingly developed due to TS. Even if TS is diagnosed on the basis of the patient's medical history and imaging findings, physicians should consider the possibility of LCPD and perform a careful observation if joint effusion continues and/or a symptom does not improve within 4 weeks. PMID:27478667

  13. A Case of Legg-Calvé-Perthes Disease due to Transient Synovitis of the Hip.

    PubMed

    Ohtsuru, Tadahiko; Murata, Yasuaki; Morita, Yuji; Munakata, Yutaro; Kato, Yoshiharu

    2016-01-01

    Transient synovitis (TS) of the hip develops spontaneously in childhood; it usually has a good prognosis and is a self-limiting disease. However, its pathology is not well known. We describe a case of Legg-Calvé-Perthes disease (LCPD) that seemingly developed due to TS. Even if TS is diagnosed on the basis of the patient's medical history and imaging findings, physicians should consider the possibility of LCPD and perform a careful observation if joint effusion continues and/or a symptom does not improve within 4 weeks. PMID:27478667

  14. Habitual hip joint activity level of the penned EMU (Dromaius novaehollandie).

    PubMed

    Troy, Karen L; Lundberg, Hannah J; Conzemius, Michael G; Brown, Thomas D

    2007-01-01

    Orthopaedic management of femoral head osteonecrosis remains problematic, partly because of inability to systematically compare treatments in an animal model whose natural history parallels the human in terms of progression to femoral head collapse. Recently, it was determined that collapse could be consistently achieved for cryogenically induced osteonecrosis in the emu. Toward delineating the comparative hip joint biomechanics of emus versus humans, for purposes of establishing the emu as a model for human femoral head osteonecrosis, habitual hip joint activity level was quantified for a group of seven healthy adult emus housed in an outdoor research pen typical of those used in emu farming operations. The daily number of steps taken, and the time spent with the hips loaded (standing, or squatting/sitting) versus unloaded (recumbent), were quantified from 24-hour videotape recordings, analyzed by four independent observers. The average number of steps taken per day was 9563, which extrapolates to 1.8 million hip loadings per year, a value that falls in the same general range as seen in normal adult humans. On average, the emus spent 4:05 hours per day idly standing, 2:12 hours squatting/sitting, and 10:44 hours recumbent; they underwent an average of 37 transitions per day between the respective posture/activity states. PMID:17907425

  15. Metallographic evaluation of hip joint implants wear and electrochemical implants potential.

    PubMed

    Kmieć, Krzysztof; Sibinski, Marcin; Synder, Marek; Drobniewski, Marek; Kozłowski, Piotr

    2014-12-01

    We performed metallographic evaluations of implants, removed during revision hip arthroplasty. The implants were evaluated for electrochemical potentials and the presence of wear products on the implants surface. A total of 50 patients (50 hips) underwent revision hip arthroplasty during the years 2007-2009 for aseptic loosening. The mean follow-up from primary hip replacement to revision was 10.1 years (from six months to 17 years). All hip joint implants removed during the revision arthroplasty were submitted to metallographic analysis and all heads were submitted to analysis under a scanning microscope. All polyethylene (PE) cups and inserts showed numerous features of wear (friction wear, plastic deformation and creeping, fatigue wear and degradation), six PE cups were broken. In six ceramic cups, only friction wear features were found; one of them was mechanically broken. In all heads articulating on PE not one had any mechanical damage. Heads of ceramic implants in ceramic-ceramic articulation undergo abrasive wear. None of the studied stems (cemented or uncemented) revealed any features of wear. Areas of titanium crystals (formed by electrolytic sedimentation of metals) were macroscopically identified on the sliding surface of six heads that was confirmed by chemical composition and scanning microscope.In the course of prosthesis use, wear products are produced and transferred onto the sliding surfaces of implant heads and cups via ways other than purely mechanical contact. It has been confirmed that metals used for implant construction, make galvanic cells with different electrochemical potentials. PMID:25362874

  16. Time dependent human hip joint lubrication for periodic motion with stochastic asymmetric density function.

    PubMed

    Wierzcholski, Krzysztof

    2014-01-01

    The present paper is concerned with the calculation of the human hip joint parameters for periodic, stochastic unsteady, motion with asymmetric probability density function for gap height. The asymmetric density function indicates that the stochastic probabilities of gap height decreasing are different in comparison with the probabilities of the gap height increasing. The models of asymmetric density functions are considered on the grounds of experimental observations. Some methods are proposed for calculation of pressure distributions and load carrying capacities for unsteady stochastic conditions in a super thin layer of biological synovial fluid inside the slide biobearing gap limited by a spherical bone acetabulum. Numerical calculations are performed in Mathcad 12 Professional Program, by using the method of finite differences. This method assures stability of numerical solutions of partial differential equations and gives proper values of pressure and load carrying capacity forces occurring in human hip joints. PMID:24707824

  17. Stochastic impulsive pressure calculations for time dependent human hip joint lubrication.

    PubMed

    Wierzcholski, Krzysztof

    2012-01-01

    The present paper is concerned with the calculation of the stochastic unsteady, impulsive pressure distributions and load carrying capacities in human hip joint for unsteady stochastic conditions, various standard deviations and Gaussian probability density function. The total changes of hydrodynamic pressure caused by viscoelastic synovial fluid properties are completely estimated. Calculations are performed in a super thin layer of biological synovial fluid inside the slide hip joint gap limited by a spherical bone head. Using a new unified operator of summation (UOS) method, the numerical topology of pressure calculation for a difference method is applied. From numerical standpoint the proposed method of solving modified hydrodynamic equations reduces this problem to resolving the partial recurrence non-homogeneous equation of second order with variable coefficients. PMID:23394099

  18. Analysis of fluid film lubrication in artificial hip joint replacements with surfaces of high elastic modulus.

    PubMed

    Jin, Z M; Dowson, D; Fisher, J

    1997-01-01

    Lubrication mechanisms and contact mechanics have been analysed for total hip joint replacements made from hard bearing surfaces such as metal-on-metal and ceramic-on-ceramic. A similar analysis for ultra-high molecular weight polyethylene (UHMWPE) against a hard bearing surface has also been carried out and used as a reference. The most important factor influencing the predicted lubrication film thickness has been found to be the radial clearance between the ball and the socket. Full fluid film lubrication may be achieved in these hard/hard bearings provided that the surface finish of the bearing surface and the radial clearance are chosen correctly and maintained. Furthermore, there is a close relation between the predicted contact half width and the predicted lubrication film thickness. Therefore, it is important to analyse the contact mechanics in artificial hip joint replacements. Practical considerations of manufacturing these bearing surfaces have also been discussed. PMID:9256001

  19. An atypically located large subchondral cyst in an osteoarthritic hip joint: a case report

    PubMed Central

    2013-01-01

    Introduction Osteoarthritic subchondral cysts within or around the hip joint can sometimes be difficult to distinguish from primary osseous and soft tissue tumors due to their radiological appearance and uncommon location. Case presentation We report the case of a 74-year-old Turkish man with a subchondral cyst arising from the hip joint, eroding the acetabulum and located on the medial side of the iliac bone, which imitated a soft tissue tumor. This cystic lesion was resected and the results of histopathological analysis of tissue samples were found to be consistent with an osteoarthritic cyst. Conclusions The present case illustrates how an osteoarthritic subchondral cyst can grow into the soft tissue planes in the presence of destruction of the articular cartilage and subchondral bone continuity, and present as an apparent soft tissue tumor. PMID:23829963

  20. Autosomal dominant (Beukes) premature degenerative osteoarthropathy of the hip joint unlinked to COL2A1

    SciTech Connect

    Beighton, P.; Ramesar, R.; Cilliers, H.J.

    1994-12-01

    Molecular investigations have been undertaken in several separate large South African families with autosomal dominant skeletal dysplasias in which premature degenerative osteoarthropathy of the hip joint was the major manifestation. There are sometimes additional minor changes in the spine and these conditions fall into the general spondyloepiphyseal dysplasia (SED) nosological category. In some kindreds, linkage between phenotype and the type II collagen gene (COL2A1) has been established, while in others there is no linkage. We have now completed molecular linkage investigations in an Afrikaner family named Beukes, in which 47 members in 6 generations have premature osteoarthropathy of the hip joint. A LOD score of minus infinity indicates that this condition is not the result of a defect of the COL2A1 gene. 12 refs., 2 figs., 1 tab.

  1. Optimizing the corrosion fatigue properties of Co-Cr-Mo Hip joints

    NASA Astrophysics Data System (ADS)

    Tensi, Hans M.; Hooputra, Hariaokto; Weinfurtner, Wolfgang; Mayr, Hubert

    1995-01-01

    Because of their affordability and their adaptability to different designs, cast Co-Cr-Mo alloys are the materials most used for hip joint endoprostheses. These alloys combine excellent biocompatibility with a high corrosion resistance. Most hip joint endoprostheses are manufactured by conventional casting. The microstructural defects caused by this casting method lead to premature fractures. Aseptic loosening of endoprostheses also contributes to fracture. This article shows that using unidirectional solidification prolongs the mean value of fatigue life by at least six times over conventional casting; comparing the lowest values, the fatigue life is more than ten times higher. The comparison is made for two different kinds of solidified tension-compression specimens without any heat treatment to study only the influence of the solidification process. It should also be noted, however, that heat treatment adapted to microstructural parameters can elevate fatigue life.

  2. Mechanical properties of HIP bonded joints of austenitic stainless steel and Cu-alloy for fusion experimental reactor blanket

    NASA Astrophysics Data System (ADS)

    Sato, S.; Kuroda, T.; Kurasawa, T.; Furuya, K.; Togami, I.; Takatsu, H.

    1996-10-01

    Tensile, fatigue and impact properties have been measured for hot isostatic pressing (HIP) bonded joints of type 316 austenitic stainless steel (SS316)/SS316, and of SS316/Al 2O 3 dispersion strengthened copper (DSCu). The HIP bonded joints of SS316/SS316 had almost the same tensile and fatigue properties as those of the base metal. The HIP bonded joints of SS316/DSCu had also almost the same tensile properties as those of the base metal of the DSCu, though total elongation and fatigue strength were slightly lower than those of the DSCu base metal. Further data accumulation, even with further optimization of fabrication conditions, is required, especially for HIP bonded SS316/DSCu joints, to confirm above data and reflect to blanket/first wall design.

  3. Management of the 'young' patient with hip disease.

    PubMed

    Ritterman, Scott A; Rubin, Lee E

    2013-03-01

    Although hip arthritis typically affects older patients, there is a rapidly growing population of "young" patients experiencing debilitating symptoms from hip disease. Most commonly, osteoarthritis and avascular necrosis affect this population, but a variety of other primary structural and metabolic causes can also occur. The expectations of these younger patients are often distinct from geriatric patients, and the challenges in optimizing their care are unique in this demanding population. Selection of the implant, bearing surface, and surgical technique can all impact the success and longevity of total hip replacement. A consideration for respecting the native bone stock is an important consideration that can potentially reduce some of the future challenges of revision arthroplasty in this young population. PMID:23641435

  4. [A shock-absorber-damper endoprosthesis for the hip joint].

    PubMed

    Sherepo, K M

    1995-01-01

    The paper deals with the construction of an implant for complete thigh joint removal. The implant works on a new principle, i.e. division of the major parts of the prosthesis into load-carrying and bearing parts which are isolated all the way with damping silicone gaskets. The implant has a fundamentally new construction. It is accessible for commercial production by advanced technologies and readily applicable in clinical practice. The estimated results of its application are positive as when used, the implant brings a considerably less pressure to bear on the bone than do the well-known Russian and foreign implant models. PMID:8668027

  5. Delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage: pearls and pitfalls

    PubMed Central

    Bittersohl, Bernd; Zilkens, Christoph; Kim, Young-Jo; Werlen, Stefan; Siebenrock, Klaus A.; Mamisch, Tallal C.; Hosalkar, Harish S.

    2011-01-01

    With the increasing advances in hip joint preservation surgery, accurate diagnosis and assessment of femoral head and acetabular cartilage status is becoming increasingly important. Magnetic resonance imaging (MRI) of the hip does present technical difficulties. The fairly thin cartilage lining necessitates high image resolution and high contrast-to-noise ratio (CNR). With MR arthrography (MRA) using intraarticular injected gadolinium, labral tears and cartilage clefts may be better identified through the contrast medium filling into the clefts. However, the ability of MRA to detect varying grades of cartilage damage is fairly limited and early histological and biochemical changes in the beginning of osteoarthritis (OA) cannot be accurately delineated. Traditional MRI thus lacks the ability to analyze the biological status of cartilage degeneration. The technique of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is sensitive to the charge density of cartilage contributed by glycosaminoglycans (GAGs), which are lost early in the process of OA. Therefore, the dGEMRIC technique has a potential to detect early cartilage damage that is obviously critical for decision-making regarding time and extent of intervention for joint-preservation. In the last decade, cartilage imaging with dGEMRIC has been established as an accurate and reliable tool for assessment of cartilage status in the knee and hip joint. This review outlines the current status of dGEMRIC for assessment of hip joint cartilage. Practical modifications of the standard technique including three-dimensional (3D) dGEMRIC and dGEMRIC after intra-articular gadolinium instead of iv-dGEMRIC will also be addressed. PMID:22053252

  6. Delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage: pearls and pitfalls.

    PubMed

    Bittersohl, Bernd; Zilkens, Christoph; Kim, Young-Jo; Werlen, Stefan; Siebenrock, Klaus A; Mamisch, Tallal C; Hosalkar, Harish S

    2011-01-01

    With the increasing advances in hip joint preservation surgery, accurate diagnosis and assessment of femoral head and acetabular cartilage status is becoming increasingly important. Magnetic resonance imaging (MRI) of the hip does present technical difficulties. The fairly thin cartilage lining necessitates high image resolution and high contrast-to-noise ratio (CNR). With MR arthrography (MRA) using intraarticular injected gadolinium, labral tears and cartilage clefts may be better identified through the contrast medium filling into the clefts. However, the ability of MRA to detect varying grades of cartilage damage is fairly limited and early histological and biochemical changes in the beginning of osteoarthritis (OA) cannot be accurately delineated. Traditional MRI thus lacks the ability to analyze the biological status of cartilage degeneration. The technique of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is sensitive to the charge density of cartilage contributed by glycosaminoglycans (GAGs), which are lost early in the process of OA. Therefore, the dGEMRIC technique has a potential to detect early cartilage damage that is obviously critical for decision-making regarding time and extent of intervention for joint-preservation. In the last decade, cartilage imaging with dGEMRIC has been established as an accurate and reliable tool for assessment of cartilage status in the knee and hip joint.This review outlines the current status of dGEMRIC for assessment of hip joint cartilage. Practical modifications of the standard technique including three-dimensional (3D) dGEMRIC and dGEMRIC after intra-articular gadolinium instead of iv-dGEMRIC will also be addressed. PMID:22053252

  7. Sources of sensory innervation of the hip joint capsule in the rabbit - a retrograde tracing study.

    PubMed

    Dudek, A; Chrószcz, A; Janeczek, M; Sienkiewicz, W; Kaleczyc, J

    2013-12-01

    The aim of the study was to investigate the sensory innervation of the hip joint capsule in the rabbit. Individual animals were injected with retrograde fluorescent tracer Fast Blue (FB) into the lateral aspect of the left hip joint capsule (group LAT, n = 5) or into the medial aspect of the hip joint capsule (group MED, n = 5), respectively. FB-positive (FB+) neurons were found within ipsilateral lumbar (L) and sacral (S) dorsal root ganglia (DRG) from L7 to S2 (group LAT) and from L6 to S4 (group MED). They were round or oval in shape with a diameter of 20-90 μm. The neurons were evenly distributed throughout the ganglia. The average number of FB+ neurons was 16 ± 2.8 and 27.6 ± 3.5 in rabbits from LAT and MED, respectively. The largest average number of FB+ neurons in animals of group LAT was found within the S1 DRG (8 ± 1.7), while S2 ganglion contained the smallest number of the neurons (3.6 ± 1). In the L7 DRG, the average number of FB+ neurons was 6.2 ± 1.6. In rabbits of MED group, the largest number of FB+ neurons was found within the S1 DRG (13.4 ± 4), while the smallest one was found within the S3 ganglion (1.4 ± 0.4). In L6, L7, S2 and S4 ganglia, the number of retrogradely labelled neurons amounted to 1.6 ± 0.5, 4 ± 1.5, 4.4 ± 1.5 and 2.8 ± 1.7, respectively. The data obtained can be very useful for further investigations regarding the efficacy of denervation in the therapy of hip joint disorders in rabbits. PMID:23406258

  8. Isolated hamstrings fatigue alters hip and knee joint coordination during a cutting maneuver.

    PubMed

    Samaan, Michael A; Hoch, Matthew C; Ringleb, Stacie I; Bawab, Sebastian; Weinhandl, Joshua T

    2015-04-01

    The aim of this study was to determine the effects of hamstrings fatigue on lower extremity joint coordination variability during a sidestep cutting maneuver. Twenty female recreational athletes performed five successful trials of a sidestep cutting task pre- and postfatigue. Each participant completed an isolated hamstrings fatigue protocol consisting of isokinetic maximum effort knee flexion and passive extension contractions. Vector coding was used to examine hip and knee joint couplings (consisting of various planar motions) during the impact and weight acceptance phases of the sidestep cut stance phase. Paired t tests were used to analyze differences of each phase as an effect of fatigue, where alpha was set a priori at .05. The hip rotation/knee rotation coupling exhibited a significant decrease in coordination variability as a function of fatigue in both the impact (P = .015) and weight acceptance phases (P = .043). Similarly, the hip adduction-abduction/knee rotation coupling exhibited a significant decrease in coordination variability in the weight acceptance phase (P = .038). Hamstrings fatigue significantly decreased coordination variability within specific lower extremity joint couplings that included knee rotation. Future studies should be conducted to determine if this decrease in coordination variability is related to lower extremity injury mechanisms. PMID:25411821

  9. Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need

    PubMed Central

    Dixon, T; Shaw, M; Ebrahim, S; Dieppe, P

    2004-01-01

    Objectives: To examine trends in primary and revision joint (hip and knee) replacement in England between 1991 and 2000. Methods: Analysis of hospital episodes statistics between 1 April 1991 and 30 March 2001 for total hip replacement (THR) and total knee replacement (TKR). Descriptive statistics and regression modelling were used to summarise patients' demographic and clinical characteristics and to explore variations in joint surgery rates by age, sex, and deprivation. Results: Between 1991 and 2000, the incidence of primary THR increased by 18%, while the incidence of revision THR more than doubled. The incidence of primary TKR doubled, with revision TKR increasing by 300%. Over the 10 year period, the proportion of THR episodes that involved revision operations rose from 8% to 20%. Substantial variations in operation rates by socioeconomic status were seen, with the most deprived fifth of the population experiencing significantly lower rates. Projections estimate that primary THR numbers could rise by up to 22% by the year 2010, with primary TKR numbers rising by up to 63%. Conclusions: Provision of joint replacement surgery in English NHS hospitals has increased substantially over the past decade. Revision operations in particular have increased markedly. The growth in primary operations has mostly occurred among those aged 60 years and over; rates among young people have changed very little. There is a significant deprivation based gradient in rates. If current trends continue there would be almost 47 000 primary hip and 54 000 primary knee operations annually by 2010. PMID:15194578

  10. Hip and knee joint loading during vertical jumping and push jerking

    PubMed Central

    Cleather, Daniel J; Goodwin, Jon E; Bull, Anthony MJ

    2014-01-01

    Background The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. Methods In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. Findings The knee experienced mean peak loadings of 2.4-4.6 × body weight at the patellofemoral joint, 6.9-9.0 × body weight at the tibiofemoral joint, 0.3-1.4 × body weight anterior tibial shear and 1.0-3.1 × body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4 × body weight and the ankle 8.9-10.0 × body weight. Interpretation The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. PMID:23146164

  11. [Stress on the ligamentum transversum acetabuli in physiological stress on the hip joint].

    PubMed

    Löhe, F; Eckstein, F; Putz, R

    1994-09-01

    We investigated the strain on the transverse acetabular ligament (TAL) and the labrum close to the anterior and posterior horn of the lunate surface using Omega strain gauges [5] while increasing loads were applied to the hip joint. Two fresh hip joint specimens and four specimens fixed in 3.7% formalin were examined. The two components of the joint were disarticulated and soaked in physiological saline and then placed in a material-testing machine (Zwick) in the neutral position of the joint. The strain on the TAL and the labrum was measured at loads of 10 N, 350 N, 700 N, 1050 N, 1400 N, 2100 N and 2800 N. Finally, the contact areas were measured at a load of 350 N using a polyether casting method. Depending on load, the length of the TAL increased by up to about 3.2% at a load of 2800 N, but the length of the labrum increased by only 0.5% at the same load. Following rotation of the femoral head to positions corresponding to 15 degrees extension and 15 degrees and 30 degrees flexion, only slight differences of about 0.2% for the TAL and even less for the labrum were measured. The contact areas are all located in the anterior and posterior horn of the lunate surface. The measured changes in strain on the TAL confirm the widening of the acetabular notch and a subsequent stretching of the TAL as the load on the hip joint increases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7973747

  12. Radiological Assessment of the Sacrofemoral Angle: A Novel Method to Measure the Range of Hip Joint Flexion

    PubMed Central

    Wei, Xian-Zhao; Xu, Xi-Ming; Wang, Fei; Li, Ming; Wang, Zi-Min

    2015-01-01

    Background: A quantitative and accurate measurement of the range of hip joint flexion (RHF) is necessarily required in the evaluation of disordered or artificial hip joint function. This study aimed to assess a novel method to measure RHF more accurately and objectively. Methods: Lateral radiographs were taken of 31 supine men with hip joints extended or flexed. Relevant angles were measured directly from the radiographs. The change in the sacrofemoral angle (SFA) (the angle formed between the axis of the femur and the line tangent to the upper endplate of S1) from hip joint extension to hip joint flexion, was proposed as the RHF. The validity of this method was assessed via concomitant measurements of changes in the femur-horizontal angle (between the axis of the femur and the horizontal line) and the sacrum-horizontal angle (SHA) (between the line tangent to the upper endplate of S1 and the horizontal line), the difference of which should equal the change in the SFA. Results: The mean change in the SFA was 112.5 ± 7.4°, and was independent of participant age, height, weight, or body mass index. The mean changes in the femur-horizontal and SHAs were 123.0 ± 6.4° and 11.4 ± 3.0°, respectively. This confirmed that the change of SFA between hip joint extension and hip joint flexion was equal to the difference between the changes in the femur-horizontal and SHAs. Conclusions: Using the SFA, to evaluate RHF could prevent compromised measurements due to the movements of pelvis and lumbar spine during hip flexion, and is, therefore, a more accurate and objective method with reasonable reliability and validity. PMID:26315079

  13. Determining the shear fracture properties of HIP joints of reduced-activation ferritic/martensitic steel by a torsion test

    NASA Astrophysics Data System (ADS)

    Nozawa, Takashi; Noh, Sanghoon; Tanigawa, Hiroyasu

    2012-08-01

    Hot isostatic pressing (HIP) is a key technology used to fabricate a first wall with cooling channels for the fusion blanket system utilizing a reduced-activation ferritic/martensitic steel. To qualify the HIPped components, small specimen test techniques are beneficial not only to evaluate the thin-wall cooling channels containing the HIP joint but also to use in neutron irradiation studies. This study aims to develop the torsion test method with special emphasis on providing a reasonable and comprehensive method to determine interfacial shear properties of HIP joints during the torsional fracture process. Torsion test results identified that the torsion process shows yield of the base metal followed by non-elastic deformation due to work hardening of the base metal. By considering this work hardening issue, we propose a reasonable and realistic solution to determine the torsional yield shear stress and the ultimate torsional shear strength of the HIPped interface. Finally, a representative torsion fracture process was identified.

  14. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  15. Electrochemical instrumentation of a hip simulator: a new tool for assessing the role of corrosion in metal-on-metal hip joints.

    PubMed

    Yan, Y; Neville, A; Dowson, D; Williams, S; Fisher, J

    2010-11-01

    Polyethylene wear debris induced osteolysis has triggered investigations to find alternative material combinations to the well-established metal-on-polyethylene hip implants. Owing to some early successful clinical cases, metal-on-metal (MoM) hip replacements have been attracting more and more interest. There is, however, considerable concern about the propensity of MoM hip replacements to release metal ions and fine, nanometre-scale metallic wear debris. The long-term effect from released metal ions and wear particles is still not clear. To date, all the work on hip simulators focused on assessing mass losses damage has been referred to as 'wear'. However, it is known in the field of tribocorrosion that mechanical removal of the passive layer on Co-Cr alloys can significantly enhance corrosion activity. In total joint replacements, it is possible that corrosion plays a significant role. However, no one has ever tried to extract, on a hip simulator, what proportion of the damage is due to mechanical processes and the corrosion processes. This paper describes the first instrumentation of an integrated hip joint simulator to provide in-situ electrochemical measurements in real time. The open circuit potential results are reported to assess the corrosion regime in the absence and presence of movement at the bearing surfaces. The importance of these measurements is that the real damage mechanisms can be assessed as a function of the operating cycle. PMID:21218689

  16. Investigation on stick phenomena in metal-on-metal hip joints after resting periods.

    PubMed

    Wimmer, M A; Nassutt, R; Sprecher, C; Loos, J; Täger, G; Fischer, A

    2006-02-01

    Insufficient understanding of tribological behaviour in total joint arthroplasty is considered as one of the reasons for prosthesis failure. Contrary to the continuous motion input profiles of hip simulators, human locomotion contains motion interruptions. These occurring resting periods can cause stick phenomena in metal-on-metal hip joints. The aim of the present study was to investigate the tribological sensitivity of all-metal bearings to motion interruptions on in vitro test specimens and retrieved implants. Friction and wear with and without resting periods were quantified. Unlike the metal-on-polyethylene joints, the static friction of metal-on-metal joints increased up to micros = 0.3 with rest, while wear appeared to be unaffected. This effect is caused by the interlocking of firmly adhered carbon layers, which were generated from the protein-containing lubricant through tribochemical reactions. Since more than 80 per cent of the retrieved implants exhibited macroscopically visible carbon layers, the increase in friction presumably also occurs under physiological conditions, which is then transferred to the bone-implant interface. These recurrent tangential stress peaks should be considered for the design features of the cup-bone interface, in particular when larger-sized implant heads are used. PMID:16669389

  17. Tribolayer Formation in a Metal-on-Metal (MoM) Hip Joint: An Electrochemical Investigation

    PubMed Central

    Mathew, MT; Nagelli, C; Pourzal, R; Fischer, A; Laurent, MP; Jacobs, JJ; Wimmer, MA

    2013-01-01

    The demand for total hip replacement (THR) surgery is increasing in the younger population due to faster rehabilitation and more complete restoration of function. Up to 2009, metal-on-metal (MoM) hip joint bearings were a popular choice due to their design flexibility, post-operative stability and relatively low wear rates. The main wear mechanisms that occur along the bearing surface of MoM joints are tribochemical reactions that deposit a mixture of wear debris, metal ions and organic matrix of decomposed proteins known as a tribolayer. No in-depth electrochemical studies have been reported on the structure and characteristics of this tribolayer or about the parameters involved in its formation. In this study, we conducted an electrochemical investigation of different surfaces (bulk-like: control, nano-crystalline: new implant and tribolayer surface: retrieved implant) made out of two commonly used hip CoCrMo alloys (high-carbon and low-carbon). As per ASTM standard, cyclic polarization tests and electrochemical impedance spectroscopy tests were conducted. The results obtained from electrochemical parameters for different surfaces clearly indicated a reduction in corrosion for the tribolayer surface (Icorr: 0.76 μA/cm2). Further, polarization resistance (Rp:2.39±0.60MΩ/cm2) and capacitance (Cdl:15.20±0.75 μF/cm2) indicated variation in corrosion kinetics for the tribolayer surface, that attributed to its structure and stability in a simulated body environment. PMID:24099949

  18. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury.

    PubMed

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-04-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities. PMID:27190461

  19. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    PubMed Central

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities. PMID:27190461

  20. Effects of rotational acetabular osteotomy on the mechanical stress within the hip joint in patients with developmental dysplasia of the hip: a subject-specific finite element analysis.

    PubMed

    Ike, H; Inaba, Y; Kobayashi, N; Yukizawa, Y; Hirata, Y; Tomioka, M; Saito, T

    2015-04-01

    In this study we used subject-specific finite element analysis to investigate the mechanical effects of rotational acetabular osteotomy (RAO) on the hip joint and analysed the correlation between various radiological measurements and mechanical stress in the hip joint. We evaluated 13 hips in 12 patients (two men and ten women, mean age at surgery 32.0 years; 19 to 46) with developmental dysplasia of the hip (DDH) who were treated by RAO. Subject-specific finite element models were constructed from CT data. The centre-edge (CE) angle, acetabular head index (AHI), acetabular angle and acetabular roof angle (ARA) were measured on anteroposterior pelvic radiographs taken before and after RAO. The relationship between equivalent stress in the hip joint and radiological measurements was analysed. The equivalent stress in the acetabulum decreased from 4.1 MPa (2.7 to 6.5) pre-operatively to 2.8 MPa (1.8 to 3.6) post-operatively (p < 0.01). There was a moderate correlation between equivalent stress in the acetabulum and the radiological measurements: CE angle (R = -0.645, p < 0.01); AHI (R = -0.603, p < 0.01); acetabular angle (R = 0.484, p = 0.02); and ARA (R = 0.572, p < 0.01). The equivalent stress in the acetabulum of patients with DDH decreased after RAO. Correction of the CE angle, AHI and ARA was considered to be important in reducing the mechanical stress in the hip joint. PMID:25820887

  1. Arthroscopic Resection of Osteochondroma of Hip Joint Associated with Internal Snapping: A Case Report

    PubMed Central

    Jung, Heung-Tae; Hwang, Deuk-Soo; Jeon, Yoo-Sun

    2015-01-01

    A 16-year old male patient visited the hospital complaining of inguinal pain and internal snapping of right hip joint. In physical examination, the patient was presumed to be diagnosed femoroacetabular impingement (FAI) and acetabular labral tear. In radiologic evaluation, FAI and acetabular labral tear were identified and bony tumor associated with internal snapping was found on the posteromedial portion of the femoral neck. Despite of conservative treatment, there was no symptomatic improvement. So arthroscopic labral repair, osteoplasty and resection of bony tumor were performed. The tumor was pathologically diagnosed as osteochondroma through biopsy and all symptoms improved after surgery. There was no recurrence, complication or abnormal finding during 1 year follow up. Osteochondroma located at posteromedial portion of femoral neck can be a cause of internal snapping hip and although technical demands are challenging, arthroscopic resection can be a good treatment option.

  2. Quantitative evaluation of hip joint laxity in 22 Border Collies using computed tomography.

    PubMed

    Kishimoto, Miori; Yamada, Kazutaka; Pae, Sa-Hun; Muroya, Naoyoshi; Watarai, Hirokazu; Anzai, Hiroshi; Shimizu, Junichiro; Iwasaki, Toshiroh; Miyake, Yoh-Ichi; Wisner, Erik R

    2009-02-01

    The purpose of this study was to obtain the computed tomography (CT) data for the hip joints of 22 Border Collies. The dorsolateral subluxation (DLS) score, lateral center edge angle (LCEA), dorsal acetabular rim angle (DARA) and center distance (CD) index were measured on the CT images in a weight-bearing position. Radiographic Norberg angle (NA) was also measured. The mean values were 45.7 +/- 10.2% for DLS score, 85.9 degrees +/- 10.3 degrees for LCEA, 18.5 degrees +/- 7.3 degrees for DARA, 0.40 +/- 0.17 for CD index and 102.7 degrees +/- 6.9 degrees for NA. Since the DLS score and LCEA showed strong correlation, combined use of these parameters might improve diagnostic accuracy. We consider CT evaluation in a weight-bearing position to be a useful method for multidirectional evaluation of hips. PMID:19262043

  3. Responsiveness and ceiling effects of the Forgotten Joint Score-12 following total hip arthroplasty

    PubMed Central

    Giesinger, J. M.; MacDonald, D. J.; Simpson, A. H. R. W.; Howie, C. R.; Giesinger, K.

    2016-01-01

    Objectives To assess the responsiveness and ceiling/floor effects of the Forgotten Joint Score -12 and to compare these with that of the more widely used Oxford Hip Score (OHS) in patients six and 12 months after primary total hip arthroplasty. Methods We prospectively collected data at six and 12 months following total hip arthroplasty from 193 patients undergoing surgery at a single centre. Ceiling effects are outlined with frequencies for patients obtaining the lowest or highest possible score. Change over time from six months to 12 months post-surgery is reported as effect size (Cohen’s d). Results The mean OHS improved from 40.3 (sd 7.9) at six months to 41.9 (sd 7.2) at 12 months. The mean FJS-12 improved from 56.8 (sd 30.1) at six months to 62.1 (sd 29.0) at 12 months. At six months, 15.5% of patients reached the best possible score (48 points) on the OHS and 8.3% obtained the best score (100 points) on the FJS-12. At 12 months, this percentage increased to 20.8% for the OHS and to 10.4% for the FJS-12. In terms of the effect size (Cohen’s d), the change was d = 0.10 for the OHS and d = 0.17 for the FJS-12. Conclusions The FJS-12 is more responsive to change between six and 12 months following total hip arthroplasty than is the OHS, with the measured ceiling effect for the OHS twice that of the FJS-12. The difference in effect size of change results in substantial differences in required sample size if aiming to detect change between these two time points. This has important implications for powering clinical trials with patient-reported measures as the primary outcome. Cite this article: Dr D. F. Hamilton. Responsiveness and ceiling effects of the Forgotten Joint Score-12 following total hip arthroplasty. Bone Joint Res 2016;5:87–91. DOI: 10.1302/2046-3758.53.2000480. PMID:26965167

  4. Depression and the Overall Burden of Painful Joints: An Examination among Individuals Undergoing Hip and Knee Replacement for Osteoarthritis.

    PubMed

    Gandhi, Rajiv; Zywiel, Michael G; Mahomed, Nizar N; Perruccio, Anthony V

    2015-01-01

    The majority of patients with hip or knee osteoarthritis (OA) report one or more symptomatic joints apart from the one targeted for surgical care. Therefore, the purpose of the present study was to investigate the association between the burden of multiple symptomatic joints and self-reported depression in patients awaiting joint replacement for OA. Four hundred and seventy-five patients at a single centre were evaluated. Patients self-reported joints that were painful and/or symptomatic most days of the previous month on a homunculus, with nearly one-third of the sample reporting 6 or more painful joints. The prevalence of depression was 12.2% (58/475). When adjusted for age, sex, education level, hip or knee OA, body mass index, chronic condition count, and joint-specific WOMAC scores, each additional symptomatic joint was associated with a 19% increased odds (odds ratio: 1.19 (95% CI: 1.08, 1.31, P < 0.01)) of self-reported depression. Individuals reporting 6 or more painful joints had 2.5-fold or greater odds of depression when compared to those patients whose symptoms were limited to the surgical joint. A focus on the surgical joint alone is likely to miss a potentially important determinant of postsurgical patient-reported outcomes in patients undergoing hip or knee replacement. PMID:25861476

  5. Depression and the Overall Burden of Painful Joints: An Examination among Individuals Undergoing Hip and Knee Replacement for Osteoarthritis

    PubMed Central

    Gandhi, Rajiv; Zywiel, Michael G.; Mahomed, Nizar N.; Perruccio, Anthony V.

    2015-01-01

    The majority of patients with hip or knee osteoarthritis (OA) report one or more symptomatic joints apart from the one targeted for surgical care. Therefore, the purpose of the present study was to investigate the association between the burden of multiple symptomatic joints and self-reported depression in patients awaiting joint replacement for OA. Four hundred and seventy-five patients at a single centre were evaluated. Patients self-reported joints that were painful and/or symptomatic most days of the previous month on a homunculus, with nearly one-third of the sample reporting 6 or more painful joints. The prevalence of depression was 12.2% (58/475). When adjusted for age, sex, education level, hip or knee OA, body mass index, chronic condition count, and joint-specific WOMAC scores, each additional symptomatic joint was associated with a 19% increased odds (odds ratio: 1.19 (95% CI: 1.08, 1.31, P < 0.01)) of self-reported depression. Individuals reporting 6 or more painful joints had 2.5-fold or greater odds of depression when compared to those patients whose symptoms were limited to the surgical joint. A focus on the surgical joint alone is likely to miss a potentially important determinant of postsurgical patient-reported outcomes in patients undergoing hip or knee replacement. PMID:25861476

  6. Hip2Norm: an object-oriented cross-platform program for 3D analysis of hip joint morphology using 2D pelvic radiographs.

    PubMed

    Zheng, G; Tannast, M; Anderegg, C; Siebenrock, K A; Langlotz, F

    2007-07-01

    We developed an object-oriented cross-platform program to perform three-dimensional (3D) analysis of hip joint morphology using two-dimensional (2D) anteroposterior (AP) pelvic radiographs. Landmarks extracted from 2D AP pelvic radiographs and optionally an additional lateral pelvic X-ray were combined with a cone beam projection model to reconstruct 3D hip joints. Since individual pelvic orientation can vary considerably, a method for standardizing pelvic orientation was implemented to determine the absolute tilt/rotation. The evaluation of anatomically morphologic differences was achieved by reconstructing the projected acetabular rim and the measured hip parameters as if obtained in a standardized neutral orientation. The program had been successfully used to interactively objectify acetabular version in hips with femoro-acetabular impingement or developmental dysplasia. Hip(2)Norm is written in object-oriented programming language C++ using cross-platform software Qt (TrollTech, Oslo, Norway) for graphical user interface (GUI) and is transportable to any platform. PMID:17499878

  7. Antegrade Flexible Ureteroscopy for Bilateral Ureteral Stones in a Patient with Severe Hip Joint Ankylosis

    PubMed Central

    Kim, Bum Soo; Lee, Jun Nyung; Choi, Jae Young; Park, Yoon Kyu

    2010-01-01

    In the past several decades there has been a remarkable development of small-caliber, flexible ureteroscopes and various ancillary instruments for stone manipulation and retrieval. Percutaneous antegrade ureteroscopy can be substituted in select cases for retrograde ureteroscopy. We report a case of a 60-year-old man with severe ankylosis in both hip joints who was diagnosed with bilateral ureteral stones. The patient underwent antegrade flexible ureteroscopy and laser lithotripsy. This case illustrates the role of antegrade flexible ureteroscopy combined with the holmium:YAG laser as a minimally invasive, safe, and effective technique for the management of stones in a patient who cannot undergo a retrograde approach. PMID:21165203

  8. Meat consumption and risk of primary hip and knee joint replacement due to osteoarthritis: a prospective cohort study

    PubMed Central

    2011-01-01

    Background There is emerging evidence for a beneficial effect of meat consumption on the musculoskeletal system. However, whether it affects the risk of knee and hip osteoarthritis is unknown. We performed a prospective cohort study to examine the relationship between meat consumption and risk of primary hip and knee replacement for osteoarthritis. Methods Eligible 35,331 participants were selected from the Melbourne Collaborative Cohort Study recruited during 1990-1994. Consumption of fresh red meat, processed meat, chicken, and fish was assessed using a food frequency questionnaire. Primary hip and knee replacement for osteoarthritis during 2001-2005 was determined by linking the cohort records to the Australian National Joint Replacement Registry. Results There was a negative dose-response relationship between fresh red meat consumption and the risk of hip replacement (hazard ratio (HR) 0.94 per increase in intake of one time/week, 95% confidence interval (CI) 0.89-0.98). In contrast, there was no association with knee replacement risk (HR 0.98, 95% CI 0.94-1.02). Consumption of processed meat, chicken and fish were not associated with risk of hip or knee replacement. Conclusion A high level consumption of fresh red meat was associated with a decreased risk of hip, but not knee, joint replacement for osteoarthritis. One possible mechanism to explain these differential associations may be via an effect of meat intake on bone strength and hip shape. Further confirmatory studies are warranted. PMID:21235820

  9. A paralabral cyst of the hip joint causing sciatica: case report and review of literature.

    PubMed

    Salunke, Abhijeet Ashok; Panchal, Ramesh

    2014-07-01

    The prolapse of the intervertebral disc is most common cause of sciatica; rare causes of sciatica are pelvic fractures, pelvic tumors, piriformis syndrome, a rupture of medial head of gastronemius and sacroiliac joint dysfunction. We report the case of a 30-year-old male with a paralabral cyst of the hip joint with an acetabular labral tear causing sciatica. Our patient had an acetabular labral tear caused by a repetitive micro-trauma and external rotation injury. The diagnosis of the paralabral cyst with acetabular labral tear was based on clinical examination and histopathological examinations, and Magnetic resonance imaging findings. The patient underwent successful surgical excision of paralabral cyst and surgical repair of an acetabular labral tear. The present case reinforces the need for clinicians to be vigilant about rare causes of sciatica. PMID:25977624

  10. Methods for determining hip and lumbosacral joint centers in a seated position from external anatomical landmarks.

    PubMed

    Peng, Junfeng; Panda, Jules; Van Sint Jan, Serge; Wang, Xuguang

    2015-01-21

    A global coordinate system (GCS) method is proposed to estimate hip and lumbosacral joint centers (HJC and LSJC) from at least three distances between joint center of interest and target anatomic landmarks (ALs). The distances from HJC and LSJC to relevant pelvis and femur ALs were analyzed with respect to usual pelvis and femur scaling dimensions. Forty six pelves and related pairs of femurs from a same sample of adult specimens were examined. The corresponding regression equations were obtained. These equations can be used to estimate HJC and LSJC in conditions where a very limited number of ALs are available: for example, during seated posture analysis as performed in the automotive industry. Compared to currently existing HJC and LSJC methods from ALs, the proposed method showed better results with an average error less than 11 mm. PMID:25497377

  11. A New Discrete Element Analysis Method for Predicting Hip Joint Contact Stresses

    PubMed Central

    Abraham, Christine L.; Maas, Steve A.; Weiss, Jeffrey A.; Ellis, Benjamin J.; Peters, Christopher L.; Anderson, Andrew E.

    2013-01-01

    Quantifying cartilage contact stress is paramount to understanding hip osteoarthritis. Discrete element analysis (DEA) is a computationally efficient method to estimate cartilage contact stresses. Previous applications of DEA have underestimated cartilage stresses and yielded unrealistic contact patterns because they assumed constant cartilage thickness and/or concentric joint geometry. The study objectives were to: 1) develop a DEA model of the hip joint with subject-specific bone and cartilage geometry, 2) validate the DEA model by comparing DEA predictions to those of a validated finite element analysis (FEA) model, and 3) verify both the DEA and FEA models with a linear-elastic boundary value problem. Springs representing cartilage in the DEA model were given lengths equivalent to the sum of acetabular and femoral cartilage thickness and joint space in the FEA model. Material properties and boundary/loading conditions were equivalent. Walking, descending, and ascending stairs were simulated. Solution times for DEA and FEA models were ~7 seconds and ~65 minutes, respectively. Irregular, complex contact patterns predicted by DEA were in excellent agreement with FEA. DEA contact areas were 7.5%, 9.7% and 3.7% less than FEA for walking, descending stairs, and ascending stairs, respectively. DEA models predicted higher peak contact stresses (9.8–13.6 MPa) and average contact stresses (3.0–3.7 MPa) than FEA (6.2–9.8 and 2.0–2.5 MPa, respectively). DEA overestimated stresses due to the absence of the Poisson’s effect and a direct contact interface between cartilage layers. Nevertheless, DEA predicted realistic contact patterns when subject-specific bone geometry and cartilage thickness were used. This DEA method may have application as an alternative to FEA for pre-operative planning of joint-preserving surgery such as acetabular reorientation during peri-acetabular osteotomy. PMID:23453394

  12. New Joints, Same Old Weight: Weight Changes After Total Hip and Knee Arthroplasty.

    PubMed

    Hurwit, Daniel J; Trehan, Samir K; Cross, Michael B

    2016-07-01

    Obesity is a well-known risk factor for postoperative complications following total joint arthroplasty. However, because the operation is often successful, orthopedic surgeons continue to operate on obese individuals, and many surgeons do so under the assumption that patients will lose weight after they are able to walk and exercise without pain. In this article, we review a recent study by Ast et al., who performed a retrospective review, using a single-center institutional registry, to determine (1) whether patients do actually lose weight after total hip and/or total knee arthroplasty, (2) whether there are predictors of postoperative weight change, and (3) whether postoperative weight changes affect patient-reported clinical outcomes. The principle conclusion was that most patients maintained their body mass index (BMI) after total hip and total knee arthroplasty (73 and 69%, respectively). However, patients undergoing total knee arthroplasty, patients who had a higher preoperative BMI, and female patients were more likely to lose weight postoperatively. When examined in the context of the current literature, this study provides valuable information for the preoperative counseling of total joint arthroplasty candidates, especially in the setting of obesity. PMID:27385952

  13. Circles on pommel horse with a suspended aid: mass-centre rotation and hip joint moment.

    PubMed

    Fujihara, Toshiyuki; Gervais, Pierre

    2012-01-01

    This is the second study of the series, and its aim was to investigate the influence of using the suspended aid on circle kinetics. In addition to the kinematic data recorded for part one (Fujihara & Gervais, 2012), the pommel reaction forces and the force applied from the suspended aid (aid reaction force) were analysed in relation to the motion of a whole-body mass centre. The hip joint moment was also computed by combining all segments in the lower extremities into a single rigid segment. Generally, the use of the aid changed the magnitude of the mass-centre trajectory or horizontal pommel reaction forces but not their patterns. The results also showed that the net hip joint moment was altered during circles with the aid. In summary, a suspended aid can be used as a progression for a variety of goals because it allows gymnasts to practise circles which would not be possible without the aid. When a suspended aid is used, however, practitioners should be aware of the possible kinetic alteration caused by the external force from the aid. PMID:22697492

  14. The High performance of nanocrystalline CVD diamond coated hip joints in wear simulator test.

    PubMed

    Maru, M M; Amaral, M; Rodrigues, S P; Santos, R; Gouvea, C P; Archanjo, B S; Trommer, R M; Oliveira, F J; Silva, R F; Achete, C A

    2015-09-01

    The superior biotribological performance of nanocrystalline diamond (NCD) coatings grown by a chemical vapor deposition (CVD) method was already shown to demonstrate high wear resistance in ball on plate experiments under physiological liquid lubrication. However, tests with a close-to-real approach were missing and this constitutes the aim of the present work. Hip joint wear simulator tests were performed with cups and heads made of silicon nitride coated with NCD of ~10 μm in thickness. Five million testing cycles (Mc) were run, which represent nearly five years of hip joint implant activity in a patient. For the wear analysis, gravimetry, profilometry, scanning electron microscopy and Raman spectroscopy techniques were used. After 0.5 Mc of wear test, truncation of the protruded regions of the NCD film happened as a result of a fine-scale abrasive wear mechanism, evolving to extensive plateau regions and highly polished surface condition (Ra<10nm). Such surface modification took place without any catastrophic features as cracking, grain pullouts or delamination of the coatings. A steady state volumetric wear rate of 0.02 mm(3)/Mc, equivalent to a linear wear of 0.27 μm/Mc favorably compares with the best performance reported in the literature for the fourth generation alumina ceramic (0.05 mm(3)/Mc). Also, squeaking, quite common phenomenon in hard-on-hard systems, was absent in the present all-NCD system. PMID:26024650

  15. STRUCTURE-FUNCTION RELATIONSHIPS IN OSTEOARTHRITIC HUMAN HIP JOINT ARTICULAR CARTILAGE

    PubMed Central

    Mäkelä, Janne T.A.; Huttu, Mari R.J.; Korhonen, Rami K.

    2013-01-01

    Objectives It is currently poorly known how different structural and compositional components in human articular cartilage are related to their specific functional properties at different stages of osteoarthritis (OA). The objective of this study was to characterize the structure-function relationships of articular cartilage obtained from osteoarthritic human hip joints. Methods Articular cartilage samples with their subchondral bone (n = 15) were harvested during hip replacement surgeries from human femoral necks. Stress-relaxation tests, Mankin scoring, spectroscopic and microscopic methods were used to determine the biomechanical properties, OA grade, and the composition and structure of the samples. In order to obtain the mechanical material parameters for the samples, a fibril-reinforced poroviscoelastic model was fitted to the experimental data obtained from the stress-relaxation experiments. Results The strain-dependent collagen network modulus (Efε) and the collagen orientation angle exhibited a negative linear correlation (r = −0.65, p < 0.01), while the permeability strain-dependency factor (M) and the collagen content exhibited a positive linear correlation (r = 0.56, p < 0.05). The non-fibrillar matrix modulus (Enf) also exhibited a positive linear correlation with the proteoglycan content (r = 0.54, p < 0.05). Conclusion The study suggests that increased collagen orientation angle during OA primarily impairs the collagen network and the tensile stiffness of cartilage in a strain-dependent manner, while the decreased collagen content in OA facilitates fluid flow out of the tissue especially at high compressive strains. Thus, the results provide interesting and important information of the structure-function relationships of human hip joint cartilage and mechanisms during the progression of OA. PMID:22858669

  16. Chondral Lesions of the Hip.

    PubMed

    Logan, Zachariah S; Redmond, John M; Spelsberg, Sarah C; Jackson, Timothy J; Domb, Benjamin G

    2016-07-01

    The treatment of chondral hip injuries is challenging. However, for young patients with hip disorders, orthopedic surgeons now have the opportunity to intervene early in the development of debilitating joint disease. As understanding of the hip joint continues to evolve, more effective treatment strategies are emerging. There are several reportedly successful options for surgical treatment. This article reviews the clinical presentation of chondral injuries and the surgical modalities, arthroscopic and open, available to treat them. PMID:27343390

  17. Friction moments of large metal-on-metal hip joint bearings and other modern designs.

    PubMed

    Bishop, N E; Waldow, F; Morlock, M M

    2008-10-01

    Modern hip joint replacements are designed to minimise wear problems. The most popular metal-on-polyethylene components are being updated by harder metal and ceramic combinations. However, this has also been shown to influence the friction moments, which could overload the interface between the implant and the body. In this study custom test apparatus was used to measure the joint moments in various modern bearings under simulated physiological joint conditions. The largest moments in serum were measured for large diameter metal-metal bearings (<8 Nm for standard bearings), followed by metal-polyethylene, and the lowest moments were for small diameter ceramic-ceramic and ceramic-metal combinations. Water as a lubricant was found to double the moments in comparison with serum. In metal-metal bearings moments were reduced by increasing loading frequency. Swing phase load and a rest period between load cycles had little effect. The moment magnitudes are within the turn-out capacity measured for press-fit cups and might become critical with higher joint loads. PMID:18291702

  18. Arthroscopic Treatment of Subchondral Bony Cyst in Early Osteoarthritis of the Hip Joint Using Allogeneic Bone Graft: A Report of Two Cases

    PubMed Central

    Lee, Gi-Soo; Kang, Chan; Lee, Jung-Bum; Noh, Chang-Kyun

    2015-01-01

    Subchondral bony cyst, large solitary or multiple cysts in acetabular dome usually exacerbate progression to degenerative osteoarthritis in the hip joint. But it can be treated through arthroscopic intervention. We report two cases that treated by arthroscopic curettage and bone graft for subchondral bony cysts in early osteoarthritis of the hip joint, and it may delay progression to moderate osteoarthritis.

  19. [Amyloid deposition in chronic joint disease].

    PubMed

    Saitou, H

    1994-07-01

    As a screening procedure for the detection of amyloidosis secondary to rheumatoid arthritis, abdominal subcutaneous fat tissues were aspirated, and were examined after Congo red staining by polarized microscopy. Positive amyloid deposits were found in 7.1 percent of the rheumatoid patients, and the amyloid in the subcutaneous fat was determined to be AA type by permanganate oxidation. The occurrence of amyloid deposition was significantly correlated with the duration of the articular symptoms, the progression of the class, and also with proteinuria. Additionally the joint capsules, including the synovium and synovial fluid sediment, from patients with rheumatoid arthritis and osteoarthritis were examined for amyloid deposition. Deposits of amyloid in the hip and knee joints were found more frequently in those with rheumatoid arthritis than in those with osteoarthritis. In osteoarthritis, the frequency of amyloid deposition tended to increase with advancing age. However these amyloid deposits in the joint structure were discovered to be resistant to permanganate oxidation. Therefore it was suspected that these amyloid deposits were of a type different from AA amyloid. PMID:8071579

  20. [Sonographic measures of the hip joint of 1328 newborns of Han and Uygur nationalities-relative factors of congenital dislocation of hip].

    PubMed

    Yang, J; Chen, L; Tian, B

    1997-08-01

    The four sonographic methods (Engesaeter, Terjesen, Graf, Morin-Harcke) were used for examining the hip joint of 1328 newborns of Han and Uygur nationalities. The difference between Han and Uygur newborns was not statistical significant, but some literatures reported that in our country, the incidence of different nationalities in different regions varied. Our conclusion is that there is no obvious relationship between the depth of the acetabulum and the percentage of the femoral head covered by the acetabulum. It is caused by other factors, inherent or acquired. The value of the hip joint of the male and female has significant difference (P < 0.0005). The incidence of CDH in girls is much higher than that in boys. This may be related to the different depth of the acetabulum and different percentage of the femoral head covered by the acetabulum. In the period of newborn, girl's depth of the acetabulum is smaller than that of boys. PMID:10678065

  1. [Femoroacetabular impingement: a new direction in the diagnosis and treatment of the hip joint].

    PubMed

    Hellmann, Ory; Cohen, Eugen; Rath, Ehud

    2011-02-01

    Femoroacetabular impingement is a relatively recently described condition in which an abnormally shaped proximal part of the femur or acetabular overcoverage causes interference between the femoral head-neck junction and the acetabular rim. These disorders are now recognized as common causes of prearthritic hip pain and secondary osteoarthritis. Two mechanisms have been described. Cam-type impingement is caused by insufficient concavity of the femoral head-neck junction. Pincer-type impingement is caused by overcoverage of the femoral head by the acetabulum. Abnormal femoroacetabular abutment predisposes affected patients to labral tears, articular cartilage damage, and premature osteoarthritis. Early diagnosis of hip disease and referral for specialized care may optimize clinical outcomes and alter the natural history of these disorders. This review aims to describe this syndrome and to review the contemporary concepts of the etiology and surgical treatment of the disorder. PMID:22164944

  2. Automated bone segmentation from large field of view 3D MR images of the hip joint.

    PubMed

    Xia, Ying; Fripp, Jurgen; Chandra, Shekhar S; Schwarz, Raphael; Engstrom, Craig; Crozier, Stuart

    2013-10-21

    Accurate bone segmentation in the hip joint region from magnetic resonance (MR) images can provide quantitative data for examining pathoanatomical conditions such as femoroacetabular impingement through to varying stages of osteoarthritis to monitor bone and associated cartilage morphometry. We evaluate two state-of-the-art methods (multi-atlas and active shape model (ASM) approaches) on bilateral MR images for automatic 3D bone segmentation in the hip region (proximal femur and innominate bone). Bilateral MR images of the hip joints were acquired at 3T from 30 volunteers. Image sequences included water-excitation dual echo stead state (FOV 38.6 × 24.1 cm, matrix 576 × 360, thickness 0.61 mm) in all subjects and multi-echo data image combination (FOV 37.6 × 23.5 cm, matrix 576 × 360, thickness 0.70 mm) for a subset of eight subjects. Following manual segmentation of femoral (head-neck, proximal-shaft) and innominate (ilium+ischium+pubis) bone, automated bone segmentation proceeded via two approaches: (1) multi-atlas segmentation incorporating non-rigid registration and (2) an advanced ASM-based scheme. Mean inter- and intra-rater reliability Dice's similarity coefficients (DSC) for manual segmentation of femoral and innominate bone were (0.970, 0.963) and (0.971, 0.965). Compared with manual data, mean DSC values for femoral and innominate bone volumes using automated multi-atlas and ASM-based methods were (0.950, 0.922) and (0.946, 0.917), respectively. Both approaches delivered accurate (high DSC values) segmentation results; notably, ASM data were generated in substantially less computational time (12 min versus 10 h). Both automated algorithms provided accurate 3D bone volumetric descriptions for MR-based measures in the hip region. The highly computational efficient ASM-based approach is more likely suitable for future clinical applications such as extracting bone-cartilage interfaces for potential cartilage segmentation. PMID:24077264

  3. Automated bone segmentation from large field of view 3D MR images of the hip joint

    NASA Astrophysics Data System (ADS)

    Xia, Ying; Fripp, Jurgen; Chandra, Shekhar S.; Schwarz, Raphael; Engstrom, Craig; Crozier, Stuart

    2013-10-01

    Accurate bone segmentation in the hip joint region from magnetic resonance (MR) images can provide quantitative data for examining pathoanatomical conditions such as femoroacetabular impingement through to varying stages of osteoarthritis to monitor bone and associated cartilage morphometry. We evaluate two state-of-the-art methods (multi-atlas and active shape model (ASM) approaches) on bilateral MR images for automatic 3D bone segmentation in the hip region (proximal femur and innominate bone). Bilateral MR images of the hip joints were acquired at 3T from 30 volunteers. Image sequences included water-excitation dual echo stead state (FOV 38.6 × 24.1 cm, matrix 576 × 360, thickness 0.61 mm) in all subjects and multi-echo data image combination (FOV 37.6 × 23.5 cm, matrix 576 × 360, thickness 0.70 mm) for a subset of eight subjects. Following manual segmentation of femoral (head-neck, proximal-shaft) and innominate (ilium+ischium+pubis) bone, automated bone segmentation proceeded via two approaches: (1) multi-atlas segmentation incorporating non-rigid registration and (2) an advanced ASM-based scheme. Mean inter- and intra-rater reliability Dice's similarity coefficients (DSC) for manual segmentation of femoral and innominate bone were (0.970, 0.963) and (0.971, 0.965). Compared with manual data, mean DSC values for femoral and innominate bone volumes using automated multi-atlas and ASM-based methods were (0.950, 0.922) and (0.946, 0.917), respectively. Both approaches delivered accurate (high DSC values) segmentation results; notably, ASM data were generated in substantially less computational time (12 min versus 10 h). Both automated algorithms provided accurate 3D bone volumetric descriptions for MR-based measures in the hip region. The highly computational efficient ASM-based approach is more likely suitable for future clinical applications such as extracting bone-cartilage interfaces for potential cartilage segmentation.

  4. Validation of Finite Element Predictions of Cartilage Contact Pressure in the Human Hip Joint

    PubMed Central

    Anderson, Andrew E.; Ellis, Benjamin J.; Maas, Steve A.; Peters, Christopher L.; Weiss, Jeffrey A.

    2010-01-01

    Methods to predict contact stresses in the hip can provide an improved understanding of load distribution in the normal and pathologic joint. The objectives of this study were to develop and validate a three-dimensional finite element (FE) model for predicting cartilage contact stresses in the human hip using subject-specific geometry from computed tomography image data, and to assess the sensitivity of model predictions to boundary conditions, cartilage geometry, and cartilage material properties. Loads based on in vivo data were applied to a cadaveric hip joint to simulate walking, descending stairs and stair-climbing. Contact pressures and areas were measured using pressure sensitive film. CT image data were segmented and discretized into FE meshes of bone and cartilage. FE boundary and loading conditions mimicked the experimental testing. Fair to good qualitative correspondence was obtained between FE predictions and experimental measurements for simulated walking and descending stairs, while excellent agreement was obtained for stair-climbing. Experimental peak pressures, average pressures, and contact areas were 10.0 MPa (limit of film detection), 4.4-5.0 MPa and 321.9-425.1 mm2, respectively, while FE predicted peak pressures, average pressures and contact areas were 10.8-12.7 MPa, 5.1-6.2 MPa and 304.2-366.1 mm2, respectively. Misalignment errors, determined as the difference in root mean squared error before and after alignment of FE results, were less than 10%. Magnitude errors, determined as the residual error following alignment, were approximately 30% but decreased to 10-15% when the regions of highest pressure were compared. Alterations to the cartilage shear modulus, bulk modulus, or thickness resulted in ±25% change in peak pressures, while changes in average pressures and contact areas were minor (±10%). When the pelvis and proximal femur were represented as rigid, there were large changes, but the effect depended on the particular loading

  5. Equine rehabilitation therapy for joint disease.

    PubMed

    Porter, Mimi

    2005-12-01

    The principles of physical rehabilitation therapy can be applied to the horse to provide a reduction in discomfort and dysfunction associated with the various forms of joint disease. Physical agents,such as ice, heat, electricity, sound, light, magnetic fields, compression, and movement, can be used by the rehabilitation therapist to attempt to control pain, reduce swelling, and restore optimal movement and function in the affected joint. The equine therapist's attention is focused not only on the affected joint but on the body as a whole to manage secondary or compensatory problems. PMID:16297723

  6. Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings

    PubMed Central

    Malfait, Bart; Dingenen, Bart; Smeets, Annemie; Staes, Filip; Pataky, Todd; Robinson, Mark A.; Vanrenterghem, Jos; Verschueren, Sabine

    2016-01-01

    Purpose The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Methods Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. Results The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001). Conclusion This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an

  7. Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides).

    PubMed

    Lawler, Dennis F; Evans, Richard H; Nieminen, Petteri; Mustonen, Anne-Mari; Smith, Gail K

    2012-01-01

    The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids. PMID:23277118

  8. Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection

    PubMed Central

    Brüggemann, Holger; Scholz, Christian F. P.; Leimbach, Andreas; Söderquist, Bo

    2016-01-01

    Propionibacterium acnes is well-established as a possible etiologic agent of prosthetic joint infections (PJIs). Other Propionibacterium spp. have occasionally been described as a cause of PJIs, but this has not previously been the case for P. avidum despite its capacity to form biofilm. We describe two patients with prosthetic hip joint infections caused by P. avidum. Both patients were primarily operated with an anteriorly curved skin incision close to the skin crease of the groin, and both were obese. Initial treatment was performed according to the DAIR procedure (debridement, antibiotics, and implant retention). In case 1, the outcome was successful, but in case 2, a loosening of the cup was present 18 months post debridement. The P. avidum isolate from case 1 and two isolates from case 2 (obtained 18 months apart) were selected for whole genome sequencing. The genome of P. avidum obtained from case 1 was approximately 60 kb larger than the genomes of the two isolates of case 2. These latter isolates were clonal with the exception of SNPs in the genome. All three strains possessed the gene cluster encoding exopolysaccharide synthesis. P. avidum has a pathogenic potential and the ability to cause clinically relevant infections, including abscess formation, in the presence of foreign bodies such as prosthetic joint components. Skin incision in close proximity to the groin or deep skin crease, such as the anteriorly curved skin incision approach, might pose a risk of PJIs by P. avidum, especially in obese patients. PMID:27355425

  9. Nondestructive inspection of phase transformation in zirconia-containing hip joints by confocal Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Zhu, Wenliang; Sugano, Nobuhiko; Pezzotti, Giuseppe

    2013-12-01

    Environmental metastability of zirconia (ZrO2) ceramic in the human body [represented by a tetragonal-to-monoclinic (t→m) phase transformation] takes place on the surface of the artificial joint and proceeds with time toward its interior. Its quantitative characterization is mandatory for the safety of joint implants and consists of the assessment of the in-depth monoclinic profile fraction as compared to that of the initially untransformed material. We attempt to fully establish a characterization protocol and present two different nondestructive approaches for resolving highly graded phase-transformation profiles along the hip-joint subsurface by confocal Raman microprobe technique. A series of partially transformed tetragonal zirconia polycrystal and zirconia-toughened alumina ceramics are used as screening samples. Probe biases could be eliminated and the real transformation profiles retrieved through a deconvolution procedure of Raman experimental data collected as a function of pinhole aperture and focal depth, respectively. Confirmation of the confocal assessments was made by a destructive cross-sectional inspection by both laser optical microscope and Raman spectral line scans. This study unveils for the first time the real quantitative amount of surface phase-transformation fractions and the related subsurface profiles in zirconia-based retrieved medical samples.

  10. Nondestructive inspection of phase transformation in zirconia-containing hip joints by confocal Raman spectroscopy.

    PubMed

    Zhu, Wenliang; Sugano, Nobuhiko; Pezzotti, Giuseppe

    2013-12-01

    Environmental metastability of zirconia (ZrO2) ceramic in the human body [represented by a tetragonal-to-monoclinic (t→m) phase transformation] takes place on the surface of the artificial joint and proceeds with time toward its interior. Its quantitative characterization is mandatory for the safety of joint implants and consists of the assessment of the in-depth monoclinic profile fraction as compared to that of the initially untransformed material. We attempt to fully establish a characterization protocol and present two different nondestructive approaches for resolving highly graded phase-transformation profiles along the hip-joint subsurface by confocal Raman microprobe technique. A series of partially transformed tetragonal zirconia polycrystal and zirconia-toughened alumina ceramics are used as screening samples. Probe biases could be eliminated and the real transformation profiles retrieved through a deconvolution procedure of Raman experimental data collected as a function of pinhole aperture and focal depth, respectively. Confirmation of the confocal assessments was made by a destructive cross-sectional inspection by both laser optical microscope and Raman spectral line scans. This study unveils for the first time the real quantitative amount of surface phase-transformation fractions and the related subsurface profiles in zirconia-based retrieved medical samples. PMID:24297000

  11. Shoulder and hip joints for hard space suits and the like

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    For use in hard space suits and the like, a joint between the torso covering and the upper arm covering (i.e., shoulder) or between the torso covering and upper leg covering (i.e., hip) is disclosed. Each joint has an outer covering and a inner covering. The outer covering has plural perferably truncated toroidal sections decreasing in size proceeding outwardly. In one embodiment at each joint there are two bearings, the first larger than the second. The outer race of the larger bearing is attached to the outer edge of the smaller end of each section and the inner race of the larger bearing is attached to the end wall. The inner race of the smaller bearing is attached to the end wall. The outer race of the smaller bearing is attached to the larger end of the next section. Each bearing hask appropriate seals. Between each section is a rubber ring for the comfort of the wearer. Such rubber rings have radial flanges attached to the inner races of two adjacent bearings. Matching semicircular grooves are formed in the abutting overlapping surfaces. Bellows-like inner walls are also provided for each section fixed at one end to an inner cylindrical flange and, at the opposite end, to an end wall. Each outer section may rotate 360 deg relative to the next outer section, whereas the bellows sections do not rotate, but rather expand or contract locally as the rigid sections rotate relative to each other.

  12. The Possibilities to Decrease the Coefficient of Friciton Between Head and Socket of the Endoprosthesis of Hip Joint

    NASA Astrophysics Data System (ADS)

    Haringová, Andrea; Stračár, Karol; Prikkel, Karol

    2014-12-01

    The article deals with the question of physical parameters that could positively influence the overall lifetime of hip joint endoprosthesis. As the important physical parameter it was selected the coefficient of friction. The contribution offers possibilities how to decrease the coefficient of friction and experimentally test these assumptions

  13. Influence of hip joint simulator design and mechanics on the wear and creep of metal-on-polyethylene bearings.

    PubMed

    Ali, Murat; Al-Hajjar, Mazen; Partridge, Susan; Williams, Sophie; Fisher, John; Jennings, Louise M

    2016-05-01

    Hip joint simulators are used extensively for preclinical testing of hip replacements. The variation in simulator design and test conditions used worldwide can affect the tribological performance of polyethylene. The aim of this study was to assess the effects of simulator mechanics and design on the wear and creep of ultra-high-molecular-weight polyethylene. In the first part of this study, an electromechanical simulator and pneumatic simulator were used to compare the wear and creep of metal-on-polyethylene components under the same standard gait conditions. In the second part of the study, the same electromechanical hip joint simulator was used to investigate the influence of kinematics on wear. Higher wear rates and penetration depths were observed from the electromechanical simulator compared with the pneumatic simulator. When adduction/abduction was introduced to the gait cycle, there was no significant difference in wear with that obtained under the gait cycle condition without adduction/abduction. This study confirmed the influence of hip simulator design and loading conditions on the wear of polyethylene, and therefore direct comparisons of absolute wear rates between different hip joint simulators should be avoided. This study also confirmed that the resulting wear path was the governing factor in obtaining clinically relevant wear rates, and this can be achieved with either two axes or three axes of rotations. However, three axes of rotation (with the inclusion of adduction/abduction) more closely replicate clinical conditions and should therefore be the design approach for newly developed hip joint simulators used for preclinical testing. PMID:27160559

  14. Influence of hip joint simulator design and mechanics on the wear and creep of metal-on-polyethylene bearings

    PubMed Central

    Ali, Murat; Al-Hajjar, Mazen; Partridge, Susan; Williams, Sophie; Fisher, John; Jennings, Louise M

    2016-01-01

    Hip joint simulators are used extensively for preclinical testing of hip replacements. The variation in simulator design and test conditions used worldwide can affect the tribological performance of polyethylene. The aim of this study was to assess the effects of simulator mechanics and design on the wear and creep of ultra-high-molecular-weight polyethylene. In the first part of this study, an electromechanical simulator and pneumatic simulator were used to compare the wear and creep of metal-on-polyethylene components under the same standard gait conditions. In the second part of the study, the same electromechanical hip joint simulator was used to investigate the influence of kinematics on wear. Higher wear rates and penetration depths were observed from the electromechanical simulator compared with the pneumatic simulator. When adduction/abduction was introduced to the gait cycle, there was no significant difference in wear with that obtained under the gait cycle condition without adduction/abduction. This study confirmed the influence of hip simulator design and loading conditions on the wear of polyethylene, and therefore direct comparisons of absolute wear rates between different hip joint simulators should be avoided. This study also confirmed that the resulting wear path was the governing factor in obtaining clinically relevant wear rates, and this can be achieved with either two axes or three axes of rotations. However, three axes of rotation (with the inclusion of adduction/abduction) more closely replicate clinical conditions and should therefore be the design approach for newly developed hip joint simulators used for preclinical testing. PMID:27160559

  15. Effect of the high femoral osteotomy upon the vascularity and blood supply of the hip joint

    SciTech Connect

    Day, B.; Shim, S.S.; Leung, G.

    1984-05-01

    This investigation was done to study the effects of high femoral osteotomy upon the vascularity and blood supply of the hip and to further our knowledge of its physiologic basis. We have used established methods of study, including bone scans, microangiography, isotope clearance and perosseous venography, and based upon the results of these studies, we have reached certain conclusions. First, high femoral osteotomy increases the blood flow and vascularity in the hip joint, the femoral head and neck and the great trochanter. Second, bone scanning techniques using /sup 99m/Tc labeled diphosphonate have shown increased uptake in the femoral head and neck after high femoral osteotomy. The localization was done using a Digital Gamma III computer, and the activity on the osteotomy side at two weeks was 3.5 times as great as on the control side. By 16 weeks postoperatively, there was still two times as much activity on the osteotomy side. Third, microangiography showed increased vascularity both at the osteotomy site and in the femoral head and neck and the greater trochanter on that side. Such an increase in vascularity first became evident two weeks after osteotomy and persisted during the four month period studied. Fourth, the results of the /sup 99m/Tc diphosphonate clearance study showed a 25 per cent increase in femoral head blood flow on the operative side. Fifth, perosseous venography of the femoral head and neck showed a marked increase in venous drainage through the osteotomy site in the immediate postosteotomy stage.

  16. Retrospective lifetime estimation of failed and explanted diamond-like carbon coated hip joint balls.

    PubMed

    Hauert, R; Falub, C V; Thorwarth, G; Thorwarth, K; Affolter, Ch; Stiefel, M; Podleska, L E; Taeger, G

    2012-08-01

    Diamond-like carbon (DLC) coatings are known to have extremely low wear in many technical applications. The application of DLC as a coating has aimed at lowering wear and to preventing wear particle-induced osteolysis in artificial hip joints. In a medical study femoral heads coated with diamond-like amorphous carbon, a subgroup of DLC, articulating against polyethylene cups were implanted between 1993 and 1995. Within 8.5 years about half of the hip joints had to be revised due to aseptic loosening. The explanted femoral heads showed many spots of local coating delamination. Several of these explanted coated TiAlV femoral heads have been analyzed to investigate the reason for this failure. Raman analysis and X-ray photoelectron spectroscopy (XPS) depth profiling showed that the coating consists of diamond-like amorphous carbon, several Si-doped layers and an adhesion-promoting Si interlayer. Focused ion beam (FIB) transverse cuts revealed that the delamination of the coatings is caused by in vivo corrosion of the Si interlayer. Using a delamination test set-up dissolution of the silicon adhesion-promoting interlayer at a speed of more than 100 μm year(-1) was measured in vitro in solutions containing proteins. Although proteins are not directly involved in the corrosion reactions, they can block existing small cracks and crevices under the coating, hindering the exchange of liquid. This results in a build-up of crevice corrosion conditions in the crack, causing a slow dissolution of the Si interlayer. PMID:22521966

  17. Movement-Pattern Training to Improve Function in People With Chronic Hip Joint Pain: A Feasibility Randomized Clinical Trial.

    PubMed

    Harris-Hayes, Marcie; Czuppon, Sylvia; Van Dillen, Linda R; Steger-May, Karen; Sahrmann, Shirley; Schootman, Mario; Salsich, Gretchen B; Clohisy, John C; Mueller, Michael J

    2016-06-01

    Study Design Feasibility randomized clinical trial. Background Rehabilitation may be an appropriate treatment strategy for patients with chronic hip joint pain; however, the evidence related to the effectiveness of rehabilitation is limited. Objectives To assess feasibility of performing a randomized clinical trial to investigate the effectiveness of movement-pattern training (MPT) to improve function in people with chronic hip joint pain. Methods Thirty-five patients with chronic hip joint pain were randomized into a treatment (MPT) group or a control (wait-list) group. The MPT program included 6 one-hour supervised sessions and incorporated (1) task-specific training for basic functional tasks and symptom-provoking tasks, and (2) strengthening of hip musculature. The wait-list group received no treatment. Primary outcomes for feasibility were patient retention and adherence. Secondary outcomes to assess treatment effects were patient-reported function (Hip disability and Osteoarthritis Outcome Score), lower extremity kinematics, and hip muscle strength. Results Retention rates did not differ between the MPT (89%) and wait-list groups (94%, P = 1.0). Sixteen of the 18 patients (89%) in the MPT group attended at least 80% of the treatment sessions. For the home exercise program, 89% of patients reported performing their home program at least once per day. Secondary outcomes support the rationale for conduct of a superiority randomized clinical trial. Conclusion Based on retention and adherence rates, a larger randomized clinical trial appears feasible and warranted to assess treatment effects more precisely. Data from this feasibility study will inform our future clinical trial. Level of Evidence Therapy, level 2b-. J Orthop Sports Phys Ther 2016;46(6):452-461. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6279. PMID:27117727

  18. Total hip joint prosthesis for in vivo measurement of forces and moments.

    PubMed

    Damm, Philipp; Graichen, Friedmar; Rohlmann, Antonius; Bender, Alwina; Bergmann, Georg

    2010-01-01

    A new instrumented hip joint prosthesis was developed which allows the in vivo measurement of the complete contact loads in the joint, i.e. 3 force and 3 moment components. A clinically proven standard implant was modified. Inside the hollow neck, 6 semiconductor strain gauges are applied to measure the deformation of the neck. Also integrated are a small coil for the inductive power supply and a 9-channel telemetry transmitter. The neck cavity is closed by a titanium plate and hermetically sealed by electron beam welding. The sensor signals are pulse interval modulated (PIM) with a sampling rate of about 120 Hz. The pulses are transmitted at radio frequencies via a small antenna loop inside the ceramic head, which is connected to the electronic circuit by a two-pin feedthrough. Inductive power supply, calculation of the loads from the measured deformations and real time load display are carried out by the external equipment. The maximum error of the load components is 2% including crosstalk. PMID:19889565

  19. Evaluation of silicon nitride as a wear resistant and resorbable alternative for total hip joint replacement

    PubMed Central

    Olofsson, Johanna; Grehk, T. Mikael; Berlind, Torun; Persson, Cecilia; Jacobson, Staffan; Engqvist, Håkan

    2012-01-01

    Many of the failures of total joint replacements are related to tribology, i.e., wear of the cup, head and liner. Accumulation of wear particles at the implants can be linked to osteolysis which leads to bone loss and in the end aseptic implant loosening. Therefore it is highly desirable to reduce the generation of wear particles from the implant surfaces. Silicon nitride (Si3N4) has shown to be biocompatible and have a low wear rate when sliding against itself and is therefore a good candidate as a hip joint material. Furthermore, wear particles of Si3N4 are predicted to slowly dissolve in polar liquids and they therefore have the potential to be resorbed in vivo, potentially reducing the risk for aseptic loosening. In this study, it was shown that α-Si3N4-powder dissolves in PBS. Adsorption of blood plasma indicated a good acceptance of Si3N4 in the body with relatively low immune response. Si3N4 sliding against Si3N4 showed low wear rates both in bovine serum and PBS compared with the other tested wear couples. Tribofilms were built up on the Si3N4 surfaces both in PBS and in bovine serum, controlling the friction and wear characteristics. PMID:23507807

  20. Nuclear microbeam analysis of wear particles in tissue surrounding failed hip joint implants

    NASA Astrophysics Data System (ADS)

    Grime, G. W.; Triffitt, J. T.; Williamson, M. C.; Athanasou, N. A.

    1994-05-01

    Particulate wear debris from hip joint replacements is an important factor in determining the response of the surrounding tissue to the implants. Failed replacement joints are surrounded by a layer of fibrous tissue showing an inflammatory response to the wear debris. This reaction leads to bone resorption and the eventual failure of the prosthesis. In preliminary experiments the Oxford scanning proton microprobe has been used to study the composition of wear particles in the membranes surrounding failed implants constructed from Ti/V/Al alloy. The membranes were observed to contain 1-10 μm particles with major constituents from the alloy and also from the cement and polyethylene used in the fitting and construction of the implant. Histological staining shows that these particles are associated with areas of high macrophage activity. Individual PIXE analysis of the metal particles indicates that two populations (high Ti/low Al and low Ti/high Al) may be present. These observations will provide further information on the mechanisms of implant degradation.

  1. A long-term follow-up of 60 Lord total hip arthroplasties in rheumatic disease: a mean follow-up of 14 years.

    PubMed

    Lybäck, C C; Lybäck, C O; Kyrö, A; Kautiainen, H J; Belt, E A

    2006-10-01

    The aim of the study was to analyse the survivorship of 60 total hip arthroplasties using the cementless Lord prosthesis in 51 patients with inflammatory joint disease. Patients were operated on between the years 1985 and 1988. The mean follow-up time was 13.8 (4.0-18.6) years. During the follow-up, one deep infection was encountered, and seven patients died of causes unrelated to the hip replacement. Revision surgery or death of the patient was used as an end point. The overall survival was 88.1% [95% confidence interval (CI) 76.6-94.1] for the stem, and 64.3% (95% CI 50.6-75.1) for the cup at 15 years. Causes for revision surgery were loosening of the cup in 17 hips, loosening of both components in five hips, and one deep infection. PMID:16691388

  2. Hip instability.

    PubMed

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  3. Femoral nerve compression secondary to a ganglion cyst arising from a hip joint: a case report and review of the literature

    PubMed Central

    2009-01-01

    Introduction Femoral nerve compression due to a cystic lesion around the hip joint is rare and only a few cases have been described in the literature. Among these, true ganglion cysts are even more rare. Case presentation We report the case of a 57-year-old woman with femoral nerve compression caused by a true ganglion cyst of the hip joint. Conclusion A high index of suspicion is required to predict a non-palpable cystic lesion around the hip joint as it may mimic different disorders and should be kept in mind in the differential diagnosis of unusual groin pain, radicular pain and peripheral vascular disorders. PMID:19178731

  4. Transient Synovitis of the Hip

    MedlinePlus

    ... inflammation and swelling of the tissues around the hip joint. Usually only one hip is affected. This condition ... to reduce the swelling and inflammation around the hip joint. Your child's doctor will probably ask you to ...

  5. The biomaterials challenge: A comparison of polyethylene wear using a hip joint simulator.

    PubMed

    Affatato, Saverio; Freccero, Nadia; Taddei, Paola

    2016-01-01

    Although hip arthroplasty is an established procedure that relieves pain and improves functions, problems remain with wear and osteolysis. Highly cross-linked polyethylene and Vitamin-E-stabilized polyethylene were introduced in the last years to solve these problems. In this study we compared the in vitro wear behaviour of cross-linked polyethylene (XLPE) versus Vitamin-E diffused XLPE (XLPE_VE) versus conventional ultra-high molecular weight polyethylene (UHMWPE) acetabular cups. The test was performed using a hip joint simulator run for two millions cycles under bovine calf serum as lubricant. Mass loss was found to decrease along the series UHMWPE>XLPE_VE>XLPE, although statistically significant differences were found only between the mass losses of XLPE and UHMWPE at 1.2 and 2 million cycles. The mass loss data were explained in relation to the crystalline morphology of the control unworn cups, as investigated by non-destructive micro-Raman spectroscopy. This technique allowed to disclose a different wear behaviour of the three sets of cups. Wear testing produced a stress-induced crystallisation in UHMWPE, with increases in both amorphous (αa) and orthorhombic (αo) phases at the expense of the third phase (αb), which decreased upon wear. Moreover, the all-trans content decreased, while the ortho-trans content increased, contrarily to the trend observed for XLPE and XLPE_VE, for which no statistically significant changes in αo, αa and αb contents were detected. The XLPE_VE specimens underwent the least significant changes in the spectroscopic markers of micromorphology upon mechanical stress, probably due to their lower starting amorphous content. PMID:26301318

  6. Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.

    PubMed

    Schmalzried, T P; Jasty, M; Harris, W H

    1992-07-01

    Thirty-four hips in which there had been prosthetic replacement were selected for study because of the presence of linear (diffuse) or lytic (localized) areas of periprosthetic bone loss. In all hips, there was careful documentation of the anatomical location of the material that had been obtained for histological analysis, and the specific purpose of the removal of the tissue was for examination to determine the cause of the resorption of bone. Specimens from twenty-three hips were retrieved during an operation and from eleven hips, at autopsy. The area of bone loss was linear only in sixteen hips, lytic only in thirteen, and both linear and lytic in five. In all thirty-four hips, intracellular particulate debris was found in the macrophages that were present in the area of bone resorption. All thirty-four had intracellular particles of polyethylene, many of which were less than one micrometer in size. Thirty-one hips had extracellular particles of polyethylene as well. Twenty-two of the thirty-four hips had intracellular metallic debris; in ten, metallic debris was found extracellularly as well. Ten of the sixteen cemented specimens had intracellular and extracellular polymethylmethacrylate debris. In the mechanically stable prostheses--cemented and uncemented--polyethylene wear debris was identified in areas of bone resorption far from the articular surfaces. The number of macrophages in a microscopic field was directly related to the amount of particulate polyethylene debris that was visible by light microscopy. Although the gross radiographic appearances of linear bone loss and lytic bone loss were different, the histological appearance of the regions in which there was active bone resorption was similar. Regardless of the radiographic appearance and anatomical origin of the specimen, bone resorption was found to occur in association with macrophages that were laden with polyethylene debris. In general, the number of macrophages present had a direct

  7. The influence of the representation of collagen fibre organisation on the cartilage contact mechanics of the hip joint.

    PubMed

    Li, Junyan; Hua, Xijin; Jones, Alison C; Williams, Sophie; Jin, Zhongmin; Fisher, John; Wilcox, Ruth K

    2016-06-14

    The aim of this study was to develop a finite element (FE) hip model with subject-specific geometry and biphasic cartilage properties. Different levels of detail in the representation of fibre reinforcement were considered to evaluate the feasibility to simplify the complex depth-dependent fibre pattern in the native hip joint. A FE model of a cadaveric hip with subject-specific geometry was constructed through micro-computed-tomography (µCT) imaging. The cartilage was assumed to be biphasic and fibre-reinforced with different levels of detail in the fibre representation. Simulations were performed for heel-strike, mid-stance and toe-off during walking and one-leg-stance over 1500s. It was found that the required level of detail in fibre representation depends on the parameter of interest. The contact stress of the native hip joint could be realistically predicted by simplifying the fibre representation to being orthogonally reinforced across the whole thickness. To predict the fluid pressure, depth-dependent fibre organisation is needed but specific split-line pattern on the surface of cartilage is not necessary. Both depth-dependent and specific surface fibre orientations are required to simulate the strains. PMID:27079623

  8. OARSI/OMERACT Initiative to Define States of Severity and Indication for Joint Replacement in Hip and Knee Osteoarthritis. An OMERACT 10 Special Interest Group

    PubMed Central

    GOSSEC, LAURE; PATERNOTTE, SIMON; BINGHAM, CLIFTON O.; CLEGG, DANIEL O.; COSTE, PHILIPPE; CONAGHAN, PHILIP G.; DAVIS, AILEEN M.; GIACOVELLI, GIAMPAOLO; GUNTHER, KLAUS-PETER; HAWKER, GILLIAN; HOCHBERG, MARC C.; JORDAN, JOANNE M.; KATZ, JEFFREY N.; KLOPPENBURG, MARGREET; LANZAROTTI, ARTURO; LIM, KEITH; LOHMANDER, L. STEFAN; MAHOMED, NIZAR N.; MAILLEFERT, JEAN FRANCIS; MANNO, REBECCA L.; MARCH, LYN M.; MAZZUCA, STEVEN A.; PAVELKA, KAREL; PUNZI, LEONARDO; ROOS, EWA M.; ROVATI, LUCIO C.; SHI, HELEN; SINGH, JASVINDER A.; SUAREZ-ALMAZOR, MARIA E.; TAJANA-MESSI, ELEONORA; DOUGADOS, MAXIME

    2012-01-01

    Objective To define pain and physical function cutpoints that would, coupled with structural severity, define a surrogate measure of “need for joint replacement surgery,” for use as an outcome measure for potential structure-modifying interventions for osteoarthritis (OA). Methods New scores were developed for pain and physical function in knee and hip OA. A cross-sectional international study in 1909 patients was conducted to define data-driven cutpoints corresponding to the orthopedic surgeons’ indication for joint replacement. A post hoc analysis of 8 randomized clinical trials (1379 patients) evaluated the prevalence and validity of cutpoints, among patients with symptomatic hip/knee OA. Results In the international cross-sectional study, there was substantial overlap in symptom levels between patients with and patients without indication for joint replacement; indeed, it was not possible to determine cutpoints for pain and function defining this indication. The post hoc analysis of trial data showed that the prevalence of cases that combined radiological progression, high level of pain, and high degree of function impairment was low (2%–12%). The most discriminatory cutpoint to define an indication for joint replacement was found to be [pain (0–100) + physical function (0–100) > 80]. Conclusion These results do not support a specific level of pain or function that defines an indication for joint replacement. However, a tentative cutpoint for pain and physical function levels is proposed for further evaluation. Potentially, this symptom level, coupled with radiographic progression, could be used to define “nonresponders” to disease-modifying drugs in OA clinical trials. PMID:21807799

  9. The influence of size, clearance, cartilage properties, thickness and hemiarthroplasty on the contact mechanics of the hip joint with biphasic layers☆

    PubMed Central

    Li, Junyan; Stewart, Todd D.; Jin, Zhongmin; Wilcox, Ruth K.; Fisher, John

    2013-01-01

    Computational models of the natural hip joint are needed to examine and optimise tissue sparing interventions where the natural cartilage remains part of the bearing surfaces. Although the importance of interstitial fluid pressurisation in the performance of cartilage has long been recognized, few studies have investigated the time dependent interstitial fluid pressurisation in a three dimensional natural hip joint model. The primary aim of this study was to develop a finite element model of the natural hip incorporating the biphasic cartilage layers that was capable of simulating the joint response over a prolonged physiological loading period. An initial set of sensitivity studies were also undertaken to investigate the influence of hip size, clearance, cartilage properties, thickness and hemiarthroplasty on the contact mechanics of the joint. The contact stress, contact area, fluid pressure and fluid support ratio were calculated and cross-compared between models with different parameters to evaluate their influence. It was found that the model predictions for the period soon after loading were sensitive to the hip size, clearance, cartilage aggregate modulus, thickness and hemiarthroplasty, while the time dependent behaviour over 3000 s was influenced by the hip clearance and cartilage aggregate modulus, permeability, thickness and hemiarthroplasty. The modelling methods developed in this study provide a basic platform for biphasic simulation of the whole hip joint onto which more sophisticated material models or other input parameters could be added in the future. PMID:23664238

  10. Hip and knee joints are more stabilized than driven during the stance phase of gait: an analysis of the 3D angle between joint moment and joint angular velocity.

    PubMed

    Dumas, R; Cheze, L

    2008-08-01

    Joint power is commonly used in orthopaedics, ergonomics or sports analysis but its clinical interpretation remains controversial. Some basic principles on muscle actions and energy transfer have been proposed in 2D. The decomposition of power on 3 axes, although questionable, allows the same analysis in 3D. However, these basic principles have been widely criticized, mainly because bi-articular muscles must be considered. This requires a more complex computation in order to determine how the individual muscle force contributes to drive the joint. Conversely, with simple 3D inverse dynamics, the analysis of both joint moment and angular velocity directions is essential to clarify when the joint moment can contribute or not to drive the joint. The present study evaluates the 3D angle between the joint moment and the joint angular velocity and investigates when the hip, knee and ankle joints are predominantly driven (angle close to 0 degrees and 180 degrees ) or stabilized (angle close to 90 degrees ) during gait. The 3D angle curves show that the three joints are never fully but only partially driven and that the hip and knee joints are mainly stabilized during the stance phase. The notion of stabilization should be further investigated, especially for subjects with motion disorders or prostheses. PMID:18206375

  11. 2-stage revision recommended for treatment of fungal hip and knee prosthetic joint infections

    PubMed Central

    2013-01-01

    Background and purpose Fungal prosthetic joint infections are rare and difficult to treat. This systematic review was conducted to determine outcome and to give treatment recommendations. Patients and methods After an extensive search of the literature, 164 patients treated for fungal hip or knee prosthetic joint infection (PJI) were reviewed. This included 8 patients from our own institutions. Results Most patients presented with pain (78%) and swelling (65%). In 68% of the patients, 1 or more risk factors for fungal PJI were found. In 51% of the patients, radiographs showed signs of loosening of the arthroplasty. Candida species were cultured from most patients (88%). In 21% of all patients, fungal culture results were first considered to be contamination. There was co-infection with bacteria in 33% of the patients. For outcome analysis, 119 patients had an adequate follow-up of at least 2 years. Staged revision was the treatment performed most often, with the highest success rate (85%). Interpretation Fungal PJI resembles chronic bacterial PJI. For diagnosis, multiple samples and prolonged culturing are essential. Fungal species should be considered to be pathogens. Co-infection with bacteria should be treated with additional antibacterial agents. We found no evidence that 1-stage revision, debridement, antibiotics, irrigation, and retention (DAIR) or antifungal therapy without surgical treatment adequately controls fungal PJI. Thus, staged revision should be the standard treatment for fungal PJI. After resection of the prosthesis, we recommend systemic antifungal treatment for at least 6 weeks—and until there are no clinical signs of infection and blood infection markers have normalized. Then reimplantation can be performed. PMID:24171675

  12. Celiac disease autoimmunity and hip fracture risk: findings from a prospective cohort study.

    PubMed

    Heikkilä, Katriina; Heliövaara, Markku; Impivaara, Olli; Kröger, Heikki; Knekt, Paul; Rissanen, Harri; Mäki, Markku; Kaukinen, Katri

    2015-04-01

    The impact of celiac disease autoimmunity on bone health is unclear. We investigated the associations of seropositivity for tissue transglutaminase antibodies (tTGA) and endomysial antibodies (EMA) with incident hip fractures using data from a prospective cohort study, Mini-Finland Health Survey. Baseline serum samples, taken in 1978-80, were tested for tTGA and EMA. Incident hip fractures up to the year 2011 were ascertained from a national hospitalization register. Associations between seropositivity and hip fractures were modeled using Cox proportional hazards regression adjusted for age, sex, body mass index, vitamin D, gamma-glutamyl transferase, smoking, and self-rated health. Our analyses were based on 6919 men and women who had no record of celiac disease or hip fracture before the study baseline. A total of 382 individuals had a hip fracture during a median follow-up of 30 years. Compared with the tTGA-negative individuals (n = 6350), tTGA-positive participants (n = 569; with hip fracture, n = 51) had a higher risk of hip fractures (hazard ratio [HR] = 1.59, 95% confidence interval [CI] 1.17, 2.14). The findings were similar for another tTGA test (n 200; with hip fracture, n = 26; HR = 2.23, 95% CI 1.49, 3.34). We found no evidence for an association between EMA positivity and hip fracture risk (HR = 0.92, 95% CI 0.34, 2.47; n = 74; with hip fracture, n = 4). In our prospective population-based study of Finnish adults, seropositivity for tTGA was associated with an increased hip fracture risk. PMID:25270967

  13. Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee arthroplasty

    PubMed Central

    2013-01-01

    Background Poor pain and function outcomes are undesirable after an elective surgery such as total hip or knee arthroplasty (THA/TKA). Recent studies have indicated that the presence of contralateral joint influences outcomes of THA/TKA, however the impact of ipsilateral knee/hip involvement on THA/TKA outcomes has not been explored. The objective of this study was to assess the association of ipsilateral knee/hip joint involvement on short-term and medium-term pain and function outcomes after THA/TKA. Methods In this retrospective study of prospectively collected data, we used the data from the Mayo Clinic Total Joint Registry to assess the association of ipsilateral knee or hip joint involvement with moderate to severe pain and moderate to severe activity limitation at 2-year and 5-year follow-up after primary and revision THA and TKA using multivariable-adjusted logistic regression analyses. Results At 2 years, 3,823 primary THA, 4,701 primary TKA, 1,218 revision THA and 725 revision TKA procedures were studied. After adjusting for multiple covariates, ipsilateral knee pain was significantly associated with outcomes after primary THA (all P values <0.01): (1) moderate to severe pain: at 2 years, odds ratio (OR), 2.3 (95% confidence interval (CI) 1.5 to 3.6); at 5 years, OR 1.8 (95% CI 1.1 to 2.7); (2) moderate to severe activity limitation: at 2 years, OR 3.1 (95% CI 2.3 to 4.3); at 5 years, OR 3.6 (95% CI 2.6 to 5.0). Ipsilateral hip pain was significantly associated with outcomes after primary TKA (all P values <0.01): (1) moderate to severe pain: at 2 years, OR 3.3 (95% CI 2.3 to 4.7); at 5 years, OR 1.8 (95% CI 1.1 to 2.7); (2) moderate to severe activity limitation: at 2 years, OR 3.6 (95% CI 2.6 to 4.9); at 5 years, OR 2.2 (95% CI 1.6 to 3.2). Similar associations were noted for revision THA and TKA patients. Conclusions To the best of our knowledge, this is the first study showing that the presence of ipsilateral joint involvement after THA or TKA is

  14. Quantitative assessments of residual stress fields at the surface of alumina hip joints.

    PubMed

    Pezzotti, Giuseppe; Munisso, Maria Chiara; Lessnau, Kristina; Zhu, Wenliang

    2010-11-01

    In-depth and in-plane response functions of photo- and electro-stimulated probes have been modeled and quantitatively evaluated in order to assess their suitability to detect the highly graded residual stress fields generated at the surface of alumina hip joints. Optical calibrations revealed large differences in probe size, which strongly affected the detected magnitude of residual stress. A comparison between the responses of Raman and fluorescence probes in polycrystalline alumina showed that the depth of those probes spread to an extent in the order of the tens of microns even with using a confocal probe configuration. On the other hand, the electro-stimulated luminescence emitted by oxygen vacancy sites (F(+) center) in the alumina lattice represented the most suitable choice for confining to a shallow volume the stress probe. This latter probe enabled us to reduce the measurement depth to the order of the tens of nanometers. We show maps of surface residual stress as collected on both main-wear and nonwear zones of an alumina femoral head. A comparison among stress maps taken at exactly the same location, but employing different probes, revealed averaging effects on the stress magnitude detected with photo-stimulated probes, while proving the superior spatial resolution of the electron probe. PMID:20848660

  15. Inflammatory response to therapeutic gold bead implantation in canine hip joint osteoarthritis.

    PubMed

    Lie, K-I; Jæger, G; Nordstoga, K; Moe, L

    2011-11-01

    Inflammatory changes associated with periarticular pure gold bead implants were studied in dogs involved in a clinical trial investigating motor dysfunction and chronic pain owing to hip joint dysplasia and osteoarthritis. Gold beads were percutaneously implanted via a needle into different locations surrounding the greater trochanter of the femur. Nine dogs with implants were necropsied. In all examined animals, characteristic histologic lesions were observed in the tissue surrounding the gold implants--namely, a fibrous capsule composed of concentric fibroblasts intermixed with a variable number of inflammatory cells and a paucicellular innermost layer of collagen with a few fibrocyte-like cells in empty lacunae. Lymphocytes dominated the inflammatory infiltrate, with rarely observed macrophages present in close proximity to the implant site. No giant cells were observed. Immunohistochemistry showed mixed populations of lymphocytes, both CD3 positive (T cells) and CD79a positive (B cells), which in some cases formed lymphoid follicles. Diffuse inflammatory changes were present to a minor extent in the perimysium and surrounding fascia. The inflammation observed in dogs is similar to that observed with gold implants in humans. It is possible that the clinically beneficial effect of gold beads for chronic osteoarthritis depends on sustained localized inflammation with localized release of soluble mediators. The encapsulation of the implant by a paucicellular and poorly vascularized fibrous capsule may help prevent an exaggerated inflammatory reaction by sequestering the gold bead from the surrounding tissue. PMID:20861497

  16. T1 assessment of hip joint cartilage following intra-articular gadolinium injection: a pilot study.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Kim, Young-Jo; Werlen, Stefan; Trattnig, Siegfried; Siebenrock, Klaus A; Mamisch, Tallal C

    2010-10-01

    This pilot study defines the feasibility of cartilage assessment in symptomatic femoroacetabular impingement patients using intra-articular delayed gadolinium-enhanced MRI of cartilage (ia-dGEMRIC). Nine patients were scanned preliminary to study the contrast infiltration process into hip joint cartilage. Twenty-seven patients with symptomatic femoroacetabular impingement were subsequently scanned with intra-articular delayed gadolinium-enhanced MRI of cartilage. These T(1) findings were correlated to morphological findings. Zonal variations were studied. This pilot study demonstrates a significant difference between the pre- and postcontrast T(1) values (P < 0.001) remaining constant for 45 min. We noted higher mean T(1) values in morphologically normal-appearing cartilage than in damaged cartilage, which was statistically significant for all zones except the anterior-superior zone. Intraobserver (0.972) and interobserver correlation coefficients (0.933) were statistically significant. This study outlines the feasibility of intra-articular delayed gadolinium-enhanced MRI of cartilage for assessment of cartilage changes in patients with femoroacetabular impingement. It can also define the topographic extent and differing severities of cartilage damage. PMID:20872764

  17. [Bone and Joint Involvement in Celiac Disease].

    PubMed

    Hoffmanová, I; Sánchez, D; Džupa, V

    2015-01-01

    Celiac disease (gluten-sensitive enteropathy) is currently regarded as a multisystem autoimmune disorder; its clinical signs and symptoms do not involve merely the gastrointestinal tract but are associated with several other medical specialties, including orthopaedics and traumatology. In orthopaedic and trauma patients, celiac disease should be suspected in the following diagnoses: osteomalacia, premenopausal osteoporosis, post-menopausal osteoporosis more severe than expected and refractory to medication, osteoporosis in men under 55 years of age, recurrent bone fractures in the limbs, large joint arthralgia or arthritis of unclear aetiology, erosive spondyloarthropathy particularly in patients with the history of chronic diarrhoea, anaemia or associated autoimmune disorders (type 1 diabetes mellitus or autoimmune thyreopathy), and in women with secondary amenorrhea or early menopause. The orthopaedist or trauma surgeon should be aware of suspected celiac disease in patients who do not respond adequately to the standard treatment of pain related to the musculoskeletal system, in patients with recurrent fractures of the limb bones and in young patients with suspected secondary osteoporosis. With the use of appropriate screening methods, celiac disease as-yet undiagnosed can be revealed. A long-life gluten-free diet in these patients results in the alleviation of metabolic osteopathy and joint and muscle problems, in reduced requirements of analgesic and antiphlogistic drugs as well as in reduced risks of fracture. PMID:26516737

  18. An artery accompanying the sciatic nerve (arteria comitans nervi ischiadici) and the position of the hip joint: a comparative histological study using chick, mouse, and human foetal specimens.

    PubMed

    Ishizawa, A; Hayashi, S; Nasu, H; Abe, H; Rodríguez-Vázquez, J F; Murakami, G

    2013-02-01

    Birds and reptiles always carry a long and thick artery accompanying the sciatic nerve (i.e., the sciatic artery), whereas mammals do not. We attempted to demonstrate a difference in courses of the nerve and artery in fetuses in relation with the hip joint posture. Eight mid-term human fetuses (15-18 weeks), five mouse fetuses (E18) and five chick embryos (11 days after incubation) were examined histologically. Thin feeding arteries in the sciatic nerve were consistently observed in human fetuses in spite of the long, inferiorly curved course of the nerve around the ischium. The tissue around the human sciatic nerve was not so tight because of the medial and inferior shift of the nerve away from the hip joint. The fetal hip joint position differed among the species, being highly flexed in humans and almost at right angle flexion in mice and chicks. Because of deep adduction of the hip joint in the mouse, the knee was located near the midline of the body. The mouse sciatic nerve ran through the tight tissue along the head of the femur, whereas the chick nerve ran through the loose space even in the gluteal region. In birds, evolution of the pelvis including the hip joint without adduction seemed to make the arterial development possible. In mammals, highly flexed or adducted hip joint seemed to be one of the disturbing factors against development of the long and thick artery. A slight change in posture may cause significant arterial variation. PMID:23749710

  19. Legg-Calvé-Perthes disease produces chronic hip synovitis and elevation of interleukin-6 in the synovial fluid.

    PubMed

    Kamiya, Nobuhiro; Yamaguchi, Ryosuke; Adapala, Naga Suresh; Chen, Elena; Neal, David; Jack, Obrien; Thoveson, Alec; Gudmundsson, Paul; Brabham, Case; Aruwajoye, Olumide; Drissi, Hicham; Kim, Harry K W

    2015-06-01

    Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder of ischemic osteonecrosis of the femoral head. Hip joint synovitis is a common feature of LCPD, but the nature and pathophysiology of the synovitis remain unknown. The purpose of this study was to determine the chronicity of the synovitis and the inflammatory cytokines present in the synovial fluid at an active stage of LCPD. Serial MRI was performed on 28 patients. T2-weighted and gadolinium-enhanced MR images were used to assess synovial effusion and synovial enhancement (hyperemia) over time. A multiple-cytokine assay was used to determine the levels of 27 inflammatory cytokines and related factors present in the synovial fluid from 13 patients. MRI analysis showed fold increases of 5.0 ± 3.3 and 3.1 ± 2.1 in the synovial fluid volume in the affected hip compared to the unaffected hip at the initial and the last follow-up MRI, respectively. The mean duration between the initial and the last MRI was 17.7 ± 8.3 months. The volume of enhanced synovium on the contrast MRI was increased 16.5 ± 8.5 fold and 6.3 ± 5.6 fold in the affected hip compared to the unaffected hip at the initial MRI and the last follow-up MRI, respectively. In the synovial fluid of the affected hips, IL-6 protein levels were significantly increased (LCPD: 509 ± 519 pg/mL, non-LCPD: 19 ± 22 pg/mL; p = 0.0005) on the multi-cytokine assay. Interestingly, IL-1β and TNF-α levels were not elevated. In the active stage of LCPD, chronic hip synovitis and significant elevation of IL-6 are produced in the synovial fluid. Further studies are warranted to investigate the role of IL-6 on the pathophysiology of synovitis in LCPD and how it affects bone healing. PMID:25556551

  20. Morphometric assessment of the canine hip joint using the dorsal acetabular rim view and the centre-edge angle.

    PubMed

    Meomartino, L; Fatone, G; Potena, A; Brunetti, A

    2002-01-01

    The dorsal acetabular rim (DAR) view of the hip joint can be used to assess the weightbearing portion of the acetabulum and the acetabular coverage, providing an adjunct to the conventional ventrodorsal (VD) view in the radiographic evaluation of hip dysplasia in the dog. A quantitative index of acetabular coverage in the DAR view, the acetabular slope (AS) angle, was originally proposed in 1990. The aim of the present study was to make a prospective, comparative assessment of a new parameter, the centre-edge (CE) angle, with the AS angle, for the evaluation of the acetabular coverage of the femoral head in the DAR view. The reliability and repeatability of the two parameters was assessed using the r(I) value of intraclass correlation coefficient (ICC) in a prospective study of 208 hip joints in large and giant breed dogs. An estimation of the added value of using the DAR view, compared with that of the VD standard view alone, was also assessed. The CE angle showed a higher r(I) value compared with the AS angle; in 26 per cent of hips of FCI classes A, B and C, the DAR view provided additional diagnostic information compared with the VD view, with respect to lateralisation and/or initial changes to the dorsal rim. It is concluded that the CE angle is more reliable than the AS angle in the evaluation of acetabular coverage, and that the DAR view provides valuable data compared with the VD view alone in the early stages of canine hip dysplasia. PMID:11833819

  1. [Effects of surgery on muscles on clinical and radiographic findings in the hip joint region in cerebral palsy patients].

    PubMed

    Schejbalová, A; Havlas, V

    2008-10-01

    PURPOSE OF THE STUDY Isolated or combined surgical procedures on muscles around the hip joint are currently indicated by many authors. In cerebral palsy patients they are regarded as essential intervention. MATERIAL In the years 2005-2007, surgery in the hip joint region was essential for 150 children between 3 and 18 years of age. At the time of surgery, the patients' locomotion ranged from stage 1 to stage 7 of the Vojta system. METHODS The outcome was evaluated by clinical and radiographic examination at 2 and 6 months post-operatively and hip migration percentage and Wiberg's CE angle were measured. RESULTS The best clinical and radiographic outcomes were achieved in children younger than 6 years of age. On the other hand, isolated transfer of the distal rectus femoris muscle significantly affected pelvis anteflexion in adolescent patients. The most marked decrease in migration percentage was found after adductor tenotomy combined with surgery on the iliopsoas muscle (55.6 %) or when the two procedures were combined with distal rectus femoris transfer. DISCUSSION Combined surigical procedures, i.e., adductor tenotomy, surgery on the iliopsoas muscle or rectus femoris muscle and medial hamstrings, with fixation using an abduction modified Atlanta brace, are effective in patients with marked lateral hip migration who are younger that 6 years. Isolated adductor tenotomy and distal transfer of the rectus femoris muscle markedly improve standing position in walking patients. CONCLUSION An appropriate combination of surgical procedures on muscles in the hip region and on medial hamstrings can significantly improve the patient's locomotion and, if lateral migration is present, help to avoid surgery on bones. PMID:19026189

  2. Hip Joint Stresses Due to Cam-Type Femoroacetabular Impingement: A Systematic Review of Finite Element Simulations

    PubMed Central

    Ng, K. C. Geoffrey; Lamontagne, Mario; Labrosse, Michel R.; Beaulé, Paul E.

    2016-01-01

    Background The cam deformity causes the anterosuperior femoral head to obstruct with the acetabulum, resulting in femoroacetabular impingement (FAI) and elevated risks of early osteoarthritis. Several finite element models have simulated adverse loading conditions due to cam FAI, to better understand the relationship between mechanical stresses and cartilage degeneration. Our purpose was to conduct a systematic review and examine the previous finite element models and simulations that examined hip joint stresses due to cam FAI. Methods The systematic review was conducted to identify those finite element studies of cam-type FAI. The review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and studies that reported hip joint contact pressures or stresses were included in the quantitative synthesis. Results Nine articles studied FAI morphologies using finite element methods and were included in the qualitative synthesis. Four articles specifically examined contact pressures and stresses due to cam FAI and were included in the quantitative synthesis. The studies demonstrated that cam FAI resulted in substantially elevated contact pressures (median = 10.4 MPa, range = 8.5–12.2 MPa) and von Mises stresses (median 15.5 MPa, range = 15.0–16.0 MPa) at the acetabular cartilage; and elevated maximum-shear stress on the bone (median = 15.2 MPa, range = 14.3–16.0 MPa), in comparison with control hips, during large amplitudes of hip motions. Many studies implemented or adapted idealized, ball-and-cup, parametric models to predict stresses, along with homogeneous bone material properties and in vivo instrumented prostheses loading data. Conclusion The formulation of a robust subject-specific FE model, to delineate the pathomechanisms of FAI, remains an ongoing challenge. The available literature provides clear insight into the estimated stresses due to the cam deformity and provides an assessment of its risks leading to early

  3. Wear properties of polyethylene-metal and polyethylene-ceramic bearings for hip joint replacements: The effect of temperature and protein precipitation in hip simulator tests

    NASA Astrophysics Data System (ADS)

    Liao, Yen-Shuo

    Ultra-high-molecular weight polyethylene (PE) cups bearing against metal or ceramic balls are the most commonly used combinations of materials for human hip joint replacements. The wear properties of these materials are typically evaluated in the laboratory using hip joint wear simulators, while lubricated with bovine serum. A previous test evaluating the PE cups against cobalt-chrome (CoCr), zirconia (Zr) and alumina balls demonstrated the sensitivity of serum proteins to elevated temperature; especially for Zr/PE, which showed the highest protein precipitation and bulk lubricant temperature but the lowest cup wear. In the present investigation, a temperature control system was used on a hip simulator to systematically evaluate the relationship between temperature and denaturation of the serum proteins which, in turn, affects the friction and wear properties of the prosthetic materials being tested. In order to control protein precipitation, the interface was temperature reduced by circulating coolant at 4°C through the center of the CoCr or Zr balls during a wear test. With cooling, protein assay of the serum showed 66% and 50% reductions in protein precipitation with the CoCr and Zr balls, respectively. The wear rate of the PE cups against the CoCr balls decreased by an average of 44%, whereas two of the three PE cups running against Zr balls exhibited slight increases in their wear rates, and the third showed a two fold increase. Under scanning electron microscopy, there were marked differences in the worn surfaces of the cups for the various conditions, and differences in the morphology of the PE wear debris recovered from the serum. For example, granular particles predominated without cooling, whereas fibrous particles predominated with cooling. Since particles generated in vivo (i.e., retrieved from periprosthetic tissues) typically show approximately equal proportions of granules and fibrils, the use of an intermediate coolant temperature might provide

  4. Clinical and Instrumented Measurements of Hip Laxity and Their Associations With Knee Laxity and General Joint Laxity

    PubMed Central

    Fan, Lixia; Copple, Timothy J.; Tritsch, Amanda J.; Shultz, Sandra J.

    2014-01-01

    Context: Hip-joint laxity may be a relevant anterior cruciate ligament injury risk factor. With no devices currently available to measure hip laxity, it is important to determine if clinical measurements sufficiently capture passive displacement of the hip. Objective: To examine agreement between hip internal-external–rotation range of motion measured clinically (HIERROM) versus internal-external–rotation laxity measured at a fixed load (HIERLAX) and to determine their relationships with knee laxity (anterior-posterior [KAPLAX], varus-valgus [KVVLAX], and internal-external rotation [KIERLAX]) and general joint laxity (GJL). Design Cross-sectional study. Setting: Controlled research laboratory. Patients or Other Participants: Thirty-two healthy adults (16 women, 16 men; age = 25.56 ± 4.08 years, height = 170.94 ± 10.62 cm, weight = 68.86 ± 14.89 kg). Main Outcome Measure(s): Participants were measured for HIERROM, HIERLAX at 0° and 30° hip flexion (−10 Nm, 7 Nm), KAPLAX (−90 N to 133 N), KVVLAX (±10 Nm), KIERLAX (±5 Nm), and GJL. We calculated Pearson correlations and 95% limits of agreement between HIERROM and HIERLAX_0° and HIERLAX_30°. Correlation analyses examined the strength of associations between hip laxity, knee laxity, and GJL. Results: The HIERROM and HIERLAX had similar measurement precision and were strongly correlated (r > 0.78). However, HIERROM was systematically smaller in magnitude than HIERLAX at 0° (95% limits of agreement = 29.0° ± 22.3°) and 30° (21.4° ± 19.3°). The HIERROM (r = 0.51–0.66), HIERLAX_0° (r = 0.52–0.69) and HIERLAX_30° (r = 0.53–0.76) were similarly correlated with knee laxity measures and GJL. The combinations of KVVLAX and either HIERROM, HIERLAX_0°, or HIERLAX_30° (R2 range, 0.42–0.44) were the strongest predictors of GJL. Conclusions: Although HIERROM and HIERLAX differed in magnitude, they were measured with similar consistency and precision and were similarly correlated with knee laxity

  5. Total hip arthroplasty in young adults, with focus on Perthes' disease and slipped capital femoral epiphysis

    PubMed Central

    2012-01-01

    Background and purpose Pediatric hip diseases account for 9% of all primary hip arthroplasties in the Norwegian Arthroplasty Register. We wanted to validate the diagnosis as reported to the register and to assess the quality of life of these patients after hip replacement. Patients and methods 540 patients accepted to participate in this follow-up study (634 hips). All were less than 40 years of age and had been reported to the Norwegian Arthroplasty Register as having undergone a primary total hip arthroplasty (THA) between 1987 and 2007. The underlying diagnosis, age at diagnosis, and type of treatment given prior to the hip replacement were recorded from the original hospital notes. Results The diagnoses reported to the Norwegian Arthroplasty Register were confirmed to be correct in 91% of all cases (538/592). For the 94 hips that had been treated due to Perthes' disease or slipped capital femoral epiphysis (SCFE), the diagnosis was verified in 95% of cases (89/94). The corresponding proportion for inflammatory hip disease was 98% (137/140) and it was only 61% for primary osteoarthritis (19/31). The self reported quality of life (EQ-5D) was poorer for these young patients with THA than for persons in age-matched cohorts from Great Britain and Sweden, except for those with an underlying SCFE. Interpretation The diagnoses reported to the Norwegian Arthroplasty Register as the underlying cause of THA were correct in 91% of cases. Individuals who undergo THA before the age of 40 have a reduced quality of life, except for those requiring a hip replacement because of SCFE. PMID:22112152

  6. The Sequence of Hip and Selected Upper-Extremity Joint Movements During the Golf Drive.

    ERIC Educational Resources Information Center

    Hunter, Charles L.

    This study analyzed wrist, elbow, and hip actions of golfers who were accurately driving a golf ball a maximum distance. Electrogoniometry and cinematography were used to measure wrist, forearm, elbow, and hip actions during the downswing of 10 low-handicap golfers who were attempting to drive a minimum of 225 yards within a 50-yard corridor.…

  7. Hip Imaging in Athletes: Sports Imaging Series.

    PubMed

    Agten, Christoph A; Sutter, Reto; Buck, Florian M; Pfirrmann, Christian W A

    2016-08-01

    Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam- and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. (©) RSNA, 2016. PMID:27429142

  8. Hip or knee replacement - after - what to ask your doctor

    MedlinePlus

    ... PA: Elsevier Mosby; 2012:chap 7. Read More Hip joint replacement Hip pain Knee joint replacement Knee pain ... joint replacement - discharge Taking care of your new hip joint Update Date 3/5/2015 Updated by: C. ...

  9. Hip or knee replacement - before - what to ask your doctor

    MedlinePlus

    ... PA: Elsevier Mosby; 2012:chap 7. Read More Hip joint replacement Hip pain Knee joint replacement Knee pain ... joint replacement - discharge Taking care of your new hip joint Update Date 3/5/2015 Updated by: C. ...

  10. The concentration of manganese, iron, and strontium in hip joint bone obtained from patients undergoing hip replacement surgery.

    PubMed

    Budis, Halina; Kalisinska, Elzbieta; Lanocha, Natalia; Kosik-Bogacka, Danuta; Sokolowski, Sebastian; Dobiecki, Konrad; Kolodziej, Lukasz; Bohatyrewicz, Andrzej

    2014-01-01

    The aim of this study was to determine the concentrations of manganese (Mn), iron (Fe) and strontium (Sr) in the cartilage with adjacent compact bone and spongy bone collected from patients after total hip replacement surgery. In addition, we examined relations between the concentrations of the metals in the bone and selected environmental factors. The concentration of Fe was the highest while Mn concentration was the lowest. The concentrations of Fe in the spongy bone in patients from larger cities were higher than in those living in smaller towns and villages. Significant correlations were found between Fe and Mn concentrations in the cartilage with adjacent compact bone and in the spongy bone, and between Mn and Sr in the spongy bone. In general, Mn, Fe and Sr concentrations in the bones of patients from NW Poland were lower than in other Polish regions and Europe, especially in industrialized countries. In conclusion, it seems that in addition to routine monitoring of the abiotic environment, it is essential to monitor concentrations of heavy metals having a long-term impact in humans. PMID:24074650

  11. Range of Hip Joint Motion in Developmental Dysplasia of the Hip Patients Following Total Hip Arthroplasty With the Surgical Technique Using the Concept of Combined Anteversion: A Study of Crowe I and II Patients.

    PubMed

    Zhang, Jingwei; Wei, Jianhe; Mao, Yuanqing; Li, Huiwu; Xie, Youzhuan; Zhu, Zhenan

    2015-12-01

    The combined anteversion surgical technique has been proposed and used in clinical practice. To more objectively evaluate the feasibility of this surgical technique using combined anteversion concept for DDH patients, we studied 34 DDH patients (40 hips) in this research. Every patient underwent pelvic CT scans before and after surgery and the HHSs were recorded. Optimal range of joint motion was measured using a three-dimensional reconstruction technique and a dynamic measurement technique. The results revealed that joint function met the requirements of daily life and the range of motion was not over-limited by impingement between the prosthesis and the skeleton. Moreover, the combined anteversion was found to be the most critical parameter in this study. PMID:26228491

  12. Rapid Destruction of the Hip Joint Accompanied by an Enlarged Iliopsoas Bursa in a Healthy Man

    PubMed Central

    Kim, Ju-Oh

    2014-01-01

    Association between enlarged iliopsoas bursa and hip lesions such as osteoarthritis of the hip or femoral head necrosis is infrequently seen. Enlarged iliopsoas bursa with a rapidly destructive arthropathy is claimed to be seen only in patients with rheumatoid arthritis. In this paper, we report a patient with a rapidly destructive arthropathy accompanied by an enlarged iliopsoas bursa that has been misdiagnosed as an infection.

  13. [Pathobiochemistry of joint destruction in inflammatory and degenerative joint diseases].

    PubMed

    Greiling, H; Kleesiek, K; Reinards, R

    1987-08-01

    While the biochemical mechanism which leads to the destruction of joints in the course of degenerative and inflammatory arthropathies has not been cleared up completely to this day, basic differences have been noted in the way the two types of arthropathy affect the articular cartilage. The differences are described from the viewpoint of pathobiochemistry as they are fundamental to causal therapy. PMID:3314203

  14. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    PubMed Central

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  15. Skeletal immaturity, rostral sparing, and disparate hip morphologies as biomechanical causes for Legg-Calvé-Perthes' disease.

    PubMed

    Berthaume, Michael A; Perry, Daniel C; Dobson, Catherine A; Witzel, Ulrich; Clarke, Nicholas M; Fagan, Michael J

    2016-09-01

    Legg-Calvé-Perthes' (Perthes') disease is a developmental disease of the hip joint that may result in numerous short and long term problems. The etiology of the disease remains largely unknown, but the mechanism is believed to be vascular and/or biomechanical in nature. There are several anatomical characteristics that tend to be prevalent in children with Perthes' disease, namely: skeletal immaturity, reduced height, and rostral sparing. We present an overview of the literature, summarizing the current understanding of the pathogenesis, particularly related to how the formation of the vasculature to the femoral epiphysis places children aged 5-8 at a higher risk for Perthes' disease, how skeletal immaturity and rostral sparing could increase the probability of developing Perthes' disease, and how animal models have aided our understanding of the disease. In doing so, we also explore why Perthes' disease is correlated to latitude, with populations at higher latitudes having higher incidence rates than populations closer to the Equator. Finally, we present five hypotheses detailing how Perthes' disease could have a biomechanical cause. Clin. Anat. 29:759-772, 2016. © 2016 Wiley Periodicals, Inc. PMID:26780125

  16. Evaluation of Anatomical and Functional Hip Joint Center Methods: The Effects of Activity Type, Gender, and Proximal Reference Segment.

    PubMed

    McGibbon, C A; Fowler, J; Chase, S; Steeves, K; Landry, J; Mohamed, A

    2016-01-01

    Accurate hip joint center (HJC) location is critical when studying hip joint biomechanics. The HJC is often determined from anatomical methods, but functional methods are becoming increasingly popular. Several studies have examined these methods using simulations and in vivo gait data, but none has studied high-range of motion activities, such a chair rise, nor has HJC prediction been compared between males and females. Furthermore, anterior superior iliac spine (ASIS) marker visibility during chair rise can be problematic, requiring a sacral cluster as an alternative proximal segment; but functional HJC has not been explored using this approach. For this study, the quality of HJC measurement was based on the joint gap error (JGE), which is the difference in global HJC between proximal and distal reference segments. The aims of the present study were to: (1) determine if JGE varies between pelvic and sacral referenced HJC for functional and anatomical methods, (2) investigate which functional calibration motion results in the lowest JGE and if the JGE varies depending on movement type (gait versus chair rise) and gender, and (3) assess whether the functional HJC calibration results in lower JGE than commonly used anatomical approaches and if it varies with movement type and gender. Data were collected on 39 healthy adults (19 males and 20 females) aged 14-50 yr old. Participants performed four hip "calibration" tests (arc, cross, star, and star-arc), as well as gait and chair rise (activities of daily living (ADL)). Two common anatomical methods were used to estimate HJC and were compared to HJC computed using a published functional method with the calibration motions above, when using pelvis or sacral cluster as the proximal reference. For ADL trials, functional methods resulted in lower JGE (12-19 mm) compared to anatomical methods (13-34 mm). It was also found that women had significantly higher JGE compared to men and JGE was significantly higher for

  17. Improved mathematical model of the wear of the cup articular surface in hip joint prostheses and comparison with retrieved components.

    PubMed

    Raimondi, M T; Santambrogio, C; Pietrabissa, R; Raffelini, F; Molfetta, L

    2001-01-01

    This paper presents an analytical model of the cobalt-based alloy-ultra-high molecular weight polyethylene (UHMWPE) wear coupling. Based on a previous model in which the cup wear volume over a gait cycle (WG) was calculated under the simplifying assumption of an ideal rigid coupling, the current version proposes a more realistic wear simulation. All three components of the hip loading force were considered for the contact pressure calculation and all three components of the hip motion were taken into account for the sliding distance calculation. The contact pressure distribution was calculated on the basis of the Hertzian theory for the elastic contact of two bodies with non-conforming geometrical shapes. The wear factor was taken from hip simulator wear tests. The calculated WG is 67 x 10(-6) mm3 for a standard reference patient. The parametric model simulations show that WG increases linearly with the patient weight, femoral head diameter and surface roughness. It increases non-linearly to a maximum and decreases to an asymptotic value with increasing cup/head clearance and with cup isotropic elastic modulus. The cup orientation in the pelvis affects only slightly the total amount of WG whereas it is the dominant factor affecting the shape of the wear distribution. The iso-wear maps show paracentral patterns at low cup inclination angles and marginal patterns at higher inclination angles. The maximum wear depth is supero-posterior when the cup is in neutral alignment and supero-anterior at increasing anteversion angles. Complex patterns with a combination of paracentral and marginal wear were obtained at specific clearance values and cup orientations. The results of the simulations are discussed in relation to the wear distribution measured on the articular surface of 12 UHMWPE components retrieved from failed hip joint prostheses, after a period of in situ functioning. PMID:11521761

  18. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    MedlinePlus

    ... developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. The ball is loose ... be taken to provide detailed pictures of the hip joint. Treatment When DDH is detected at birth, it ...

  19. A geometric morphometric analysis of acetabular shape of the primate hip joint in relation to locomotor behaviour.

    PubMed

    San Millán, Marta; Kaliontzopoulou, Antigoni; Rissech, Carme; Turbón, Daniel

    2015-06-01

    The description of acetabular shape variation among primates is essential for our understanding of the locomotor behaviour and ecology of both extant and fossil species. In this study, we use two-dimensional geometric morphometrics to examine variation in acetabular shape in human and non-human primates and to determine the degree to which it co-varies with locomotor behaviour, while taking both intra and inter-specific variation into account. To these ends, we examined the acetabulum of 303 left hip bones of 27 extant genera of primates (including humans) with different locomotor behaviours. After accounting for shape variation due to sex, size, and phylogeny, the results confirm that acetabular shape varies significantly across locomotor groups. The two most differentiated locomotor groups are leapers and slow-climbing quadrupeds, which exhibit a unique acetabular shape. Furthermore, the acetabulum of humans differed significantly from all other groups, while no significant differences existed between chimpanzees and gorillas. The most noticeable differences are detected in both cranial and dorsal areas and around the acetabular horns. This variation in acetabular morphology may have biomechanical implications at the level of the hip joint, potentially determining joint range motion and load distribution during locomotion. Given the increasing number of published studies on fossil pelves, our results are widely applicable to fossil analyses, with critical implications for paleoanthropological analyses about the complex locomotor behaviour of fossil specimens and their classification into locomotor groups, which may enhance our understanding of their ecological habits. PMID:25929707

  20. Are all metal-on-metal hip revision operations contributing to the National Joint Registry implant survival curves?

    PubMed Central

    Sabah, S. A.; Henckel, J.; Koutsouris, S.; Rajani, R.; Hothi, H.; Skinner, J. A.; Hart, A. J.

    2016-01-01

    Aims The National Joint Registry for England, Wales and Northern Ireland (NJR) has extended its scope to report on hospital, surgeon and implant performance. Data linkage of the NJR to the London Implant Retrieval Centre (LIRC) has previously evaluated data quality for hip primary procedures, but did not assess revision records. Methods We analysed metal-on-metal hip revision procedures performed between 2003 and 2013. A total of 69 929 revision procedures from the NJR and 929 revised pairs of components from the LIRC were included. Results We were able to link 716 (77.1%) revision procedures on the NJR to the LIRC. This meant that 213 (22.9%) revision procedures at the LIRC could not be identified on the NJR. We found that 349 (37.6%) explants at the LIRC completed the full linkage process to both NJR primary and revision databases. Data completion was excellent (> 99.9%) for revision procedures reported to the NJR. Discussion This study has shown that only approximately one third of retrieved components at the LIRC, contributed to survival curves on the NJR. We recommend prospective registry-retrieval linkage as a tool to feedback missing and erroneous data to the NJR and improve data quality. Take home message: Prospective Registry – retrieval linkage is a simple tool to evaluate and improve data quality on the NJR. Cite this article: Bone Joint J 2016;98-B:33–9. PMID:26733513

  1. Risk factors for hip fracture among elderly patients with Alzheimer's disease.

    PubMed

    Sato, Yoshihiro; Kanoko, Tomohiro; Satoh, Kei; Iwamoto, Jun

    2004-08-30

    Incidence of hip fracture among patients with Alzheimer's disease (AD), especially in elderly patients, is high. To analyze risk factors of hip fracture, we prospectively studied a cohort of elderly female patients with AD. Subjects studied were 225 female patients with AD, and the average age was 76 years old. At baseline, we recorded body mass index (BMI), a score of Mini-Mental State Examination (MMSE) and bone mineral density (BMD), and measured serum concentrations of ionized calcium, intact parathyroid hormone (PTH), pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), intact bone Gla protein (BGP), 25-hydroxyvitamin (25-OHD) and 1, 25-dihydroxyvitamin D (1, 25-[OH]2D). The patients were followed for 2 years. During the 2-year study, hip fractures occurred in 29 patients. We compared baseline variables between the 29 patients with and 176 patients without hip fracture. AD patients with lower BMD, low concentrations of serum ionized calcium and 25-OHD (mean 3.0 ng/ml) with compensatory hyperparathyroidism were found to have an increased risk of hip fracture. Also, concentrations of serum ICTP and BGP were higher in the fracture group than in the nonfracture group. Elderly female AD patients with low BMD and serum 25-OHD concentrations <5 ng/ml with secondary hyperparathyroidism have a high risk of hip fracture, and the risk may be reduced by vitamin D supplementation. PMID:15337610

  2. Soft tissue influence on ex vivo mobility in the hip of Iguana: comparison with in vivo movement and its bearing on joint motion of fossil sprawling tetrapods.

    PubMed

    Arnold, Patrick; Fischer, Martin S; Nyakatura, John A

    2014-07-01

    The reconstruction of a joint's maximum range of mobility (ROM) often is a first step when trying to understand the locomotion of fossil tetrapods. But previous studies suggest that the ROM of a joint is restricted by soft tissues surrounding the joint. To expand the limited informative value of ROM studies for the reconstruction of a fossil species' locomotor characteristics, it is moreover necessary to better understand the relationship of ex vivo ROM with the actual in vivo joint movement. To gain insight into the relationship between ex vivo mobility and in vivo movement, we systematically tested for the influence of soft tissues on joint ROM in the hip of the modern lizard Iguana iguana. Then, we compared the ex vivo mobility to in vivo kinematics of the hip joint in the same specimens using X-ray sequences of steady-state treadmill locomotion previously recorded. With stepwise removal of soft tissues and a repeated-measurement protocol, we show that soft tissues surrounding the hip joint considerably limit ROM, highlighting the problems when joint ROM is deduced from bare bones only. We found the integument to have the largest effect on the range of long-axis rotation, pro- and retraction. Importantly, during locomotion the iguana used only a fragment of the ROM that was measured in our least restrictive dissection situation (i.e. pelvis and femur only conjoined by ligaments), demonstrating the discrepancy between hip joint ROM and actual in vivo movement. Our study emphasizes the necessity for caution when attempting to reconstruct joint ROM or even locomotor kinematics from fossil bones only, as actual in vivo movement cannot be deduced directly from any condition of cadaver mobility in Iguana and likely in other tetrapods. PMID:24762236

  3. Soft tissue influence on ex vivo mobility in the hip of Iguana: comparison with in vivo movement and its bearing on joint motion of fossil sprawling tetrapods

    PubMed Central

    Arnold, Patrick; Fischer, Martin S; Nyakatura, John A

    2014-01-01

    The reconstruction of a joint's maximum range of mobility (ROM) often is a first step when trying to understand the locomotion of fossil tetrapods. But previous studies suggest that the ROM of a joint is restricted by soft tissues surrounding the joint. To expand the limited informative value of ROM studies for the reconstruction of a fossil species’ locomotor characteristics, it is moreover necessary to better understand the relationship of ex vivo ROM with the actual in vivo joint movement. To gain insight into the relationship between ex vivo mobility and in vivo movement, we systematically tested for the influence of soft tissues on joint ROM in the hip of the modern lizard Iguana iguana. Then, we compared the ex vivo mobility to in vivo kinematics of the hip joint in the same specimens using X-ray sequences of steady-state treadmill locomotion previously recorded. With stepwise removal of soft tissues and a repeated-measurement protocol, we show that soft tissues surrounding the hip joint considerably limit ROM, highlighting the problems when joint ROM is deduced from bare bones only. We found the integument to have the largest effect on the range of long-axis rotation, pro- and retraction. Importantly, during locomotion the iguana used only a fragment of the ROM that was measured in our least restrictive dissection situation (i.e. pelvis and femur only conjoined by ligaments), demonstrating the discrepancy between hip joint ROM and actual in vivo movement. Our study emphasizes the necessity for caution when attempting to reconstruct joint ROM or even locomotor kinematics from fossil bones only, as actual in vivo movement cannot be deduced directly from any condition of cadaver mobility in Iguana and likely in other tetrapods. PMID:24762236

  4. 2006 Frank Stinchfield Award: grafting of biocompatible polymer for longevity of artificial hip joints.

    PubMed

    Moro, Toru; Takatori, Yoshio; Ishihara, Kazuhiko; Nakamura, Kozo; Kawaguchi, Hiroshi

    2006-12-01

    Aseptic loosening induced by wear particles from the polyethylene liner is likely the most common cause of long-term total hip arthroplasty failure. We developed a novel hip polyethylene liner with the surface graft of a biocompatible phospholipid polymer, 2-methacryloyloxyethyl phosphorylcholine (MPC), and previously reported the grafting decreased the short-term production of wear particles and the subsequent bone resorptive responses. For clinical application, we investigated the stability of the 2-methacryloyloxyethyl phosphorylcholine grafting during sterilization and the wear resistance of the sterilized liner during longer loading comparable to clinical usage. Radiographic spectroscopy confirmed the stability of the 2-methacryloyloxyethyl phosphorylcholine polymer on the liner surface after the gamma irradiation. We used a hip wear simulator up to 1 x 10(7) cycles to test sterilized cross-linked polyethylene liners with and without 2-methacryloyloxyethyl phosphorylcholine grafting. The 2-methacryloyloxyethyl phosphorylcholine grafting markedly decreased the friction, the production of wear particles, and the wear of the liner surface. These data suggest a marked improvement in the wear resistance of the polyethylene liner by the 2-methacryloyloxyethyl phosphorylcholine grafting for clinically relevant periods after sterilization, indicating 2-methacryloyloxyethyl phosphorylcholine grafting is a promising technology for extending longevity of artificial hips. PMID:17053564

  5. Regenerative Injection Therapy with Whole Bone Marrow Aspirate for Degenerative Joint Disease: A Case Series

    PubMed Central

    Hauser, Ross A.; Orlofsky, Amos

    2013-01-01

    Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months. Patient-reported assessments were collected in interviews and by questionnaire. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. These preliminary findings suggest that OA treatment with WBM injection merits further investigation. PMID:24046512

  6. Correlation of Structural Bony Abnormalities and Mechanical Symptoms of Hip Joints

    PubMed Central

    Lyu, Sung-Hwa; Kwak, Yoon-Ho; Lee, Young-Kyun; Koo, Kyung-Hoi

    2014-01-01

    Purpose The purpose of this study is to determine structural bony abnormalities predisposing for femoroacetabular impingement by comparison of patients with and without mechanical symptoms. Materials and Methods We conducted this comparative study on 151 patients (151 hips; mean age 44.8 years; range 16-73 years) with mechanical symptoms with results of multi-detector computed tomography (MDCT) arthrography (the symptomatic group). Each patient was matched with a control who underwent MDCT due to ureter stone (the asymptomatic group) in terms of age, gender, site (right or left), and time at diagnosis. Acetabular evaluations, which included cranial and central anteversion and anterior and lateral center edge angles and femoral measurements, were performed. In addition, we evaluated the prevalence and characteristics of structural bone abnormalities between the two groups. Results The prevalence for patients who had at least one structural bony abnormality in the symptomatic and asymptomatic groups was 80.1% (121/151) and 54.3% (82/151), respectively (odds ratio: 3.39, 95% confidence interval: 2.30-5.66; P<0.001). The most common osseous abnormality was the isolated Pincer type in both groups: 89 (73.6%) of 121 hips with an osseous abnormality in the symptomatic group and 57 (69.5%) of 82 hips with an osseous abnormality in the asymptomatic group. By analysis of CT arthrography in symptomatic patients, a labral tear was found in 107 hips (70.9%), and 86 (80%) of these hips had a structural bony abnormality. Conclusion A significantly greater prevalence rate of structural bony abnormality was observed for the symptomatic group than for the asymptomatic group. These findings are helpful for development of appropriate treatment plans.

  7. Sports hip injuries: assessment and management.

    PubMed

    Kelly, Bryan T; Maak, Travis G; Larson, Christopher M; Bedi, Asheesh; Zaltz, Ira

    2013-01-01

    Over the past 10 years, the understanding, assessment, and management of hip pain and injuries in the athlete have improved. Traditionally, the evaluation of hip pain and injuries was limited to obvious disorders, such as hip arthritis and fractures, or disorders that were previously considered to be simply soft-tissue strains and contusions, such as groin pulls, hip pointers, and bursitis. Two parallel tracks of progress have improved understanding of the complexities of hip joint athletic injuries and the biomechanical basis of early hip disease. In the field of sports medicine, improved diagnostic skills now allow better interpretation of debilitating intra-articular hip disorders and their effects on core performance. In the field of hip preservation, there has been an evolution in understanding the effects of biomechanical mismatches between the femoral head and the acetabulum on the development of early hip damage, injury, and arthritis. The integration of these two parallel fields has accelerated the understanding of the importance of hip biomechanics and early hip injury in human performance and function. PMID:23395055

  8. Revision hip replacement for recurrent Hydatid disease of the pelvis: a case report and review of the literature.

    PubMed

    Neelapala, Venkata S S; Chandrasekar, Coonoor R; Grimer, Robert J

    2010-01-01

    A case of a large recurrent hydatid cyst involving the right ilium and right hip treated with excision of the cyst, Total hip replacement and revision of the acetabular component with a Tripolar articulation for cyst recurrence and acetabular component loosening is presented along with a review of the relevant literature. To our knowledge there is no reported case of Total Hip replacement and revision for hydatid disease involving the bony pelvis. PMID:20222941

  9. Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

    PubMed

    Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

    2009-01-01

    The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care. PMID:19369812

  10. [An unusual early complication in cementless replacement of the hip joint. Case report].

    PubMed

    Kauschke, T; Zilch, H

    1994-12-01

    This is the first description of a dislocation of the polyethyleninlay from the cup of a cementless hip prosthesis. Due to a fall of the patient 8 months after the implantation an unspecific complaint arised. In spite of detailed diagnostic no reason could have been found. During the renewed operation we saw the dislocated inlay by mechanical anchorage of the cup and the shaft. Retrospective there were made suggestions how the described complication could be recognized earlier. PMID:7871611

  11. Frontal Lobe Function and Risk of Hip Fracture in Patient With Alzheimer Disease

    PubMed Central

    Roh, Hyun Woong; Hong, Chang Hyung; Lee, SooJin; Lee, Yunhwan; Lee, Kang Soo; Chang, Ki Jung; Oh, Byoung Hoon; Choi, Seong Hye; Kim, Seong Yoon; Back, Joung Hwan; Chung, Young Ki; Lim, Ki Young; Noh, Jai Sung; Son, Sang Joon

    2015-01-01

    Abstract To determine the association between frontal lobe function and risk of hip fracture in patients with Alzheimer disease (AD). Retrospective cohort study using multicenter hospital-based dementia registry and national health insurance claim data was done. Participants who had available data of neuropsychological test, national health insurance claim, and other covariates were included. A total of 1660 patients with AD were included based on Stroop Test results. A total of 1563 patients with AD were included based on the Controlled Oral Word Association Test (COWAT) results. Hip fracture was measured by validated identification criteria using national health insurance claim data. Frontal lobe function was measured by Stroop Test and COWAT at baseline. After adjusting for potential covariates, including cognitive function in other domains (language, verbal and nonverbal memory, and attention), the Cox proportional hazard regression analysis revealed that risk of a hip fracture was decreased with a hazard ratio (HR) of 0.98 per one point of increase in the Stroop Test (adjusted HR = 0.98, 95% confidence interval [CI]: 0.97–1.00) and 0.93 per one point increase in COWAT (adjusted HR = 0.93, 95% CI: 0.88–0.99). The risk of hip fracture in AD patients was associated with baseline frontal lobe function. The result of this research presents evidence of association between frontal lobe function and risk of hip fracture in patients with AD. PMID:26559259

  12. Determination of hip-joint loading patterns of living and extinct mammals using an inverse Wolff's law approach.

    PubMed

    Christen, Patrik; Ito, Keita; Galis, Frietson; van Rietbergen, Bert

    2015-04-01

    It is well known that bone adapts its microstructure in response to loading. Based on this form-follows-function relationship, we previously developed a reverse approach to derive joint loads from bone microstructure as acquired with micro-computed tomography. Here, we challenge this approach by calculating hip-joint loading patterns for human and dog, two species exhibiting different locomotion, and comparing them to in vivo measurements. As a proof of concept to use the approach also for extinct taxa, we applied it to a cave lion fossil bone. Calculations were in close agreement with in vivo measurements during walking for extant species, showing distinguished patterns for bipedalism and quadrupedalism. The cave lion calculations clearly revealed its quadrupedal locomotion and suggested a more diverse behaviour compared to the dog, which is in agreement with extant felids. This indicates that our novel approach is potentially useful for making inferences about locomotion in living as well as extinct mammals and to study evolutionary joint development. PMID:24952222

  13. Management of periprosthetic joint infection after total hip arthroplasty using a custom made articulating spacer (CUMARS); the Exeter experience.

    PubMed

    Tsung, Jason D; Rohrsheim, James A L; Whitehouse, Sarah L; Wilson, Matthew J; Howell, Jonathan R

    2014-09-01

    Periprosthetic joint infection (PJI) after THA is a major complication with an incidence of 1%-3%. We report our experiences with a technique using a custom-made articulating spacer (CUMARS) at the first of two-stage treatment for PJI. This technique uses widely available all-polyethylene acetabular components and the Exeter Universal stem, fixed using antibiotic loaded acrylic cement. Seventy-six hips were treated for PJI using this technique. Performed as the first of a two-stage procedure, good functional results were commonly seen, leading to postponing second stage indefinitely with retention of the CUMARS prosthesis in 34 patients. The CUMARS technique presents an alternative to conventional spacers, using readily available components that are well tolerated, allowing weight bearing and mobility, and achieving comparable eradication rates. PMID:24851790

  14. Proposed frequencies of a vibrator used for implant retrieval at the time of hip joint revision surgery.

    PubMed

    Roychowdhury, Amit; Hayes, Westley; Rasquinha, Vijay J; Saha, Subrata

    2009-01-01

    The number and the rate of success of hip implantation surgeries have increased significantly during last thirty years, not only in the USA, but also throughout the world. It has been reported that the failure rates of implanted hip joints are less than 8% after 10 years, and less than 20% after twenty years. Failures occur directly or indirectly due to wear, stress shielding and infection. Revision surgery is needed for those failed implant replacements. In the future, as the elderly population increases, the frequency of this type of revision surgery will also increase. At the time of revision surgery, removal of the existing cemented femoral implant can be a problem for the surgeon. Use of a vibrator for loosening of the existing cement layer between the bone and the implant may be a helpful solution. In this study, we investigated the optimum resonance frequencies of such a vibrator that might be used to loosen the cement layer easily and efficiently. Natural frequencies of different-sized implants and of different materials were determined. For harmonic analysis, CT scan data of a femur was processed in the image processing software MIMICS. Then the outline of the total hip was modeled and was analyzed by the finite element software ANSYS. The required portion of the femoral part was edited, implant and cement layer were introduced in that model, and elements were generated in that FEA software. Then elements of the femoral part, except the cement layer and the implant, were sent to MIMICS software again for assignment of different Youngs modulus of each element, which are proportionate to their densities. Then the elements were brought back to the FEA software. The harmonic analysis was performed for the total model in the FEA software ANSYS. For that particular boundary condition, the first three natural frequencies of the three types of implant sizes and materials varied by a maximum of 7-8%. Results of the numerical harmonic analysis showed that at the

  15. Postoperative changes in in vivo measured friction in total hip joint prosthesis during walking.

    PubMed

    Damm, Philipp; Bender, Alwina; Bergmann, Georg

    2015-01-01

    Loosening of the artificial cup and inlay is the most common reasons for total hip replacement failures. Polyethylene wear and aseptic loosening are frequent reasons. Furthermore, over the past few decades, the population of patients receiving total hip replacements has become younger and more active. Hence, a higher level of activity may include an increased risk of implant loosening as a result of friction-induced wear. In this study, an instrumented hip implant was used to measure the contact forces and friction moments in vivo during walking. Subsequently, the three-dimensional coefficient of friction in vivo was calculated over the whole gait cycle. Measurements were collected from ten subjects at several time points between three and twelve months postoperative. No significant change in the average resultant contact force was observed between three and twelve months postoperative. In contrast, a significant decrease of up to 47% was observed in the friction moment. The coefficient of friction also decreased over postoperative time on average. These changes may be caused by 'running-in' effects of the gliding components or by the improved lubricating properties of the synovia. Because the walking velocity and contact forces were found to be nearly constant during the observed period, the decrease in friction moment suggests an increase in fluid viscosity. The peak values of the contact force individually varied by 32%-44%. The friction moment individually differed much more, by 110%-129% at three and up to 451% at twelve months postoperative. The maximum coefficient of friction showed the highest individual variability, about 100% at three and up to 914% at twelve months after surgery. These individual variations in the friction parameters were most likely due to different 'running-in' effects that were influenced by the individual activity levels and synovia properties. PMID:25806805

  16. Postoperative Changes in In Vivo Measured Friction in Total Hip Joint Prosthesis during Walking

    PubMed Central

    Damm, Philipp; Bender, Alwina; Bergmann, Georg

    2015-01-01

    Loosening of the artificial cup and inlay is the most common reasons for total hip replacement failures. Polyethylene wear and aseptic loosening are frequent reasons. Furthermore, over the past few decades, the population of patients receiving total hip replacements has become younger and more active. Hence, a higher level of activity may include an increased risk of implant loosening as a result of friction-induced wear. In this study, an instrumented hip implant was used to measure the contact forces and friction moments in vivo during walking. Subsequently, the three-dimensional coefficient of friction in vivo was calculated over the whole gait cycle. Measurements were collected from ten subjects at several time points between three and twelve months postoperative. No significant change in the average resultant contact force was observed between three and twelve months postoperative. In contrast, a significant decrease of up to 47% was observed in the friction moment. The coefficient of friction also decreased over postoperative time on average. These changes may be caused by ‘running-in’ effects of the gliding components or by the improved lubricating properties of the synovia. Because the walking velocity and contact forces were found to be nearly constant during the observed period, the decrease in friction moment suggests an increase in fluid viscosity. The peak values of the contact force individually varied by 32%-44%. The friction moment individually differed much more, by 110%-129% at three and up to 451% at twelve months postoperative. The maximum coefficient of friction showed the highest individual variability, about 100% at three and up to 914% at twelve months after surgery. These individual variations in the friction parameters were most likely due to different ‘running-in’ effects that were influenced by the individual activity levels and synovia properties. PMID:25806805

  17. TREATMENT OF PARALYTIC HIP DISLOCATION AMONG SPASTIC QUADRIPLEGIC CEREBRAL PALSY PATIENTS BY MEANS OF FEMORAL AND PELVIC OSTEOTOMY, WITHOUT OPENING THE JOINT CAPSULE (CAPSULOPLASTY)

    PubMed Central

    Junior, Fernando Farcetta; Abreu, Fabio Peluzo; Neves, Daniella Lins; Kertzman, Paulo Facciola; Zuccon, Alexandre; De Oliveira Bittencourt, Simone; Lopes, Davi Moshe Leopold

    2015-01-01

    Objectives: To show the preoperative planning and results from surgical treatment for paralytic hip dislocation among patients with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy in association with Dega iliac osteotomy, without opening the joint capsule. Methods: We performed a retrospective review of ten hips in eight patients with spastic quadriplegic cerebral palsy who underwent surgical treatment between 2003 and 2005, with the same surgical technique. The pre and postoperative clinical and radiological parameters, and the preoperative planning using an image intensifier, were assessed. The clinical parameters analyzed were: pain, hygiene-related difficulties and positioning difficulties. The radiological parameters were Reimer's index, the acetabular index and the neck-shaft angle. These results were subjected to statistical analysis. Results: We obtained good results with this technique. After a mean follow-up of three years, all the hips were observed to be stable at the last assessment, and there was a high degree of satisfaction among the families in relation to the treatment. We also showed that preoperative planning using an image intensifier allowed us to reduce and stabilize these hips without the need for capsuloplasty. Conclusion: The authors conclude that in treating hip dislocation among spastic quadriplegic cerebral palsy patients, capsuloplasty is unnecessary for stabilizing the coxofemoral joint. PMID:27022539

  18. Comparison of two palpation, four radiographic and three ultrasound methods for early detection of mild to moderate canine hip dysplasia.

    PubMed

    Adams, W M; Dueland, R T; Daniels, R; Fialkowski, J P; Nordheim, E V

    2000-01-01

    Hip joint laxity was evaluated in Golden Retriever (n = 60), Labrador Retriever (n = 23), and Labrador/Golden Retriever mix (n = 24) puppies. Ortolani and Bardens maneuvers, four radiographic measurement indices and three dynamic ultrasonographic measurements were used. Each puppy was evaluated twice; at 6.5 to 9 and 43 to 79 weeks of age. These nine methods were compared for accuracy in predicting the development of canine hip dysplasia with or without degenerative joint disease by a median age of 16 months. The Bardens maneuver was a significant predictor of canine hip dysplasia/+/-degenerative joint disease for Golden Retriever puppies, however, it was not a reliable predictor for the other two breeds. Norberg angle measurements taken with femurs in a neutral position with hips distracted (PennHip position) was a significant predictor of degenerative joint disease in two breeds, but not in Golden Retriever puppies. Ultrasound measurement was a reliable predictor of hip canine hip dysplasia/+/-degenerative joint disease for Labrador/Golden Retriever mix puppies, but was not reliable for the other two breeds. Palpation, radiographic, and ultrasonographic methods of evaluating hip joint laxity in puppies at 6.5 to 9 weeks of age were not consistently reliable for all three breeds in predicting hip dysplasia with or without degenerative joint disease at one year of age. A strong association was found between Norberg angle and degenerative joint disease occurrence, as well as between distraction index (PennHip) and degenerative joint disease occurrence when measured at 52 to 79 weeks of age, but not when measured at 6.5 to 9 weeks of age in these breeds. These results emphasize the difficulty of early detection of mild hip dysplasia in the dog. PMID:11130786

  19. Test-retest reliability of an active range of motion test for the shoulder and hip joints by unskilled examiners using a manual goniometer

    PubMed Central

    Kim, Seong-Gil; Kim, Eun-Kyung

    2016-01-01

    [Purpose] The purpose of this study was to analyze test-retest reliability of an active range of motion test using a manual goniometer by unskilled examiners. [Subjects and Methods] Active range of motion was measured in 30 students attending U university (4 males, 26 females). Range of motion during flexion and extension of the shoulder and hip joints were measured using a manual goniometer. [Results] Flexion and extension of the shoulder joint (ICC=0.906 and ICC=0.808) and (ICC=0.946 and ICC=0. 955) of the hip joint showed excellent reliabilities. [Conclusion] The active range of motion test using a manual goniometer showed very high test-retest reliability in unskilled examiners. When examiners are aware of the method of the test, an objective assessment can be conducted. PMID:27134347

  20. Treatment of Nongout Joint Deposition Diseases: An Update

    PubMed Central

    Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  1. Treatment of nongout joint deposition diseases: an update.

    PubMed

    Pascart, Tristan; Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  2. Prevention of cement leakage into the hip joint by a standard cement plug during PFN-A cement augmentation: a technical note.

    PubMed

    Hanke, M; Djonov, V; Tannast, M; Keel, M J; Bastian, J D

    2016-06-01

    Medial penetration of the helical blade into the hip joint after fixation of trochanteric fractures using the proximal femur nail antirotation (PFN-A) is a potential failure mode. In low demand patients a blade exchange with cement augmentation may be an option if conversion to total hip arthroplasty is unfeasible to salvage the cut-through. This article describes a technique to avoid intraarticular cement leakage using a cement plug to close the defect in the femoral head caused by the cut-through. PMID:27010468

  3. [Concomitant diseases in primary joint hypermobility syndrome].

    PubMed

    Skoumal, Martin; Haberhauer, Günther; Mayr, Hans

    2004-10-15

    The primary joint hypermobility syndrome (pJH) is an overlap disorder of connective-tissue dysplasias, which incorporates features seen in the Marfan syndromes (MFS), Ehlers-Danlos syndromes (EDS), and osteogenesis imperfecta. Patients with pJH usually present arthralgia, back pain, soft-tissue lesions, recurrent joint dislocation, or subluxation. Extraarticular features may include, e. g., striae cutis, keratoconus, easy bruising, mitral valve prolapse, aortic incompetence, aneurysms, pneumothorax, hernia, urinary incontinence, and pelvic floor prolapse. Due to the high frequency of critical dissection and rupture, the early recognition of rare life-threatening complications such as dilatation of the aortic root and aneurysms is important. Therefore, patients (and their family members) with pJH should also be examined for life-threatening features seen in MFS and EDS. PMID:15490074

  4. Joint hypermobility: emerging disease or illness behaviour?

    PubMed

    Grahame, Rodney

    2013-12-01

    Joint hypermobility syndrome is a common clinical entity which is much misunderstood, overlooked, misdiagnosed and mistreated. It was first described in the 1960s as a purely musculoskeletal condition due to joint laxity and hypermobility occurring in otherwise healthy individuals. Some four decades later it is now perceived to be a multi-systemic heritable disorder of connective tissue with manifestations occurring far beyond the confines of the locomotor system and with ramifications potentially affecting most, if not all, of the bodily systems in one way or another. Most authorities in the field find it clinically indistinguishable from the Ehlers-Danlos syndrome--hypermobility type (formerly, EDS type III). In >50% of patients the diagnosis is delayed for ≥10 years. Failure to diagnose and treat the condition correctly results in needless pain and suffering and in many patients to a progressive decline in their quality of life and in some to a loss of independence. PMID:24298184

  5. Tribological behavior of ultra-high molecular weight polyethylene in a hip joint simulator

    NASA Astrophysics Data System (ADS)

    Mohamad Raffi, N.; Kanagarajan, D.; Srinivasan, V.

    2012-12-01

    In this paper effects of various injection molding parameters on tribological properties of ultra-high molecular weight polyethylene (UHMWPE) were investigated. The tribological properties like coefficient of friction and wear rate were obtained from the experimental results of hip simulator which was designed and fabricated in the laboratory. Bovine serum was used as a lubricant in this study. In addition, the hardness of the specimen was also investigated as well. The injection molding parameters that varied for this study are melt temperature, injection velocity and compaction time. The results show that contact loads and melt temperature were mostly influenced the tribological behavior of UHMWPE. A wear mechanism map was developed to study the dominant wear mechanism that influences the wear behavior of UHMWPE. SEM was employed to study the worn out morphologies of UHMWPE. The dominant wear mechanisms that are dominated through our study are ironing, scratching, ploughing, plastic deformation, and fatigue wear.

  6. Topology of calculating pressure and friction coefficients for time-dependent human hip joint lubrication.

    PubMed

    Wierzcholski, Krzysztof

    2011-01-01

    The paper deals with the calculations of the unsteady, impulsive pressure distributions, carrying capacities and friction forces under unsteady conditions in a super-thin layer of biological synovial fluid inside the slide biobearing gap limited by a spherical bone head. Unsteady and random flow conditions for the biobearing lubrication are given. Moreover, the numerical topology of pressure calculation for a difference method is applied. From a mathematical viewpoint the present method for the solution of the modified Reynolds equation allows this problem to be resolved by the partial recurrence nonhomogeneous equation of the second order with variable coefficients. To the best of the author knowledge, an adaptation of the known numerical difference method to the spherical boundary conditions applied during the pressure calculations for a human hip bonehead seems to be decisive. PMID:21500763

  7. The effect of lubricant constituents on lubrication mechanisms in hip joint replacements.

    PubMed

    Nečas, David; Vrbka, Martin; Urban, Filip; Křupka, Ivan; Hartl, Martin

    2015-03-01

    The aim of the present paper is to provide a novel experimental approach enabling to assess the thickness of lubricant film within hip prostheses in meaning of the contribution of particular proteins. Thin film colorimetric interferometry was combined with fluorescent microscopy finding that a combination of optical methods can help to better understand the interfacial lubrication processes in hip replacements. The contact of metal femoral head against a glass disc was investigated under various operating conditions. As a test lubricant, the saline solution containing the albumin and γ-globulin in a concentration 2:1 was employed. Two different mean speeds were applied, 5.7 and 22mm/s, respectively. The measurements were carried out under pure rolling, partial negative and partial positive sliding conditions showing that kinematic conditions substantially affects the formation of protein film. Under pure rolling conditions, an increasing tendency of lubricant film independently on rolling speed was detected, while the total thickness of lubricant film can be attributed mainly to albumin. When the ball was faster than the disc (negative sliding), a very thin lubricant film was observed for lower speed with no significant effect of particular proteins. The increase in sliding speed led to the increase of film thickness mainly caused due to the presence of γ-globulin. On the contrary, when the disc was faster than the ball (positive sliding), the film formation was very complex and time dependent while both of the studied proteins have shown any qualitative change during the test, however the effect of albumin seems to be much more important. Since a very good agreement of the results was obtained, it can be concluded that the approach consisting of two optical methods can provide the fundamental information about the lubricant film formation in meaning of particular proteins while the simultaneous presence of other constituents in model synovial fluid. PMID

  8. Characterization of joint disease in mucopolysaccharidosis type I mice

    PubMed Central

    de Oliveira, Patricia G; Baldo, Guilherme; Mayer, Fabiana Q; Martinelli, Barbara; Meurer, Luise; Giugliani, Roberto; Matte, Ursula; Xavier, Ricardo M

    2013-01-01

    Mucopolysaccharidoses (MPS) are lysosomal storage disorders characterized by mutations in enzymes that degrade glycosaminoglycans (GAGs). Joint disease is present in most forms of MPS, including MPS I. This work aimed to describe the joint disease progression in the murine model of MPS I. Normal (wild-type) and MPS I mice were sacrificed at different time points (from 2 to 12 months). The knee joints were collected, and haematoxylin–eosin staining was used to evaluate the articular architecture. Safranin-O and Sirius Red staining was used to analyse the proteoglycan and collagen content. Additionally, we analysed the expression of the matrix-degrading metalloproteinases (MMPs), MMP-2 and MMP-9, using immunohistochemistry. We observed progressive joint alterations from 6 months, including the presence of synovial inflammatory infiltrate, the destruction and thickening of the cartilage extracellular matrix, as well as proteoglycan and collagen depletion. Furthermore, we observed an increase in the expression of MMP-2 and MMP-9, which could conceivably explain the degenerative changes. Our results suggest that the joint disease in MPS I mice may be caused by a degenerative process due to increase in proteases expression, leading to loss of collagen and proteoglycans. These results may guide the development of ancillary therapies for joint disease in MPS I. PMID:23786352

  9. First Report of a Hip Prosthetic and Joint Infection Caused by Lactococcus garvieae in a Woman Fishmonger▿

    PubMed Central

    Aubin, G. G.; Bémer, P.; Guillouzouic, A.; Crémet, L.; Touchais, S.; Fraquet, N.; Boutoille, D.; Reynaud, A.; Lepelletier, D.; Corvec, S.

    2011-01-01

    We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae. PMID:21367987

  10. First report of a hip prosthetic and joint infection caused by Lactococcus garvieae in a woman fishmonger.

    PubMed

    Aubin, G G; Bémer, P; Guillouzouic, A; Crémet, L; Touchais, S; Fraquet, N; Boutoille, D; Reynaud, A; Lepelletier, D; Corvec, S

    2011-05-01

    We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae. PMID:21367987

  11. Patient-related medical risk factors for periprosthetic joint infection of the hip and knee

    PubMed Central

    Eka, Aleeson

    2015-01-01

    Despite advancements and improvements in methods for preventing infection, periprosthetic joint infection (PJI) is a significant complication following total joint arthroplasty (TJA). Prevention is the most important strategy to deal with this disabling complication, and prevention should begin with identifying patient-related risk factors. Medical risk factors, such as morbid obesity, malnutrition, hyperglycemia, uncontrolled diabetes mellitus, rheumatoid arthritis (RA), preoperative anemia, cardiovascular disorders, chronic renal failure, smoking, alcohol abuse and depression, should be evaluated and optimized prior to surgery. Treating patients to get laboratory values under a specified threshold or cessation of certain modifiable risk factors can decrease the risk of PJI. Although significant advances have been made in past decades to identify these risk factors, there remains some uncertainty regarding the risk factors predisposing TJA patients to PJI. Through a review of the current literature, this paper aims to comprehensively evaluate and provide a better understanding of known medical risk factors for PJI after TJA. PMID:26539450

  12. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint.

    PubMed

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-08-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn. In this short article, we attempt to explain some of the abnormal kinematic and kinetic patterns associated with FAI by highlighting similarities between the gait seen in early osteoarthritis (OA) and that of FAI. We also propose an approach for future research in this field and emphasise the importance of quantifying early OA in FAI based on magnetic resonance imaging (MRI) scans and the amount of chondral damage seen during open or arthroscopic surgery. PMID:24687267

  13. Effect of implant material properties on the performance of a hip joint replacement.

    PubMed

    Rotem, A

    1994-01-01

    A composite material implant prosthesis for hip replacement has been developed. The design of the prosthesis substructure was based on investigation of the stress and strain fields that were developed in the human femur at the proximal end when a prosthesis stem had been inserted into it. The prosthesis stem structure was of unidirectional fibrous composite material core (graphite fibres in polysulfone matrix), wrapped with four layers of the same material but orientated at different angles. The orthotropic moduli of the outer layer are very close to the moduli of a human cortical bone in the vertical and circumferential directions. The moduli increased gradually from the outer layer to the inner core. A three-dimensional finite element model of the prosthesis and the bone has been constructed and loaded with the range of forces that might appear upon operation. The behaviour of the composite prosthesis and the femur was then compared with the intact femur and three other types of prosthesis materials, namely stainless steel, titanium, an isoelastic material and a hypothetical one with moduli identical to the cortical bone. The titanium has modulus of elasticity that is only half of the stainless steel. It was found that the composite prosthesis gave the best performance for most of the categories that were examined. PMID:7595934

  14. Hydroxyapatite deposition disease of the joint.

    PubMed

    Molloy, Eamonn S; McCarthy, Geraldine M

    2003-06-01

    Basic calcium phosphate (BCP) crystals include partially carbonate-substituted hydroxyapatite, octacalcium phosphate, and tricalcium phosphate. They may form deposits, which are frequently asymptomatic but may give rise to a number of clinical syndromes including calcific periarthritis, Milwaukee shoulder syndrome, and osteoarthritis, in and around joints. Recent data suggest that magnesium whitlockite, another form of BCP, may play a pathologic role in arthritis. Data from the past year have provided further understanding of the mechanisms by which BCP crystals induce inflammation and degeneration. There remains no specific treatment to modify the effects of BCP crystals. Although potential drugs are being identified as the complex pathophysiology of BCP crystals is unraveled, much work remains to be done in order to translate research advances to date into tangible clinical benefits. PMID:12744814

  15. Cartilage tissue engineering for degenerative joint disease.

    PubMed

    Nesic, Dobrila; Whiteside, Robert; Brittberg, Mats; Wendt, David; Martin, Ivan; Mainil-Varlet, Pierre

    2006-05-20

    Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair techniques. The combination of autologous cells, specifically designed scaffolds, bioreactors, mechanical stimulations and growth factors together with the knowledge that underlies the principles of cell biology offers promising avenues for cartilage tissue regeneration. The present review explores basic biology mechanisms for cartilage reconstruction and summarizes the advances in the tissue engineering approaches. Furthermore, the limits of the new methods and their potential application in the osteoarthritic conditions are discussed. PMID:16574268

  16. The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

    PubMed Central

    Göthlin, Jan H.

    2013-01-01

    Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections. PMID:24078921

  17. Lumbosacral transitional vertebrae, canine hip dysplasia, and sacroiliac joint degenerative changes on ventrodorsal radiographs of the pelvis in police working German shepherd dogs.

    PubMed

    Komsta, Renata; Łojszczyk-Szczepaniak, Anna; Dębiak, Piotr

    2015-03-01

    Lumbosacral transitional vertebrae (LTV) frequently occur in German shepherd dogs. The aim of the study was to evaluate the prevalence and interdependence between LTV and canine hip dysplasia (CHD) as well as sacroiliac joint degenerative changes visualized on ventrodorsal radiographs of the pelvis in both working and companion German shepherd dogs. The presence of LTV was found in 12% of working dogs and in 33% of companion dogs. Similar incidence of hip dysplasia in both the groups was found. It has been shown that dogs with LTV have a higher frequency of severe CHD. A higher percentage of sacroiliac joint degenerative changes was observed in dogs with no signs of LTV and in working dogs. PMID:26041591

  18. The study of wear behaviors on abducted hip joint prostheses by an alternate finite element approach.

    PubMed

    Lin, Yi-Tsung; Wu, James Shih-Shyn; Chen, Jian-Horng

    2016-07-01

    An acetabular cup with larger abduction angles is able to affect the normal function of the cup seriously that may cause early failure of the total hip replacement (THR). Complexity of the finite element (FE) simulation in the wear analysis of the THR is usually concerned with the contact status, the computational effort, and the possible divergence of results, which become more difficult on THRs with larger cup abduction angles. In the study, we propose a FE approach with contact transformation that offers less computational effort. Related procedures, such as Lagrangian Multiplier, partitioned matrix inversion, detection of contact forces, continuity of contact surface, nodal area estimation, etc. are explained in this report. Through the transformed methodology, the computer round-off error is tremendously reduced and the embedded repetitive procedure can be processed precisely and quickly. Here, wear behaviors of THR with various abduction angles are investigated. The most commonly used combination, i.e., metal-on-polyethylene, is adopted in the current study where a cobalt-chromium femoral head is paired with an Ultra High Molecular Weight Polyethylene (UHMWPE) cup. In all illustrations, wear coefficients are estimated by self-averaging strategy with available experimental datum reported elsewhere. The results reveal that the THR with larger abduction angles may produce deeper depth of wear but the volume of wear presents an opposite tendency; these results are comparable with clinical and experimental reports. The current approach can be widely applied easily to fields such as the study of the wear behaviors on ante-version, impingement, and time-dependent behaviors of prostheses etc. PMID:27265055

  19. Segmenting the Femoral Head and Acetabulum in the Hip Joint Automatically Using a Multi-Step Scheme

    NASA Astrophysics Data System (ADS)

    Wang, Ji; Cheng, Yuanzhi; Fu, Yili; Zhou, Shengjun; Tamura, Shinichi

    We describe a multi-step approach for automatic segmentation of the femoral head and the acetabulum in the hip joint from three dimensional (3D) CT images. Our segmentation method consists of the following steps: 1) construction of the valley-emphasized image by subtracting valleys from the original images; 2) initial segmentation of the bone regions by using conventional techniques including the initial threshold and binary morphological operations from the valley-emphasized image; 3) further segmentation of the bone regions by using the iterative adaptive classification with the initial segmentation result; 4) detection of the rough bone boundaries based on the segmented bone regions; 5) 3D reconstruction of the bone surface using the rough bone boundaries obtained in step 4) by a network of triangles; 6) correction of all vertices of the 3D bone surface based on the normal direction of vertices; 7) adjustment of the bone surface based on the corrected vertices. We evaluated our approach on 35 CT patient data sets. Our experimental results show that our segmentation algorithm is more accurate and robust against noise than other conventional approaches for automatic segmentation of the femoral head and the acetabulum. Average root-mean-square (RMS) distance from manual reference segmentations created by experienced users was approximately 0.68mm (in-plane resolution of the CT data).

  20. [APPLICATION OF PREPARATION OF COCARNIT FOR PATIENTS AFTER ENDOPROSTHESIS OF HIP AND KNEE JOINTS].

    PubMed

    Korzh, N A; Filippenko, V A; Leont'eva, F S; Tulyakov, V A; Bondarenko, S E

    2015-01-01

    In the article the results of clinical researches of efficiency of preparation of Cocarnit are resulted for patients after endoprosthesis of large joints. It is routine that for patients, receiving preparation of Cocarnit after the operation period there was a decline in the amount of complaints of patients on the total somatical state. Preparation of Ccocarnit was positively estimated outside patients, meaningful by-reactions, serving reason of abolition of preparation, was not marked. At the reception preparation of Cocarnit greater part of investigational laboratory indexes (table of contents of glucose, β-lipoproteines, total chondroitisulfates, TBC-productes (malonic dyaldehyde), activity of aspartataminotransferase, alkaline phosphatase and β-glutamyltranspeptidase), the indexes of clinical blood test and leucocytar indexes during a supervision did not have reliable differences from such as the persons of the control group, that confirms good bearab leness of the indicated preparation. Application preparation of Cocarnit for patients in composition the chart of treatment of patients after endoprosthesis of large joints brought maintenance over of cholesterol to the decline, glycoproteins, TBC-products (malonic dyaldehyde), activity of alaninaminotransferase, that specifies on normalizing influence of the indicated preparation in relation to the basic types of exchange of matters. PMID:27089730

  1. Temporomandibular joint dysfunction in various rheumatic diseases.

    PubMed

    Aceves-Avila, F J; Chávez-López, M; Chavira-González, J R; Ramos-Remus, C

    2013-01-01

    Temporomandibular disorder (TMD) is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA), osteoarthrosis (OA), ankylosing spondylitis (AS) and systemic lupus erythematosus, and to define the limitations in everyday's life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1) the presence of pain; 2) difficulty on mouth opening, chewing or speaking; 3) the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%). Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005). We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16%) patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily. PMID:23884028

  2. Treatment of Arthritis Associated With Legg-Calve-Perthes Disease With Modular Total Hip Arthroplasty.

    PubMed

    Seufert, Christopher R; McGrory, Brian J

    2015-10-01

    Legg-Calve-Perthes (LCP) disease can result in morphological deformities and associated adult hip arthritis. Thirty-five consecutive total hip arthroplasties (THA) were performed in 28 patients with a history of LCP using a non-cemented modular femoral component. There was one revision for late hematogenous infection and no evidence of prosthesis failure. Harris hip scores, on average, improved from 49.8 (26-73) to 93.9 (82-100) (P<0.05) after a minimum of 2 years follow-up (average, 8.2 years, range 2-14 years). Clinically, patients demonstrated diminished or no limping (94%, 33/35) and improved leg length equality post-operatively (100%, 35/35). This style of stem accommodated metaphyseal/diaphyseal size mismatch in 80% (28/35), allowed for abnormal anteversion in 71% (25/35), and resulted in radiographic improvements in trochanteric height (P<0.05), body weight lever arm (P<0.05), and leg length (P<0.05). PMID:25979188

  3. Total Hip Arthroplasty in Patient with the Sequelae of Legg-Calvé-Perthes Disease

    PubMed Central

    Lim, Young Wook; Kim, Myung Jin; Lee, Yong Suk

    2014-01-01

    Purpose Patients who have secondary hip osteoarthritis as sequelae of Legg-Calvé-Perthes disease (LCPD) are severe deformities of femoral head and acetabulum. A few studies have presented that the clinical results and risks associated with total hip arthroplasty (THA) for patients with a history of LCPD were not satisfactory. In this study, we reported the radiographic and clinical outcomes of THA in patients with sequelae of LCPD. Materials and Methods Between March 2007 and May 2012, 23 hips (23 patients) underwent cementless THA and were followed up at least 2 years after surgery. There were 11 male patients and 12 female patients with an average age of 49.2 years old (range, 25 to 69 years old), and the average follow up period was 40.8 months (range, 24 to 84 months). The clinical and radiological evaluations were performed. Results The Harris hip score improved from 48.3 points preoperatively to 92.4 points at the time of the last follow-up. The shortening of affected limb was improved from -1.6 cm to 0.2 cm. The complications included one case of sciatic nerve palsy that developed after extensive lengthening of lower extremity, three cases of intraoperative femur fractures. There was no component loosening. Conclusion Fractures and motor nerve palsies may be more frequent in this population. Careful preoperative planning should be performed to overcome the technical pitfalls. If overcoming this early complication, the clinical and radiological evaluations showed excellent outcomes at average 40-month follow-ups.

  4. Particle Disease: A Current Review of the Biological Mechanisms in Periprosthetic Osteolysis After Hip Arthroplasty

    PubMed Central

    Sukur, Erhan; Akman, Yunus Emre; Ozturkmen, Yusuf; Kucukdurmaz, Fatih

    2016-01-01

    Background: Inflammatory responses to wear debris cause osteolysis that leads to aseptic prosthesis loosening and hip arthroplasty failure. Although osteolysis is usually associated with aseptic loosening, it is rarely seen around stable implants. Aseptic implant loosening is a simple radiologic phenomenon, but a complex immunological process. Particulate debris produced by implants most commonly causes osteolysis, and this is called particle-associated periprosthetic osteolysis (PPO). Objective: The objective of this review is to outline the features of particle-associated periprosthetic osteolysis to allow the physician to recognise this condition and commence early treatment, thereby optimizing patient outcome. Methods: A thorough literature search was performed using available databases, including Pubmed, to cover important research published covering particle-associated PPO. Results: Although osteolysis causes bone resorption, clinical, animal, and in vitro studies of particle bioreactivity suggest that particle-associated PPO represents the culmination of several biological reactions of many cell types, rather than being caused solely by the osteoclasts. The biological activity is highly dependent on the characteristics and quantity of the wear particles. Conclusion: Despite advances in total hip arthroplasty (THA), particle-associated PPO and aseptic loosening continue to be major factors that affect prosthetic joint longevity. Biomarkers could be exploited as easy and objective diagnostic and prognostic targets that would enable testing for osteolysis after THA. Further research is needed to identify new biomarkers in PPO. A comprehensive understanding of the underlying biological mechanisms is crucial for developing new therapeutic interventions to reverse or suppress biological responses to wear particles. PMID:27499822

  5. The radiology of joint disease. Volume 2. Third edition

    SciTech Connect

    Forrester, D.M.; Brown, J.C.

    1987-01-01

    This book explains the diagnostic criteria and radiologic appearance of joint disease - principally arthritis. It covers the soft tissues, alignment abnormalities, bony mineralization, and abnormalities of the cartilage space of the hand; arthritis from head to foot; and the differential diagnosis of arthritis.

  6. Chronic Obstructive Pulmonary Disease Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study.

    PubMed

    Huang, Shih-Wei; Wang, Wei-Te; Chou, Lin-Chuan; Chen, Hung-Chou; Liou, Tsan-Hon; Lin, Hui-Wen

    2016-01-01

    Hip fractures can lead to functional disability and high mortality rates among elderly patients. The aim of this study was to investigate whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture. A retrospective population-based 4-year cohort study was conducted using case-control matched analysis of data from the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005). Patients with a diagnosis of COPD between January 1, 2004 and December 31, 2007 were enrolled. A 2-stage approach and data from the National Health Interview Survey 2005 were applied to adjust for missing confounders in the LHID2005 cohort. Hazard ratios (HRs) and adjusted HRs were estimated hip fracture risk for the COPD. We enrolled 16,239 patients in the COPD cohort and 48,747 (1:3) patients in non-COPD cohort. The hip fracture incidences were 649 per 100,000 person-years in the study cohort and 369 per 100,000 person-years in non-COPD cohort. The hip fracture HR during the follow-up period was 1.78 (P < 0.001) and the adjusted hip fracture HR was 1.57 (P < 0.001) after adjustment for covariates by using the 2-stage approach method. Patients with COPD were at hip fracture risk and fracture-prevention strategies are essential for better quality of care. PMID:26987933

  7. Chronic Obstructive Pulmonary Disease Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study

    PubMed Central

    Huang, Shih-Wei; Wang, Wei-Te; Chou, Lin-Chuan; Chen, Hung-Chou; Liou, Tsan-Hon; Lin, Hui-Wen

    2016-01-01

    Hip fractures can lead to functional disability and high mortality rates among elderly patients. The aim of this study was to investigate whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture. A retrospective population-based 4-year cohort study was conducted using case–control matched analysis of data from the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005). Patients with a diagnosis of COPD between January 1, 2004 and December 31, 2007 were enrolled. A 2-stage approach and data from the National Health Interview Survey 2005 were applied to adjust for missing confounders in the LHID2005 cohort. Hazard ratios (HRs) and adjusted HRs were estimated hip fracture risk for the COPD. We enrolled 16,239 patients in the COPD cohort and 48,747 (1:3) patients in non-COPD cohort. The hip fracture incidences were 649 per 100,000 person-years in the study cohort and 369 per 100,000 person-years in non-COPD cohort. The hip fracture HR during the follow-up period was 1.78 (P < 0.001) and the adjusted hip fracture HR was 1.57 (P < 0.001) after adjustment for covariates by using the 2-stage approach method. Patients with COPD were at hip fracture risk and fracture-prevention strategies are essential for better quality of care. PMID:26987933

  8. TRPV4 as a Therapeutic Target for Joint Diseases

    PubMed Central

    McNulty, Amy L.; Leddy, Holly A.; Liedtke, Wolfgang; Guilak, Farshid

    2014-01-01

    Biomechanical factors play a critical role in regulating the physiology as well as the pathology of multiple joint tissues, and have been implicated in the pathogenesis of osteoarthritis. Therefore, the mechanisms by which cells sense and respond to mechanical signals may provide novel targets for the development of disease-modifying osteoarthritis drugs (DMOADs). Transient receptor potential vanilloid 4 (TRPV4) is a Ca2+-permeable cation channel that serves as a sensor of mechanical or osmotic signals in several musculoskeletal tissues, including cartilage, bone, and synovium. The importance of TRPV4 in joint homeostasis is apparent in patients harboring TRPV4 mutations, which result in the development of a spectrum of skeletal dysplasias and arthropathies. In addition, the genetic knockout of Trpv4 results in the development of osteoarthritis and decreased osteoclast function. In engineered cartilage replacements, chemical activation of TRPV4 can reproduce many of the anabolic effects of mechanical loading to accelerate tissue growth and regeneration. Overall, TRPV4 plays a key role in transducing mechanical, pain, and inflammatory signals within joint tissues, and thus is an attractive therapeutic target to modulate the effects of joint diseases. In pathological conditions in the joint, when the delicate balance of TRPV4 activity is altered, a variety of different tools could be utilized to directly or indirectly target TRPV4 activity. PMID:25519495

  9. Prediction of Large Joint Destruction in Patients With Rheumatoid Arthritis Using 18F-FDG PET/CT and Disease Activity Score

    PubMed Central

    Suto, Takahito; Okamura, Koichi; Yonemoto, Yukio; Okura, Chisa; Tsushima, Yoshito; Takagishi, Kenji

    2016-01-01

    Abstract The assessments of joint damage in patients with rheumatoid arthritis (RA) are mainly restricted to small joints in the hands and feet. However, the development of arthritis in RA patients often involves the large joints, such as the shoulder, elbow, hip, knee, and ankle. Few studies have been reported regarding the degree of large joint destruction in RA patients. 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) visualizes the disease activity in large joints affected by RA. In this study, the associations between destruction of the large joints and the findings of FDG-PET/CT as well as laboratory parameters were investigated, and factors associated with large joint destruction after the administration of biological therapy were identified in RA patients. A total of 264 large joints in 23 RA patients (6 men and 17 women; mean age of 66.9 ± 7.9 years) were assessed in this study. FDG-PET/CT was performed at baseline and 6 months after the initiation of biological therapy. The extent of FDG uptake in large joints (shoulder, elbow, wrist, hip, knee, and ankle) was analyzed using the maximum standardized uptake value (SUVmax). Radiographs of the 12 large joints per patient obtained at baseline and after 2 years were assessed according to Larsen's method. A logistic regression analysis was performed to determine the factors most significantly contributing to the progression of joint destruction within 2 years. Radiographic progression of joint destruction was detected in 33 joints. The SUVmax at baseline and 6 months, and the disease activity score (DAS) 28-erythrocyte sedimentation rate (ESR) at 6, 12, and 24 months were significantly higher in the group with progressive joint destruction. The SUVmax at baseline and DAS28-ESR at 6 months were found to be factors associated with joint destruction at 2 years (P < 0.05). The FDG uptake in the joints with destruction was higher than that observed in the

  10. Hip Injuries and Disorders

    MedlinePlus

    ... or falling can all sometimes lead to hip injuries. These include Strains Bursitis Dislocations Fractures Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited ...

  11. Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint.

    PubMed

    Resnick, D; Niwayama, G; Coutts, R D

    1977-05-01

    A comprehensive study of femoral heads of patients and cadavers with osteoarthritis, rheumatoid arthritis, osteonecrosis, and calcium pyrophosphate dihydrate deposition disease allows insight into the radiographic and pathologic appearance of subchondral radiolucencies in these disorders. The term geode, rather than cyst or pseudocyst, may be a more appropriate decription of these lesions. In osteoarthritis, goedes occur on the pressure segment of the femoral head in association with loss of articular space; in rheumatoid arthritis, they are initially noted at the chondro-osseous junction and subsequently involve the entire femoral head. In osteonecrosis, geodes appear in the necrotic segment of the femoral head. In calcium pyrophosphate deposition disease, geodes resemble those in osteoarthritis but are larger, more numerous, and more widespread. PMID:404905

  12. 'Hip' pain.

    PubMed

    Zacher, Josef; Gursche, Angelika

    2003-02-01

    'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders. PMID:12659822

  13. Digital correction of magnification in pelvic x rays for preoperative planning of hip joint replacements: Theoretical development and clinical results of a new protocol

    SciTech Connect

    The, B.; Diercks, R.L.; Stewart, R.E.; Ooijen, P.M.A. van; Horn, J.R. van

    2005-08-15

    The introduction of digital radiological facilities leads to the necessity of digital preoperative planning, which is an essential part of joint replacement surgery. To avoid errors in the preparation and execution of hip surgery, reliable correction of the magnification of the projected hip is a prerequisite. So far, no validated method exists to accomplish this. We present validated geometrical models of the x-ray projection of spheres, relevant for the calibration procedure to correct for the radiographic magnification. With help of these models a new calibration protocol was developed. The validity and precision of this procedure was determined in clinical practice. Magnification factors could be predicted with a maximal margin of error of 1.5%. The new calibration protocol is valid and reliable. The clinical tests revealed that correction of magnification has a 95% margin of error of -3% to +3%. Future research might clarify if a strict calibration protocol, as presented in this study, results in more accurate preoperative planning of hip joint replacements.

  14. PRE- AND POST-OPERATIVE SELF-REPORTED FUNCTION AND QUALITY OF LIFE IN WOMEN WITH AND WITHOUT GENERALIZED JOINT LAXITY UNDERGOING HIP ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT

    PubMed Central

    Pontiff, Mattie; Ithurburn, Matthew P.; Ellis, Thomas; Cenkus, Kathleen

    2016-01-01

    ABSTRACT Background Generalized joint laxity is more prevalent in women than men and may lead to poorer post-operative outcomes in select orthopedic populations. There are no studies examining peri-operative function in patients with generalized joint laxity (GJL) and femoroacetabular impingement (FAI). Purpose The purpose of this study was to determine the difference in perceived function and quality of life as measured by the Hip Outcome Score ADL subscale (HOS-ADL), International Hip Outcomes Tool (iHOT-33) and the Short Form 12-Item Health Survey (SF-12) in women with and without GJL prior to and six months after undergoing hip arthroscopy for FAI. Study Design Cohort Study Methods Peri-operative data were collected from women with FAI from November 2011-September 2014. Lax subjects were women with laxity scores ≥4/9 on the Beighton and Horan Joint Mobility Index; Nonlax subjects were women with laxity scores <4/9. Functional outcomes were evaluated using the HOS-ADL, iHOT-33, PCS-12, and the MCS-12 pre-operatively and at 6 months post-operatively. Change scores (post-score – pre-score) were calculated for each outcome measure and compared between groups, along with pre-operative and post-operative means, using Mann-Whitney U tests. Results 166 women met the inclusion criteria: Nonlax (n = 131), Lax (n = 35). There were no statistically significant differences between groups in pre-operative functional outcomes (all p > .05). Additionally, there were no statistically significant differences between groups in post-operative means or change scores, respectively, for HOS-ADL (p = .696, .358), iHOT-33 (p = .550, .705), PCS-12 (p = .713, .191), and MCS-12 (p = .751, .082). Laxity score was not associated with any post-operative functional outcome score or change score (all p > .05). Conclusion Women with and without generalized joint laxity do not appear to report differences in hip function in the 6-month peri-operative period before and after hip

  15. Lubrication of metal-on-metal hip joints: the effect of protein content and load on film formation and wear.

    PubMed

    Myant, C; Underwood, R; Fan, J; Cann, P M

    2012-02-01

    Lubricant films were measured for a series of bovine serum and protein containing (albumin, globulin) saline solutions for CoCrMo femoral component sliding against a glass disc. Central film thickness was measured by optical interferometry as a function of time (constant mean speed: 0 and 10 mm/s) and variable mean speed (0-50 mm/s). The effect of load (5-20 N) on film thickness was also studied. The development of the wear scar on the CoCrMo surface was monitored by measuring the width of the contact zone during the film thickness tests. The results showed film thickness increased with time for both the static and sliding tests. Films formed in the static, loaded test were typically in the range of 3-40 nm. The globulin containing solutions formed the thickest films. In the sliding tests a wear scar rapidly formed on the implant component for the bovine serum and albumin fluids, negligible wear was observed for the globulin solutions. Film thickness increased with sliding time for all test solutions and was much greater than predicted by isoviscous EHL models. The film increase was found to correlate with increasing wear scar size and thus decreasing contact pressure. A new lubricating mechanism is proposed whereby during sliding the fluid undergoes bulk phase separation rheology, so that an elevated protein phase forms in the inlet zone. This protein phase is a high-viscosity biphasic matrix, which is periodically entrained into the contact forming a thick protective hydro-gel film. One of the main findings of this study is that film thickness was very sensitive to load; to a much greater extent than predicted by EHL models. Thus film formation in MoM hip joints is very susceptible to high contact pressures which might be due to implant misalignment and edge-loading. PMID:22301171

  16. Peripheral organ doses from radiotherapy for heterotopic ossification of non-hip joints: is there a risk for radiation-induced malignancies?

    PubMed

    Berris, Theocharis; Mazonakis, Michalis; Kachris, Stefanos; Damilakis, John

    2014-05-01

    Radiotherapy, used for heterotopic ossification (HO) management, may increase radiation risk to patients. This study aimed to determine the peripheral dose to radiosensitive organs and the associated cancer risks due to radiotherapy of HO in common non-hip joints. A Monte Carlo model of a medical linear accelerator combined with a mathematical phantom representing an average adult patient were employed to simulate radiotherapy for HO with standard AP and PA fields in the regions of shoulder, elbow and knee. Radiation dose to all out-of-field radiosensitive organs defined by the International Commission on Radiological Protection was calculated. Cancer induction risk was estimated using organ-specific risk coefficients. Organ dose change with increased field dimensions was also evaluated. Radiation therapy for HO with a 7 Gy target dose in the sites of shoulder, elbow and knee, resulted in the following equivalent organ dose ranges of 0.85-62 mSv, 0.28-1.6 mSv and 0.04-1.6 mSv, respectively. Respective ranges for cancer risk were 0-5.1, 0-0.6 and 0-1.3 cases per 10(4) persons. Increasing the field size caused an average increase of peripheral doses by 15-20%. Individual organ dose increase depends upon the primary treatment site and the distance between organ of interest and treatment volume. Relatively increased risks of more than 1 case per 10,000 patients were found for skin, breast and thyroid malignancies after treatment in the region of shoulder and for skin cancer following elbow irradiation. The estimated risk for inducing any other malignant disease ranges from negligible to low. PMID:24084192

  17. Primary osteoarthritis of the hip: a genetic disease caused by European genetic variants.

    PubMed

    Hoaglund, Franklin T

    2013-03-01

    Primary osteoarthritis of the hip is a separate phenotype that occurs at a rate of 3% to 6% in the populations of the world with European ancestry. In all non-European populations, there is a consistent rarity of primary osteoarthritis that suggests a different etiology for these few patients. Family, sibling, and twin studies prove primary osteoarthritis to be a genetic disease with a 50% heritability caused by European genetic variants. The genetic basis is reinforced by the lower rate of primary osteoarthritis in American minorities consistent with their degree of European gene admixture. Whether the mechanism of degeneration of primary osteoarthritis may be secondary through a morphologic deformity, such as femoroacetabular impingement, remains unknown. The virtual absence of the disease in non-Europeans indicates that the European gene component is necessary for the expression of this separate phenotype of osteoarthritis. PMID:23467870

  18. [Evaluation of Artificial Hip Joint with Radiofrequency Heating Issues during MRI Examination: A Comparison between 1.5 T and 3 T].

    PubMed

    Yamazaki, Masaru; Ideta, Takahiro; Kudo, Sadahiro; Nakazawa, Masami

    2016-06-01

    In magnetic resonance imaging (MRI), when radiofrequency (RF) is irradiated to a subject with metallic implant, it can generate heat by RF irradiation. Recently 3 T MRI scanner has spread widely and imaging for any regions of whole body has been conducted. However specific absorption rate (SAR) of 3 T MRI becomes approximately four times as much as the 1.5 T, which can significantly affect the heat generation of metallic implants. So, we evaluated RF heating of artificial hip joints in different shapes and materials in 1.5 T and 3 T MRI. Three types of artificial hip joints made of stainless alloy, titanium alloy and cobalt chrome alloy were embedded in the human body-equivalent phantom respectively and their temperature change were measured for twenty minutes by 1.5 T and 3 T MRI. The maximum temperature rise was observed at the bottom head in all of three types of artificial hip joints, the rise being 12°C for stainless alloy, 11.9°C for titanium alloy and 6.1°C for cobalt chrome alloy in 1.5 T. The temperature rise depended on SAR and the increase of SAR had a good linear relationship with the temperature rise. It was found from the result that the RF heating of metallic implants can take place in various kinds of material and the increase of SAR has a good linear relationship with the temperature rise. This experience shows that reduction of SAR can decrease temperature of metallic implants. PMID:27320151

  19. Effects of administration of adipose-derived stromal vascular fraction and platelet-rich plasma to dogs with osteoarthritis of the hip joints.

    PubMed

    Upchurch, David A; Renberg, Walter C; Roush, James K; Milliken, George A; Weiss, Mark L

    2016-09-01

    OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressure-sensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS AND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group. PMID:27580105

  20. A healthy patient with bilateral frozen hips preceding bilateral frozen shoulders: a cautionary tale.

    PubMed

    Miller, Abigail R; Arnot, Dean; Wake, Melissa

    2015-01-01

    Adhesive capsulitis of the shoulder (frozen shoulder) is a common disease characterised by spontaneous onset of pain and restriction of movement, followed by 'thawing', with complete or near-complete resolution. Adhesive capsulitis of the hip has been reported in around a dozen patients. This report describes an otherwise-healthy middle-aged woman with apparent sequential resolving adhesive capsulitis of all four ball-and-socket joints over a 9-year period, initially affecting each hip and then each shoulder sequentially. The likely hip diagnosis became clear only retrospectively with development of the second frozen shoulder, 5 years after the first pain. All joints subsequently resolved within the expected timeframe and the patient remains healthy, other than having mild hypertension. This case illustrates that, when hip precedes shoulder involvement, there is the potential for the frozen hip to receive alternate diagnoses for which invasive open hip surgery could unnecessarily be recommended. PMID:26564111

  1. Hip fracture - discharge

    MedlinePlus

    ... hemiarthroplasty to replace the ball part of your hip joint. You should have received physical therapy while you were in the hospital or at a rehabilitation center before going home from the hospital.

  2. Unknown syndrome: mental retardation with postaxial polydactyly, congenital absence of hair, severe seborrhoeic dermatitis, and Perthes' disease of the hip.

    PubMed

    Garrett, C; Tripp, J H

    1988-04-01

    We report a six year old male with mental retardation, postaxial polydactyly and syndactyly, atrichia congenita totalis, severe seborrhoeic dermatitis, recurrent staphylococcal skin sepsis, and Perthes' disease of the hip. His birth may have resulted from an incestuous mating. PMID:2966861

  3. Wear of ultra-high molecular weight polyethylene acetabular cups in a physiological hip joint simulator in the anatomical position using bovine serum as a lubricant.

    PubMed

    Bigsby, R J; Hardaker, C S; Fisher, J

    1997-01-01

    The Leeds physiological anatomical (PA) hip joint simulator was developed to apply three axes of loading and a complex three-dimensional motion so that the forces and motions can reproduce exactly the walking cycles defined by Paul. This paper presents the results of a study using the Leeds PA hip joint simulator to determine the wear of 32 mm ultra-high molecular weight polyethylene (UHMWPE) acetabular cups against stainless steel and zirconia ceramic heads, using bovine serum as lubricant. These results have been compared with the results of a previous study that used water as the lubricant, which led to UHMWPE transfer film being formed on the stainless steel head. Comparisons are also made with clinical results and results from other simulators. The study indicates that it is preferable to use bovine serum in simulator studies. In addition, the results indicate that if the surface roughness of the metallic and femoral heads are similar, and they remain undamaged during the tests, the wear rates of the UHMWPE cups are likely to be similar. PMID:9256003

  4. Polysaccharide intercellular adhesin or protein factors in biofilm accumulation of Staphylococcus epidermidis and Staphylococcus aureus isolated from prosthetic hip and knee joint infections.

    PubMed

    Rohde, Holger; Burandt, Eike C; Siemssen, Nicolaus; Frommelt, Lars; Burdelski, Christoph; Wurster, Sabine; Scherpe, Stefanie; Davies, Angharad P; Harris, Llinos G; Horstkotte, Matthias A; Knobloch, Johannes K-M; Ragunath, Chandran; Kaplan, Jeffrey B; Mack, Dietrich

    2007-03-01

    Nosocomial staphylococcal foreign-body infections related to biofilm formation are a serious threat, demanding new therapeutic and preventive strategies. As the use of biofilm-associated factors as vaccines is critically restricted by their prevalence in natural staphylococcal populations we studied the distribution of genes involved in biofilm formation, the biofilm phenotype and production of polysaccharide intercellular adhesin (PIA) in clonally independent Staphylococcus aureus and Staphylococcus epidermidis strains isolated from prosthetic joint infections after total hip or total knee arthroplasty. Biofilm formation was detected in all S. aureus and 69.2% of S. epidermidis strains. Importantly, 27% of biofilm-positive S. epidermidis produced PIA-independent biofilms, in part mediated by the accumulation associated protein (Aap). Protein-dependent biofilms were exclusively found in S. epidermidis strains from total hip arthroplasty (THA). In S. aureus PIA and proteins act cooperatively in biofilm formation regardless of the infection site. PIA and protein factors like Aap are of differential importance for the pathogenesis of S. epidermidis in prosthetic joint infections (PJI) after THA and total knee arthroplasty (TKA), implicating that icaADBC cannot serve as a general virulence marker in this species. In S. aureus biofilm formation proteins are of overall importance and future work should focus on the identification of functionally active molecules. PMID:17187854

  5. Novel artificial hip joint: A layer of alumina on Ti-6Al-4V alloy formed by micro-arc oxidation.

    PubMed

    Khanna, Rohit; Kokubo, Tadashi; Matsushita, Tomiharu; Nomura, Yuuji; Nose, Norihiro; Oomori, Yoshiyuki; Yoshida, Takuya; Wakita, Koichi; Takadama, Hiroaki

    2015-10-01

    In many hip replacement surgeries, monolithic alumina is used as a femoral head due to its high wear resistance. However, it is liable to fracture under load bearing operations in artificial joints. We propose a promising way to overcome this limitation by forming a dense alumina layer onto a relatively tough substrate such as Ti-6Al-4V alloy to obtain high wear resistance on a material that can sustain relatively high toughness. For this purpose, Al metal powders were deposited onto Ti-6Al-4V alloy by cold spraying in N2 atmosphere. Interfacial adhesion between Al and the Ti alloy was improved by the formation of a reaction layer of Al3Ti between them by heating at 640 °C for 1h in air. Subsequently, micro-arc oxidation treatment was performed to oxidize Al. The oxidized layer was composed of an outer porous layer of γ-alumina and inner-most dense layer of α-alumina. The α-alumina layer was almost fully densified and exhibited high Vickers hardness almost equal to that of alumina ceramics used as the femoral head. Thus, the newly developed dense alumina/Ti alloy can be potentially used to produce the reliable bearing surfaces of artificial hip joint. PMID:26117770

  6. The Effects of a Warm-up on Acute Hip Joint Flexibility Using a Modified PNF Stretching Technique

    PubMed Central

    Cornelius, William L.; Hands, Mary R.

    1992-01-01

    This study was conducted in order to determine the effects of various types of warm-up on performance of the slow-reversal-hold-relax modified Proprioceptive Neuromuscular Facilitation (PNF) flexibility maneuver. The subjects for this study (N=54) were active, injuryfree females who were randomly assigned to stationary cycling, whirlpool, or control groups. Each group participated in its assigned treatment for 20 minutes and did not perform any stretching exercises before or during their warm-up. Acute flexibility data were collected for hip flexion with the use of a Leighton Flexometer following the treatment condition. Hip range of motion (ROM) did not differ between the groups performing a warm-up and the control group; therefore, a warm-up had no effect on hip ROM when using a modified PNF technique. ImagesFig 1. PMID:16558145

  7. Perspectives on the future of bone and joint diseases.

    PubMed

    McGowan, Joan A

    2003-08-01

    The diseases of bones, joints, and muscles are common, chronic, and very costly to society. While the impact of these diseases falls across the age spectrum, the worldwide growth in the percentage of elderly in the population makes attention to musculoskeletal disorders and conditions particularly critical. An effective prevention strategy, driven by an understanding of the fundamental biology of bone and connective tissue, can only result from an upshift in the efforts of many sectors--public and private, academic, scientific, and patient-based--with new opportunities for partnerships and collaborative efforts flourishing. The Decade of the Bone and Joint can serve as a catalyst in this effort. The National Institutes of Health (NIH) are pleased to join with other national and international organizations to promote new activities and initiatives during the next decade. The NIH Osteoarthritis Initiative is highlighted as an example of a public-private partnership to develop resources and information on the natural history of the disease process that can drive new clinical intervention studies in osteoarthritis. Hopefully, this initiative and others will pave the way for important, scientifically driven prevention strategies during the next decade. PMID:12926660

  8. The role of hip arthroscopy in the management of osteonecrosis

    PubMed Central

    Papavasiliou, A.; Yercan, H. S.; Koukoulias, N.

    2014-01-01

    Hip arthroscopy has emerged as a diagnostic and therapeutic tool in the management of osteonecrosis (ON) of the femoral head. Direct visualization of the joint, aids the staging of the disease, while mechanical symptoms and pain can be alleviated by addressing the often coexisting intra-articular pathology (labral tears, chondral delamination, loose bodies and synovitis) thereby improving the clinical outcome in some patients. The article explores the role and possible value of hip arthroscopy as a surgical technique in the treatment of hip ON. PMID:27011804

  9. Pathologic ligamentous constraint of the hip.

    PubMed

    Crowninshield, R D; Johnston, R C; Brand, R A; Pedersen, D R

    1983-12-01

    A mathematic model of the hip capsule and lower extremity musculature was utilized to predict the forces present in the hip ligaments during locomotion. The results demonstrate principles and trends (rather than absolute results) in hip mechanics, the details of which are affected by the associated modeling assumptions. The active stretching of a hip joint capsule tightened by scarring or surgical transfer may appreciably increase the hip contact force. Capsular elements that prevent hip flexion and adduction play a major role in hip contact force exaggeration during common activities. The positive effect of maintaining the hip capsule to reduce total hip component dislocation contrasts with the potential negative effects of restricting joint motion and increasing the joint contact force. Increased joint loading due to capsular restriction may contribute to prosthetic component loosening. PMID:6641064

  10. The radiology of joint disease. 3rd Ed

    SciTech Connect

    Forrester, D.M.; Brown, J.C.

    1987-01-01

    The book is a systematic radiographic approach to the arthritides. Part one deals with hand abnormalities ''to facilitate the teaching of basic principles and to dramatize the differences between radiographic features of various arthritides,'' as stated in the forward of the first edition. Part two, ''Arthritis from Head to Foot,'' illustrates the same diseases as they affect other joints. The ABCs (alignment, bone mineralization, cartilage space, soft tissue) approach is followed throughout the book. For example, reflex sympathetic dystrophy syndrome is dealt with in six different locations, and metatarsal stress fractures are mentioned in a chapter on erosions in rheumatoid arthritis.

  11. Regenerative therapies for equine degenerative joint disease: a preliminary study.

    PubMed

    Broeckx, Sarah; Zimmerman, Marieke; Crocetti, Sara; Suls, Marc; Mariën, Tom; Ferguson, Stephen J; Chiers, Koen; Duchateau, Luc; Franco-Obregón, Alfredo; Wuertz, Karin; Spaas, Jan H

    2014-01-01

    Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment. PMID:24465787

  12. Rose Hip

    MedlinePlus

    ... a chemical found in rose hip, might slow blood clotting. Taking rose hip might increase the risk of ... a chemical found in rose hip, might slow blood clotting. There is concern that rose hip might cause ...

  13. Hip pain

    MedlinePlus

    ... the bones or cartilage of your hip, including: Hip fractures – can cause sudden hip pain. These injuries can be serious and lead to major problems. Hip fractures are more common as people get older because ...

  14. Joint issues – conflicts of interest, the ASR hip and suggestions for managing surgical conflicts of interest

    PubMed Central

    2014-01-01

    Background Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery. Discussion We identify financial and nonfinancial conflicts of interest experienced by surgeons, hospitals and regulators in the ASR case. These conflicts may have impacted surgical advice, decision-making and evidence gathering with respect to the ASR prosthesis, and contributed to the significant harms experienced by patients in whom the hip was implanted. Drawing on this case we explore shortcomings in the standard responses to conflicts of interest – disclosure and recusal. We argue disclosure is necessary but by no means sufficient to address conflicts of interest. Using the concept of recusal we develop remedies including second opinions and third party consent which may be effective in mitigating conflicts, but their implementation introduces new challenges. Summary Deployment of the ASR hip is a case of surgical innovation gone wrong. As we show, there were multiple conflicts of interest involved in the introduction of the ASR hip into practice and subsequent attempts to gloss over the mounting body of evidence about its lack of safety and effectiveness. Conflicts of interest in surgery are often not well managed. We suggest strategies in this paper which can minimise the conflicts of interest associated with surgical innovation. PMID:25128372

  15. Joint Modeling of Transitional Patterns of Alzheimer's Disease

    PubMed Central

    Liu, Wei; Zhang, Bo; Zhang, Zhiwei; Zhou, Xiao-Hua

    2013-01-01

    While the experimental Alzheimer's drugs recently developed by pharmaceutical companies failed to stop the progression of Alzheimer's disease, clinicians strive to seek clues on how the patients would be when they visit back next year, based upon the patients' current clinical and neuropathologic diagnosis results. This is related to how to precisely identify the transitional patterns of Alzheimer's disease. Due to the complexities of the diagnosis of Alzheimer's disease, the condition of the disease is usually characterized by multiple clinical and neuropathologic measurements, including Clinical Dementia Rating (CDRGLOB), Mini-Mental State Examination (MMSE), a score derived from the clinician judgement on neuropsychological tests (COGSTAT), and Functional Activities Questionnaire (FAQ). In this research article, we investigate a class of novel joint random-effects transition models that are used to simultaneously analyze the transitional patterns of multiple primary measurements of Alzheimer's disease and, at the same time, account for the association between the measurements. The proposed methodology can avoid the bias introduced by ignoring the correlation between primary measurements and can predict subject-specific transitional patterns. PMID:24073268

  16. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre

    PubMed Central

    Sabah, S. A.; Henckel, J.; Cook, E.; Whittaker, R.; Hothi, H.; Pappas, Y.; Blunn, G.; Skinner, J. A.; Hart, A. J.

    2015-01-01

    Arthroplasty registries are important for the surveillance of joint replacements and the evaluation of outcome. Independent validation of registry data ensures high quality. The ability for orthopaedic implant retrieval centres to validate registry data is not known. We analysed data from the National Joint Registry for England, Wales and Northern Ireland (NJR) for primary metal-on-metal hip arthroplasties performed between 2003 and 2013. Records were linked to the London Implant Retrieval Centre (RC) for validation. A total of 67 045 procedures on the NJR and 782 revised pairs of components from the RC were included. We were able to link 476 procedures (60.9%) recorded with the RC to the NJR successfully. However, 306 procedures (39.1%) could not be linked. The outcome recorded by the NJR (as either revised, unrevised or death) for a primary procedure was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval linkage and correct assignment of outcome code improved over time. The rates of error for component reference numbers on the NJR were as follows: femoral head category number 14/229 (5.0%); femoral head batch number 13/232 (5.3%); acetabular component category number 2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. This study suggests that NJR reports may underestimate rates of revision for many types of metal-on-metal hip replacement. This is topical given the increasing scope for NJR data. We recommend a system for continuous independent evaluation of the quality and validity of NJR data. Cite this article: Bone Joint J 2015;97-B:10–18. PMID:25568407

  17. The palmitoyl acyltransferase HIP14 shares a high proportion of interactors with huntingtin: implications for a role in the pathogenesis of Huntington's disease

    PubMed Central

    Butland, Stefanie L.; Sanders, Shaun S.; Schmidt, Mandi E.; Riechers, Sean-Patrick; Lin, David T.S.; Martin, Dale D.O.; Vaid, Kuljeet; Graham, Rona K.; Singaraja, Roshni R.; Wanker, Erich E.; Conibear, Elizabeth; Hayden, Michael R.

    2014-01-01

    HIP14 is the most highly conserved of 23 human palmitoyl acyltransferases (PATs) that catalyze the post-translational addition of palmitate to proteins, including huntingtin (HTT). HIP14 is dysfunctional in the presence of mutant HTT (mHTT), the causative gene for Huntington disease (HD), and we hypothesize that reduced palmitoylation of HTT and other HIP14 substrates contributes to the pathogenesis of the disease. Here we describe the yeast two-hybrid (Y2H) interactors of HIP14 in the first comprehensive study of interactors of a mammalian PAT. Unexpectedly, we discovered a highly significant overlap between HIP14 interactors and 370 published interactors of HTT, 4-fold greater than for control proteins (P = 8 × 10−5). Nearly half of the 36 shared interactors are already implicated in HD, supporting a direct link between HIP14 and the disease. The HIP14 Y2H interaction set is significantly enriched for palmitoylated proteins that are candidate substrates. We confirmed that three of them, GPM6A, and the Sprouty domain-containing proteins SPRED1 and SPRED3, are indeed palmitoylated by HIP14; the first enzyme known to palmitoylate these proteins. These novel substrates functions might be affected by reduced palmitoylation in HD. We also show that the vesicular cargo adapter optineurin, an established HTT-binding protein, co-immunoprecipitates with HIP14 but is not palmitoylated. mHTT leads to mislocalization of optineurin and aberrant cargo trafficking. Therefore, it is possible that optineurin regulates trafficking of HIP14 to its substrates. Taken together, our data raise the possibility that defective palmitoylation by HIP14 might be an important mechanism that contributes to the pathogenesis of HD. PMID:24705354

  18. Hip arthroscopy in the setting of hip dysplasia

    PubMed Central

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  19. Adhesive capsulitis of the hip: a review.

    PubMed

    Looney, Colin G; Raynor, Brett; Lowe, Rebecca

    2013-12-01

    Adhesive capsulitis of the hip (ACH) is a rare clinical entity. Similar to adhesive capsulitis of the shoulder, ACH is characterized by a painful decrease in active and passive range of motion as synovial inflammation in the acute stages of the disease progresses to capsular fibrosis in the chronic stages. Once other diagnoses have been ruled out, management of ACH is tailored to reduce inflammation in the acute stages with NSAIDs, intra-articular steroid injections, and targeted physical therapy while biomechanical dysfunction in the spine, hip, sacroiliac joint, or lower limb joints is addressed. In chronic stages of the disease, intervention should focus on decreasing the progression of fibrotic changes and regaining range of motion through aggressive physical therapy. Interventions described for chronic ACH include manipulation under anesthesia; pressure dilatation; and open or arthroscopic synovectomy, lysis of adhesions, and capsular release. Surgical intervention should be considered only after failure of a minimum 3-month course of nonsurgical treatment. PMID:24292931

  20. Progressive Change in Joint Degeneration in Patients with Knee or Hip Osteoarthritis Treated with Fentanyl in a Randomized Trial

    PubMed Central

    Fujii, Tatsuya; Takana, Koshi; Orita, Sumihisa; Inoue, Gen; Ochiai, Nobuyasu; Kuniyoshi, Kazuki; Aoki, Yasuchika; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Gou; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Yamauchi, Kazuyo; Toyone, Tomoaki; Nakamura, Junichi; Kishida, Shunji; Takahashi, Kazuhisa

    2014-01-01

    Purpose Opioids improve pain from knee and hip osteoarthritis (OA) and decrease the functional impairment of patients. However, there is a possibility that opioids induce analgesia and suppress the physiological pain of OA in patients, thereby inducing the progression of OA changes in these patients. The purpose of the current study was to investigate the possibility of progressive changes in OA among patients using opioids. Materials and Methods Two hundred knee or hip OA patients were evaluated in the current prospective, randomized, active-controlled study. Patients were randomized 1:1:1 into three parallel treatment groups: loxoprofen, tramadol/acetaminophen, and transdermal fentanyl groups. Medication was administered for 12 weeks. Pain scores and progressive OA changes on X-ray films were evaluated. Results Overall, pain relief was obtained by all three groups. Most patients did not show progressive OA changes; however, 3 patients in the transdermal fentanyl group showed progressive OA changes during the 12 weeks of treatment. These 3 patients used significantly higher doses than others in the transdermal fentanyl group. Additionally, the average pain score for these 3 patients was significantly lower than the average pain score for the other patients in the transdermal fentanyl group. Conclusion Fentanyl may induce progressive changes in knee or hip OA during a relatively short period, compared with oral Non-Steroidal Anti-Inflammatory Drugs or tramadol. PMID:25048500

  1. Neurovascular Injury in Hip Arthroplasty

    PubMed Central

    2014-01-01

    Neurological and vascular complications following hip arthroplasty are uncommon, and their impact ranges from transient and trivial to permanent and devastating. The proximity of neural and vascular structures makes any operation on the hip potentially hazardous. Direct or indirect injuries of these structures may occur during operative exposure and subsequent procedures. Thus, complete awareness of the anatomy of the pelvis and proximal femur is required. Peripheral nerve injuries can involve either distant sites or nerves in the immediate vicinity of the hip joint. Sciatic nerve injury is the most common nerve injury following total hip arthroplasty. Femoral nerve injury is much less common and is associated with an anterior approach. Its diagnosis is often delayed, but the prognosis is generally better than with sciatic nerve injury. The superior gluteal nerve is at risk during the direct lateral approach. Obturator nerve injury is the least common type of injury and has the least functional consequences. Vascular injuries are less common but more immediately life threatening. The mechanisms of vascular injury include occlusion associated with preexisting peripheral vascular disease and vascular injury during removal of cement during screw fixation of acetabular components, cages, or structural grafts. It is critical to avoid the anterior quadrants for acetabular screw fixation. All acetabular and femoral defects should be bone-grafted to avoid inadvertent cement migration. Following these guidelines, surgeons should be able to offer the most appropriate treatment and counseling to the patients.

  2. Fabrication of dense α-alumina layer on Ti-6Al-4V alloy hybrid for bearing surfaces of artificial hip joint.

    PubMed

    Khanna, Rohit; Kokubo, Tadashi; Matsushita, Tomiharu; Takadama, Hiroaki

    2016-12-01

    Recent advances in hip replacements are focused towards producing reliable bearing surfaces to enhance their longevity. In this perspective, progressive attempts have been made to improve the wear resistance of polyethylene to eliminate osteolysis and mechanical reliability of brittle alumina ceramics, but in vain. It is proposed that both high wear resistance and mechanical reliability can be retained if a thin layer of dense alumina is formed onto high toughness Ti-6Al-4V alloy. For this purpose, we devised a unique methodology in which a layer of Al metal was deposited onto the Ti alloy substrate by cold spraying (CS), followed by a heat treatment to form Al3Ti reaction layer at their interface to improve adhesion and subsequent micro-arc oxidation (MAO) treatment to transform Al to alumina layer. An optimal MAO treatment of cold sprayed Al formed an adherent and dense α-alumina layer with high Vickers hardness matching with that of sintered alumina used as a femoral head. Structure-phase-property relationships in dense α-alumina layer have been revealed and discussed in the light of our research findings. The designed alumina/Ti alloy hybrid might be a potential candidate for reliable bearing surfaces of artificial hip joint. PMID:27612821

  3. A comparative study-efficacy and safety of combined spinal epidural anesthesia versus spinal anesthesia in high-risk geriatric patients for surgeries around the hip joint

    PubMed Central

    Tummala, Vengamamba; Rao, Lella Nageswara; Vallury, Manoj Kumar; Sanapala, Anitha

    2015-01-01

    Context: Combined spinal epidural anesthesia (CSEA) has a significant advantage by enabling the use of low dose intrathecal local anesthetic, with knowledge that the epidural catheter may be used to extend the block as necessary. CSEA is useful in high-risk geriatric patients by providing greater hemodynamic stability. Aim: This study is designed to compare the clinical effects of CSEA versus spinal anesthesia in high-risk geriatric patients undergoing surgeries around the hip joint. Materials and Methods: Sixty patients aged >65 years, American Society of Anaesthesiology III and IV were randomly allocated into two equal groups. Group A (n = 30) received CSEA with 1 ml (5 mg) of 0.5% hyperbaric bupivacaine with 25 μg fentanyl through spinal route, and the expected incompleteness of spinal block was managed with small incremental dose of 0.5% isobaric bupivacaine through epidural catheter, 1–1.5 ml for every unblocked segment to achieve T10 sensory level. Group B (n = 30) received spinal anesthesia with 2.5 ml (12.5 mg) of 0.5% hyperbaric bupivacaine and 25 μg fentanyl. Result: Both the groups showed rapid onset, excellent analgesia and good quality motor block. Group A showed a significantly less incidence of hypotension (P < 0.01) along with the provision of prolonging analgesia as compared to Group B. Conclusion: CSEA is a safe, effective, reliable technique with better hemodynamic stability along with the provision of prolonging analgesia compared to spinal anesthesia for high-risk geriatric patients undergoing surgeries around the hip joint. PMID:26417125

  4. Joint Leveling for Advanced Kienbock’s Disease

    PubMed Central

    Calfee, Ryan P.; Van Steyn, Marlo O.; Gyuricza, Cassie; Adams, Amelia; Weiland, Andrew J.; Gelberman, Richard H.

    2010-01-01

    PURPOSE The use of joint leveling procedures to treat Kienbock’s disease has been limited by the degree of disease advancement. This study was designed to compare clinical and radiographic outcomes of wrists with more advanced Kienbock’s disease (stage IIIB) to wrists with less advanced disease (stage II/IIIA) following radius shortening osteotomy. METHODS This retrospective study enrolled 31 adult wrists (30 patients, mean age 39 years), treated by radius shortening osteotomy between two institutions for either stage IIIB (n=14) or stage II/IIIA (n=17) disease. Evaluation was carried out at a mean of 74 months (IIIB, 77 months; II/IIIA, 72 months). Radiographic assessment determined disease progression. Clinical outcomes were determined by validated patient-based and objective measures. RESULTS Patient-based outcome ratings of wrists treated for stage IIIB were similar to those with stage II/IIIA [QuickDASH (15 vs 12:p=.63), MMWS (84 vs 87:p=.59), VAS pain (1.2 vs 1.7:p=.45), VAS function (2.6 vs 2.1:p=.59)]. The average flexion/extension arc was 102° for wrists with stage IIIB and 106° for wrists with stage II/IIIA Kienbock’s (p=.70). Grip strength was 77% of the opposite side for stage IIIB wrists versus 85% for stage II/IIIA (p=.25). Postoperative carpal height ratio and radioscaphoid angle were worse (p<.05) for wrists treated for stage IIIB (0.46:65°) than stage II/IIIA (0.53:53°) disease. Radiographic disease progression occurred in 7 wrists (6 stage II/IIIA: 1 stage IIIB). The one stage IIIB wrist that progressed underwent wrist arthrodesis. CONCLUSIONS In this limited series, clinical outcomes of radius shortening using validated, patient-based assessment instruments and objective measures failed to demonstrate predicted “clinically relevant” differences between stage II/IIIA and IIIB Kienbock’s. Provided the high percentage successful clinical outcomes in this case series of 14 stage IIIB wrists, we believe that static carpal malalignment

  5. Multi-Disciplinary Antimicrobial Strategies for Improving Orthopaedic Implants to Prevent Prosthetic Joint Infections in Hip and Knee

    PubMed Central

    Getzlaf, Matthew A.; Lewallen, Eric A.; Kremers, Hilal M.; Jones, Dakota L.; Bonin, Carolina A.; Dudakovic, Amel; Thaler, Roman; Cohen, Robert C.; Lewallen, David G.; van Wijnen, Andre J.

    2016-01-01

    Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria. PMID:26449208

  6. Multi-disciplinary antimicrobial strategies for improving orthopaedic implants to prevent prosthetic joint infections in hip and knee.

    PubMed

    Getzlaf, Matthew A; Lewallen, Eric A; Kremers, Hilal M; Jones, Dakota L; Bonin, Carolina A; Dudakovic, Amel; Thaler, Roman; Cohen, Robert C; Lewallen, David G; van Wijnen, Andre J

    2016-02-01

    Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria. PMID:26449208

  7. [Pseudotumors caused by hip prostheses].

    PubMed

    Helkamaa, Teemu; Lohman, Martina; Alberty, Anne

    2015-01-01

    More than 100000 hip replacements have been performed in Finland. In the hip replacement operations performed due to osteoarthritis, the artificial joint surfaces are made of metal, plastic or ceramics. Pseudotumors associated with metal-on-metal (MoM) sliding surfaces have received worldwide attention. Soft issue lesions, not always symptomatic, may develop around the joint replacements. These may even require joint revision surgery. PMID:26237883

  8. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders.

    PubMed

    Agca, R; Heslinga, S C; van Halm, V P; Nurmohamed, M T

    2016-05-15

    Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care. PMID:26888573

  9. Hip Arthroscopy: A Brief History.

    PubMed

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day. PMID:27343387

  10. [Symptoms. Localizations: knee, hip, hands, spine, other localizations].

    PubMed

    Pérez Martín, Álvaro

    2014-01-01

    The symptoms of osteoarthritis vary widely from patient to patient, depending especially on the localization on the disease. There is a poor correlation between radiological involvement and pain. In general, symptom onset is gradual and symptoms increase slowly but progressively. The most commonly affected joints are the knees, hips, hands, and spine. The main signs and symptoms are pain, stiffness, joint deformity, and crepitus. Pain is mechanical and its causes are multifactorial; in the initial phases, pain usually manifests in self-limiting episodes but may subsequently be almost constant. The criteria of the American college of Rheumatology for the classification of osteoarthritis of the knee, hip and hands are an aid to classification and standardization but are not useful for diagnosis. Hip osteoarthritis usually produces inguinal pain in the internal and anterior sections of the muscle extending to the knee and, with progression, tends to limit mobility. Knee osteoarthritis is more frequent in women and is usually associated with hand osteoarthritis and obesity. In hand osteoarthritis, the most commonly affected joints are the distal interphalangeal joints, followed by the proximal interphalangeal joints and the trapeziometacarpal joints; the development of Heberden and Bouchard nodes is common; involvement of the trapeziometacarpal joint is called rhizarthrosis and is one of the forms of osteoarthritis that produces the greatest limitation on hand function. Osteoarthritis of the spine affects the facet joints and the vertebral bodies. Other, less frequent, localizations are the foot, elbow and shoulder, which are generally secondary forms of osteoarthritis. PMID:24467955

  11. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis.

    PubMed

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  12. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis

    PubMed Central

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  13. The pathogenesis and diagnosis of canine hip dysplasia: a review.

    PubMed Central

    Fries, C L; Remedios, A M

    1995-01-01

    Hip dysplasia is a common developmental problem affecting the canine population. Despite extensive research into the condition, many questions remain unanswered and numerous misconceptions are present among the general public. The purpose of this paper is to review the current knowledge on the development of hip dysplasia, factors modifying its development, and current diagnostic techniques. A computerized literature search was conducted for the period of January 1983 to April 1985 using the MEDLINE and CAB databases, and the keywords hip dysplasia, hip, dog, and canine. Other articles, wherever possible original research articles, published before 1983 were also reviewed. Animals affected by hip dysplasia are born with normal hips, but quickly develop subluxation of the femoral head. Degenerative joint disease follows. Hip dysplasia is a complex, inherited, polygenic trait. Selective breeding of only normal dogs with normal littermates, parents, and grandparents is the recommended method of reducing the incidence in the general population. Gene expression in affected individuals may be modified by a number of environmental factors. These factors do not cause hip dysplasia, but they alter manifestations of the trait and its severity. Nutrition is a major environmental factor. Excess energy consumption increases the frequency and severity of hip dysplasia in genetically predisposed dogs. Food intake should be regulated to maintain a slender figure with the ribs and dorsal vertebral spines easily palpable, but not visible. Excess dietary calcium and vitamin D contribute to hip dysplasia in genetically predisposed individuals and should be avoided. High dose vitamin C supplementation in growing puppies does not prevent hip dysplasia, and this practice should be discontinued.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1. Figure 2. Figure 3. PMID:7585436

  14. Irradiation response in weldment and HIP joint of reduced activation ferritic/martensitic steel, F82H

    SciTech Connect

    Hirose, Takanori; Sokolov, Mikhail A; Ando, M.; Tanigawa, H.; Shiba, K.; Stoller, Roger E; Odette, G.R.

    2013-11-01

    This work investigates irradiation response in the joints of F82H employed for a fusion breeding blanket. The joints, which were prepared using welding and diffusion welding, were irradiated up to 6 dpa in the High Flux Isotope Reactor at the Oak Ridge National Laboratory. Post-irradiation tests revealed hardening in weldment (WM) and base metal (BM) greater than 300 MPa. However, the heat affected zones (HAZ) exhibit about half that of WM and BM. Therefore, neutron irradiation decreased the strength of the HAZ, leaving it in danger of local deformation in this region. Further the hardening in WM made with an electron beam was larger than that in WM made with tungsten inert gas welding. However the mechanical properties of the diffusion-welded joint were very similar to those of BM even after the irradiation.

  15. Bony abnormalities of the hip joint: a new comprehensive, reliable and radiation-free measurement method using magnetic resonance imaging

    PubMed Central

    Harris-Hayes, Marcie; Commean, Paul K.; Patterson, Jacqueline D.; Clohisy, John C.; Hillen, Travis J.

    2014-01-01

    The objective of this study was to develop comprehensive and reliable radiation-free methods to quantify femoral and acetabular morphology using magnetic resonance imaging (MRI). Thirty-two hips [16 subjects, 6 with intra-articular hip disorder (IAHD); 10 controls] were included. A 1.5-T magnetic resonance system was used to obtain three-dimensional fat-suppressed gradient-echo images at the pelvis and distal femora. After acquisition, pelvic images were post-processed to correct for coronal, axial and sagittal rotation. Measurements performed included acetabular version (AV), femoral version (FV), lateral center-edge angle (LCEA), femoral neck angle (FNA) and alpha angle (AA) at 3, 2, 1 and 12 a.m. Two experienced raters, a musculoskeletal radiologist and an orthopedic physical therapist, and a novice rater, a research assistant, completed reliability testing. Raters measured all hips twice with minimum 2 weeks between sessions. Intra-class Correlation Coefficients (ICCs) were used to determine rater reliability; standard error of measurements was reported to estimate the reasonable limits of the expected error in the different raters’ scores. Inter-rater reliability was good to excellent for all raters for AV, FV, FNA and LCEA (ICCs: 0.82–0.98); good to excellent between experienced raters (ICCs: 0.78–0.86) and poor to good between novice and experienced raters (ICCs: 0.23–0.78) for AA. Intra-rater reliability was good to excellent for all raters for AV, FV and FNA (ICCs: 0.93–0.99); for one experienced and novice rater for LCEA (ICCs: 0.84–0.89); moderate to excellent for the experienced raters for AA (ICCs: 0.72-0.89). Intra-rater reliability was poor for the second experienced rater for LCEA (ICC: 0.56), due to a single measurement error and for the novice rater for AA (ICCs: 0.17–0.38). We described MRI methods to comprehensively assess femoral and acetabular morphology. Measurements such as AV, FV and FNA and the LCEA can be made reliably by

  16. [Dislocation of the hip in a patient with von Recklinghausen disease].

    PubMed

    Del Bosque-Herrero, A; Ezquerra-Herrando, L; Albareda-Albareda, J

    2014-01-01

    Neurofibromatosis type 1 (NF-1) is one of the most common autosomal dominant disorders affecting humans. Patients with NF-1 may present with characteristic orthopaedic manifestations such as scoliosis, congenital pseudoarthrosis and limb hyperttrophy. Dislocation of the hip associated with NF-1 is a rare occurrence. There is a relative paucity of reported cases of pathological hip dislocation in patients with NF-1, with 13 documented cases found in the published literature. Seven dislocations occurred following trivial trauma and 6 cases were deemed atraumatic. We report a case of hip dislocation in a 26 years old male with NF-1 and scoliosis, that was treated successfully by closed reduction and skin traction. PMID:24094733

  17. The Effects of Dynamic Range of Motion Exercises and Static Stretching on Strength and Range of Motion of the Hip Joint.

    ERIC Educational Resources Information Center

    Kanetzke, Carol A.

    The effects of Dynamic Range of Motion (D'ROM) exercises and static stretch on hip flexibility and hip strength were examined. One hundred one male and female college students were divided into three groups: D'ROM, static stretch (ST), and control (C). All subjects were measured before and after treatment for hip flexibility and strength. Two…

  18. Hip dysplasia in the skeletally mature patient.

    PubMed

    Goldstein, Rachel Y; Kaye, Ian David; Slover, James; Feldman, David

    2014-01-01

    Abnormal hip development causes one-quarter to one-half of all hip disease. Dysplastic hips typically share characteristic anatomic abnormalities. The dysplastic acetabulum is typically shallow, lateralized, and anteverted with insufficient coverage anteriorly, superiorly, and laterally. The dysplastic proximal femur has a small femoral head with excessive femoral neck anteversion and a short neck with an increased neck shaft angle. These characteristic changes result in intraarticular pathology leading to hip arthritis. A variety of treatment options exist based on the degree of dysplasia and the amount of concomitant hip arthritis. Treatment options include hip arthroscopy, acetabular or femoral osteotomies, hip arthrodesis, and total hip arthroplasty. PMID:25150325

  19. Rose Hip

    MedlinePlus

    ... de l’Églantier, Gulab, Heps, Hip, Hip Fruit, Hip Sweet, Hipberry, Hop Fruit, Persian Rose, Phool Gulab, Pink Rose, Poire d’oiseaux, Rosa alba, Rosa centifolia, Rosa damascena, Rosa de castillo, Rosa ... Rose Hips, Rosa lutetiana, Rosa pomifera, Rosa rugosa, Rosa villosa, ...

  20. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    PubMed

    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

    This article presents a case of a patient with degenerative hip disease in paralytic dislocation by poliomyelitis. Poliomyelitis is an acute infection disease caused by a group of neurotrophic viruses, which has a special affinity by the anterior horns cells of the spinal cord and for certain motor nuclei of the brain stem. Paralysis is a flaccid type and characteristically paralysis is asymmetrical. It is said that the joints of the affected limb by poliomyelitis are protected from the development of osteoarthritis. Hip dislocation in poliomyelitis is an acquired deformity caused by flaccid paralysis and the resulting muscular imbalance. In young children, when the gluteus maximus and medius muscles are paralyzed and the hip flexors and adductors are of normal strength, eventual luxation of the hip is almost inevitable. Hip osteoarthritis in a limb with poliomyelitis is an unusual entity because these limbs do not support excessive loads. In patients who present with the residual effects of poliomyelitis including degenerative disease and hip dysplastic, surgery is one of the most difficult challenges faced by reconstructive surgeons. In such cases, surgeons should attempt to optimize the component position and choice, surgical approach, and soft tissue tensioning because stability of the prosthesis can be problematic. PMID:19292189

  1. Body mass indices in patients with disabling hip osteoarthritis

    PubMed Central

    Marks, Ray; Allegrante, John P

    2002-01-01

    Hip osteoarthritis (OA) is a degenerative joint disease that results in substantial morbidity. The disease may be preventable in some instances by reducing risk factors associated with the disease. We undertook a study to determine whether being overweight or obese, a health risk that applies to younger and older age groups, is commonly associated with hip joint OA. The body mass indices (BMIs) of 1021 males and females ranging in age from 23 to 94 years and requiring surgery for end-stage hip joint OA were analyzed to find the prevalence of high body weights at the time of surgery. Being overweight was defined as having a BMI of 25–29.9 kg/m2 and being obese as having a BMI >30 kg/m2. BMIs indicative of overweight were recorded for 68% of the patients surveyed. Of 35 patients aged 30–39 years, 53.3% had BMIs >25, with a mean of 28.8, which nearly reaches the lower limit defined for obesity. On average, patients who had had previous surgery and complications warranting reimplantation of new surgical devices had BMIs in the obese range. Our findings suggest that a high percentage of patients with end-stage hip OA are overweight, including younger adults and those with symptoms of 3–6 months' duration. Moreover, patients whose BMIs are in the obese range may be at increased risk for removal and reimplantation of their prosthesis. PMID:11879546

  2. HIP ARTHROSCOPY IN ATHLETES

    PubMed Central

    Polesello, Giancarlo Cavalli; Keiske Ono, Nelson; Bellan, Davi Gabriel; Honda, Emerson Kiyoshi; Guimarães, Rodrigo Pereira; Junior, Walter Riccioli; Do Val Sella, Guilherme

    2015-01-01

    To confirm the therapeutic importance of hip arthroplasty in athletes whose pain precludes sportive function of the hip joint, being able to minimize it to the extent of helping on the return of sports practice at satisfactory levels. Methods: 49 athlete patients (51 hips) submitted to hip arthroscopy complaining of pain and inability to practice sports were assessed. Follow-up time ranged from 12 to 74 months (mean: 39.0 months). Preoperatively, pain site, severity according to Facial Expression Scale (FES) and the degree of disability using the modified Harris Hip Score (HHS) were assessed. Different diagnoses were provided, which led to the indication of arthroscopy, such as femoralacetabular impact, acetabular lip injury not secondary to femoral-acetabular impact, etc. Postoperatively, the patients were assessed by using the same methods as used at baseline and by the subjective analysis of return to sports activities. Results: Based on pre-and postoperative HHS and FES, the statistical analysis showed significance between values. We found some improvement in all cases and return to sports activities at a satisfactory level in most of the cases. Conclusion: As a result of our study, we confirm that arthroscopy in athletes with local hip injuries is an effective technique, able to promote the return to sports practice in most of the cases, without pain, and with an effective joint function, provided well indicated. PMID:26998449

  3. Arthritis Mechanisms May Vary by Joint

    MedlinePlus

    ... Molecular differences between knee and hip joints with rheumatoid arthritis may inform more personal treatment strategies. Sebastian Kaulitzki/Hemera/Thinkstock Knee and hip joints with rheumatoid arthritis have differing genetic markers linked to inflammation, suggesting ...

  4. Accuracy of methods for calculating volumetric wear from coordinate measuring machine data of retrieved metal-on-metal hip joint implants.

    PubMed

    Lu, Zhen; McKellop, Harry A

    2014-03-01

    This study compared the accuracy and sensitivity of several numerical methods employing spherical or plane triangles for calculating the volumetric wear of retrieved metal-on-metal hip joint implants from coordinate measuring machine measurements. Five methods, one using spherical triangles and four using plane triangles to represent the bearing and the best-fit surfaces, were assessed and compared on a perfect hemisphere model and a hemi-ellipsoid model (i.e. unworn models), computer-generated wear models and wear-tested femoral balls, with point spacings of 0.5, 1, 2 and 3 mm. The results showed that the algorithm (Method 1) employing spherical triangles to represent the bearing surface and to scale the mesh to the best-fit surfaces produced adequate accuracy for the wear volume with point spacings of 0.5, 1, 2 and 3 mm. The algorithms (Methods 2-4) using plane triangles to represent the bearing surface and to scale the mesh to the best-fit surface also produced accuracies that were comparable to that with spherical triangles. In contrast, if the bearing surface was represented with a mesh of plane triangles and the best-fit surface was taken as a smooth surface without discretization (Method 5), the algorithm produced much lower accuracy with a point spacing of 0.5 mm than Methods 1-4 with a point spacing of 3 mm. PMID:24531891

  5. Arthroscopic hip labral repair.

    PubMed

    Philippon, Marc J; Faucet, Scott C; Briggs, Karen K

    2013-05-01

    Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

  6. A Systems Biology Approach to Synovial Joint Lubrication in Health, Injury, and Disease

    PubMed Central

    Hui, Alexander Y.; McCarty, William J.; Masuda, Koichi; Firestein, Gary S.; Sah, Robert L.

    2013-01-01

    The synovial joint contains synovial fluid (SF) within a cavity bounded by articular cartilage and synovium. SF is a viscous fluid that has lubrication, metabolic, and regulatory functions within synovial joints. SF contains lubricant molecules, including proteoglycan-4 and hyaluronan. SF is an ultrafiltrate of plasma with secreted contributions from cell populations lining and within the synovial joint space, including chondrocytes and synoviocytes. Maintenance of normal SF lubricant composition and function are important for joint homeostasis. In osteoarthritis, rheumatoid arthritis, and joint injury, changes in lubricant composition and function accompany alterations in the cytokine and growth factor environment and increased fluid and molecular transport through joint tissues. Thus, understanding the synovial joint lubrication system requires a multi-faceted study of the various parts of the synovial joint and their interactions. Systems biology approaches at multiple scales are being used to describe the molecular, cellular, and tissue components and their interactions that comprise the functioning synovial joint. Analyses of the transcriptome and proteome of SF, cartilage, and synovium suggest that particular molecules and pathways play important roles in joint homeostasis and disease. Such information may be integrated with physicochemical tissue descriptions to construct integrative models of the synovial joint that ultimately may explain maintenance of health, recovery from injury, or development and progression of arthritis. PMID:21826801

  7. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study

    PubMed Central

    Nevitt, Michael C; Niu, Jingbo; Clancy, Mary M; Lane, Nancy E; Link, Thomas M; Vlad, Steven; Tolstykh, Irina; Jungmann, Pia M.; Felson, David T; Guermazi, Ali

    2015-01-01

    Study question Is there concordance between hip pain and radiographic hip osteoarthritis? Methods In this diagnostic test study, pelvic radiographs were assessed for hip osteoarthritis in two cohorts: the Framingham Osteoarthritis Study (community of Framingham, Massachusetts) and the Osteoarthritis Initiative (a multicenter longitudinal cohort study of osteoarthritis in the United States). Using visual representation of the hip joint, participants reported whether they had hip pain on most days and the location of the pain: anterior, groin, lateral, buttocks, or low back. In the Framingham study, participants with hip pain were also examined for hip pain with internal rotation. The authors analysed the agreement between radiographic hip osteoarthritis and hip pain, and for those with hip pain suggestive of hip osteoarthritis they calculated the sensitivity, specificity, positive predictive value, and negative predictive value of radiographs as the diagnostic test. Study answer and limitations In the Framingham study (n=946), only 15.6% of hips in patients with frequent hip pain showed radiographic evidence of hip osteoarthritis, and 20.7% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of radiographic hip osteoarthritis for hip pain localised to the groin was 36.7%, specificity 90.5%, positive predictive value 6.0%, and negative predictive value 98.9%. Results did not differ much for hip pain at other locations or for painful internal rotation. In the Osteoarthritis Initiative study (n=4366), only 9.1% of hips in patients with frequent pain showed radiographic hip osteoarthritis, and 23.8% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of definite radiographic hip osteoarthritis for hip pain localised to the groin was 16.5%, specificity 94.0%, positive predictive value 7.1%, and negative predictive value 97.6%. Results also did not differ much for hip pain at other locations. What this

  8. Early MRI and intraoperative findings in rapidly destructive osteoarthritis of the hip: A case report

    PubMed Central

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami

    2015-01-01

    Introduction The pathophysiology of rapidly destructive hip osteoarthritis (OA) of the hip is still unclear. Also, there have been only few reports on the initial stage of the disease. We report a case of an initial-stage rapidly destructive hip OA, documented by magnetic resonance imaging and intraoperative findings. Presentation of case A 77-year-old woman reported left hip pain without any antecedent trauma. Initial radiographs showed no obvious abnormality. After 4 months of conservative therapy, radiographs showed progressive joint-space narrowing and T1-weighted magnetic resonance images revealed a bone-marrow edema pattern not only on the femoral head but also on the lateral side of the acetabulum. Then during total hip arthroplasty, we found extensive inversion of the anterosuperior portion of the acetabular labrum, and the location was mostly consistent with the bone-marrow edema lesions in the femoral head and acetabulum. Discussion Several theories for the etiology of rapidly destructive hip OA have been proposed, including idiopathic chondrolysis, abnormal immunoreaction, intra-articular deposition of hydroxyapatite crystals, and subchondral insufficiency fracture. One of the reasons rapidly destructive hip OA is still considered idiopathic is the lack of reports regarding the initial stage of the disease. Our report is the first to demonstrate magnetic resonance imaging for initial-stage disease with intraoperative findings before collapse of the femoral head. Conclusion Inversion of the acetabular labrum may be a mechanism of rapidly destructive hip OA. PMID:25603485

  9. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation.

    PubMed

    Papakonstantinou, Olympia; Mohana-Borges, Aurea V R; Campell, Loretta; Trudell, Debra; Haghighi, Parviz; Resnick, Donald

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. PMID:15316682

  10. Imaging of Hip Pain: From Radiography to Cross-Sectional Imaging Techniques

    PubMed Central

    Ruiz Santiago, Fernando; Santiago Chinchilla, Alicia; Ansari, Afshin; Guzmán Álvarez, Luis; Castellano García, Maria del Mar; Martínez Martínez, Alberto; Tercedor Sánchez, Juan

    2016-01-01

    Hip pain can have multiple causes, including intra-articular, juxta-articular, and referred pain, mainly from spine or sacroiliac joints. In this review, we discuss the causes of intra-articular hip pain from childhood to adulthood and the role of the appropriate imaging techniques according to clinical suspicion and age of the patient. Stress is put on the findings of radiographs, currently considered the first imaging technique, not only in older people with degenerative disease but also in young people without osteoarthritis. In this case plain radiography allows categorization of the hip as normal or dysplastic or with impingement signs, pincer, cam, or a combination of both. PMID:26885391

  11. Bilateral Total Hip Arthroplasty in a Rare Case of Multicentric Reticulohistiocytosis

    PubMed Central

    Sen, Ramesh Kumar; Das, Ashim; Sharma, Aman

    2015-01-01

    Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, which commonly manifests as muco-cutaneous papulonodules and inflammatory erosive polyarthropathy. In this research, we report the clinical manifestations and management of a rare case of MRH with destructive arthropathy of bilateral hip joints and arthritis mutilans presenting with characteristic deformities. Disabling hip arthropathy that occurs secondary to MRH can be successfully managed with bilateral total hip arthroplasty (THA). Osteopenia and acetabular bone defects must be anticipated during THA. This case is reported due to its rare occurrence and because little literature has been published regarding THA in such patients. PMID:26640636

  12. Assay of synovial fluid parameters: hyaluronan concentration as a potential marker for joint diseases.

    PubMed

    Praest, B M; Greiling, H; Kock, R

    1997-10-31

    Synovial fluids from the knees of patients with degenerative joint disease (n = 29), osteoarthritis (n = 16), diabetic arthropathy (n = 12), gout (n = 7) and acute inflammatory joint disease (n = 7) were investigated by high-performance size-exclusion chromatography combined with multiangle laser light scattering detection and differential refractometry. These data were compared with the viscosities of the same samples measured by rotation viscometry with one low shear rate, as well as with C reactive protein. The median value of the weight-average molecular weight of hyaluronan in synovial fluids, which differed less than the viscosity of these groups, varied between 1.09 x 10(6) g/mol (range 0.849-1.63 x 10(6) g/mol) (acute-inflammatory joint disease) and 1.91 x 10(6) g/mol (range 1.06-3.48 x 10(6) g/mol) (degenerative joint disease). The correlation between viscosity and hyaluronan concentration was much better than between viscosity and weight-average molecular weight. Changes in C reactive protein concentration were correlated with the disease activity. The concentration of hyaluronan was significantly higher in the cases of degenerative joint disease and diabetic arthropathy. These results suggest that synovial fluid concentration of hyaluronan is appropriate as a prognostic value in the evaluation of different kinds of joint diseases. PMID:9437540

  13. Capsular Management in Hip Arthroscopy.

    PubMed

    Harris, Joshua D

    2016-07-01

    The hip capsule is a highly complex anatomic structure, which influences normal hip motion and biomechanics. A dynamic stabilizing capsular contribution exists in the iliocapsularis and gluteus minimus, among other musculotendinous structures crossing the joint. Variable types and sizes of capsulotomy are necessary to sufficiently visualize and address the bony and soft tissue pathologic source of symptoms. Unrepaired capsulotomies may leave the hip significantly unstable to variable degrees. Capsular closure is a necessary part of a comprehensive arthroscopic hip preservation procedure. Greater titration of the degree of plication may be performed for patients with risk factors for postoperative instability. PMID:27343391

  14. Easing Arthritis: Research offers new hope for people with common joint disease.

    MedlinePlus

    ... Current Issue Past Issues Easing Arthritis: Research offers new hope for people with common joint disease Past ... knees, pain plagued her every step. Living in New York City, Saisselin relied on walking and public ...

  15. What's new in mycotic bone and joint diseases?

    PubMed

    Schwarz, J

    1984-07-01

    Deep fungi exhibit different degrees of aggressiveness toward joints and bone, most likely depending on the individual make-up of the respective organism. Immunodepressed patients have a propensity to bone and joint involvement by sporotrichosis, cryptococcosis and candidiasis. African histoplasmosis, blastomycosis and coccidioidomycosis are the main mycoses to produce osteoarthritic complications. Arthralgias as part of primary mycotic infection are seen in histoplasmosis capsulati and in coccidioidomycosis. The recognition of the specific agent by morphologic, cultural and serologic methods changes potentially the prognosis and treatment of patients. PMID:6483686

  16. Assessment of glycosaminoglycan concentration in equine synovial fluid as a marker of joint disease.

    PubMed Central

    Palmer, J L; Bertone, A L; McClain, H

    1995-01-01

    A modification of a colorimetric assay was used to determine synovial fluid total and individual sulphated-glycosaminoglycan concentration in various clinical presentations of joint disease in horses. Concentrations of synovial fluid and serum sulphated-glycosaminoglycan (GAG) were measured by the 1,9-dimethylmethylene blue (DMMB) dye assay in normal horses (n = 49), horses with acute (n = 26) or chronic (n = 27) joint disease (defined by clinical, radiographic, and clinicopathological parameters), and horses with cartilaginous lesions at diagnostic arthroscopy, but with normal radiographs and synovial fluid (n = 9). Horses with acute joint disease were subdivided into moderate acute (n = 21) and severe acute (n = 5) joint disease on the basis of synovial fluid analysis and clinical examination. Horses with chronic joint disease were subdivided into mild chronic (n = 9), moderate chronic (n = 10), and severe chronic (n = 8) joint disease on the basis of synovial fluid analysis, clinical examination, and radiographic findings. The concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) were analyzed in each sample following sequential enzymatic digestion of the sample with chondroitinase or keratanase. In addition, the concentration of hyaluronate (HA) in each sample was determined by a colorimetric assay following digestion of the sample with microbial hyaluronidase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8521354

  17. Hip Problems

    MedlinePlus

    ... HIPS. See your doctor. Use ice and an anti-inflammatory medicine to relieve the pain. *3. Do you ... hip pain may be from ARTHRITIS. Try an anti-inflammatory medicine. If you don't feel better, see ...

  18. Canine hip and elbow dysplasia in UK Labrador retrievers.

    PubMed

    Woolliams, J A; Lewis, T W; Blott, S C

    2011-08-01

    This paper examines the outcomes from recent genetic analyses of hip and elbow scores from British Veterinary Association (BVA)/UK Kennel Club (KC) screening programmes targeted at reducing the prevalence of hip dysplasia (HD) and elbow dysplasia in UK Labrador retrievers. The analyses made use of 25,243 hip scores and 3613 elbow scores. Heritabilities (± standard error) for hip score, analysed on a log scale, and for elbow score were 0.35±0.02 and 0.19±0.04, respectively, with a genetic correlation of 0.41±0.09. For both hip and elbow scores, there was a near perfect genetic correlation between the left and right joint; analysis of hip score showed a predictive benefit of using the total of left and right scores rather than worst score and the benefit of using all component scores rather than their aggregate score. Downward genetic trends were observed in both hip and elbow scores, although the latter was consistent with it being correlated to response to genetic change in hip score. Estimated breeding values (EBVs) offered substantial benefits in accuracy and hence genetic progress when compared to the use of phenotypes for both hip and elbow scores. There are major opportunities for improving selection against elbow dysplasia through the use of bivariate evaluations, although progress against dysplasia would be improved by more widespread elbow scoring. The studies highlighted a number of ways in which data recording for addressing complex traits may be improved in the future. Ongoing advances in genomic technology may be utilised for increasing the rate of genetic progress in selection against HD and for complex diseases in general, through the use of genomic evaluations. PMID:21737322

  19. Identifying compositional and structural changes in spongy and subchondral bone from the hip joints of patients with osteoarthritis using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Mirosław; Siatkowski, Marcin; Krauss, Hanna

    2012-01-01

    Raman microspectroscopy was used to examine the biochemical composition and molecular structure of extracellular matrix in spongy and subchondral bone collected from patients with clinical and radiological evidence of idiopathic osteoarthritis of the hip and from patients who underwent a femoral neck fracture, as a result of trauma, without previous clinical and radiological evidence of osteoarthritis. The objectives of the study were to determine the levels of mineralization, carbonate accumulation and collagen quality in bone tissue. The subchondral bone from osteoarthritis patients in comparison with control subject is less mineralized due to a decrease in the hydroxyapatite concentration. However, the extent of carbonate accumulation in the apatite crystal lattice increases, most likely due to deficient mineralization. The alpha helix to random coil band area ratio reveals that collagen matrix in subchondral bone is more ordered in osteoarthritis disease. The hydroxyapatite to collagen, carbonate apatite to hydroxyapatite and alpha helix to random coil band area ratios are not significantly changed in the differently loaded sites of femoral head. The significant differences also are not visible in mineral and organic constituents' content in spongy bone beneath the subchondral bone in osteoarthritis disease.

  20. Validation of hip joint center localization methods during gait analysis using 3D EOS imaging in typically developing and cerebral palsy children.

    PubMed

    Assi, Ayman; Sauret, Christophe; Massaad, Abir; Bakouny, Ziad; Pillet, Hélène; Skalli, Wafa; Ghanem, Ismat

    2016-07-01

    Localization of the hip joint center (HJC) is essential in computation of gait data. EOS low dose biplanar X-rays have been shown to be a good reference in evaluating various methods of HJC localization in adults. The aim is to evaluate predictive and functional techniques for HJC localization in typically developing (TD) and cerebral palsy (CP) children, using EOS as an image based reference. Eleven TD and 17 CP children underwent 3D gait analysis. Six HJC localization methods were evaluated in each group bilaterally: 3 predictive (Plug in Gait, Bell and Harrington) and 3 functional methods based on the star arc technique (symmetrical center of rotation estimate, center transformation technique and geometrical sphere fitting). All children then underwent EOS low dose biplanar radiographs. Pelvis, lower limbs and their corresponding external markers were reconstructed in 3D. The center of the femoral head was considered as the reference (HJCEOS). Euclidean distances between HJCs estimated by each of the 6 methods and the HJCEOS were calculated; distances were shown to be lower in predictive compared to functional methods (p<0.0001). Contrarily to findings in adults, functional methods were shown to be less accurate than predictive methods in TD and CP children, which could be mainly due to the shorter thigh segment in children. Harrington method was shown to be the most accurate in the prediction of HJC (mean error≈18mm, SD=9mm) and quasi-equivalent to the Bell method. The bias for each method was quantified, allowing its correction for an improved HJC estimation. PMID:27477704

  1. Accuracy of Functional and Predictive Methods to Calculate the Hip Joint Center in Young Non-pathologic Asymptomatic Adults with Dual Fluoroscopy as a Reference Standard.

    PubMed

    Fiorentino, Niccolo M; Kutschke, Michael J; Atkins, Penny R; Foreman, K Bo; Kapron, Ashley L; Anderson, Andrew E

    2016-07-01

    Predictions from biomechanical models of gait may be sensitive to joint center locations. Most often, the hip joint center (HJC) is derived from locations of reflective markers adhered to the skin. Here, predictive techniques use regression equations of pelvic anatomy to estimate the HJC, whereas functional methods track motion of markers placed at the pelvis and femur during a coordinated motion. Skin motion artifact may introduce errors in the estimate of HJC for both techniques. Quantifying the accuracy of these methods is an area of open investigation. In this study, we used dual fluoroscopy (DF) (a dynamic X-ray imaging technique) and three-dimensional reconstructions from computed tomography images, to measure HJC locations in vivo. Using dual fluoroscopy as the reference standard, we then assessed the accuracy of three predictive and two functional methods. Eleven non-pathologic subjects were imaged with DF and reflective skin marker motion capture. Additionally, DF-based solutions generated virtual markers placed on bony landmarks, which were input to the predictive and functional methods to determine if estimates of the HJC improved. Using skin markers, functional methods had better mean agreement with the HJC measured by DF (11.0 ± 3.3 mm) than predictive methods (18.1 ± 9.5 mm); estimates from functional and predictive methods improved when using the DF-based solutions (1.3 ± 0.9 and 17.5 ± 8.6 mm, respectively). The Harrington method was the best predictive technique using both skin markers (13.2 ± 6.5 mm) and DF-based solutions (10.6 ± 2.5 mm). The two functional methods had similar accuracy using skin makers (11.1 ± 3.6 and 10.8 ± 3.2 mm) and DF-based solutions (1.2 ± 0.8 and 1.4 ± 1.0 mm). Overall, functional methods were superior to predictive methods for HJC estimation. However, the improvements observed when using the DF-based solutions suggest that skin motion artifact is a large source of error for the

  2. HIP osteoarthritis and work.

    PubMed

    Harris, E Clare; Coggon, David

    2015-06-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  3. HIP OSTEOARTHRITIS AND WORK

    PubMed Central

    Harris, E Clare; Coggon, David

    2016-01-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by elimination or redesign of processes and use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age, and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  4. Hip or knee replacement - before - what to ask your doctor

    MedlinePlus

    ... replace all or part of your hip or knee joint with an artificial device (a prosthesis). Below are some questions you may want to ask your health care provider to help you prepare for your hip or knee replacement.

  5. Validity of a tablet computer version of the Japanese Orthopaedic Association hip disease evaluation questionnaire: a pilot study.

    PubMed

    Takegami, Yasuhiko; Seki, Taisuke; Kaneuji, Ayumi; Nakao, Akinobu; Hasegawa, Yukiharu; Ishiguro, Naoki

    2016-08-01

    The Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) was established as a new patient-reported outcome for patients with hip disease. We developed a JHEQ application beta version for tablet computers. The application has a slider system to input visual analogue scale (VAS) measurements. The purposes of this study were 1) to test whether the VAS that was acquired from this slider system was equal to the value recorded on paper and 2) to evaluate the validity and agreement of the JHEQ tablet version. A total of 57 patients were analyzed in the study (mean age, 60.2 years; range, 29-81 years). They received either the paper-and-pencil version (paper version) or the tablet computer version (tablet version). To evaluate the validity of the tablet version, we analyzed differences in the VAS and total scores between the paper version and tablet computer version. In addition, we calculated Cronbach's alpha, the intraclass correlation coefficient (ICC), and the Pearson's correlation coefficient (CC). The VAS scores in the tablet version were significantly lower than those in the paper version (22.3 ± 5.4 vs. 17.0 ± 4.5 and 28.1 ± 6.1 vs. 23.5 ± 5.3, respectively; all P < 0.05). Values of Cronbach's alpha, the ICC, and the CC among subscales ranged from 0.90 to 0.95. In conclusion, the total JHEQ score on the tablet computer beta version was in agreement with the score on the paper version. However, the VAS on the tablet version, which used a slider bar system, proved unreliable. PMID:27578907

  6. Validity of a tablet computer version of the Japanese Orthopaedic Association hip disease evaluation questionnaire: a pilot study

    PubMed Central

    Takegami, Yasuhiko; Seki, Taisuke; Kaneuji, Ayumi; Nakao, Akinobu; Hasegawa, Yukiharu; Ishiguro, Naoki

    2016-01-01

    ABSTRACT The Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) was established as a new patient-reported outcome for patients with hip disease. We developed a JHEQ application beta version for tablet computers. The application has a slider system to input visual analogue scale (VAS) measurements. The purposes of this study were 1) to test whether the VAS that was acquired from this slider system was equal to the value recorded on paper and 2) to evaluate the validity and agreement of the JHEQ tablet version. A total of 57 patients were analyzed in the study (mean age, 60.2 years; range, 29–81 years). They received either the paper-and-pencil version (paper version) or the tablet computer version (tablet version). To evaluate the validity of the tablet version, we analyzed differences in the VAS and total scores between the paper version and tablet computer version. In addition, we calculated Cronbach’s alpha, the intraclass correlation coefficient (ICC), and the Pearson’s correlation coefficient (CC). The VAS scores in the tablet version were significantly lower than those in the paper version (22.3 ± 5.4 vs. 17.0 ± 4.5 and 28.1 ± 6.1 vs. 23.5 ± 5.3, respectively; all P < 0.05). Values of Cronbach’s alpha, the ICC, and the CC among subscales ranged from 0.90 to 0.95. In conclusion, the total JHEQ score on the tablet computer beta version was in agreement with the score on the paper version. However, the VAS on the tablet version, which used a slider bar system, proved unreliable. PMID:27578907

  7. Detection of degenerative disease of the temporomandibular joint by bone scintigraphy: concise communication

    SciTech Connect

    Goldstein, H.A.; Bloom, C.Y.

    1980-10-01

    Nine patients with facial pain were evaluated with limited bone scans. The scintigrams correlated with microscopy in all patients, although radiographs correlated with microscopy in only five patients. The degenerative disease process in the temporomandibular joint was more extensive in the patients with radiographic and scintigraphic abnormalities than in those with scintigraphic abnormalities alone. The limited bone scan appears useful in detecting early degenerative changes in the temporomandibular joint.

  8. Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint.

    PubMed

    Nicolosi, Nicole; Hehemann, Chris; Connors, James; Boike, Allan

    2015-01-01

    Cheilectomy is the surgical resection of 20% to 30% of the dorsal metatarsal head and proximal phalanx. The present retrospective study evaluated the long-term efficacy of aggressive cheilectomy to address degenerative joint disease of the first metatarsophalangeal joint. To our knowledge, this is the second longest duration study to date to evaluate the long-term efficacy of the cheilectomy procedure, with a mean follow-up period of 7.14 years (range 39 weeks to 14.87 years). The mean patient age was 55.71 ± 9.51 years, and 37 (65%) of the patients were female. Age, sex, foot type, and preoperative radiographic parameters of hallux rigidus were also evaluated and correlated. The mean percentage of success with this operation was 87.69%. Of the 58 patients, 51 (87.93%) experienced no limitations in their daily activities. Only 2 patients (3.33%) subsequently required subsequent arthrodesis. The results of the present study suggest that cheilectomy offers long-term satisfaction for patients with hallux rigidus and is an acceptable alternative to the joint destructive procedure of first metatarsophalangeal arthrodesis. PMID:25981441

  9. Hip impingement: beyond femoroacetabular

    PubMed Central

    Bardakos, Nikolaos V.

    2015-01-01

    In the last 20 years, femoroacetabular impingement has been at the forefront of clinical practice as a cause of hip pain in young adults. As arthroscopic techniques for the hip continue to evolve, the possible presence of a new group of conditions creating mechanical conflict in and around the hip joint (ischiofemoral, subspine and iliopsoas impingement) has recently been elucidated whilst interest in already known ‘impingement’ syndromes (pelvic-trochanteric and pectineofoveal impingement) is now revived. This article attempts to increase awareness of these relatively uncommon clinical entities by describing their pathomorphology, contact mechanics, treatment and published results available to present. It is hoped that such knowledge will diversify therapeutic options for the clinician, thereby improving outcomes in a small but not negligible portion of patients with previously unexplained persistent symptoms. PMID:27011843

  10. [Acute and chronic anticoagulation therapy in relation to joint replacements].

    PubMed

    Malý, Jaroslav

    2015-06-01

    Thromboembolic disease (TED) is a considerable social and health problem. The solution evidently consists in the prevention of TED in clinical fields, not in the treatment itself. We can assume that effective prevention consequently reduces the cost of the following treatment. A lethal pulmonary embolism (PE) can be the first and the final clinical manifestation in patients with an asymptomatic deep venous thrombosis. This makes the systematic prevention of venous thromboembolism in higher risk patients necessary. Unfortunately, pharmacological prevention has been used less than would be needed. Inseparable from the TED prevention are physical methods. Pharmacological possibilities of the thromboembolic disease prevention were significantly extended within the past decade. To ensure the TED prevention after the total replacement (TEP) of hip and knee joints the following rules need to be observed: the TED prevention should be effected with LMWH, fondaparinux, dabigatran, rivaroxaban or apixaban for a period of 28-35 days after the hip joint replacement surgery and for 14 days after the knee joint replacement. The use of ASA, dextran and UFH as a thromboprophylaxis after the hip and knee joint TEP is not justified within the Czech Republic. Physical means (graduated compression stockings or IPC) can be used to support the recommended pharmacological treatment, they should not be used individually except in cases where pharmacological thromboprophylaxis is contraindicated.Key words: apixaban - dabigatran - LMWH - rivaroxaban - total hip and knee joint replacement - thromboembolic disease. PMID:26258975

  11. Inflammatory joint disease and human immunodeficiency virus infection

    PubMed Central

    Forster, S M; Seifert, M H; Keat, A C; Rowe, I F; Thomas, B J; Taylor-Robinson, D; Pinching, A J; Harris, J R W

    1988-01-01

    Nine men positive for antibody to human immunodeficiency virus (HIV) who developed peripheral, non-erosive arthritis were followed up. The clinical features were compatible with reactive arthritis but were atypical in several respects: the joint symptoms were generally severe, persistent, and unresponsive to non-steroidal anti-inflammatory drugs. The onset of arthritis was associated with various infections, none of which are known to be associated with the development of reactive arthritis. HLA typing was performed for three patients, all of whom were positive for HLA-B27. HIV was isolated from the synovial fluid of one patient. No patient had AIDS before developing arthritis, but four progressed to having AIDS after a mean of 7·5 months, and two died. Arthritis resolved in only one patient. The possibility of HIV infection should be considered in all patients with conditions suggesting reactive arthritis. Synovitis in patients with severe immunodeficiency has important pathogenetic implications. PMID:3135044

  12. Evaluation of the patient with hip pain.

    PubMed

    Wilson, John J; Furukawa, Masaru

    2014-01-01

    Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears. PMID:24444505

  13. [Joint and sensory branch block of the obturator and femoral nerves in a case of femoral head osteonecrosis and arthritis].

    PubMed

    Cortiñas-Sáenz, M; Salmerón-Velez, G; Holgado-Macho, I A

    2014-01-01

    The sensory innervation of the hip joint is complex. The joint and sensory branch block of the obturator and femoral nerves is effective for treating the pain caused due to different hip diseases. This could be an option to be considered in certain circumstances such as, being a surgical-anaesthetic high risk, or if there is significant overweight, It could also be useful on other occasions if the traumatoligist considers that it is better to delay hip replacement for a limited period. PMID:24656423

  14. [Pain control of bone and joint diseases in the elderly].

    PubMed

    Soen, Satoshi

    2014-10-01

    The decline of multiple physiological processes, even in the absence of disease, combined should logically influence treatment options. Decreased gastric secretions, intestinal motility, and vitamin D receptors lead to loss of appetite, malnutrition. Increased arterial thickening and rigidity elevate cardiac risk, while decreased elasticity in the lungs potentially exacerbates breathing disorders. Memory impairment and cognitive decline progress as neurons become less resilient to stress over time. Reduced hepatic and renal blood flow limit metabolism and filtration, increasing the risk for accumulation of toxic substances. Physiologic changes, drug-drug interactions resulting from polypharmacy, and drug-disease interactions combine to make elderly patients more sensitive to the AEs of medications. Effective pain management in the elderly is challenging. The purpose of this review is to highlight the use of several treatment options for elderly patients. PMID:25509813

  15. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

    PubMed Central

    2012-01-01

    Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD. PMID:22281125

  16. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints.

    PubMed

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  17. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints

    PubMed Central

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  18. Can a linear combination of gait principal component vectors identify hip OA stages?

    PubMed

    Ardestani, Marzieh M; Wimmer, Markus A

    2016-07-01

    Hip osteoarthritis (OA) has been shown to affect gait patterns of lower extremities. However, until now, no specific identifying gait characteristics for the various disease stages of hip OA have emerged. The present study addresses the following questions: (1) does a vector-based principal component analysis (PCA) discriminate between various disease stages? And, is this analysis more robust than using discrete gait variables? (2) Does the elimination of differences in walking speed affect the discriminatory robustness of a vector-based PCA? De-identified data sets of forty-five unilateral hip OA patients with varying disease stages and twenty-three age-matched, healthy control subjects were obtained from an available repository. PCA was performed on trial matrices consisting of all external joint moments and sagittal joint angles of one full gait cycle. Group differences in sagittal angles, external moments and the linear combination of PC vectors were investigated using spatial parameter mapping (SPM), a statistical vector field test. Several individual gait variables (i.e. joint moments or angles) demonstrated differences between healthy and moderately and/or severely affected subjects. Only the hip adduction moment could discriminate between the healthy and the early-stage OA group. There was no variable that could distinguish between all OA disease stages. In contrast, the linear combination of PC vectors demonstrated significant group differences between all stages of osteoarthritis; furthermore, these group differences stayed significant when matched speeds were input to the model. PMID:27255606

  19. ACR Appropriateness Criteria Osteonecrosis of the Hip.

    PubMed

    Murphey, Mark D; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Chang, Eric Y; Dempsey, Molly E; Fox, Michael G; Fries, Ian Blair; Greenspan, Bennett S; Hochman, Mary G; Jacobson, Jon A; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Rubin, David A; Small, Kirstin M; Weissman, Barbara N

    2016-02-01

    Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse. The likelihood of articular collapse is significantly increased with involvement of greater than 30%-50% of the femoral head area, which is optimally evaluated by MRI, often in the sagittal plane. Contrast-enhanced MRI may be needed to detect early osteonecrosis of the hip in pediatric patients, revealing hypoperfusion. In patients with a contraindication for MRI, use of either CT or bone scintigraphy with SPECT (single-photon emission CT) are alternative radiologic methods of assessment. Imaging helps guide treatment, which may include core decompression, osteotomy, and ultimately, need for joint replacement. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26846390

  20. Neuromuscular Hip Dysplasia in Charcot-Marie-Tooth Disease Type 1A

    ERIC Educational Resources Information Center

    Bamford, Nigel S.; White, Klane K.; Robinett, Stephanie A.; Otto, Randolph K.; Gospe, Sidney M., Jr.

    2009-01-01

    Charcot-Marie-Tooth disease (CMT) is one of the most common inherited neurological disorders, affecting 36 in 100,000 people. CMT type 1A (hereditary motor and sensory neuropathy) is the most frequent form of this disease, affecting 60 to 80% of the CMT population, but its diagnosis may be delayed because of inconsistent clinical signs and…

  1. Granulocyte elastase as a new biochemical marker in the diagnosis of chronic joint diseases.

    PubMed

    Kleesiek, K; Reinards, R; Brackertz, D; Neumann, S; Lang, H; Greiling, H

    1986-01-01

    Human granulocyte elastase (EC 3.4.21.37) is released from granulocytes in large amounts in chronic inflammatory joint diseases and is therefore of special pathogenic and diagnostic importance. In order to examine the diagnostic significance of this enzyme as a clinico-chemical parameter, we determined the concentration of granulocyte elastase in complex with alpha 1-proteinase inhibitor by an enzyme immunoassay in synovial fluids and plasma of patients with chronic joint diseases. In inflammatory synovial fluids the concentration of complexed elastase correlates well with the granulocyte number and may increase to an extremely high level. In 90% of patients with manifest rheumatoid arthritis increased elastase levels are also observed in the plasma, probably due to the large gradient between the synovial fluid and plasma concentration, whereas in osteoarthrosis normal plasma concentrations were observed. Thus, these results indicate that normal plasma concentrations in patients with chronic joint diseases exclude the diagnosis of rheumatoid arthritis with high probability. The simultaneous determination of complexed elastase in plasma and synovial fluid improves the nosological differentiation of chronic joint diseases. Elastase activity on a specific chromogenic substrate, which was found in many inflammatory synovial fluids, is mainly attributed to elastase alpha 2-macroglobulin complexes. In some purulent synovial fluids, however, we were able to detect free elastase, which has been shown to play an important role in the destruction of articular cartilage. PMID:2431451

  2. Early detection of canine hip dysplasia: comparison of two palpation and five radiographic methods.

    PubMed

    Adams, W M; Dueland, R T; Meinen, J; O'Brien, R T; Giuliano, E; Nordheim, E V

    1998-01-01

    Hip joint laxity was evaluated in four breeds (i.e., greyhound, Labrador retriever, Irish setter, hound mixed-breed) of puppies (n=32) by Ortolani's and Bardens' maneuvers, by subjective assessment of radiographs (Orthopedic Foundation for Animals [OFA] method), and by four radiographic measurement indices. Puppies were studied at four, six-to-10, 16-to-18, and 52 weeks of age. The purpose of this study was to compare palpation and radiographic methods of hip laxity detection in puppies for predicting the development of degenerative joint disease (DJD) by one year of age. Twenty-seven (42%) hips developed DJD. Ortolani's method was not a reliable predictor of hip dysplasia at six-to-10 weeks; it was significantly predictive at 16-to-18 weeks but had a high incidence of false negatives. Bardens' and subjective (OFA) assessment methods were not reliable at six-to-10 or 16-to-18 weeks. Radiographic measurements taken with femurs in a neutral position and hips distracted (distraction index [DI] and Norberg angle) and measurements taken with femurs extended in OFA position (Norberg angle) of six- to 10-week-old puppies accurately predicted DJD occurrence by one year of age (p less than 0.01). Distraction index measurement (PennHIP method) was the most accurate in predicting the development of DJD (p less than 0.001). Distraction index radiography in puppies six-to-10 and 16-to-18 weeks of age was the most reliable predictor of hip dysplasia. Norberg angle measurement was more reliable during hip distraction than when hips were measured in the OFA position in 16- to 18-week-old puppies, but had similar reliability in six- to 10-week-old puppies. PMID:9657168

  3. Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population.

    PubMed

    Ragab, Y; Nabih, M; Aly, I; Kamal, A; Abd-Allah, M A; El-Refai, R; Emad, Y; El-Naggar, A; El-Shaarawy, N; Rasker, J J

    2015-01-01

    Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI) in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6%) and 32 females (44.4)] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3%) cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%), septic arthritis in 10 (13.9%), tuberculous arthritis in 4 (5.6%), sickle-cell disease in 7 (9.7%), complicated with septic arthritis in 3 (4.2%), transient bone marrow edema (BME) in 3 (4.2%), osteomyelitis in 2 (2.8%), osteosarcoma in 2 (2.8%), sciatic nerve injury in 1 (1.4%), leukemia with BME in 1 (1.4%), coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%), and a benign bone cyst in 1 (1.4%). MRI studies showed hip effusion in a total of 51 patients (70.8%), joint space narrowing in 9 (12.5%), and BME in 15(20.8%). MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology. PMID:26492965

  4. Hip Resurfacing Implants.

    PubMed

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants. PMID:26270748

  5. Feasibility of T2* mapping for the evaluation of hip joint cartilage at 1.5T using a three-dimensional (3D), gradient-echo (GRE) sequence: a prospective study.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Hughes, Tim; Kim, Young-Jo; Werlen, Stefan; Siebenrock, Klaus A; Mamisch, Tallal C

    2009-10-01

    This study defines the feasibility of utilizing three-dimensional (3D) gradient-echo (GRE) MRI at 1.5T for T(2)* mapping to assess hip joint cartilage degenerative changes using standard morphological MR grading while comparing it to delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). MRI was obtained from 10 asymptomatic young adult volunteers and 33 patients with symptomatic femoroacetabular impingement (FAI). The protocol included T(2)* mapping without gadolinium-enhancement utilizing a 3D-GRE sequence with six echoes, and after gadolinium injection, routine hip sequences, and a dual-flip-angle 3D-GRE sequence for dGEMRIC T(1) mapping. Cartilage was classified as normal, with mild changes, or with severe degenerative changes based on morphological MRI. T(1) and T(2)* findings were subsequently correlated. There were significant differences between volunteers and patients in normally-rated cartilage only for T(1) values. Both T(1) and T(2)* values decreased significantly with the various grades of cartilage damage. There was a statistically significant correlation between standard MRI and T(2)* (T(1)) (P < 0.05). High intraclass correlation was noted for both T(1) and T(2)*. Correlation factor was 0.860 to 0.954 (T(2)*-T(1) intraobserver) and 0.826 to 0.867 (T(2)*-T(1) interobserver). It is feasible to gather further information about cartilage status within the hip joint using GRE T(2)* mapping at 1.5T. PMID:19645008

  6. The Examination of the Musculoskeletal System Based Only on the Evaluation of Pelvic-Hip Complex Muscle and Trunk Flexibility May Lead to Failure to Screen Children for Generalized Joint Hypermobility

    PubMed Central

    Czaprowski, Dariusz; Kędra, Agnieszka; Pawłowska, Paulina; Kolwicz-Gańko, Aleksandra; Leszczewska, Justyna; Tyrakowski, Marcin

    2015-01-01

    Objective The aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH). Design A cross-sectional study. Setting Center of Body Posture in Olsztyn, North East Poland. Participants The study included 136 females and 113 males aged 10–13 years. Main outcome measures In order to assess muscle flexibility, the straight leg raise (SLR) test (for hamstring) and modified Thomas test for one- (O-JHF) and two-joint (T-JHF) hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF) and lateral trunk flexion (LTF) tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males). The analysis was carried out separately for females and males. Results There were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively), O-JHF (p = 0.89, p = 0.35 for females and males, respectively), T-JHF (p = 0.77, p = 0.4 for females and males, respectively), FTF (p = 0.19, p = 0.84 for females and males, respectively) and LTF (p = 0.58, p = 0.35 for females and males, respectively) tests results. Conclusions Clinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10–13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth. PMID:25786251

  7. Invariant hip moment pattern while walking with a robotic hip exoskeleton.

    PubMed

    Lewis, Cara L; Ferris, Daniel P

    2011-03-15

    Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 min of the powered condition and the unpowered condition. After completing three 30-min training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed. PMID:21333995

  8. Developmental dysplasia of the hip: What has changed in the last 20 years?

    PubMed Central

    Kotlarsky, Pavel; Haber, Reuben; Bialik, Victor; Eidelman, Mark

    2015-01-01

    Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades. PMID:26716085

  9. Developmental dysplasia of the hip: What has changed in the last 20 years?

    PubMed

    Kotlarsky, Pavel; Haber, Reuben; Bialik, Victor; Eidelman, Mark

    2015-12-18

    Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades. PMID:26716085

  10. Arthroscopic Management of Synovial Osteochondromatosis of the Hip.

    PubMed

    Blitzer, Charles M; Scarano, Kyle A

    2015-06-01

    Synovial osteochondromatosis is a benign metaplasia of the synovium resulting in the formation of osteocartilaginous nodules within the synovial lining. At presentation, radiographs typically reveal these nodules to have broken free from the synovial lining, becoming loose bodies residing in the free space of the affected joint. These fragments readily receive the necessary nutrients for continued growth from the synovial fluid in which they reside. Controversy exists over the management of the disease. Some physicians call for arthrotomy with a complete synovectomy, whereas others vouch for a minimally invasive arthroscopic approach. In the case described here, the surgeon decided on hip arthroscopy to treat synovial osteochondromatosis in a 61-year-old woman. All but one loose body that was adherent in the anterior hip capsule was successfully removed and the patient recovered promptly. This case highlights the importance of hip arthroscopy and its usefulness not only in treating conditions such as synovial osteochondromatosis, but also in accurately diagnosing them. Recognition and management of hip conditions such as synovial osteochondromatosis through arthroscopy result in minimally invasive treatment and decreased morbidity and may markedly accelerate patient rehabilitation. It is the authors' belief that this unique case further suggests the practicality of using hip arthroscopy to successfully treat synovial osteochondromatosis. PMID:26091229

  11. Current perspectives on the pediatric hip: selected topics in hip dysplasia, Perthes disease, and chondrolysis: synopsis of the hip subspecialty session at the POSNA Annual Meeting, May 1, 2013, Toronto.

    PubMed

    Millis, Michael B; Zaltz, Ira

    2014-01-01

    The following are proceedings from the Hip Breakout Session held at the 2013 annual meeting of the Pediatric Orthopaedic Society of North America in Toronto, Canada. The organizer's goal of the meeting was to gather experts with years of clinical experience to discuss topics based upon both experience and current clinical evidence. The topics that were selected represented the most commonly encountered pathology where there are wide variations of clinical practice. The invited speakers were asked to summarize both their clinical experience and the current scientific evidence and to summarize areas that require further scientific investigation. PMID:25207735

  12. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime

    PubMed Central

    Murphy, Louise B; Helmick, Charles G.; Schwartz, Todd A; Renner, Jordan B; Tudor, Gail; Koch, Gary G; Dragomir, Anca D; Kalsbeek, William D; Luta, Gheorghe; Jordan, Joanne M

    2010-01-01

    Summary Objective To estimate the lifetime risk of symptomatic hip osteoarthritis (OA). Design We analyzed data from the Johnston County Osteoarthritis Project (a longitudinal population-based study of OA in North Carolina, United States [n=3,068]). The weighted baseline sample comprised 18% blacks and 54% women, and the mean age was 63 years (range=45-93). Symptomatic hip OA was defined as a Kellgren-Lawrence (K-L) radiographic score of ≥2 (anterior-posterior pelvis x-rays) and pain, aching or stiffness on most days, or groin pain, in the same hip. Lifetime risk, defined as the proportion who developed symptomatic hip OA in at least one hip by age 85, among people who live to age 85, was modeled using logistic regression with repeated measures (through generalized estimating equations). Results Lifetime risk of symptomatic hip OA was 25.3% (95% confidence interval [CI] = 21.3–29.3). Lifetime risk was similar by sex, race, highest educational attainment, and hip injury history. We studied lifetime risk by body mass index (BMI) in three forms: at age 18; at baseline and follow-up; and at age 18, baseline and follow-up and found no differences in estimates. Conclusion The burden of symptomatic hip OA is substantial with one in four people developing this condition by age 85. The similar race-specific estimates suggest that racial disparities in total hip replacements are not attributable to differences in disease occurrence. Despite increasing evidence that obesity predicts an increased risk of both hip OA and joint replacement, we found no association between BMI and lifetime risk. PMID:20713163

  13. Simple suture and anchor in rabbit hips

    PubMed Central

    Garcia Filho, Fernando Cal; Guarniero, Roberto; de Godoy Júnior, Rui Maciel; Pereira, César Augusto Martins; Matos, Marcos Almeida; Garcia, Lucas Cortizo

    2012-01-01

    Objective Using biomechanical studies, this research aims to compare hip capsulorrhaphy in rabbits, carried out with two different techniques: capsulorrhaphy with simple sutures and with anchors. Method Thirteen New Zealand Albino (Oryctolaguscuniculus) male rabbits, twenty-six hip joints, were used. First, a pilot project was performed with three rabbits (six hip joints). This experiment consisted of ten rabbits divided into two groups: group 1 underwent capsulorrhaphy on both right and left hips with simple suture using polyglycolic acid absorbable thread, and group 2 underwent capsulorrhaphy with titanium anchors. After a four-week postoperative period, the animals were euthanized and the hip joints were frozen. On the same day of the biomechanical studies, after the hip joints were previously unfrozen, the following parameters were evaluated: rigidity, maximum force, maximum deformity and energy. Results There was no relevant statistical difference in rigidity, maximum force, maximum deformity and energy between the simple suture and anchor groups. Conclusion Through biomechanical analyses, using parameters of rigidity, maximum force, maximum deformity and energy, it has been shown that capsulorrhaphy with simple suture and with anchors has similar results in rabbit hip joints. Level of Evidence II, Prospective Comparative Study. PMID:24453618

  14. Total Hip Arthroplasty Using the S-ROM-A Prosthesis for Anatomically Difficult Asian Patients

    PubMed Central

    Hozumi, Akira; Kobayashi, Kyousuke; Tsuru, Nobuhisa; Miyamoto, Chikara; Maeda, Jyunichiro; Chiba, Ko; Goto, Hisataka; Osaki, Makoto

    2015-01-01

    Background. The S-ROM-A prosthesis has been designed for the Asian proximal femur with a small deformed shape and narrow canal. In this study, the clinical and radiological results using the S-ROM-A prosthesis for Japanese patients with severe deformity due to dysplasia and excessive posterior pelvic tilt were examined. Methods. 94 hips were followed up for a mean of 55 months, with a mean age at surgery of 61 years. The primary diagnoses were 94 coxarthritis cases, including 51 dysplasia and 37 primary OA, 1 avascular necrosis, 2 traumatic arthritis, and 3 Perthes disease. Thirty-one hips had been treated with osteotomy of the hip joints. Preoperative intramedullary canal shapes were stovepipe in 23 hips, normal in 51 hips, and champagne-flute in 5 hips. The maximum pelvic inclination angle was 56°. Results. The mean JOA score improved from 46 points preoperatively to 80 points at final follow-up. On radiological evaluation of the fixation of the implants according to the Engh classification, 92 (97%) hips were classified as “bone ingrown fixation.” Conclusion. In primary THA, using the S-ROM-A prosthesis for Asian patients with proximal femoral deformity, even after osteotomy and with posterior pelvic tilt, provided good short- to midterm results. PMID:26582575

  15. DYSPLASIA OF HIP DEVELOPMENT: UPDATE

    PubMed Central

    Guarniero, Roberto

    2015-01-01

    The term “developmental dysplasia of the hip” (DDH) includes a wide spectrum of abnormalities that affect the hip during its growth, ranging from dysplasia to joint dislocation and going through different degrees of coxofemoral subluxation. The incidence of DDH is variable, and depends on a number of factors, including geographical location. Approximately one in 1,000 newborn infants may present hip dislocation and around 10 in 1,000 present hip instability. Brazil has an incidence of five per 1,000 in terms of findings of a positive Ortolani sign, which is the early clinical sign for detecting the disorder. The risk factors for DDH include: female sex, white skin color, primiparity, young mother, breech presentation at birth, family history, oligohydramnios, newborns with greater weight and height, and deformities of the feet or spine. Hip examinations should be routine for newborns, and should be emphasized in maternity units. Among newborns and infants, the diagnosis of DDH is preeminently clinical and is made using the Ortolani and Barlow maneuvers. Conventional radiography is of limited value for confirming the diagnosis of DDH among newborns, and ultrasound of the hip is the ideal examination. The treatment of DDH is challenging, both for pediatric orthopedists and for general practitioners. The objectives of the treatment include diagnosis as early as possible, joint reduction and stabilization of the hip in a secure position. Classically, treatment options are divided according to different age groups, at the time of diagnosis. PMID:27022528

  16. Hip Abduction Can Prevent Posterior Edge Loading of Hip Replacements

    PubMed Central

    van Arkel, Richard J; Modenese, Luca; Phillips, Andrew TM; Jeffers, Jonathan RT

    2013-01-01

    Edge loading causes clinical problems for hard-on-hard hip replacements, and edge loading wear scars are present on the majority of retrieved components. We asked the question: are the lines of action of hip joint muscles such that edge loading can occur in a well-designed, well-positioned acetabular cup? A musculoskeletal model, based on cadaveric lower limb geometry, was used to calculate for each muscle, in every position within the complete range of motion, whether its contraction would safely pull the femoral head into the cup or contribute to edge loading. The results show that all the muscles that insert into the distal femur, patella, or tibia could cause edge loading of a well-positioned cup when the hip is in deep flexion. Patients frequently use distally inserting muscles for movements requiring deep hip flexion, such as sit-to-stand. Importantly, the results, which are supported by in vivo data and clinical findings, also show that risk of edge loading is dramatically reduced by combining deep hip flexion with hip abduction. Patients, including those with sub-optimally positioned cups, may be able to reduce the prevalence of edge loading by rising from chairs or stooping with the hip abducted. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1172–1179, 2013. PMID:23575923

  17. Mortality after total hip replacement surgery

    PubMed Central

    Berstock, J. R.; Beswick, A. D.; Lenguerrand, E.; Whitehouse, M. R.; Blom, A. W.

    2014-01-01

    Total hip replacement causes a short-term increase in the risk of mortality. It is important to quantify this and to identify modifiable risk factors so that the risk of post-operative mortality can be minimised. We performed a systematic review and critical evaluation of the current literature on the topic. We identified 32 studies published over the last 10 years which provide either 30-day or 90-day mortality data. We estimate the pooled incidence of mortality during the first 30 and 90 days following hip replacement to be 0.30% (95% CI 0.22 to 0.38) and 0.65% (95% CI 0.50 to 0.81), respectively. We found strong evidence of a temporal trend towards reducing mortality rates despite increasingly co-morbid patients. The risk factors for early mortality most commonly identified are increasing age, male gender and co-morbid conditions, particularly cardiovascular disease. Cardiovascular complications appear to have overtaken fatal pulmonary emboli as the leading cause of death after hip replacement. Cite this article: Bone Joint Res 2014;3:175–82. PMID:24894596

  18. Joint and fascial chronic graft-vs-host disease: correlations with clinical and laboratory parameters

    PubMed Central

    Vukić, Tamara; Smith, Sean Robinson; Ljubas Kelečić, Dina; Desnica, Lana; Prenc, Ema; Pulanić, Dražen; Vrhovac, Radovan; Nemet, Damir; Pavletic, Steven Z.

    2016-01-01

    Aim To determine if there are correlations between joint and fascial chronic graft-vs-host disease (cGVHD) with clinical findings, laboratory parameters, and measures of functional capacity. Methods 29 patients were diagnosed with cGVHD based on National Institutes of Health (NIH) Consensus Criteria at the University Hospital Centre Zagreb from October 2013 to October 2015. Physical examination, including functional measures such as 2-minute walk test and hand grip strength, as well as laboratory tests were performed. The relationship between these evaluations and the severity of joint and fascial cGVHD was tested by logistical regression analysis. Results 12 of 29 patients (41.3%) had joint and fascial cGVHD diagnosed according to NIH Consensus Criteria. There was a significant positive correlation of joint and fascial cGVHD and skin cGVHD (P < 0.001), serum C3 complement level (P = 0.045), and leukocytes (P = 0.032). There was a significant negative correlation between 2-minute walk test (P = 0.016), percentage of cytotoxic T cells CD3+/CD8+ (P = 0.022), serum albumin (P = 0.047), and Karnofsky score (P < 0.001). Binary logistic regression model found that a significant predictor for joint and fascial cGVHD was cGVHD skin involvement (odds ratio, 7.79; 95 confidence interval 1.87-32.56; P = 0.005). Conclusion Joint and fascial cGVHD manifestations correlated with multiple laboratory measurements, clinical features, and cGVHD skin involvement, which was a significant predictor for joint and fascial cGVHD. PMID:27374828

  19. Hip Morphology Characterization

    PubMed Central

    Barrientos, Cristián; Diaz, Jorge; Brañes, Julian; Chaparro, Felipe; Barahona, Maximiliano; Salazar, Alfonso; Hinzpeter, Jaime

    2014-01-01

    Background: Femoroacetabular impingement (FAI) is the result of a mechanical conflict in the hip joint, and its diagnosis is based on clinical and radiological parameters. To our knowledge, there are no published studies describing the radiologic characteristics of FAI in Latin American populations. Purpose: To describe the radiological features associated with FAI in an asymptomatic Chilean population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We prospectively recruited asymptomatic patients with no history or symptoms of hip pathology who underwent abdomen-pelvis computed tomography (CT) for a nonorthopaedic indication. The acetabular and femoral parameters related to FAI were measured. Results: We studied 101 subjects (202 hips) with a mean age of 36.8 ± 14.4 years. The mean center-edge angle was 39.4° ± 7.2°. The crossover sign was present in 34 cases (33.7%). The mean alpha angle was 49.7° ± 8.3°. Depending on the cut points chosen for FAI-related parameters, between 39.6% and 69.3% of an asymptomatic Chilean population were found to have morphological features related to FAI. Conclusion: Our findings suggest that the proposed pathological threshold values in the literature cannot be extrapolated to a Chilean population, and this must be taken into consideration when evaluating Latin American patients with hip pain. PMID:26535273

  20. COMPLICATIONS IN HIP ARTHROSCOPY

    PubMed Central

    Contreras, Marcos Emílio Kuschnaroff; Hoffmann, Rafael Barreiros; de Araújo, Lúcio Cappelli Toledo; Dani, William Sotau; José Berral, Francisco

    2015-01-01

    Objectives: To determine the prevalence of complications in a series of consecutive cases of hip arthroscopy; to assess the progression of the sample through a learning curve; and to recognize the causes of complications in arthroscopic hip operations. Method: 150 consecutive cases that underwent hip arthroscopy between May 2004 and December 2008 were evaluated. The complications encountered were classified in three ways: organic system affected, severity and groups of 50 consecutive cases. The data were analyzed by means of descriptive statistics and Fisher's exact test. Results: We observed 15 complications in this study (10%): ten were neurological, two were osteoarticular, one was vascular-ischemic and two were cutaneous. In the classification of severity, three were classified as major, 12 as intermediate and none as minor. The incidence of complications over the course of the learning curve did not present any statistically significant difference (p = 0.16). Conclusions: Hip arthroscopy is a surgical procedure that involves low morbidity, but which presents complications in some cases. These complications are frequently neurological and transitory, and mainly occur because of joint traction. The complication rate did not decrease with progression of our sample. PMID:27022521

  1. Hip arthroscopy

    MedlinePlus

    Johnson D, Weiss WM. Basic arthroscopic principles. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ... 11. Sanchez VMI, Meza AO. Hip arthroscopy. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ...

  2. Hip arthroscopy☆

    PubMed Central

    de Amorim Cabrita, Henrique Antônio Berwanger; de Castro Trindade, Christiano Augusto; de Campos Gurgel, Henrique Melo; Leal, Rafael Demura; de Souza Marques, Ricardo da Fonseca

    2014-01-01

    Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff), although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve. PMID:26229924

  3. Hip flexor strain - aftercare

    MedlinePlus

    Pulled hip flexor - aftercare; Hip flexor injury - aftercare; Hip flexor tear - aftercare; Iliopsoas strain - aftercare; Strained iliopsoas muscle - aftercare; Torn iliopsoas muscle - aftercare; Psoas strain - aftercare

  4. [Avascular necrosis of the hip - diagnosis and treatment].

    PubMed

    Drescher, W; Pufe, T; Smeets, R; Eisenhart-Rothe, R V; Jäger, M; Tingart, M

    2011-04-01

    Femoral head necrosis is an ischaemic bone necrosis of traumatic or nontraumatic pathogenesis which can lead to hip joint destruction in young age. It is today the indication for 10 % of all the total hip joint replacements. Known aetiologies of nontraumatic femoral head necrosis are alcoholism, steroids, sickle cell anaemia, caisson, and Gaucher's disease. Further risk factors are chemotherapy, chronic inflammatory bowel disease, systemic lupus erythematosus, and multiple sclerosis, in which also steroids are involved. Gravidity is another risk factor, but still idiopathic pathogenesis is found. In diagnosis, the ARCO-classification of the Association for the Research of Osseous Circulation is essential. While stage 0 can only be found histologically, the reversible early stage 1 shows MR signal changes. In the irreversible early stage 2, first native x-ray changes are seen as lower radiolucency reflects new bone apposition on dead trabeculae. In stage 3, subchondral fracture follows, and in stage 4 secondary arthritis of the hip. Established therapy in stage 1 is core decompression, physiotherapy, and more and more also bisphosphonates. Sufficient data to support extracorporeal shock wave therapy are still lacking. Stem cell therapy seems to be a promising new therapy method in stage 2. In stage 2 and 3 mainly proximal femoral osteotomies and (non)vascularised bone transplantation are performed. In stage 4, depending on size and location of the necrotic zone and pathology of the adjacent bone, resurfacing or short stem hip arthroplasty can be performed. However, conventional THA is still golden standard. The problem and challenge, however, is the often young patient age in femoral head necrosis. Especially chemotherapy-associated osteonecrosis in leukaemia is found in patients in their second decade of life. Therefore, the hip should be preserved as long as possible. PMID:21469042

  5. Total Joint Arthroplasty in Patients with Chronic Renal Disease: Is It Worth the Risk?

    PubMed

    Warth, Lucian C; Pugely, Andrew J; Martin, Christopher T; Gao, Yubo; Callaghan, John J

    2015-09-01

    26-27% of patients with end stage hip and knee arthritis requiring TJR have chronic renal disease. A multi-center, prospective clinical registry was queried for TJA's from 2006 to 2012, and 74,300 cases were analyzed. Renal impairment was quantified using estimated glomerular filtration rate (eGFR) to stratify each patient by stage of CRD (1-5). There was a significantly greater rate of overall complications in patients with moderate to severe CRD (6.1% vs. 7.6%, P<0.001). In those with CRD (Stage 3-5), mortality was twice as high (0.26% vs. 0.48%, P<0.001). Patients with Stage 4 and 5 CRD had a 213% increased risk of any complication (OR 2.13, 95% CI: 1.73-2.62). Surgeons may use these findings to discuss the risk-benefit ratio of elective TJR in patients with CRD. PMID:26122111

  6. Bursae and abscess cavities communicating with the hip: diagnosis using arthrography and CT

    SciTech Connect

    Steinbach, L.S.; Schneider, R.; Goldman, A.B.; Kazam, E.; Ranawat, C.S.; Ghelman, B.

    1985-08-01

    Bursae or abscess cavities communicating with the hip joint were demonstrated by hip arthrography or by computed tomography (CT) in 40 cases. The bursae or abscess cavities were associated with underlying abnormalities in the hip, including painful hip prostheses, infection, and inflammatory or degenerative arthritis. Symptoms may be produced directly as a result of infection or indirectly as a result of inflammation or pressure on adjacent structures. Hip arthrography can confirm a diagnosis of bursae and abscess cavities communicating with the hip joint in patients with hip pain or soft-tissue masses around the groin. Differentiation of enlarged bursae from other abnormalities is important to avoid unnecessary or incorrect surgery.

  7. Evaluation of the Hip: History and Physical Examination

    PubMed Central

    2007-01-01

    Examination of a painful hip is fairly concise and reliable at detecting the presence of a hip joint problem. Hip joint disorders often go undetected, leading to the development of secondary disorders. Using a thoughtful approach and methodical examination techniques, most hip joint problems can be detected and a proper treatment strategy can then be implemented based on an accurate diagnosis. The purpose of this clinical commentary is to present a systematic examination process that outlines important components in each of the evaluation areas of history and physical examination (including inspection, measurements, symptom localization, muscle strength, and special tests). PMID:21509142

  8. Influence of head size on the development of metallic wear and on the characteristics of carbon layers in metal-on-metal hip joints

    PubMed Central

    Sprecher, Christoph M; Wimmer, Markus A; Milz, Stefan; Taeger, Georg

    2009-01-01

    Background and purpose Particles originating from the articulating surfaces of hip endoprostheses often induce an inflammatory response, which can be related to implant failure. We therefore analyzed the metal content in capsular tissue from 44 McKee-Farrar metal-on-metal hip prostheses (with 3 different head sizes) and we also analyzed the morphological structure of layers located on articulating surfaces. Methods Atomic absorption spectrometry (AAS) was used to analyze the metal content in capsular tissue. Visually detectable carbon layers located on the articulating surfaces were evaluated using scanning electron microscopy (SEM), energy-dispersive Xray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS). Results Metallic debris was detected in all capsular tissue samples but no statistically significant differences in metal content were found in relation to implant head size. The morphological characteristics of the different layer zones allowed an exact analysis of contact and non-contact areas. Furthermore, surface layers appear to have a protective function because they can prevent sharp-edged particles from damaging the prostheses surface. Interpretation The implant head size does not appear to influence the amount of metallic debris. The layers obviously act like a lubricating agent because the protection function does not occur in regions without layers where the metal surface often shows numerous scratches. As layers are not generated immediately after the implantation of hip prostheses, these findings may at least partially explain the high amount of wear early after implantation. PMID:19421914

  9. Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry

    PubMed Central

    2010-01-01

    Background Total joint replacements represent a considerable part of day-to-day orthopaedic routine and a substantial proportion of patients undergoing unilateral total hip arthroplasty require a contralateral treatment after the first operation. This report compares complications and functional outcome of simultaneous versus early and delayed two-stage bilateral THA over a five-year follow-up period. Methods The study is a post hoc analysis of prospectively collected data in the framework of the European IDES hip registry. The database query resulted in 1819 patients with 5801 follow-ups treated with bilateral THA between 1965 and 2002. According to the timing of the two operations the sample was divided into three groups: I) 247 patients with simultaneous bilateral THA, II) 737 patients with two-stage bilateral THA within six months, III) 835 patients with two-stage bilateral THA between six months and five years. Results Whereas postoperative hip pain and flexion did not differ between the groups, the best walking capacity was observed in group I and the worst in group III. The rate of intraoperative complications in the first group was comparable to that of the second. The frequency of postoperative local and systemic complication in group I was the lowest of the three groups. The highest rate of complications was observed in group III. Conclusions From the point of view of possible intra- and postoperative complications, one-stage bilateral THA is equally safe or safer than two-stage interventions. Additionally, from an outcome perspective the one-stage procedure can be considered to be advantageous. PMID:20973941

  10. [Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

    PubMed

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

    2009-02-01

    In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention. PMID:19180004

  11. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset.

    PubMed

    Patel, A; Pavlou, G; Mújica-Mota, R E; Toms, A D

    2015-08-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are recognised and proven interventions for patients with advanced arthritis. Studies to date have demonstrated a steady increase in the requirement for primary and revision procedures. Projected estimates made for the United States show that by 2030 the demand for primary TKA will grow by 673% and for revision TKA by 601% from the level in 2005. For THA the projected estimates are 174% and 137% for primary and revision surgery, respectively. The purpose of this study was to see if those predictions were similar for England and Wales using data from the National Joint Registry and the Office of National Statistics. Analysis of data for England and Wales suggest that by 2030, the volume of primary and revision TKAs will have increased by 117% and 332%, respectively between 2012 and 2030. The data for the United States translates to a 306% cumulative rate of increase between 2012 and 2030 for revision surgery, which is similar to our predictions for England and Wales. The predictions from the United States for primary TKA were similar to our upper limit projections. For THA, we predicted an increase of 134% and 31% for primary and revision hip surgery, respectively. Our model has limitations, however, it highlights the economic burden of arthroplasty in the future in England and Wales as a real and unaddressed problem. This will have significant implications for the provision of health care and the management of orthopaedic services in the future. PMID:26224824

  12. The genetic influence on radiographic osteoarthritis is site specific at the hand, hip and knee

    PubMed Central

    Li, Q.; Spector, T. D.; Williams, F. M. K.

    2009-01-01

    Objective. To identify whether a shared genetic influence accounts for the occurrence of OA at different skeletal sites. Methods. Multivariate modelling of data on prevalent radiographic OA at the hand (DIP, PIP and CMC joints), hip and knee joints assessed in 992 monozygotic and dizygotic female twin participants from the TwinsUK Registry. Results. OA at all the five joint sites was heritable. Genetic influences were strongly correlated among joints in the hand; however, there was little evidence of common genetic pathways to account for the co-occurrence of OA at the hand, hip and knee. Conclusions. While genetic influences are important in explaining the variation in occurrence of OA at the hand, hip and knee, there is no evidence that common or shared genetic factors determine the occurrence of disease across all these skeletal sites. The findings suggest that there are important aetiological differences in the disease that are site-specific in women. These results have implications for the design of studies examining the genetic basis of OA as well as for strategies aimed at preventing and treating the disease. PMID:19153142

  13. Effects of limited food consumption on the incidence of hip dysplasia in growing dogs.

    PubMed

    Kealy, R D; Olsson, S E; Monti, K L; Lawler, D F; Biery, D N; Helms, R W; Lust, G; Smith, G K

    1992-09-15

    Forty-eight 8-week-old Labrador Retrievers were allotted to 2 groups of 24 dogs each; 1 group was fed ad libitum and the other group was given 25% less of the same feed until the dogs were 2 years old. Radiography of the hip joints was done when the dogs were 30, 42, 54, 78, and 104 weeks old. Subluxation was measured by the Norberg angle on radiographs made with the dog in the standard (extended limb) position. Independent of age at which the radiography was done, there was less subluxation of the femoral heads in the limit-fed dogs. Using the Swedish method of hip joint evaluation on the same radiographs, it was found that fewer dogs on limited food intake had signs of hip dysplasia. Radiographs done when dogs were 2 years old, for all the methods used (Norberg angle in standard and frog-limb position, the Orthopedic Foundation for Animals [OFA] score, and the Swedish score), revealed less hip dysplasia (less joint subluxation and less degenerative joint disease) in the limit-fed dogs. Using the OFA method, 7 of the 24 limit-fed dogs and 16 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. Similarly, using the Swedish method, 5 of the 24 limit-fed dogs and 18 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. The food-intake-related differences were significant both for the OFA score and for the Swedish score.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1399793

  14. Cementless total hip arthroplasty.

    PubMed

    Morscher, E W

    1983-12-01

    The differences between prostheses fixed with and without cement are mainly in the design and nature of the surface implant. The shapes of the sockets to be implanted without cement show a wide variety: cylinder, square, conus, and ellipsoid with and without threads. The hemispheric shape, however, which was chosen for the acetabular component of the isoelastic hip joint, does not disturb the natural form and function of the hip joint since the outer surface is closely adapted to the original subchondral bone layer. The noncemented cup is secured by threads, pegs, screws, etc., and by ingrowth of bony tissue in the grooves of the surfaces. Most femoral stems are based on the self-locking principle. All prosthetic models incorporate attempts to increase the surface of the stem (ribs, wings, corrugations, rims, etc.). There is a tendency to use less rigid elastic implants instead of the well known rigid metallic prostheses. The aim is to overcome the problems of stress protection and stress concentration observed with rigid implants. For the biomechanical integration of an implant, the properties of the surface, especially macroporosity and microporosity, are important. Most European models of noncemented endoprostheses are based on macroporosity (porometal, madreporic, etc.). The increase in implant surface area achieved with macroscopic perforations and recesses is relatively minor compared with the possibilities offered by microporosity ("alumine fritée," Proplast, fiber-metal, etc.). The best indication for use of a cementless hip endoprosthesis is in revision arthroplasty. The lost bone stock is replaced by bone grafts, thereby creating a situation comparable with that of a primary arthroplasty. Clinical experience with noncemented hip endoprostheses is, to date, promising, although the observation time for most models is short. PMID:6357588

  15. Unilateral total hip replacement patients with symptomatic leg length inequality have abnormal hip biomechanics during walking

    PubMed Central

    Li, Junyan; McWilliams, Anthony B.; Jin, Zhongmin; Fisher, John; Stone, Martin H.; Redmond, Anthony C.; Stewart, Todd D.

    2015-01-01

    Background Symptomatic leg length inequality accounts for 8.7% of total hip replacement related claims made against the UK National Health Service Litigation authority. It has not been established whether symptomatic leg length inequality patients following total hip replacement have abnormal hip kinetics during gait. Methods Hip kinetics in 15 unilateral total hip replacement patients with symptomatic leg length inequality during gait was determined through multibody dynamics and compared to 15 native hip healthy controls and 15 ‘successful’ asymptomatic unilateral total hip replacement patients. Finding More significant differences from normal were found in symptomatic leg length inequality patients than in asymptomatic total hip replacement patients. The leg length inequality patients had altered functions defined by lower gait velocity, reduced stride length, reduced ground reaction force, decreased hip range of motion, reduced hip moment and less dynamic hip force with a 24% lower heel-strike peak, 66% higher mid-stance trough and 37% lower toe-off peak. Greater asymmetry in hip contact force was also observed in leg length inequality patients. Interpretation These gait adaptions may affect the function of the implant and other healthy joints in symptomatic leg length inequality patients. This study provides important information for the musculoskeletal function and rehabilitation of symptomatic leg length inequality patients. PMID:25900447

  16. Posterior Hip Pain in an Athletic Population

    PubMed Central

    Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

  17. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre: a study using the NJR dataset.

    PubMed

    Sabah, S A; Henckel, J; Cook, E; Whittaker, R; Hothi, H; Pappas, Y; Blunn, G; Skinner, J A; Hart, A J

    2015-01-01

    Arthroplasty registries are important for the surveillance of joint replacements and the evaluation of outcome. Independent validation of registry data ensures high quality. The ability for orthopaedic implant retrieval centres to validate registry data is not known. We analysed data from the National Joint Registry for England, Wales and Northern Ireland (NJR) for primary metal-on-metal hip arthroplasties performed between 2003 and 2013. Records were linked to the London Implant Retrieval Centre (RC) for validation. A total of 67,045 procedures on the NJR and 782 revised pairs of components from the RC were included. We were able to link 476 procedures (60.9%) recorded with the RC to the NJR successfully. However, 306 procedures (39.1%) could not be linked. The outcome recorded by the NJR (as either revised, unrevised or death) for a primary procedure was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval linkage and correct assignment of outcome code improved over time. The rates of error for component reference numbers on the NJR were as follows: femoral head category number 14/229 (5.0%); femoral head batch number 13/232 (5.3%); acetabular component category number 2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. This study suggests that NJR reports may underestimate rates of revision for many types of metal-on-metal hip replacement. This is topical given the increasing scope for NJR data. We recommend a system for continuous independent evaluation of the quality and validity of NJR data. PMID:25568407

  18. Psoriatic nail involvement and its relationship with distal interphalangeal joint disease.

    PubMed

    Lai, T L; Pang, H T; Cheuk, Y Y; Yip, M L

    2016-08-01

    Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. PMID:27251673

  19. A Rare Case of Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Wrist Joint

    PubMed Central

    Nakamura, Osamu; Kaji, Yoshio; Yamagami, Yoshiki; Yamaguchi, Kounosuke; Nishimura, Hideki; Fukuoka, Natsuko; Yamamoto, Tetsuji

    2015-01-01

    Introduction. Tumoral calcium pyrophosphate dihydrate (CPPD) crystal deposition disease (CPPDCD), also known as tophaceous calcium pyrophosphate deposition disease (CPDD), is a tumorlike lesion, and it should be distinguished from usual CPDD that causes severe joint inflammation and arthralgia. A case of tumoral CPPDCD of the wrist joint that required differentiation from synovial osteochondromatosis is described. Case Presentation. The patient was a 78-year-old woman with a 5-year history of nodular lesions at the right wrist that had gradually increased in size. An excisional biopsy and a histological examination of the excised nodular lesions by hematoxylin and eosin (H&E) staining were performed, demonstrating numerous polarizable, rhabdoid, and rectangular crystals, surrounded by fibroblasts, macrophages, and foreign body-type giant cells, consistent with tumoral CPPDCD. Conclusion. Tumoral CPPDCD, especially at the wrist joint, is rare, and, to the best of our knowledge, only 2 articles have been published. This case seems to need further follow-up for recurrence, because tumoral CPPDCD may recur after complete or incomplete surgical excision. PMID:26783477

  20. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  1. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  2. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  3. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  4. [Complications after hip osteotomy].

    PubMed

    Renner, L; Perka, C; Zahn, R

    2014-01-01

    Complex deformities of the acetabulum are one of the most common reasons for secondary pelvic osteoarthritis. One option of treatment is osteotomy of the acetabulum close to the joint. The correction of the spatially reduced roof of the femoral head resulting from pelvic dysplasia can minimize the risk of developing secondary osteoarthritis or reduce the progression of an already existing osteoarthritis. The Ganz periacetabular osteotomy (PAO) and Tönnis triple osteotomy procedures are the predominant methods used to correct hip dysplasia in adolescents. Both are complex procedures which bear specific risks and complications, thus requiring very experienced surgeons. PMID:24356819

  5. A retrospective study of canine hip dysplasia in 116 military working dogs. Part I: Angle measurements and orthopedic foundation for animals (OFA) grading.

    PubMed

    Banfield, C M; Bartels, J E; Hudson, J A; Wright, J C; Hathcock, J T; Montgomery, R D

    1996-01-01

    The progression of hip dysplasia was investigated in 116 military working dogs. Serial pelvic radiographs were graded for degree of dysplasia and degenerative joint disease (DJD). Norberg angles, angles of inclination, and joint space widths were measured. There was a significant correlation between the Norberg angle and the degree of dysplasia (p less than 0.0001). Angles of inclination and joint space width measurements did not demonstrate a correlation to canine hip dysplasia. Dysplastic dogs had a significant estimated risk for development of DJD compared to normal dogs (p less than 0.0001; odds ratio of 70.2). Dogs with normal hip conformation at 24 months of age or older did not develop moderate nor severe DJD. PMID:8875357

  6. [Differential diagnosis of pediatric hip pain in MR tomography].

    PubMed

    Glas, K; Obletter, N; Staudt, F; Scheuerer, K

    1991-01-01

    The efficiency of spin echo tomography in the differential diagnosis of hip joint pain in children in comparison with other imaging methods was tested in 115 spin echo tomography examinations of 68 patients. By means of the different modes available it was possible to determine joint effusion, necrosed areas and the formation of abscesses with great accuracy. In the case of Legg-Calve-Perthes disease the MRT is especially in the early diagnosis superior to the other Methods, already in the early stage a classification in the four Catterall groups was possible. Furthermore the "head at risk" signs, except the gage-sign, were better to describe by BRI than by conventional x-rays. The MRT allows an exacter staging and a better observation of the course of disease, especially the beginning of the revitalisation of the femora epiphysis in earlier and clearer visible than in other imaging methods. Further diseases like epiphysial dysplasie, specific and unspecific coxitis and slipped capital femora epiphysis were also investigated. We regard spin echo examination in the differential diagnosis of hip pain in children indicated by the following criteria: 1. with over six weeks uncertain differential diagnosis of coxitis fugax and Legg-Calve-Perthes disease 2. with Legg-Calve-Perthes disease in the early stage for therapy option 3. with TBC- and non-TBC-coxitis as a therapy attend and diagnostic measure. PMID:1829298

  7. Photoacoustic tomography of the human finger: towards the assessment of inflammatory joint diseases

    NASA Astrophysics Data System (ADS)

    van Es, P.; Biswas, S. K.; Bernelot Moens, H. J.; Steenbergen, W.; Manohar, S.

    2015-03-01

    Inflammatory arthritis is often manifested in finger joints. The growth of new or withdrawal of old blood vessels can be a sensitive marker for these diseases. Photoacoustic (PA) imaging has great potential in this respect since it allows the sensitive and highly resolved visualization of blood. We systematically investigated PA imaging of finger vasculature in healthy volunteers using a newly developed PA tomographic system. We present the PA results which show excellent detail of the vasculature. Vessels with diameters ranging between 100 μm and 1.5 mm are visible along with details of the skin, including the epidermis and the subpapillary plexus. The focus of all the studies is at the proximal and distal interphalangeal joints, and in the context of ultimately visualizing the inflamed synovial membrane in patients. This work is important in laying the foundation for detailed research into PA imaging of the phalangeal vasculature in patients suffering from rheumatoid arthritis.

  8. Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.

    PubMed

    Dimitroulis, G

    2014-08-01

    The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (P<0.01), rib graft patients were more likely to experience complications (43.8%) necessitating a return to theatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01). PMID:24629849

  9. Diagnosis, genetic control and preventive management of canine hip dysplasia: a review.

    PubMed

    Ginja, M M D; Silvestre, A M; Gonzalo-Orden, J M; Ferreira, A J A

    2010-06-01

    Despite expensive screening and breeding programmes, hip dysplasia (HD) continues to be one of the most common orthopaedic diseases in dogs. The vast majority of dogs afflicted with HD show minimal to no clinical signs, but it can also be a highly debilitating condition for both working and pet dogs. Hip joint laxity is considered a major risk factor for the development of degenerative joint disease and a definitive diagnosis is made if characteristic signs are evident on a ventrodorsal view of the pelvis. Early prediction of the condition can be made using stress radiographic techniques to evaluate the passive hip laxity. The diagnosis of HD may be used for the purpose of selecting breeding stock or to decide on the best treatment approach. Breeding programmes based on individual dog phenotypes have been ineffective and a selection procedure based on breeding value (BV) estimation is recommended. Traditional conservative and surgical treatment approaches are reserved for dogs with overt clinical signs of the disease but such treatments can be expensive and aggressive, and are often ineffective in eliminating clinical signs or subluxation and in preventing the development of degenerative joint disease. The implementation of breeding programmes based on BVs and further research into early prediction/diagnosis of HD and effective preventive treatment approaches are essential. PMID:19428274

  10. Compliant joint

    NASA Technical Reports Server (NTRS)

    Eklund, Wayne D. (Inventor); Kerley, James J. (Inventor)

    1990-01-01

    A compliant joint is provided for prosthetic and robotic devices which permits rotation in three different planes. The joint provides for the controlled use of cable under motion. Perpendicular outer mounting frames are joined by swaged cables that interlock at a center block. Ball bearings allow for the free rotation of the second mounting frame relative to the first mounting frame within a predetermined angular rotation that is controlled by two stop devices. The cables allow for compliance at the stops and the cables allow for compliance in six degrees of freedom enabling the duplication or simulation of the rotational movement and flexibility of a natural hip or knee joint, as well as the simulation of a joint designed for a specific robotic component for predetermined design parameters.

  11. Sensitivity and specificity of simultaneously acquired (dual channel) radiogallium and Tc-99m-HDP in painful hip and knee prosthetic joints

    SciTech Connect

    Skarzynski, J.J.; Sziklas, J.J.; Rosenberg, R.J.; Rich, D.A.; Spencer, R.P.

    1985-05-01

    Differentiation of prosthetic loosening from infection, by use of sequential bone and radiogallium imaging, has been discussed in the literature. The authors investigated simultaneous (2 channel) imaging of Ga-67 and Tc-99m-HDP in multiviews, in order to assess the parameter of Tc-99m-Ga-67 incongruity. Acquisition of data was carried out 2 days after 5 mCi of Ga-67 citrate IV and 2 hours after 8 mCi of Tc-99m-HDP. Dual data channels were used to insure perfect superimposition of the images and to reduce total imaging time. Normalized bone images were taken, then subtracted from those of Ga-67, by means of progressive weighting factors. A total of 68 studies were carried out on 43 patients. Exams involved both knee and hip prostheses, in population with 63% of the patients over age 60 years. Time from placement of the prosthesis to the dual radionuclide exam was within 2 years in 48% and within 5 years in 78%. Sensitivity was 0.88 and specificity 0.89. Using information on the follow-up dual channel studies, 40/43 cases were correctly identified (93%). Dual channel radionuclide imaging offers a readily available and accurate means of differentiating infection from loosening of hip or knee prostheses.

  12. Editorial Commentary: Helping Those Who Seek the Company of "Lord Stanley": Hockey Players and Hip Injuries Highlight the Current State and Future Challenges in Understanding, Treating, and Preventing Nonarthritic Hip Disease.

    PubMed

    Christoforetti, John

    2016-09-01

    The state of the art in caring for athletic hip injuries requires comprehensive understanding of dynamic sport-specific biomechanical demands, accurate musculoskeletal diagnosis, and a mindset towards matching hip structure with functional demand at all levels of play. The sport of hockey presents a unique opportunity to review these fundamentals of modern management and illuminates the way towards future understanding of the cause of common nonarthritic hip conditions. PMID:27594336

  13. Techniques and Results for Open Hip Preservation

    PubMed Central

    Levy, David M.; Hellman, Michael D.; Haughom, Bryan; Stover, Michael D.; Nho, Shane J.

    2015-01-01

    While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg–Calve–Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/or acetabulum. Chronic slipped capital femoral epiphysis may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy. PMID:26649292

  14. Hip arthrosis and surgical intervention: what and when?

    PubMed

    Innocenti, Massimo; Nistri, Lorenzo; Biondi, Marco; Del Prete, Armando; Giorgini, Marco; Macera, Armando; Soderi, Stefano

    2013-01-01

    Osteoarthritis of the hip is a common pathology and involves forms of disability and need for treatments that affect the quality of life of patients and their families, and in general of the whole society. It should be considered as such degenerative joint disease is increasing as the increase in life expectancy and musculoskeletal trauma, the latter responsible for secondary forms of osteoarthritis. The treatment of osteoarthritis of the hip has changed a lot over the years, since the earlier diagnosis and, before, with prevention through proper lifestyle. More in-depth knowledge of the biology of the tissues involved, first of all hyaline cartilage, has lead to non-surgical treatments such as infiltration with hyaluronic acid (viscosupplementation) and autologous growth factors derived from platelets (platelet rich plasma). Surgical therapy with prosthetic replacement is finally a choice to share with the patient based on pain and functional limitation, bearing in mind always the best technology and tribology and the possibility of less invasive surgical access, while recognizing that there are not still eternal prosthesis. Of particular importance then is the age of the patient. There are also other types of surgery (hip arthroscopy, forage) for other pathologies of the hip which can be resolutive, or, in a sense, can delay the arrival to the prosthetic replacement. We will discuss below the decision-making process that leads the surgeon with the patient to the surgery option. PMID:23858310

  15. Relationship between pelvic incidence and osteoarthritis of the hip

    PubMed Central

    Weinberg, D. S.; Bohl, M. S.; Liu, R. W.

    2016-01-01

    Objectives Sagittal alignment of the lumbosacral spine, and specifically pelvic incidence (PI), has been implicated in the development of spine pathology, but generally ignored with regards to diseases of the hip. We aimed to determine if increased PI is correlated with higher rates of hip osteoarthritis (HOA). The effect of PI on the development of knee osteoarthritis (KOA) was used as a negative control. Methods We studied 400 well-preserved cadaveric skeletons ranging from 50 to 79 years of age at death. Each specimen’s OA of the hip and knee were graded using a previously described method. PI was measured from standardised lateral photographs of reconstructed pelvises. Multiple regression analysis was performed to determine the relationship between age and PI with HOA and KOA. Results The mean age was 60.2 years (standard deviation (sd) 8.1), and the mean PI was 46.7° (sd 10.7°). Multiple regression analysis demonstrated a significant correlation between increased PI and HOA (standardised beta = 0.103, p = 0.017). There was no correlation between PI and KOA (standardised beta = 0.003, p = 0.912). Conclusion Higher PI in the younger individual may contribute to the development of HOA in later life. Cite this article: Dr J. J. Gebhart. Relationship between pelvic incidence and osteoarthritis of the hip. Bone Joint Res 2016;5:66–72. DOI: 10.1302/2046-3758.52.2000552. PMID:26912384

  16. Imaging of hip and groin injuries in athletes.

    PubMed

    Overdeck, Kimberlee Horton; Palmer, William Ewing

    2004-03-01

    Proper function of the hip joint is imperative for athletes who participate in sporting activities that rely on utilization of the lower extremity; these primarily include kicking, running, and jumping activities. Sports-related injuries of the hip and groin are not frequent sources of disability in athletes; however, they may present a significant diagnostic dilemma, both from a clinical and radiological standpoint. Delay in diagnosis and treatment may result in undesired complications, such as premature degenerative disease, as well as time lost from athletic activities. Magnetic resonance (MR) imaging of the hip, particularly following the intra-articular administration of gadolinium, has proven to be extremely valuable in the diagnosis of radiographically occult osseous abnormalities as well as soft-tissue injuries, such as pubalgia, musculotendinous abnormalities, and bursitis. This article will review several pathological conditions of the hip and groin in both recreational and professional athletes, with an emphasis on MR imaging as the modality of choice in the diagnosis of these injuries. PMID:15085477

  17. Uneven damage on head and liner contact surfaces of a retrieved Co-Cr-based metal-on-metal hip joint bearing: An important reason for the high failure rate.

    PubMed

    Koizumi, Yuichiro; Chen, Yan; Li, Yunping; Yamanaka, Kenta; Chiba, Akihiko; Tanaka, Shun-Ichiro; Hagiwara, Yoshihiro

    2016-05-01

    Detailed metallurgical investigations have been performed on a used Co-Cr-based metal-on-metal (MoM) hip joint bearing containing a type of liner that is commonly used in such joints. The damage on the metal-liner sliding surface was considerably more severe than that on the metal head counterpart, in terms of wear-scar density and width and microcrack frequency. Cross-sectional transmission electron microscopy revealed that a thick (>3 μm) nanocrystalline layer formed on the sliding surface of the head, whereas the liner had coarse carbides embedded in it and nanocrystals were formed in a very limited region no deeper than 1 μm. Comparative investigation of an unused head and a liner of identical type showed that although the chemical compositions of the liner and head were nearly identical, their microstructures were significantly different. Specifically, the grain size in the liner was larger than that in the head on average, and the grain boundaries of the liner were decorated with coarse carbides. Moreover, X-ray diffraction analysis revealed a large tensile residual stress only in the liner. These differences are possibly responsible for the wear damage on the liner being more serious than that on the head. PMID:26952456

  18. Foreword to Selected presentations from the 1st European Hip Sport Meeting.

    PubMed

    Dallari, Dante; Ribas, Manuel

    2016-05-14

    Recent years have witnessed a growing number of people practising sports both at professional and amateur level. This trend led to a progressive rise in the incidence and prevalence of acute and chronic hip damage. The treatment of hip disease in subjects practising sports is a major challenge for the orthopaedic surgeon. The evaluation of patients, in particular those of young age with high functional demands, is inevitably complex and should be performed with a multidisciplinary approach; from a surgical point of view, it is essential to carefully assess whether the indication is towards conservative surgery or hip replacement surgery. The advent of arthroscopic surgery in recent years has allowed us to improve our knowledge of hip joint diseases, such as femoroacetabular impingement that is typical of sports and overuse activity. A correct and early diagnosis of the disease can direct the patient promptly to a conservative surgical treatment that could reduce the progression of degenerative pathology. However, when the joint is permanently damaged, the only reliable solution remains prosthetic surgery, leading to a series of issues that the orthopaedic surgeon should be able to master, leading to a thoughtful decision on, for example, which implant to use, which biomaterials, which surgical approach or which sport to practise after surgery. This supplement contains selected contributions stemming from the work performed by internationally recognised experts in the field and presented during the 1st European Hip Sport Meeting held in Bologna on May 19th, 20th, 2016 that we had the honour to co-chair. We hope that these contributions will help the orthopaedic surgeon, the sports physician and physiotherapist in their day-to-day practice, and will help in fulfilling our ultimate aim to improve the knowledge of the hip pathology related to sports and overuse activities. PMID:27174057

  19. Picking a bone with WISP1 (CCN4): new strategies against degenerative joint disease

    PubMed Central

    Maiese, Kenneth

    2016-01-01

    As the world’s population continues to age, it is estimated that degenerative joint disease disorders such as osteoarthritis will impact at least 130 million individuals throughout the globe by the year 2050. Advanced age, obesity, genetics, gender, bone density, trauma, and a poor level of physical activity can lead to the onset and progression of osteoarthritis. However, factors that lead to degenerative joint disease and involve gender, genetics, epigenetic mechanisms, and advanced age are not within the control of an individual. Furthermore, current therapies including pain management, improved nutrition, and regular programs for exercise do not lead to the resolution of osteoarthritis. As a result, new avenues for targeting the treatment of osteoarthritis are desperately needed. Wnt1 inducible signaling pathway protein 1 (WISP1), a matricellular protein and a downstream target of the wingless pathway Wnt1, is one such target to consider that governs cellular protection, stem cell proliferation, and tissue regeneration in a number of disorders including bone degeneration. However, increased WISP1 expression also has been associated with the progression of osteoarthritis. WISP1 has an intricate relationship with a number of proliferative and protective pathways that include phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin -6 (IL-6), transforming growth factor-β, matrix metalloproteinase, small non-coding ribonucleic acids (RNAs), sirtuin silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), and the mechanistic target of rapamycin (mTOR). Taken together, this complex association WISP1 holds with these signaling pathways necessitates a fine biological regulation of WISP1 activity that can offset the progression of degenerative joint disease, but not limit the cellular protective capabilities of the WISP1 pathway. PMID:26893943

  20. Septic arthritis of the hip - current concepts.

    PubMed

    Rutz, E; Brunner, R

    2009-01-01

    Septic arthritis of the hip is the commonest septic condition during growth, reaching a distinct peak in frequency during infancy. The aetiology is a haematogenous joint infection. Indicative signs are severe pain when moving the joint, septic appearance and a poor general condition of these small and young patients. The diagnosis often can be difficult in infants since septic temperatures are not always present. An ultrasound scan shows the hip joint effusion and the capsular distension. X-ray investigation helps to exclude defective situations. Therapeutic options are: in patients with short history without radiologically visible complications we recommend repeated arthroscopic irrigation and in patients with long history and a radiologically visible defect of the femoral head or dislocation we recommend arthrotomy and open revision or reduction of the hip joint. PMID:19306242