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Sample records for birmingham hip resurfacing

  1. Survivorship and clinical outcome of Birmingham hip resurfacing: a minimum ten years' follow-up.

    Science.gov (United States)

    Azam, Md Quamar; McMahon, Stephen; Hawdon, Gabrielle; Sankineani, Sukesh Rao

    2016-01-01

    Resurfacing as a percentage of total hip arthroplasty rose from 5.6 % in 2001 to 8.9 % in 2005 in Australia. During the same period the resurfacing to conventional prosthesis rose from 19.6 % to 29 % in the younger age group (less than 55 years). Long term (more than ten years) functional results of BHR are sparingly documented. Among the literatures available, the patient selection criteria vary from osteoarthritis, avascular necrosis, and dysplastic hip to slipped capital femoral epiphysis. The objective of the current study is to evaluate long term survivorship and functional outcome of Birmingham hip resurfacing surgery in osteoarthritic hip patients performed by a single surgeon. In this retrospective clinical study, all patients who underwent hip resurfacing for osteoarthritis of hip between 1999 and 2004 are included. All surgeries were performed by single surgeon (SJM) and in all patients Smith & Nephew system (Midland Medical Technologies, Birmingham, United Kingdom)) was used. Revision surgery is considered the end point of survivorship. Means, standard deviations, and confidence interval were calculated for all continuous measures. Survival analysis was performed with the Kaplan-Meier method and 95 % confidence intervals were calculated. The result is based on 222 patients (244 hips). This included 153 males and 69 females. Our mean follow up was 12.05 years and overall survival was 93.7 %. In terms of gender, survival in males was 95.43 % while in females it was 89.86 %. Failure was seen in 14 patients (16 hips), which included seven female (10.14 %) and seven male (4.57 %) patients. Failure of femoral components due to aseptic loosening and varus collapse was seen in eight patients after a mean 9.6 years. Metal allergy was seen in three patients (five hips), all of them were female of which two had bilateral resurfacing. Other complications included femoral neck stress fractures in two patients and acetabular component loosening in one patient. We

  2. Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data.

    Science.gov (United States)

    Schuh, Reinhard; Neumann, Daniel; Rauf, Rauend; Hofstaetter, Jochen; Boehler, Nikolaus; Labek, Gerold

    2012-07-01

    Hip resurfacing arthroplasty has gained popularity for treating young and active patients who have arthritis. There are two major data sources for assessing outcome and revision rate after total joint arthroplasty: sample-based clinical trials and national arthroplasty registers. The purpose of this study was to evaluate the outcome of the Birmingham Hip Resurfacing (BHR) arthroplasty in terms of revision rate as reported in clinical studies and recorded by national arthroplasty registers. A comprehensive literature research was performed from English-language, peer-reviewed journals and annual reports from national joint arthroplasty registers worldwide. Only publications from MEDLINE-listed journals were included. The revision rate was used as the primary outcome parameter. In order to allow for direct comparison of different data sets, calculation was based on revisions per 100 observed component years. For statistical analysis, confidence intervals (CI) were calculated. A total of 18,708 implants, equivalent to 106,565 observed component years, were analysed in the follow-up studies. The register reports contained 9,806 primary cases corresponding to 44,294 observed component years. Statistical analysis revealed a significant difference in revisions per 100 observed component years between the development team (0.27; CI: 0.14-0.40) and register data (0.74; CI: 0.72-0.76). The BHR arthroplasty device shows good results in terms of revision rate in register data as well as in clinical studies. However, the excellent results reported by the development team are not reproducible by other surgeons. Based on the results of our study, we believe that comprehensive national arthroplasty registers are the most suitable tool for assessing hip arthroplasty revision rate.

  3. Structure and corrosion resistance of Co-Cr-Mo alloy used in Birmingham Hip Resurfacing system.

    Science.gov (United States)

    Dobruchowska, Ewa; Paziewska, Monika; Przybyl, Krzysztof; Reszka, Kazimierz

    2017-01-01

    The endoprostheses made of cobalt-chromium-molybdenum (Co-Cr-Mo) alloys belong to the group of the most popular metallic implants used for reconstruction of hip joints. For such biomaterials, the primary goal is a correct and long-term functioning in the aggressive environment of body fluids. Therefore, the purpose of this study was to examine both the morphology and the corrosion resistance of implants made of the cobalt alloy used in Birmingham Hip Resurfacing (BHR) system (Smith & Nephew). For comparative purposes, the electrochemical studies were done for the nitrided stainless steel - Orthinox. Observations of the microstructure of the material under investigation were performed by means of the optical metallographic microscope and the scanning electron microscope. Furthermore, Energy Dispersive X-ray Spectroscopy was used to analyse the chemical composition of the endoprosthesis. Characterisation and evaluation of electrochemical corrosion resistance of the selected alloys were performed by potentiodynamic polarisation tests. The structural studies confirmed that Co-Cr-Mo (BHR system) is characterised by a typical dendritic microstructure with carbide precipitates, mainly M23C6, within the interdendritic areas. The results of the polarisation measurements showed that the cobalt alloy investigated exhibits lower corrosion potential than Orthinox in the utilised environments (3% NaCl, simulated body fluid - Hank's Body Fluid). However, the high passivation ability of the Co-Cr-Mo alloy, as well as its resistance to the initiation and propagation of localised corrosion processes, indicate that this material is significantly more appropriate for long-term implants.

  4. Dual energy X-ray absorptiometry analysis of peri-prosthetic stress shielding in the Birmingham resurfacing hip replacement.

    LENUS (Irish Health Repository)

    Harty, J A

    2012-02-03

    INTRODUCTION: Numerous reports in the literature refer to the femoral neck fracture rate in hip resurfacing. The aim of this study was to determine the bone mineral density and evidence of stress shielding around the femoral component of the Birmingham resurfacing prosthesis. MATERIAL AND METHODS: Twenty-eight patients with primary unilateral osteoarthritis had a Birmingham resurfacing prosthesis. DEXA analysis of the proximal femur and femoral neck was performed and compared with the opposite unaffected side. RESULTS: Total periprosthetic bone mineral density was 0.49% greater than the control, but this did not achieve statistical significance. Although the BMD of the femoral neck was slightly increased on the prosthetic side (1.002 g\\/cm2) as opposed to the control side, this difference did not reach statistical significance. CONCLUSION: The Birmingham resurfacing prosthesis does not appear to reduce femoral neck bone mineral density in comparison to the normal femoral neck bone density. We conclude that femoral neck fractures are unlikely to be due to stress shielding related to the prosthesis.

  5. Biomimetic Composite-Metal Hip Resurfacing Implant

    Directory of Open Access Journals (Sweden)

    Habiba Bougherara

    2008-01-01

    Full Text Available Hip resurfacing technique is a conservative arthroplasty used in the young patient in which the femoral head is reshaped to accept metal cap with small guide stem. In the present investigation, a hybrid composite-metal resurfacing implant is proposed. The cup is made of carbon fiber/polyamide 12 (CF/PA12 covered with a thin layer of cobalt chrome (Co-Cr. Finite element (FE method was applied to analyze and compare the biomechanical performances of the hybrid hip resurfacing (HHR and the conventional Birmingham (BHR. Results of the finite element analysis showed that the composite implant leads to an increase in stresses in the cancellous bone by more than 15% than BHR, indicating a lower potential for stress shielding and bone fracture and higher potential for bone apposition with the HHR.

  6. Cobalt serum levels differ in well functioning Birmingham resurfacing and Birmingham modular THA.

    Science.gov (United States)

    Renner, Lisa; Faschingbauer, Martin; Schmidt-Braekling, Tom; Boettner, Friedrich

    2016-05-01

    Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) and resurfacings (HR). (1) Is there a difference in metal ion concentrations between HR and MoM-THR using the same bearing design (Birmingham Hip Resurfacing System, Smith & Nephew, Inc. Memphis, TN, USA)? (2) Are metal ion levels changing over time in MoM-THA or HR? (3) Do acetabular inclination angle and femoral component size influence cobalt and chromium levels? Is there a correlation between clinical outcome and metal ion levels? A retrospective analysis was conducted in 77 well functioning unilateral Birmingham HR and 42 well functioning unilateral modular Birmingham MoM-THA (Smith & Nephew, Inc. Memphis, TN, USA) operated on between 2007 and 2012. Blood samples were taken at a minimum of 13 months and subsequent during annual follow-ups. (1) Cobalt levels were significantly higher in MoM-THA compared to HR (p Cobalt is increasing over time in MoM-THA (p = 0.030) whereas metal ions remain stable in HR. (3) Metal ion levels were not affected by acetabular inclination angle and femoral component size in MoM-THA. Chromium levels correlate with the femoral component size (r = -0.240; p = 0.037), the UCLA activity score (r = -0.344; p = 0.003) and the VAS (r = 0.263; p = 0.38) in HR. Considering that HR and MoM-THA used the same MoM bearing design, increased cobalt levels may be related to trunnion wear or corrosion. Elevated cobalt levels should raise concern for corrosion related failure in MoM-THA.

  7. Hip Resurfacing: An Alternative to Conventional Hip Replacement?

    Science.gov (United States)

    ... Is hip resurfacing a good alternative to hip replacement? Answers from Mark Spangehl, M.D. Hip resurfacing has lost favor with many surgeons ... women with poor bone quality. Unlike traditional hip replacement, hip resurfacing doesn't completely replace the "ball" ...

  8. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  9. The Effectiveness of Blood Metal Ions in Identifying Patients with Unilateral Birmingham Hip Resurfacing and Corail-Pinnacle Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris.

    Science.gov (United States)

    Matharu, Gulraj S; Berryman, Fiona; Brash, Lesley; Pynsent, Paul B; Treacy, Ronan B C; Dunlop, David J

    2016-04-20

    We investigated whether blood metal ions could effectively identify patients with metal-on-metal hip implants with two common designs (Birmingham Hip Resurfacing [BHR] and Corail-Pinnacle) who were at risk of adverse reactions to metal debris. This single-center, prospective study involved 598 patients with unilateral hip implants (309 patients with the BHR implant and 289 patients with the Corail-Pinnacle implant) undergoing whole blood metal ion sampling at a mean time of 6.9 years. Patients were classified into two groups, one that had adverse reactions to metal debris (those who had to undergo revision for adverse reactions to metal debris or those with adverse reactions to metal debris on imaging; n = 46) and one that did not (n = 552). Three metal ion parameters (cobalt, chromium, and cobalt-chromium ratio) were compared between groups. Optimal metal ion thresholds for identifying patients with adverse reactions to metal debris were determined using receiver operating characteristic analysis. All ion parameters were significantly higher (p adverse reactions to metal debris compared with those who did not. Cobalt maximized the area under the curve for patients with the BHR implant (90.5%) and those with the Corail-Pinnacle implant (79.6%). For patients with the BHR implant, the area under the curve for cobalt was significantly greater than that for the cobalt-chromium ratio (p = 0.0005), but it was not significantly greater than that for chromium (p = 0.8483). For the patients with the Corail-Pinnacle implant, the area under the curve for cobalt was significantly greater than that for chromium (p = 0.0004), but it was similar to that for the cobalt-chromium ratio (p = 0.8139). Optimal blood metal ion thresholds for identifying adverse reactions to metal debris varied between the two different implants. When using cobalt, the optimal threshold for identifying adverse reactions to metal debris was 2.15 μg/L for the BHR group and 3.57 μg/L for the Corail

  10. Hip resurfacing arthroplasty and perioperative blood testing.

    Science.gov (United States)

    Cook, Andrew; Cook, Steven; Smith, Ian; Weinrauch, Patrick

    2014-01-01

    It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate.

  11. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

    Full Text Available It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate.

  12. Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years

    Directory of Open Access Journals (Sweden)

    Régis Pailhé

    2013-07-01

    Full Text Available There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS and Postel-Merle d’Aubigné (MDA score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1 [100 Durom® (Zimmer Inc., Warsaw, IN, USA and 42 Birmingham Hip Resurfacing® (Smith & Nephew, Memphis, TN, USA] and 278 patients with total hip arthroplasty (group 2. The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001. In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

  13. Hip resurfacing: history, current status, and future.

    Science.gov (United States)

    Amstutz, Harlan C; Le Duff, Michel J

    2015-01-01

    Hip resurfacing arthroplasty (HRA) presents several advantages over conventional total hip arthroplasty (THA), including conservation and preservation of bone, reduced risk of dislocation, easy replication of hip biomechanics and easy revision if needed. It is a particularly appealing procedure for young patients. HRA has been performed for over 40 years following the same technological advances as THA. The bearing material used by most designs is metal-on-metal (MoM), which has the best compromise between strength and wear properties. However, MoM HRA has a specific set of possible complications. Aseptic femoral failures were initially the most prevalent cause for revision but progress in patient selection and surgical technique seem to have resolved this problem. Wear-related failures (high metal ion levels and adverse local tissue reactions) are now the main concern, and are essentially associated with poor acetabular component design and orientation, to which MoM is more sensitive than other bearing materials. The concept of functional coverage is key to understanding how MoM bearings are affected by edge wear. Only a 3-D assessment of cup position (e.g., the contact patch to rim distance) provides the necessary information to determine the role of cup positioning in relationship with abnormal bearing wear.The concept of hip resurfacing is more valid today than ever as the age of the patients in need of hip arthroplasty keeps getting lower. The recent publication of several excellent long-term survivorship results suggests that selection of a well-designed resurfacing system and accuracy in the placement of the cup can achieve long-term durability.

  14. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3400 Section 888.3400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip joint...

  15. Hip resurfacing does not improve proprioception compared with THA.

    Science.gov (United States)

    Larkin, Brian; Nyazee, Humaa; Motley, John; Nunley, Ryan M; Clohisy, John C; Barrack, Robert L

    2014-02-01

    Proposed benefits of total hip resurfacing arthroplasty over total hip arthroplasty (THA) include better proprioception, but this has not been rigorously tested or validated. Our purpose was to apply an advanced testing device that objectively quantifies dynamic postural stability to determine if total hip resurfacing is associated with improved proprioception compared with standard or large-head THA. Three groups of 25 patients (total hip resurfacing, THA femoral head > 32 mm, THA femoral head ≤ 32 mm) and a matched control group were recruited. All participants had UCLA scores ≥ 5 and Harris hip scores ≥ 90 at the time of testing. Testing was conducted using a commercially available device that uses a multidirectional, powered platform to measure deviations of the center of mass and consisted of trials with both double- and single-limb support. Double-limb testing showed no differences between groups. In single-limb testing, the operative side performed better in patients who had undergone total hip resurfacing versus THA, but this difference disappeared when the operative side was normalized to the nonoperative side. When compared with control subjects who had not had arthroplasty, both operative and nonoperative sides showed significantly worse proprioception for all arthroplasty cohorts, suggesting that decreased proprioception is associated with arthritis of the hip in young adults. Total hip resurfacing arthroplasty did not result in improved proprioception compared with THA. These results tend to refute the concept that improved proprioception is a rationale for selecting total hip resurfacing over THA in young patients.

  16. Metal-on-Metal Hip Resurfacing Arthroplasty

    Science.gov (United States)

    Sehatzadeh, S; Kaulback, K; Levin, L

    2012-01-01

    Background Metal-on-metal (MOM) hip resurfacing arthroplasty (HRA) is in clinical use as an appropriate alternative to total hip arthroplasty in young patients. In this technique, a metal cap is placed on the femoral head to cover the damaged surface of the bone and a metal cup is placed in the acetabulum. Objectives The primary objective of this analysis was to compare the revision rates of MOM HRA using different implants with the benchmark set by the National Institute of Clinical Excellence (NICE). The secondary objective of this analysis was to review the literature regarding adverse biological effects associated with implant material. Review Methods A literature search was performed on February 13, 2012, to identify studies published from January 1, 2009, to February 13, 2012. Results The revision rates for MOM HRA using 6 different implants were reviewed. The revision rates for MOM HRA with 3 implants met the NICE criteria, i.e., a revision rate of 10% or less at 10 years. Two implants had short-term follow-ups and MOM HRA with one of the implants failed to meet the NICE criteria. Adverse tissue reactions resulting in failure of the implants have been reported by several studies. With a better understanding of the factors that influence the wear rate of the implants, adverse tissue reactions and subsequent implant failure can be minimized. Many authors have suggested that patient selection and surgical technique affect the wear rate and the risk of tissue reactions. The biological effects of high metal ion levels in the blood and urine of patients with MOM HRA implants are not known. Studies have shown an increase in chromosomal aberrations in patients with MOM articulations, but the clinical implications and long-term consequences of this increase are still unknown. Epidemiological studies have shown that patients with MOM HRA implants did not have an overall increase in mortality or risk of cancer. There is insufficient clinical data to confirm the

  17. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

    Zustin, Jozef; Sauter, Guido; Hahn, Michael; Morlock, Michael M.; Ruether, Wolfgang; Amling, Michael

    2010-01-01

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  18. High-impact sport after hip resurfacing: The Ironman triathlon.

    Science.gov (United States)

    Girard, J; Lons, A; Pommepuy, T; Isida, R; Benad, K; Putman, S

    2017-09-01

    Returning to high-impact sport is an increasingly frequent functional demand following hip replacement. The literature, however, is sparse on the subject and nonexistent regarding triathlon. We therefore conducted a retrospective study of hip resurfacing in triathlon players, to determine: (1) whether it is possible to return to this kind of sport; (2) if so, whether it is possible to return to the same level; and (3) how a resurfaced hip behaves under these conditions. Hip resurfacing allows return to competition level in long-distance triathlon. A single-center single-operator retrospective study included patients undergoing hip resurfacing with the Conserve Plus implant inserted through a posterolateral approach, who had ceased long-distance triathlon practice due to osteoarthritis of the hip. Fifty-one of the 1688 patients undergoing resurfacing during the inclusion period were long-distance triathlon players. The series comprised 48 patients: 51 implants; 43 male, 5 female; mean age, 44.8 years (range, 28.2-58.9 years). At a mean 4.7 years' follow-up (range, 2.2-7.6 years), all clinical scores showed significant improvement; Merle d'Aubigné and Harris scores rose respectively from 12.3 (5-16) and 42 (37-56) preoperatively to 17.5 (13-18) and 93.2 (73-100) (Phip resurfacing. Non-impact sports (swimming, cycling) predominated postoperatively, whereas the rate of impact sport (running) diminished. Return to competition-level sport (extreme triathlon) was possible for 28/48 patients (58%). Implant survival seemed unaffected by this high-impact sports activity at a mean 4.7 years' follow-up. IV, retrospective, non-controlled. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Resurfacing total hip replacement–a therapeutical approach in postmenopausal women with osteoporosis and hip arthrosis

    OpenAIRE

    Popescu, D; Ene, R; Cirstoiu, C

    2011-01-01

    Aim: Patients with incipient hip arthrosis may benefit from a relatively new therapeutical approach using resurfacing total hip replacement, but in those with associated osteoporosis, this type of surgical intervention is contraindicated, given the poor quality of osteoporotic bones. We assessed the efficacy of the antiosteoporotic pharmacological therapy to improve bone quality and bone strength in postmenopausal women diagnosed with hip arthrosis and osteoporosis thus facilitating the hip s...

  20. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    OpenAIRE

    Cook, Andrew; Cook, Steven; Smith, Ian; Weinrauch, Patrick

    2014-01-01

    It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testin...

  1. Confronting hip resurfacing and big femoral head replacement gait analysis

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2014-03-01

    Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

  2. Resurfacing total hip replacement–a therapeutical approach in postmenopausal women with osteoporosis and hip arthrosis

    Science.gov (United States)

    Popescu, D; Ene, R

    2011-01-01

    Aim: Patients with incipient hip arthrosis may benefit from a relatively new therapeutical approach using resurfacing total hip replacement, but in those with associated osteoporosis, this type of surgical intervention is contraindicated, given the poor quality of osteoporotic bones. We assessed the efficacy of the antiosteoporotic pharmacological therapy to improve bone quality and bone strength in postmenopausal women diagnosed with hip arthrosis and osteoporosis thus facilitating the hip surgical intervention. Methods: We evaluated 20 postmenopausal women aged between 53–60 years diagnosed with osteoporosis according to the WHO criteria, by using dual–energy X–ray absorptiometry (DXA) for bone mineral density measurements. All these patients had low hip T score (osteopenia/ osteoporosis) and also incipient hip arthrosis. The surgical approach was delayed for 12 months and all the patients received bisphosphonate therapy with calcium and vitamin D supplements. DXA scans were performed after 12 months of therapy in all the patients. Results: A surgical intervention with resurfacing total hip replacement was performed in 12 of the 16 patients presenting with increasing BMD, 4 of them showing elements of rapidly advancing hip arthrosis to a stage that made this type of intervention impossible. We chose not to use this technique in the group with stable BMD (4 patients). All 12 women surgically treated had a favorable post–operative outcome without experiencing a femoral neck fracture during the surgical intervention or during the twelve–month follow–up. All 20 patients continued to receive bisphosphonate therapy. Conclusion: In postmenopausal women with osteoporosis and associated hip arthrosis, improving bone mass and bone quality with bisphosphonate therapy is necessary and important in order to allow hip arthroplasty, by using the technique of resurfacing, avoiding the risk of intra–operative fractures and with a favorable post–operative long

  3. Resurfacing total hip replacement--a therapeutical approach in postmenopausal women with osteoporosis and hip arthrosis.

    Science.gov (United States)

    Popescu, D; Ene, R; Cirstoiu, C

    2011-05-15

    Patients with incipient hip arthrosis may benefit from a relatively new therapeutical approach using resurfacing total hip replacement, but in those with associated osteoporosis, this type of surgical intervention is contraindicated, given the poor quality of osteoporotic bones. We assessed the efficacy of the antiosteoporotic pharmacological therapy to improve bone quality and bone strength in postmenopausal women diagnosed with hip arthrosis and osteoporosis thus facilitating the hip surgical intervention. We evaluated 20 postmenopausal women aged between 53-60 years diagnosed with osteoporosis according to the WHO criteria, by using dual-energy X-ray absorptiometry (DXA) for bone mineral density measurements. All these patients had low hip T score (osteopenia/ osteoporosis) and also incipient hip arthrosis. The surgical approach was delayed for 12 months and all the patients received bisphosphonate therapy with calcium and vitamin D supplements. DXA scans were performed after 12 months of therapy in all the patients. A surgical intervention with resurfacing total hip replacement was performed in 12 of the 16 patients presenting with increasing BMD, 4 of them showing elements of rapidly advancing hip arthrosis to a stage that made this type of intervention impossible. We chose not to use this technique in the group with stable BMD (4 patients). All 12 women surgically treated had a favorable post-operative outcome without experiencing a femoral neck fracture during the surgical intervention or during the twelve-month follow-up. All 20 patients continued to receive bisphosphonate therapy. In postmenopausal women with osteoporosis and associated hip arthrosis, improving bone mass and bone quality with bisphosphonate therapy is necessary and important in order to allow hip arthroplasty, by using the technique of resurfacing, avoiding the risk of intra-operative fractures and with a favorable post-operative long-term outcome.

  4. Bone mineral density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim

    2010-01-01

    Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position....

  5. Inflammatory pseudotumor causing deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

    LENUS (Irish Health Repository)

    Memon, Adeel Rasool

    2013-01-01

    Metal-on-metal hip resurfacings have recently been associated with a variety of complications resulting from adverse reaction to metal debris. We report a case of extensive soft tissue necrosis associated with a huge pelvic mass causing extensive deep vein thrombosis of the lower limb secondary to mechanical compression of the iliac vein. This is a rare and unusual cause of deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

  6. Hip resurfacing arthroplasty in treatment of avascular necrosis of the femoral head.

    Science.gov (United States)

    Pyda, Michał; Koczy, Bogdan; Widuchowski, Wojciech; Widuchowska, Małgorzata; Stołtny, Tomasz; Mielnik, Michał; Hermanson, Jacek

    2015-01-25

    Hip resurfacing is a conservative type of total hip arthroplasty but its use is controversial, especially in patients with osteonecrosis. The aim of this study was analysis of the clinical and radiographic outcomes of hip resurfacing in patients with osteonecrosis. Between 2007 and 2008, 30 hip resurfacing arthroplasties were performed due to osteoarthritis secondary to avascular necrosis of femoral head staged as Ficat III and IV. Patients were qualified to resurfacing arthroplasty when the extent of avascular necrosis using Kerboul's method was avascular necrosis and head-neck junction was >20°. All patients were evaluated clinically and radiologically before and 60 months after the operation. The mean Harris Hip Score (HHS) score increased from 47.8 to 94.25 (p<0.05). Physical activity level (University of California, Los Angeles activity score--UCLA activity score) improved from 3.7 to 7.55 (p<0.05). No implant migration was observed. Management of osteonecrosis of the hip with resurfacing arthroplasty seems to be effective in strictly-selected patients.

  7. Computer-assisted vs conventional mechanical jig technique in hip resurfacing arthroplasty.

    Science.gov (United States)

    Resubal, Jose Rafael E; Morgan, David A F

    2009-04-01

    To compare the effectiveness of computer-assisted surgery (CAS) and mechanical jig technique in hip resurfacing arthroplasty, we reviewed 176 hip resurfacing arthroplasty performed in 158 patients. The initial 131 hips were resurfaced using the conventional mechanical jig technique, and the remaining 45 hips with the CAS technique. The demographic data of the patients were similar for both techniques. Follow-up radiographs taken 2 months after the surgery showed patients in the CAS technique having a significantly better alignment of the femoral component on the frontal and sagittal planes. There was no difference in the risk of implant notching on the femoral neck for both techniques. The implant sizes were similar for both techniques; thus, the amount of bone stock preserved was not technique specific.

  8. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement

    DEFF Research Database (Denmark)

    Penny, J O; Brixen, K; Varmarken, J E

    2012-01-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into ...

  9. Periacetabular Bone Mineral Density Changes After Resurfacing Hip Arthroplasty Versus Conventional Total Hip Arthroplasty. A Randomized Controlled DEXA Study

    NARCIS (Netherlands)

    Smolders, J.M.H.; Pakvis, D.F.; Hendrickx, B.W.; Verdonschot, Nicolaas Jacobus Joseph; van Susante, J.L.C.

    2013-01-01

    A randomized controlled trial was performed to evaluate acetabular bone mineral density (BMD) changes after hip resurfacing (RHA) versus an established conventional total hip arthroplasty (THA). A total of 71 patients were allocated randomly to receive either an RHA press-fit cobalt–chromium cup (n

  10. Recovery in horizontal gait after hip resurfacing vs. total hip arthroplasty at 6-month follow-up - a RCT study

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, Søren

    2012-01-01

    Background: Standard total hip arthroplasty (S-THA) is the established surgical treatment for patients older than 65 years with progressive osteoarthritis. However, implant survivorship curves decline more rapidly in patients younger than 50 years. Resurfacing total hip arthroplasty (R-THA) has t...

  11. Patient-reported outcome of hip resurfacing arthroplasty and standard total hip replacement after short-term follow-up

    DEFF Research Database (Denmark)

    Nissen, Nina; Douw, Karla; Overgaard, Søren

    2011-01-01

    The purpose of this study was to investigate patientreported outcome in terms of satisfaction in two study groups that had undergone hip resurfacing arthro-plasty (HRA) or total hip replacement (THR). The procedure consists of placing a hollow, mushroom-shaped metal cap over the femoral head while...

  12. Computer navigation experience in hip resurfacing improves femoral component alignment using a conventional jig.

    Science.gov (United States)

    Morison, Zachary; Mehra, Akshay; Olsen, Michael; Donnelly, Michael; Schemitsch, Emil

    2013-11-01

    The use of computer navigation has been shown to improve the accuracy of femoral component placement compared to conventional instrumentation in hip resurfacing. Whether exposure to computer navigation improves accuracy when the procedure is subsequently performed with conventional instrumentation without navigation has not been explored. We examined whether femoral component alignment utilizing a conventional jig improves following experience with the use of imageless computer navigation for hip resurfacing. Between December 2004 and December 2008, 213 consecutive hip resurfacings were performed by a single surgeon. The first 17 (Cohort 1) and the last 9 (Cohort 2) hip resurfacings were performed using a conventional guidewire alignment jig. In 187 cases, the femoral component was implanted using the imageless computer navigation. Cohorts 1 and 2 were compared for femoral component alignment accuracy. All components in Cohort 2 achieved the position determined by the preoperative plan. The mean deviation of the stem-shaft angle (SSA) from the preoperatively planned target position was 2.2° in Cohort 2 and 5.6° in Cohort 1 (P = 0.01). Four implants in Cohort 1 were positioned at least 10° varus compared to the target SSA position and another four were retroverted. Femoral component placement utilizing conventional instrumentation may be more accurate following experience using imageless computer navigation.

  13. Computer navigation experience in hip resurfacing improves femoral component alignment using a conventional jig

    Directory of Open Access Journals (Sweden)

    Zachary Morison

    2013-01-01

    Full Text Available Background:The use of computer navigation has been shown to improve the accuracy of femoral component placement compared to conventional instrumentation in hip resurfacing. Whether exposure to computer navigation improves accuracy when the procedure is subsequently performed with conventional instrumentation without navigation has not been explored. We examined whether femoral component alignment utilizing a conventional jig improves following experience with the use of imageless computer navigation for hip resurfacing. Materials and Methods:Between December 2004 and December 2008, 213 consecutive hip resurfacings were performed by a single surgeon. The first 17 (Cohort 1 and the last 9 (Cohort 2 hip resurfacings were performed using a conventional guidewire alignment jig. In 187 cases, the femoral component was implanted using the imageless computer navigation. Cohorts 1 and 2 were compared for femoral component alignment accuracy. Results:All components in Cohort 2 achieved the position determined by the preoperative plan. The mean deviation of the stem-shaft angle (SSA from the preoperatively planned target position was 2.2° in Cohort 2 and 5.6° in Cohort 1 ( P = 0.01. Four implants in Cohort 1 were positioned at least 10° varus compared to the target SSA position and another four were retroverted. Conclusions: Femoral component placement utilizing conventional instrumentation may be more accurate following experience using imageless computer navigation.

  14. Computer-assisted hip resurfacing planning using Lie group shape models.

    Science.gov (United States)

    Hefny, Mohamed S; Rudan, John F; Ellis, Randy E

    2015-06-01

    Hip resurfacing is a surgical option for osteoarthritis young and active patients. Early failures has been reported due to improper implant placement. Computer-assisted surgery is a promising avenue for more successful procedures. This paper presents a novel automatic surgical planning for computer-assisted hip resurfacing procedures. The plan defined the femoral head axis that was used to place the implant. The automatic planning was based on a Lie group statistical shape model. A statistical shape model was constructed using 50 femurs from osteoarthritis patients who underwent computer-assisted hip resurfacing. The model was constructed using product Lie groups representation of shapes and nonlinear analysis on the manifold of shapes. A surgical plan was drawn for the derived base shape. The base shape was transformed to 14 femurs with known manual plans. The transformed base plan was used as the computed plan for each femur. Both actual and computed plans were compared. The method showed a success by computing plans that differ from the actual plans within the surgical admissible ranges. The minimum crossing distance between the two plans had a mean of 0.75 mm with a standard deviation of 0.54 mm. The angular difference between the two plans had the mean of 5.94° with a standard deviation of 2.145.94°. Product Lie groups shape models were proved to be successful in automatic planning for hip resurfacing computer-assisted surgeries. The method can be extended to other orthopedic and general surgeries.

  15. Asymptomatic pseudotumours after metal-on-metal hip resurfacing show little change within one year

    NARCIS (Netherlands)

    van der Weegen, W.; Brakel, K.; Horn, R. J.; Hoekstra, H. J.; Sijbesma, T.; Pilot, P.; Nelissen, R. G. H. H.

    2013-01-01

    The aim of this study was to establish the natural course of unrevised asymptomatic pseudotumours after metal-on-metal (MoM) hip resurfacing during a six- to 12-month follow-up period. We used repeated metal artefact reduction sequence (MARS)-magnetic resonance imaging (MRI), serum metal ion

  16. The Tribology of Explanted Hip Resurfacings Following Early Fracture of the Femur

    Directory of Open Access Journals (Sweden)

    James K. Lord

    2015-10-01

    Full Text Available A recognized issue related to metal-on-metal hip resurfacings is early fracture of the femur. Most theories regarding the cause of fracture relate to clinical factors but an engineering analysis of failed hip resurfacings has not previously been reported. The objective of this work was to determine the wear volumes and surface roughness values of a cohort of retrieved hip resurfacings which were removed due to early femoral fracture, infection and avascular necrosis (AVN. Nine resurfacing femoral heads were obtained following early fracture of the femur, a further five were retrieved due to infection and AVN. All fourteen were measured for volumetric wear using a co-ordinate measuring machine. Wear rates were then calculated and regions of the articulating surface were divided into “worn” and “unworn”. Roughness values in these regions were measured using a non-contacting profilometer. The mean time to fracture was 3.7 months compared with 44.4 months for retrieval due to infection and AVN. Average wear rates in the early fracture heads were 64 times greater than those in the infection and AVN retrievals. Given the high wear rates of the early fracture components, such wear may be linked to an increased risk of femoral neck fracture.

  17. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... semiconstrained resurfacing cemented prosthesis. 888.3410 Section 888.3410 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained resurfacing cemented prosthesis is a two-part device intended to be implanted to replace the articulating surfaces of...

  18. Periprosthetic fractures in the resurfaced hip--A case report and review of the literature.

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2013-02-01

    Traumatic periprosthetic fractures adjacent a hip resurfacing prosthesis are rare. When proximal fractures are encountered the obvious surgical solution is to revise to a large head stemmed femoral component. A previously well functioning implant may however be retained as various non-operative and operative treatment options exist. This paper reports the case history of a traumatic periprosthetic fracture successfully treated with cannulated screw fixation and reviews the current literature.

  19. Direct to consumer advertising via the Internet, a study of hip resurfacing.

    Science.gov (United States)

    Ogunwale, B; Clarke, J; Young, D; Mohammed, A; Patil, S; Meek, R M D

    2009-02-01

    With increased use of the internet for health information and direct to consumer advertising from medical companies, there is concern about the quality of information available to patients. The aim of this study was to examine the quality of health information on the internet for hip resurfacing. An assessment tool was designed to measure quality of information. Websites were measured on credibility of source; usability; currentness of the information; content relevance; content accuracy/completeness and disclosure/bias. Each website assessed was given a total score, based on number of scores achieved from the above categories websites were further analysed on author, geographical origin and possession of an independent credibility check. There was positive correlation between the overall score for the website and the score of each website in each assessment category. Websites by implant companies, doctors and hospitals scored poorly. Websites with an independent credibility check such as Health on the Net (HoN) scored twice the total scores of websites without. Like other internet health websites, the quality of information on hip resurfacing websites is variable. This study highlights methods by which to assess the quality of health information on the internet and advocates that patients should look for a statement of an "independent credibility check" when searching for information on hip resurfacing.

  20. Outcomes of hip resurfacing in a professional dancer: a case report.

    Science.gov (United States)

    Dunleavy, Kim

    2012-02-01

    A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with hip osteoarthritis. A more aggressive rehabilitation program than the typical total hip arthroplasty protocol is needed for active individuals. This case report describes interventions used to maximize function in a 46-year-old professional dancer after hip resurfacing with a progressive therapeutic exercise program. Exercise choices were selected to address dance-specific requirements while respecting healing of the posterior capsular incision. Strengthening focused on hip abduction, extension, and external rotation. Precautions included avoiding gluteal stretching until 6 months. Pelvic alignment and weight-bearing distribution were emphasized. The patient was able to return to rehearsal by 7 months, at which time strength was equivalent to the unaffected leg. Range of motion reached unaffected side values at week 8 for internal rotation, week 11 for extension, week 13 for adduction, and week 28 for flexion. External rotation and abduction were still limited at 1 year, which influenced pelvic alignment with resultant pain on the unaffected side. Functional and impairment outcomes are presented with timelines to provide a basis for postoperative benchmarks for active clients after hip resurfacing. Although this case report presents a dance-specific program, exercise progressions for other active individuals may benefit from similar exercise intensity and sports-specific focus. Future rehabilitation programs should take into account possible flexion and external rotation range limitations and the need for gluteal muscle strengthening along with symmetry and pelvic alignment correction. Long-term studies investigating intensity of rehabilitation are warranted for patients intending to participate in higher level athletic activity.

  1. Finite element modeling of resurfacing hip prosthesis: estimation of accuracy through experimental validation.

    Science.gov (United States)

    Taddei, Fulvia; Martelli, Saulo; Gill, Harinderjit Singh; Cristofolini, Luca; Viceconti, Marco

    2010-02-01

    Metal-on-metal hip resurfacing is becoming increasingly popular, and a number of new devices have been recently introduced that, in the short term, appear to have satisfactory outcome but many questions are still open on the biomechanics of the resurfaced femur. This could be investigated by means of finite element analysis, but, in order to be effective in discerning potential critical conditions, the accuracy of the models' predictions should be assessed. The major goal of this study was to validate, through a combined experimental-numerical study, a finite element modeling procedure for the simulation of resurfaced femurs. In addition, a preliminary biomechanical analysis of the changes induced in the femoral neck biomechanics by the presence of the device was performed, under a physiologic range of hip joint reaction directions. For this purpose, in vitro tests and a finite element model based on the same specimen were developed using a cadaver femur. The study focused on the Conserve Plus, one of the most common contemporary resurfacing designs. Five loading configurations were identified to correspond to the extremes of physiological directions for the hip joint. The agreement between experimental measurements and numerical predictions was good both in the prediction of the femoral strains (R(2)>0.9), and in the prosthesis micromotions (errorprosthesis, apart from localized strain increments that can be considerable, always predicted near the stem. Low micromotions and contact pressure were predicted, suggesting a good stability of the prosthesis. The model accuracy was good in the prediction of the femoral strains and moderately good in the prediction of the bone-prosthesis micromovements. Although the investigated loading conditions were not completely physiological, the preliminary biomechanical analysis showed relatively small changes for the proximal femur after implantation. This validated model can support realistic simulations to examine physiological

  2. Comparison of Cemented and Bone Ingrowth Fixation Methods in Hip Resurfacing for Osteonecrosis.

    Science.gov (United States)

    O'Leary, Ryan J; Gaillard, Melissa D; Gross, Thomas P

    2017-02-01

    The optimal surgical treatment for osteonecrosis of the femoral head has yet to be elucidated. To evaluate the role of femoral fixation techniques in hip resurfacing, we present a comparison of the results for 2 consecutive groups: group 1 (75 hips) received hybrid hip resurfacing implants with a cemented femoral component; group 2 (103 hips) received uncemented femoral components. Both groups received uncemented acetabular components. We retrospectively analyzed our clinical database to compare failures, reoperations, complications, clinical results, metal ion test results, and X-ray measurements. Using consecutive groups caused time interval bias, so we required all group 2 patients to be at least 2 years out from surgery; we compared results from 2 years and final follow-up. Patient groups matched similarly in age, body mass index, and percent female. Despite similar demographics, the uncemented, group 2 cases showed a lower raw failure rate (0% vs 16%; P < .0001), a lower 2-year failure rate (0% vs 7%; P = .04), and a superior 8-year implant survivorship (100% vs 91%; log-rank P = .0028; Wilcoxon P = .0026). In cases that did not fail, patient clinical (P = .05), activity (P = .02), and pain scores (P = .03), as well as acetabular component position (P < .0001), all improved in group 2, suggesting advancements in surgical management. There were no cases of adverse wear-related failure in either group. This study demonstrates a superior outcome for cases of osteonecrosis with uncemented hip resurfacings compared to cases employing hybrid devices. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. High incidence of pseudotumours after hip resurfacing even in low risk patients; results from an intensified MRI screening protocol.

    NARCIS (Netherlands)

    Weegen, W. van der; Smolders, J.M.; Sijbesma, T.; Hoekstra, H.J.; Brakel, K.; Susante, J.L.C. van

    2013-01-01

    We intensified our screening protocol for the presence of pseudotumours in a consecutive series of patients with a hip resurfacing arthroplasty (HRA), to establish whether we should be alert to the presence of 'silent' pseudotumours. Patients categorised with high risk (11 hips) and low risk (10

  4. Reliability of using DXA around RTHAs. Bone Mineral Density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim

    2010-01-01

      Background and purpose: Resurfacing Total Hip Arthroplasty (RTHA) may preserve the femoral neck bone-stock post-operatively. Bone Mineral Density (BMD), could theoretically be affected by the hip-position, and bias longitudinal studies. We aimed to investigate BMD precision dependency on type...... of ROI and position of hip. Method: We DXA scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations; 15° internal, neutral, and 15° external. For each position BMD was analyzed with 3 different surface area models. One model measured BMD in the total femoral neck......, the second model divided the neck in two and the third model had 6 divisions. Results: When all hip positions were pooled a mean Coefficient of variation (CV) of 3.1%, 3.6% and 4.6% was found in the 1, 2 and 6-region models, respectively, The external rotated hip position was less reproducible. When the hip...

  5. Bone mineral density of the femoral neck in resurfacing hip arthroplasty.

    Science.gov (United States)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim; Varmarken, Jens-Erik; Overgaard, Søren

    2010-06-01

    Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position. We DXA-scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations: 15 degrees internal, neutral, and 15 degrees external. For each position, BMD was analyzed with 3 surface area models. One model measured BMD in the total femoral neck, the second model divided the neck in two, and the third model had 6 divisions. When all hip positions were pooled, average coefficients of variation (CVs) of 3.1%, 3.6%, and 4.6% were found in the 1-, 2-, and 6-region models, respectively. The externally rotated hip position was less reproducible. When rotating in increments of 15 degrees or 30 degrees , the average CVs rose to 7.2%, 7.3%, and 12% in the 3 models. Rotation affected the precision most in the model that divided the neck in 6 subregions, predominantly in the lateral and distal regions. For larger-region models, some rotation could be allowed without compromising the precision. If hip rotation is strictly controlled, DXA can reliably provide detailed topographical information about the BMD changes around an RTHA. As rotation strongly affects the precision of the BMD measurements in small regions, we suggest that a less detailed model should be used for analysis in studies where the leg position has not been firmly controlled.

  6. What are the risks accompanying the reduced wear benefit of low-clearance hip resurfacing?

    Science.gov (United States)

    Daniel, Joseph; Ziaee, Hena; Kamali, Amir; Pradhan, Chandra; McMinn, Derek

    2012-10-01

    Clearance is an important determinant of metal-metal bearing function. Tribologic theory and laboratory evidence suggest low clearance (LC) reduces wear but with a potential to increase friction and clinical reports show LC resurfacings have high implant failure rates. Thus, the role of LC is unclear. We asked: is in vivo wear as reflected by cobalt (Co) and chromium (Cr) levels reduced in LC bearings, and if so, is this benefit offset by increased friction as assessed by implant-bone interface changes? We retrospectively reviewed 26 patients with LC resurfacings. We assessed Co and Cr levels in blood and urine, hip function, and radiographic adverse features. These data were compared with those from 26 patients with a similar resurfacing but with conventional clearance (CC) from a previous study. Minimum followup was 4.0 years (mean, 4.1 years; range, 4.0-4.7 years). Co and Cr ion comparisons showed three phases: in the first 2 months, there was no difference between the cohorts; at 2 to 24 months, the CC group showed higher levels; and subsequently, levels in the two groups converged. A mean Oxford hip score of 13 and step activity of 1.9 million cycles per year in the LC group were similar to those of the CC group. Cup radiolucencies were seen in three patients in the LC group and none in the CC group. Lower Co and Cr levels suggest lower wear in the LC resurfacings in the intermediate term, but the presence of radiolucencies raises the concern that higher bearing friction is affecting implant fixation. A larger clearance than the theoretically predicted ideal may be required to allow for minor manufacturing imperfections, component deformation, and progressive changes in the in vivo lubricant. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  7. Computer navigation vs conventional mechanical jig technique in hip resurfacing arthroplasty: a meta-analysis based on 7 studies.

    Science.gov (United States)

    Liu, Hao; Li, Lin; Gao, Wei; Wang, Meilin; Ni, Chunhui

    2013-01-01

    The studies on the accuracy of femoral component in hip resurfacing arthroplasty with the help of computer-assisted navigation were not consistent. This study aims to assess at the functional outcomes after computer navigation in hip resurfacing arthroplasty by systematically reviewing and meta-analyzing the data, which were searched up to December 2011 in PubMed, MEDLINE, EMBASE, MetaMed, EBSCO HOST, and the Web site of Google scholar. Totally, 197 articles about hip resurfacing arthroplasty were collected; finally, 7 articles met the inclusion criteria and were included in this meta-analysis (520 patients with 555 hip resurfacing arthroplasty). The odds ratio for the number of outliers was 0.155 (95% confidence interval, 0.048-0.498; P < .003). In conclusion, this meta-analysis suggests that the computer-assisted navigation system makes the femoral component positioning in hip resurfacing arthroplasty easier and more precise. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  8. Similar range of motion and function after resurfacing large-head or standard total hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Varmarken, Jens-Erik

    2013-01-01

    BACKGROUND AND PURPOSE: Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA......° (35), 232° (36), and 225° (30) respectively, but the differences were not statistically significant. The 3 groups were similar regarding Harris hip score, UCLA activity score, step rate, and sick leave. INTERPRETATION: Head size had no influence on range of motion. The lack of restriction allowed...... for large articulations did not improve the clinical and patient-perceived outcomes. The more extensive surgical procedure of RHA did not impair the rehabilitation. This project is registered at ClinicalTrials.gov under # NCT01113762....

  9. A comparison of conventional guidewire alignment jigs with imageless computer navigation in hip resurfacing arthroplasty.

    Science.gov (United States)

    Olsen, Michael; Chiu, Mark; Gamble, Patrick; Boyle, Richard A; Tumia, Nezar; Schemitsch, Emil H

    2010-08-04

    Correct positioning of the initial femoral guidewire is vital in order to prepare the femoral head properly for hip resurfacing. The purpose of the present investigation was to determine the accuracy and precision of the placement of the initial femoral guidewire with use of conventional alignment jigs and to compare the results with those of imageless computer navigation. Five commercially available jigs (two lateral pin jigs, two neck centering jigs, and one head planing jig) were obtained. Four surgeons used each jig and navigation three times to insert a guidewire in 10 degrees of relative valgus and neutral version into individual synthetic femora. A single surgeon then used each jig three times to align the initial guidewire in 10 degrees of relative valgus and neutral version in each of ten human cadaver femora. Radiographs of the synthetic and human femora were made to assess and compare guidewire inclination and version between conventional instrumentation and navigation. Navigation provided ranges of error in the coronal guidewire alignment of up to eight times less than the conventional jigs, but both methods provided similar ranges of error for version. In both arms of the study, there were significant differences in coronal alignment accuracy between the two neck centering jigs. Next to navigation, one lateral pin jig provided the most accurate coronal placement of the initial guidewire whereas one neck centering jig provided the most precise coronal placement of the guidewire. Navigation was similar to conventional jigs in terms of the accuracy and precision of guidewire version. In hip resurfacing arthroplasty, the choice of a femoral alignment device may influence the accuracy and precision of guidewire insertion, ultimately impacting femoral component placement. Imageless computer navigation can facilitate accurate and precise coronal alignment of the initial femoral guidewire, superior to that of conventional instrumentation. The results of this

  10. How accurate is image-free computer navigation for hip resurfacing arthroplasty? An anatomical investigation

    International Nuclear Information System (INIS)

    Schnurr, C.; Nessler, J.; Koenig, D.P.; Meyer, C.; Schild, H.H.; Koebke, J.

    2009-01-01

    The existing studies concerning image-free navigated implantation of hip resurfacing arthroplasty are based on analysis of the accuracy of conventional biplane radiography. Studies have shown that these measurements in biplane radiography are imprecise and that precision is improved by use of three-dimensional (3D) computer tomography (CT) scans. To date, the accuracy of image-free navigation devices for hip resurfacing has not been investigated using CT scans, and anteversion accuracy has not been assessed at all. Furthermore, no study has tested the reliability of the navigation software concerning the automatically calculated implant position. The purpose of our study was to analyze the accuracy of varus-valgus and anteversion using an image-free hip resurfacing navigation device. The reliability of the software-calculated implant position was also determined. A total of 32 femoral hip resurfacing components were implanted on embalmed human femurs using an image-free navigation device. In all, 16 prostheses were implanted with the proposed position generated by the navigation software; the 16 prostheses were inserted in an optimized valgus position. A 3D CT scan was undertaken before and after operation. The difference between the measured and planned varus-valgus angle averaged 1 deg (mean±standard deviation (SD): group I, 1 deg±2 deg; group II, 1 deg±1 deg). The mean±SD difference between femoral neck anteversion and anteversion of the implant was 4 deg (group I, 4 deg±4 deg; group II, 4 deg±3 deg). The software-calculated implant position differed 7 deg±8 deg from the measured neck-shaft angle. These measured accuracies did not differ significantly between the two groups. Our study proved the high accuracy of the navigation device concerning the most important biomechanical factor: the varus-valgus angle. The software calculation of the proposed implant position has been shown to be inaccurate and needs improvement. Hence, manual adjustment of the

  11. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, S

    2011-01-01

    in maximal lower limb muscle strength (in 2/6 muscle groups) compared to S-THA. Notably, the attenuated strength recovery following R-THA was most markedly manifested in the late phase (1 yr) of post-surgical recovery, and appeared to be due to the detachment of the lower half of the gluteus maximus muscle...... randomised into (A) standard total hip arthroplasty (S-THA) and (B) resurfacing total hip arthroplasty (R-THA). Pre-surgery assessment and follow-up were conducted (8, 26 and 52 wks). Maximal isometric muscle strength (Nm) and between-limb asymmetry for the knee extensors/flexors, hip adductors....../abductors, hip extensors/flexors were analysed. RESULTS: Maximal knee extensor and hip abductor strength were higher in S-THA than R-THA at 52 wks post-surgery (P ≤ 0.05) and hip extensors tended to be higher in S-THA at 52 wks (P = 0.06). All muscle groups showed substantial between-limb strength asymmetry (7...

  12. A randomised controlled trial of total hip arthroplasty versus resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint.

    Science.gov (United States)

    Achten, Juul; Parsons, Nick R; Edlin, Richard P; Griffin, Damian R; Costa, Matthew L

    2010-01-14

    Hip replacement (arthroplasty) surgery is a highly successful treatment for patients with severe symptomatic arthritis of the hip joint. For older patients, several designs of Total Hip Arthroplasty have shown excellent results in terms of both function and value for money. However, in younger more active patients, there is approximately a 50% failure rate at 25 years for traditional implants. Hip resurfacing is a relatively new arthroplasty technique. In a recent review of the literature on resurfacing arthroplasty it was concluded that the short-term functional results appear promising but some potential early disadvantages were identified, including the risk of femoral neck fracture and collapse of the head of the femur. The aim of the current study is to assess whether there is a difference in functional hip scores at one year post-operation between Total Hip Arthroplasty and Resurfacing Arthroplasty. Secondary aims include assessment of complication rates for both procedures as well cost effectiveness. All patients medically fit for surgery and deemed suitable for a resurfacing arthroplasty are eligible to take part in this study. A randomisation sequence will be produced and administered independently. After consenting, all patients will be clinically reviewed and hip function, quality of life and physical activity level will be assessed through questionnaires. The allocated surgery will then be performed with the preferred technique of the surgeon. Six weeks post-operation hip function will be assessed and complications recorded. Three, six and 12 months post-operation hip function, quality of life and physical activity level will be assessed. Additional information about patients' out-of-pocket expenses will also be collected. Current Controlled Trials ISRCTN33354155. UKCLRN portfolio ID 4093.

  13. Hip resurfacing using a modified lateral approach with limited splitting of the gluteus medius muscle results in significant impairment of hip abductor strength.

    Science.gov (United States)

    Moussazadeh, A J; Kohlhof, H; Wirtz, D C; Wimmer, M D; Randau, T M; Wölk, T; Gravius, S

    2013-01-01

    A lateral, transgluteal approach for hip resurfacing carries the risk of approach-related weakening of the hip abductors due to unsuccessful re-adaptation of the gluteal muscles to the greater trochanter or to injury to the inferior nerve branch of the superior gluteal nerve. We investigated whether hip resurfacing using a soft tissue-sparing, modified transgluteal approach with limited cranial splitting of the gluteus medius muscle reduces hip abductor strength and the risk of approach-related injury to the superior gluteal nerve. Thirty-one patients (14 female, 17 male; mean age 53.5 ± 5.2 years) underwent hip resurfacing using a modified transgluteal approach with limited cranial splitting of the gluteus medius muscle. Nerve conduction signals were measured by surface electromyography (EMG), hip abductor strength by isokinetic testing a mean 36.2 months (± 11 mos) after surgery. The unoperated side was used as control. Surface EMG disclosed no neural lesions of the inferior branch of the superior gluteal nerve. Isokinetics revealed a significant reduction in muscle strength on the operated versus the contralateral side. Even a limited incision of the gluteus medius muscle resulted in significant impairment of hip abductor strength 2.5 years after surgery.

  14. Are Females at Greater Risk for Revision Surgery After Hip Resurfacing Arthroplasty With the Articular Surface Replacement Prosthesis?

    Science.gov (United States)

    Donahue, Gabrielle S; Lindgren, Viktor; Galea, Vincent P; Madanat, Rami; Muratoglu, Orhun; Malchau, Henrik

    2016-10-01

    Female patients undergoing hip resurfacing arthroplasties may be at greater risk of revision surgery than males, but it is unclear whether this is related to sex or other factors. We focused our analysis on data from a prospective multicenter cohort study monitoring the ASR(TM) hip resurfacing arthroplasty prosthesis on the potential association of sex on patient-reported outcome measures (PROMs), metal ion levels, revision surgery, and presence of adverse local tissue reaction. As thousands of patients with the ASR(TM) prosthesis are still undergoing followup it is critical to optimize the protocol for monitoring these patients. We wished (1) to assess the associations between sex and implant survival, and adverse local tissue reaction; and (2) to report the differences between sexes in metal ion levels and patient-reported outcome measures. One thousand two hundred fifty-two patients (1390 hips) who underwent hip resurfacing arthroplasty with implantation of the ASR(TM) prosthesis from April 2003 to July 2010 were eligible for enrollment in a multicenter followup study of the ASR(TM) Hip Resurfacing System after the voluntary recall of this device was initiated by DePuy in 2010. Nine hundred seventy patients (1098 hips) were enrolled at a mean of 7 years after surgery, with a mean followup of 2 years (range, 1-3.5 years). Nine hundred fifty-eight patients (1084 hips) met the inclusion criteria: ability to provide informed consent, complete PROMs, and continued routine followup. A subset of patients (150 patients, 171 hips), who all were from one center, with annual metal artifact reduction sequence MRI were analyzed. Ninety-three percent of patients from this center had routine MRI performed. The EuroQoL (EQ-5D), Harris hip score (HHS), University of California Los Angeles (UCLA) activity score, VAS pain, radiographs, patient and surgery details, and blood cobalt and chromium levels were obtained. Cox regression analysis was conducted to identify factors

  15. Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis

    Science.gov (United States)

    Gustafson, Klas; Jakobsen, Stig S; Lorenzen, Nina D; Thyssen, Jacob P; Johansen, Jeanne D; Bonefeld, Charlotte M; Stilling, Maiken; Baad-Hansen, Thomas; Søballe, Kjeld

    2014-01-01

    Background Metal-on-metal (MOM) total hip arthroplasties were reintroduced because of the problems with osteolysis and aseptic loosening related to polyethylene wear of early metal-on-polyethylene (MOP) arthroplasties. The volumetric wear rate has been greatly reduced with MOM arthroplasties; however, because of nano-size wear particles, the absolute number has been greatly increased. Thus, a source of metal ion exposure with the potential to sensitize patients is present. We hypothesized that higher amounts of wear particles result in increased release of metal ions and ultimately lead to an increased incidence of metal allergy. Methods 52 hips in 52 patients (median age 60 (51–64) years, 30 women) were randomized to either a MOM hip resurfacing system (ReCap) or a standard MOP total hip arthoplasty (Mallory Head/Exeter). Spot urine samples were collected preoperatively, postoperatively, after 3 months, and after 1, 2, and 5 years and tested with inductively coupled plasma-sector field mass spectrometry. After 5 years, hypersensitivity to metals was evaluated by patch testing and lymphocyte transformation assay. In addition, the patients answered a questionnaire about hypersensitivity. Results A statistically significant 10- to 20-fold increase in urinary levels of cobalt and chromium was observed throughout the entire follow-up in the MOM group. The prevalence of metal allergy was similar between groups. Interpretation While we observed significantly increased levels of metal ions in the urine during the entire follow-up period, no difference in prevalence of metal allergy was observed in the MOM group. However, the effect of long-term metal exposure remains uncertain. PMID:24930546

  16. Effect of simplifications of bone and components inclination on the elastohydrodynamic lubrication modeling of metal-on-metal hip resurfacing prosthesis.

    Science.gov (United States)

    Meng, Qingen; Liu, Feng; Fisher, John; Jin, Zhongmin

    2013-05-01

    It is important to study the lubrication mechanism of metal-on-metal hip resurfacing prosthesis in order to understand its overall tribological performance, thereby minimize the wear particles. Previous elastohydrodynamic lubrication studies of metal-on-metal hip resurfacing prosthesis neglected the effects of the orientations of the cup and head. Simplified pelvic and femoral bone models were also adopted for the previous studies. These simplifications may lead to unrealistic predictions. For the first time, an elastohydrodynamic lubrication model was developed and solved for a full metal-on-metal hip resurfacing arthroplasty. The effects of the orientations of components and the realistic bones on the lubrication performance of metal-on-metal hip resurfacing prosthesis were investigated by comparing the full model with simplified models. It was found that the orientation of the head played a very important role in the prediction of pressure distributions and film profiles of the metal-on-metal hip resurfacing prosthesis. The inclination of the hemispherical cup up to 45° had no appreciable effect on the lubrication performance of the metal-on-metal hip resurfacing prosthesis. Moreover, the combined effect of material properties and structures of bones was negligible. Future studies should focus on higher inclination angles, smaller coverage angle and microseparation related to the occurrences of edge loading.

  17. What is the natural history of asymptomatic pseudotumours in metal-on-metal hip resurfacing patients?

    Science.gov (United States)

    Matharu, Gulraj S; Ostlere, Simon J; Pandit, Hemant G; Murray, David W

    2016-11-10

    We assessed the natural history of asymptomatic pseudotumours associated with metal-on-metal hip resurfacings (MoMHRs), and factors associated with future revision. In 2007-2008, we identified 25 MoMHRs (21 patients; mean age 59.9 years; 76% female) with asymptomatic pseudotumours. All patients underwent identical initial assessment (ultrasound, blood metal ions, radiographs, Oxford Hip Score [OHS]) and were considered asymptomatic because they denied experiencing hip symptoms, were satisfied with their MoMHR surgery, and had good or excellent OHSs (≥34). In 2012-2013, repeat assessments were performed in all non-revised patients. Revision for pseudotumour was performed/recommended in 15 MoMHRs (60%) at a mean 2.7 years (range 0.4-6.4 years) from initial assessment, with 14 developing symptoms before revision. Non-revised MoMHRs (n = 10) underwent repeat ultrasound at a mean 5.1 years (range 4.0-6.5 years) later, with no changes in pseudotumour volume (p = 0.956) or OHS (p = 0.065) between assessments. High blood cobalt (p = 0.0048) and chromium (p = 0.0162), large pseudotumours (p = 0.0458), low OHS (p = 0.0183), and bilateral MoMHRs (p = 0.049) predicted future revision. Patients with blood metal ions above established unilateral/bilateral thresholds and/or initial pseudotumours >30 cm3 had an 86.7% sensitivity, 70.0% specificity, 81.2% positive predictive value, and 77.8% negative predictive value for future revision. MoMHR patients with initially asymptomatic pseudotumours often become symptomatic and require revision. Patients with high blood metal ions and/or pseudotumours >30 cm3 should remain under annual surveillance or be considered for revision (especially in patients also having lower initial OHSs, bilateral MoMHRs, and/or those becoming symptomatic). Less regular surveillance of patients outside these parameters appears acceptable.

  18. The effect of motion patterns on edge-loading of metal-on-metal hip resurfacing.

    Science.gov (United States)

    Mellon, S J; Kwon, Y-M; Glyn-Jones, S; Murray, D W; Gill, H S

    2011-12-01

    The occurrence of pseudotumours (soft tissue masses relating to the hip joint) following metal-on-metal hip resurfacing arthroplasty (MoMHRA) has been associated with high serum metal ion levels and consequently higher than normal bearing wear. We investigated the relationship between serum metal ion levels and contact stress on the acetabular component of MoMHRA patients for two functional activities; gait and stair descent. Four subjects with MoMHRA, who had their serum metal ion levels measured, underwent motion analysis followed by CT scanning. Their motion capture data was combined with published hip contact forces and finite element models representing 14% (peak force) and 60% (end of stance) of the gait cycle and 52% (peak force) of stair descent activity were created. The inclination angle of the acetabular component was increased by 10° in 1° intervals and the contact stresses were determined at each interval for each subject. When the inclination angle was altered in such a way as to cause the hip contact force to pass through the edge of the acetabular component edge-loading occurred. Edge-loading increased the contact stress by at least 50%; the maximum increase was 108%. Patients with low serum metal ion levels showed no increase in contact stress at peak force during gait or stair descent. Patients with high serum metal ion levels exhibited edge-loading with an increase to the inclination angle of their acetabular components. The increase in inclination angle that induced edge-loading for these subjects was less than the inter-subject variability in the angle of published hip contact forces. The results of this study suggest that high serum metal ion levels are the result of inclination angle influenced edge-loading but that edge-loading cannot be attributed to inclination angle alone and that an individual's activity patterns can reduce or even override the influence of a steep acetabular component and prevent edge-loading. Copyright © 2011 IPEM

  19. Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007

    DEFF Research Database (Denmark)

    Johanson, Per-Erik; Fenstad, Anne Marie; Furnes, Ove

    2010-01-01

    The reported outcomes of hip resurfacing arthroplasty (HRA) vary. The frequency of this procedure in Denmark, Norway, and Sweden is low. We therefore determined the outcome of HRA in the NARA database, which is common to all 3 countries, and compared it to the outcome of conventional total hip...

  20. Revision rates for metal-on-metal hip resurfacing and metal-on-metal total hip arthroplasty - a systematic review.

    Science.gov (United States)

    Ras Sørensen, Sofie-Amalie L; Jørgensen, Henrik L; Sporing, Sune L; Lauritzen, Jes B

    2016-11-10

    To compare revision rates of metal-on-metal (MoM) hip resurfacing (HRS) and MoM total hip arthroplasty (THA), as well as the primary causes for revisions. The PubMed database was queried for potentially relevant articles addressing MoMTHA and MoMHRS, a total of 51 articles were included. The review includes a total number of 5,399 MoMHRS and 3,244 THA prosthesis and the reasons for prosthesis failure were divided into 7 categories and the main causes discussed. The overall MoMTHA revision rate was 4.7% after 6.9 years. MoMHRS revision rate was 5.9% after 5.7 years. The odds ratio was 1.25 (1.03:1.53) 95% CI (p = 0.03) (MoMHRS vs. MoMTHA).The studies of hip prostheses were separated into 2 categories of short- and long-term (more or less than 5 years). Short-term revision rate for MoMTHA was 4.5% after 4.8 years, and for MoMHRS 4.0% after 4.2 years. The odds ratio was 1.09 (0.82:1.43) 95% CI (0 = 0.56) (MoMTHA vs. MoMHRS). Long-term revision rate for MoMTHA was 5.2% after 7.7 years and 8.2% after 7.6 years for MoMHRS. The odds ratio was 1.58 (1.53:1.96) 95% CI (p = 0.0001) (MoMHRS vs. MoMTHA).Revision causes were divided into 7 main categories. The most common cause for revision for both MoMTHA and MoMHRS was loosening 47.6% vs. 37.7%, fracture (MoMTHA 7.69%; MoMHRS 19.62%), metal reactions (MoMTHA 7.69%; MoMHRS 26.92%) infection (MoMTHA 12.08%; MoMHRS 6.54%), instability (MoMTHA 9.13%; MoMHRS 2.69%), manufacturer defect 6.73% for MoMTHA and nonreported for MoMHRS, and miscellaneous (MoMTHA 7.69%; MoMHRS 6.54%) was stated. The comparison of MoMHRS and MoMTHA revision rates showed no difference in the short term, however in the longer term, the revision rate of MoMHRS was significantly higher than for MoMTHA. The linear increase in revision rate of MoMHRS may indicate a progression in failure.

  1. Reliability of using DXA around RTHAs. Bone Mineral Density of the femoral neck in resurfacing hip arthroplasty. Precision biased by region of interest and rotation of the hip

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Varmarken, Jens-Erik; Ovesen, Ole

    2009-01-01

    the hip was rotated in increments of 15° and 30°, the mean CVs rose to 7.2%, 7.3% and 11.8%.  Rotation affected the precision most in the model that divided the neck in 6 sub regions, predominantly in the lateral and distal regions. For larger-region models, some rotation could be allowed without......  Introduction:  Resurfacing Total Hip Arthroplasty (RTHA) may preserve the femoral neck bone-stock post-operatively. Bone Mineral Density (BMD), could theoretically be affected by the hip-position, and bias longitudinal studies. We aimed to investigate BMD precision dependency on type of ROI...... and position of hip.   Method and Materials  We DXA scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations; 15° internal, neutral, and 15° external. For each position BMD was analyzed with 3 different surface area models. One model measured BMD in the total femoral neck...

  2. A MRI classification of periprosthetic soft tissue masses (pseudotumours) associated with metal-on-metal resurfacing hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Hauptfleisch, Jennifer; Ostlere, Simon [Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Department of Radiology, Oxford (United Kingdom); Pandit, Hemant; Grammatopoulos, George; Gill, Harinderjit S.; Murray, David W. [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Botnar Research Centre, Oxford (United Kingdom)

    2012-02-15

    Metal-on-metal hip resurfacing arthroplasty (MoMHRA) has become a popular option for young patients requiring hip replacement. A recognised complication is the formation of a symptomatic reactive periprosthetic soft tissue mass (pseudotumour). We present a radiological classification system for these reactive masses, dividing them into three groups: Type I are thin-walled cystic masses (cyst wall <3 mm), Type II are thick-walled cystic masses (cyst wall >3 mm, but less than the diameter of the cystic component) and Type III are predominantly solid masses. We reviewed all MRI performed over a 4-year period in patients with primary MoMHRA referred to our institution. In all cases the masses were assessed on MRI according to size, anatomical position, signal intensity and involvement of bone, muscle or neighbouring neurovascular bundles. Periprosthetic masses were seen in 33 hips in 17 female (7 bilateral) and 8 male patients (1 bilateral). The Type I lesions were the most common and more likely to be posterior to the hip joint. The Type III masses were significantly larger than the cystic lesions and were more likely to be located anterior to the hip joint. To date 22 patients have undergone revision surgery with conversions to total hip replacement. Severity of symptoms and revision rates were lowest in the Type I group and highest in the Type III group. Solid anterior pseudotumours were most likely to have the more severe symptoms and require revision surgery. (orig.)

  3. Revision of failed hip resurfacing to total hip arthroplasty rapidly relieves pain and improves function in the early post operative period

    Directory of Open Access Journals (Sweden)

    Muirhead-Allwood Sarah K

    2010-11-01

    Full Text Available Abstract We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases. There were 12 male and 13 female patients with average time to revision of 34.4 and 26.4 months respectively. The mean follow up period was 12.7 months (3 to 31. All patients reported relief of pain and excellent satisfaction scores. Two patients experienced stiffness up to three months post operatively. Pre operative Oxford, Harris and WOMAC hip scores were 39.1, 36.4 and 52.2 respectively. Mean post operative scores at last follow up were 17.4, 89.8 and 6.1 respectively (p

  4. Adverse reaction to metal debris in a consecutive series of DUROM™ hip resurfacing: pseudotumour incidence and metal ion concentration.

    Science.gov (United States)

    Hartmann, Albrecht; Kieback, Jan-Dirk; Lützner, Jörg; Günther, Klaus-Peter; Goronzy, Jens

    2017-07-25

    The aim of this study was to evaluate the incidence of adverse reactions to metal debris (ARMD) in a consecutive series of DUROM™ Hip Resurfacing Arthroplasty (HRA) at mid-term follow-up. Between October 2003 and March 2007 a total of 134 consecutive DUROM™ HRA in 121 patients were performed at our institution. Follow-up could be obtained in 101 unrevised patients (83%) at a mean time of 8.51 ± 0.97 years postoperatively and included patient-related outcome measurement, plain radiographs, MARS-MRI as well as whole blood metal ion assessment. 17 (16.5%) out of 103 hips revealed pseudotumour occurrence in MRI investigation, 1 (10.6%) with a diameter of ≥2 cm. Higher incidence of pseudotumours was found patients with femoral component size 7 μg/l. In contrast to cobalt determination, only elevated chromium values showed a positive association with pseudotumour occurrence and size. A significant proportion of patients developed pseudotumours and metal ion elevation in a consecutive cohort of DUROM™ HRA after mid-term follow-up. The incidence, however, seems not to differ from results of other well performing resurfacing brands; clinical relevance of our findings is unclear. Regarding potential local as well as systemic effects of metal particle release, close follow-up of patients is essential, even with clinically well-performing implants.

  5. Changes of the bone mineral density in proximal femur following total hip resurfacing arthroplasty in osteonecrosis of femoral head.

    Science.gov (United States)

    Lian, Yong-yun; Pei, Fu-xing; Yoo, Myung-chul; Cheng, Jing-qiu; Fatou, Camara-yagouba

    2008-04-01

    Total hip resurfacing arthroplasty (THRA) is being performed with increasing frequency for osteonecrosis of femoral head (ONFH). To evaluate femoral bone remodeling in ONFH after THRA and determine the impact of stem-neck angle (SNA) of inserted femoral component on bone remodeling, we monitored the changes in BMD in proximal femur in 23 patients with ONFH after surgery. Patients were divided into group A (SNA >or= 5 degrees ) and group B (SNA < 5 degrees ). The BMD was measured in seven Gruen zones and two neck zones using dual-energy X-ray absorptiometry preoperatively, then at 3, 6, 12, and 24 months after surgery. At all ROIs, the BMD decreased significantly by 3 months postoperatively. The BMD ceased to decrease and reversed by 6 months. The BMD in neck increased significantly in group A, compared with group B at 24 months. The BMD increased 2% at ROI1 at 24 months in both groups, and at ROI7, the BMD in group A reversed to baseline value by 6 months and increased 5.81% at 24 months. These findings implied that the bone stock of proximal femur in ONFH can be well reserved after total hip resurfacing arthroplasty with valgus positioning of the femoral component.

  6. Outcomes after revision of metal on metal hip resurfacing to total arthroplasty using the direct anterior approach.

    Science.gov (United States)

    Bouveau, Victoire; Haen, Thomas-Xavier; Poupon, Joel; Nich, Christophe

    2018-03-08

    Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs). The most common indications for revision were aseptic loosening of the acetabular component or of the femoral component and femoral neck fracture. In 16 hips, a conversion to a ceramic-on-ceramic (CoC) (13 hips) or to a metal-on polyethylene (MOP) (2), or to a large-head MoM (1) THA was done. An isolated femoral revision was done in one hip. After 6.7 ± 3 years, no hip had required a re-revision. The Postel-Merle d'Aubigne (PMA) functional score improved from 9 (4-14) to 16 (12-18) (p hip) and dysesthesia of the lateral femoral cutaneous nerve (four hips) were reported. Mean serum chromium concentration decreased from 33.2 μg/L (11.8-62 μg/L) pre-operatively to 5.8 μg/L (0.4-35.5 μg/L) post-operatively (p Revision of failed MoM-HRA using the DAA resulted in an acceptable clinical outcome, no specific complication and no further surgery. A consistent decline in serum ion levels may be expected following HRA conversion to THA.

  7. Revision rates for metal-on-metal hip resurfacing and metal-on-metal total hip arthroplasty – a systematic review

    DEFF Research Database (Denmark)

    Ras Sørensen, Sofie-amalie L.; Jørgensen, Henrik L.; Sporing, Sune L.

    2016-01-01

    Purpose To compare revision rates of metal-on-metal (MoM) hip resurfacing (HRS) and MoM total hip arthroplasty (THA), as well as the primary causes for revisions. Methods The PubMed database was queried for potentially relevant articles addressing MoMTHA and MoMHRS, a total of 51 articles were...... cause for revision for both MoMTHA and MoMHRS was loosening 47.6% vs. 37.7%, fracture (MoMTHA 7.69%; MoMHRS 19.62%), metal reactions (MoMTHA 7.69%; MoMHRS 26.92%) infection (MoMTHA 12.08%; MoMHRS 6.54%), instability (MoMTHA 9.13%; MoMHRS 2.69%), manufacturer defect 6.73% for MoMTHA and nonreported...

  8. Metal-on-metal hip resurfacing: correlation between clinical and radiological assessment, metal ions and ultrasound findings.

    Science.gov (United States)

    Scaglione, M; Fabbri, L; Bianchi, N; Dell'Omo, D; Guido, G

    2015-04-01

    We report the clinical, radiological and wear analysis of 52 consecutive MoM hip resurfacings (performed on 49 younger patients) to a mean follow-up of 9.2 years. Every patient underwent X-ray and clinical evaluation (HHS). Ultrasonography of the hip was performed in all patients in order to identify possible cystic or solid mass in periprosthetic tissue. In case of mass >20 mm, further MRI was performed to better analyse the characteristics of lesion. Five patients (five hips) had a revision. The overall survival rate was 90.38 %. The average HHS at follow-up examination was 95.5 points. No progressive radiolucent areas and no sclerosis or osteolysis around the implants were found. The US and RMI imaging showed a pseudotumour formation in two patients (correlated with high metal ion levels in blood and urine), both asymptomatic. A significant positive correlation between inclination of the acetabular component and serum metal ion levels was found (r = 0.64 and r = 0.62 for cobalt and chromium, respectively).

  9. Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis 5-year follow-up of 52 patients

    DEFF Research Database (Denmark)

    Gustafson, Klas; Jakobsen, Stig S; Lorenzen, Nina D

    2014-01-01

    to an increased incidence of metal allergy. METHODS: 52 hips in 52 patients (median age 60 (51-64) years, 30 women) were randomized to either a MOM hip resurfacing system (ReCap) or a standard MOP total hip arthoplasty (Mallory Head/Exeter). Spot urine samples were collected preoperatively, postoperatively, after....... RESULTS: A statistically significant 10- to 20-fold increase in urinary levels of cobalt and chromium was observed throughout the entire follow-up in the MOM group. The prevalence of metal allergy was similar between groups. INTERPRETATION: While we observed significantly increased levels of metal ions...

  10. Dislocation and spontaneous reduction of the femoral implant against the femoral neck in an infected metal on metal hip resurfacing with complex collection

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard, E-mail: Bernhard.Tins@rjah.nhs.uk [Department of Radiology, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY 107 AG (United Kingdom)

    2011-07-15

    Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections.

  11. Usefulness of metal artifact reduction with WARP technique at 1.5 and 3T MRI in imaging metal-on-metal hip resurfacings

    Energy Technology Data Exchange (ETDEWEB)

    Lazik, Andrea; Lauenstein, Thomas C.; Theysohn, Jens M. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Landgraeber, Stefan; Schulte, Patrick [University Hospital Essen, Department of Orthopedics, Essen (Germany); Kraff, Oliver [University of Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2015-03-25

    To evaluate the usefulness of the metal artifact reduction technique ''WARP'' in the assessment of metal-on-metal hip resurfacings at 1.5 and 3T in the context of image quality and imaging speed. Nineteen patients (25 hip resurfacings) were randomized for 1.5 and 3T MRI, both including T1 and T2 turbo spin-echo as well as turbo inversion recovery magnitude sequences with and without view angle tilting and high bandwidth. Additional 3T sequences were acquired with a reduced number of averages and using the parallel acquisition technique for accelerating imaging speed. Artifact size (diameter, area), image quality (5-point scale) and delineation of anatomical structures were compared among the techniques, sequences and field strengths using the Wilcoxon sign-rank and paired t-test with Bonferroni correction. At both field strengths, WARP showed significant superiority over standard sequences regarding image quality, artifact size and delineation of anatomical structures. At 3T, artifacts were larger compared to 1.5T without affecting diagnostic quality, and scanning time could be reduced by up to 64 % without quality degradation. WARP proved useful in imaging metal-on-metal hip resurfacings at 1.5T as well as 3T with better image quality surrounding the implants. At 3T imaging could be considerably accelerated without losing diagnostic quality. (orig.)

  12. Usefulness of metal artifact reduction with WARP technique at 1.5 and 3T MRI in imaging metal-on-metal hip resurfacings

    International Nuclear Information System (INIS)

    Lazik, Andrea; Lauenstein, Thomas C.; Theysohn, Jens M.; Landgraeber, Stefan; Schulte, Patrick; Kraff, Oliver

    2015-01-01

    To evaluate the usefulness of the metal artifact reduction technique ''WARP'' in the assessment of metal-on-metal hip resurfacings at 1.5 and 3T in the context of image quality and imaging speed. Nineteen patients (25 hip resurfacings) were randomized for 1.5 and 3T MRI, both including T1 and T2 turbo spin-echo as well as turbo inversion recovery magnitude sequences with and without view angle tilting and high bandwidth. Additional 3T sequences were acquired with a reduced number of averages and using the parallel acquisition technique for accelerating imaging speed. Artifact size (diameter, area), image quality (5-point scale) and delineation of anatomical structures were compared among the techniques, sequences and field strengths using the Wilcoxon sign-rank and paired t-test with Bonferroni correction. At both field strengths, WARP showed significant superiority over standard sequences regarding image quality, artifact size and delineation of anatomical structures. At 3T, artifacts were larger compared to 1.5T without affecting diagnostic quality, and scanning time could be reduced by up to 64 % without quality degradation. WARP proved useful in imaging metal-on-metal hip resurfacings at 1.5T as well as 3T with better image quality surrounding the implants. At 3T imaging could be considerably accelerated without losing diagnostic quality. (orig.)

  13. Bone mineral density of the proximal femur after hip resurfacing arthroplasty: 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    Anttila Esa

    2011-05-01

    Full Text Available Abstract Background Hip resurfacing arthroplasty (HRA is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to implant-related stress-shielding factors, various patient-related factors may also have an effect on bone mineral density (BMD of the proximal femur in patients with HRA. Thus, we studied the effects of stem-neck angle, demographic variables, and physical functioning on the BMD of the proximal femur in a one-year follow-up. Methods Thirty three patients (9 females and 24 males with a mean (SD age of 55 (9 years were included in the study. BMD was measured two days and 3, 6, and 12 months postoperatively and 10 regions of interest (ROI were used. Stem-neck angle was analyzed from anteroposterior radiographs. Results Three months postoperatively, BMD decreased in six out of 10 regions of interest (ROI on the side operated on and in one ROI on the control side (p Conclusions After an early drop, the BMD of the upper femur was restored and even exceeded the preoperative level at one year follow-up. From a clinical standpoint, the changes in BMD in these HRA patients could not be explained by stem-neck angle or patient related factors.

  14. Advanced metal artifact reduction MRI of metal-on-metal hip resurfacing arthroplasty implants: compressed sensing acceleration enables the time-neutral use of SEMAC

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, Jan; Thawait, Gaurav K. [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Section of Musculoskeletal Radiology, Baltimore, MD (United States); Fritz, Benjamin [University of Freiburg, Department of Radiology, Freiburg im Breisgau (Germany); Raithel, Esther; Nittka, Mathias [Siemens Healthcare GmbH, Erlangen (Germany); Gilson, Wesley D. [Siemens Healthcare USA, Inc., Baltimore, MD (United States); Mont, Michael A. [Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2016-10-15

    Compressed sensing (CS) acceleration has been theorized for slice encoding for metal artifact correction (SEMAC), but has not been shown to be feasible. Therefore, we tested the hypothesis that CS-SEMAC is feasible for MRI of metal-on-metal hip resurfacing implants. Following prospective institutional review board approval, 22 subjects with metal-on-metal hip resurfacing implants underwent 1.5 T MRI. We compared CS-SEMAC prototype, high-bandwidth TSE, and SEMAC sequences with acquisition times of 4-5, 4-5 and 10-12 min, respectively. Outcome measures included bone-implant interfaces, image quality, periprosthetic structures, artifact size, and signal- and contrast-to-noise ratios (SNR and CNR). Using Friedman, repeated measures analysis of variances, and Cohen's weighted kappa tests, Bonferroni-corrected p-values of 0.005 and less were considered statistically significant. There was no statistical difference of outcomes measures of SEMAC and CS-SEMAC images. Visibility of implant-bone interfaces and pseudocapsule as well as fat suppression and metal reduction were ''adequate'' to ''good'' on CS-SEMAC and ''non-diagnostic'' to ''adequate'' on high-BW TSE (p < 0.001, respectively). SEMAC and CS-SEMAC showed mild blur and ripple artifacts. The metal artifact size was 63 % larger for high-BW TSE as compared to SEMAC and CS-SEMAC (p < 0.0001, respectively). CNRs were sufficiently high and statistically similar, with the exception of CNR of fluid and muscle and CNR of fluid and tendon, which were higher on intermediate-weighted high-BW TSE (p < 0.005, respectively). Compressed sensing acceleration enables the time-neutral use of SEMAC for MRI of metal-on-metal hip resurfacing implants when compared to high-BW TSE and image quality similar to conventional SEMAC. (orig.)

  15. Assessment of femoral neck fracture risk for a novel proximal epiphyseal hip prosthesis.

    Science.gov (United States)

    Cristofolini, Luca; Juszczyk, Mateusz; Taddei, Fulvia; Field, Richard E; Rushton, Neil; Viceconti, Marco

    2011-07-01

    This study addresses the risk of femoral neck fracture associated with resurfacing hip prostheses. A novel cemented Proximal Epiphyseal Replacement (PER) featuring a short curved stem was investigated. Seven pairs of femurs were in vitro tested. One femur of each pair was randomly assigned for PER implantation. The contralateral femur was tested intact. All femurs were loaded to failure in a validated, physiological configuration. High-speed videos (10,000-12,000 frames/s) were acquired to identify the location of fracture initiation. For comparison, data were included from Birmingham Hip Resurfacing previously tested in an identical fashion (N=3). Relative to the contralateral intact femurs, the failure load of the PER and Birmingham implants was 15.4% higher and 10.0% lower, respectively. In six of the seven PER implants, fracture initiation (neck or inter-trochanteric) was similar to the contralateral intact femurs, suggesting comparable stress distribution. Conversely, fracture initiation in the Birmingham implants occurred at the lateral prosthesis rim, which differed substantially from the intact femurs. No correlation existed between bone quality and strengthening/weakening effect of the PER (failure load of implant as a percentage of intact: R^2=0.067). Conversely, Birmingham implantation weakened the femurs with lower density (R^2=0.92). Therefore, unlike most resurfacing prostheses, the PER seems suitable also for osteoporotic subjects. This study seems to confirm that resurfacing with a Birmingham Hip tends to reduce the strength of the proximal femur. The opposite seemed to happen with the PER, which slightly reduced the risk of neck fracture, also in low-quality bones. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. A Randomized Seven-Year Study on Performance of the Stemmed Metal M2a-Magnum and Ceramic C2a-Taper, and the Resurfacing ReCap Hip Implants

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Borgwardt, Lotte; Zerahn, Bo

    2018-01-01

    BACKGROUND: The large-diameter metal-on-metal hip prostheses were expected to have low wear and reduced dislocation rate compared to the traditional metal-on-polyethylene implants. We compare 2 such prostheses, the ReCap resurfacing implant and the M2a-Magnum stemmed implant, with the C2a ceramic...

  17. Effects of chronic cobalt and chromium exposure after metal-on-metal hip resurfacing: An epigenome-wide association pilot study.

    Science.gov (United States)

    Steinberg, Julia; Shah, Karan M; Gartland, Alison; Zeggini, Eleftheria; Wilkinson, Jeremy Mark

    2017-10-01

    Metal-on-metal (MOM) hip resurfacing has recently been a popular prosthesis choice for the treatment of symptomatic arthritis, but results in the release of cobalt and chromium ions into the circulation that can be associated with adverse clinical effects. The mechanism underlying these effects remains unclear. While chromosomal aneuploidy and translocations are associated with this exposure, the presence of subtle structural epigenetic modifications in patients with MOM joint replacements remains unexplored. Consequently, we analyzed whole blood DNA methylation in 34 OA patients with MOM hip resurfacing (MOM HR) compared to 34 OA patients with non-MOM total hip replacements (non-MOM THR), using the genome-wide Illumina HumanMethylation 450k BeadChip. No probes showed differential methylation significant at 5% false-discovery rate (FDR). We also tested association of probe methylation levels with blood chromium and cobalt levels directly; there were no significant associations at 5% FDR. Finally, we used the "epigenetic clock" to compare estimated to actual age at sample for all individuals. We found no significant difference between MOM HR and non-MOM THR, and no correlation of age acceleration with blood metal levels. Our results suggest the absence of large methylation differences systemically following metal exposure, however, larger sample sizes will be required to identify potential small effects. Any DNA methylation changes that may occur in the local periprosthetic tissues remain to be elucidated. © 2017 The Authors. Orthopaedic Research Society. Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 35:2323-2328, 2017. © 2017 The Authors. Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  18. [OBSERVATION OF EFFECTIVENESS OF HIP RESURFACING ARTHROPLASTY IN TREATMENT OF OSTEONECROSIS OF FEMORAL HEAD IN YOUNG AND MIDDLE-AGED PATIENTS].

    Science.gov (United States)

    Yu, Yinxian; Yi, Chengqing; Ma, Jinzhong; Wang, Qiugen

    2016-02-01

    To evaluate the clinical and radiographic outcomes of hip resurfacing arthroplasty (HRA) for treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients. Between January 2008 and April 2009, 34 patients with ONFH underwent HRA. There were 19 males and 15 females with an average age of 54 years (range, 33-59 years). Of 34 cases, 16 left hips and 18 right hips were involved, including 9 cases of alcohol-induced ONFH, 8 cases of steroid-induced ONFH, 7 cases of traumatic ONFH, and 10 cases of unexplained ONFH. According to modified Ficat classification system, 26 hips were rated as stage III, and 8 hips as stage IV. The Harris hip score (HHS) and modified University of California, Los Angeles (UCLA) activity score were used to evaluate the clinical results. Migration of prosthesis was assessed on the anteroposterior radiographs. The abduction angle was measured on the acetabular side. On the femoral side, varus-valgus shift was determined by measurement of stem-shaft angle. The axial collapse of femoral component was assessed with the component-lateral cortex ratio. Healing of incision by first intention was achieved in all patients without complications of infection and thrombosis of deep vein of lower extremities. Thirty-two patients were followed up 78 months on average (range, 70-84 months). No implant loosening, infection, femoral neck fracture, dislocation, and inflammatory pseudotumor were observed. At last follow-up, the HHS score was significantly increased to 95.22 +/- 1.47 from preoperative 50.10 +/- 2.27 (t=1.510, P=0.008). Modified UCLA activity score was significantly increased to 7.70 +/- 1.13 from preoperative 3.90 +/- 0.90 (t=0.830, P=0.003). The abduction angle, stem-shaft angle, and compotent-lateral cortex ratio showed no significant difference between at 3 days after operation and last follow-up (P>0.05). If the indication of operation is mastered strictly, HRA may be effective in treatment for ONFH at Ficat stage III or IV

  19. Akanidomo ibanga University of Birmingham, Birmingham, UK ...

    African Journals Online (AJOL)

    Corresponding author: Akanidomo Ibanga, Department of Psychology, University of Birmingham, Birmingham, UK. ... Issue of this nature have at one level increased the need for a clearer understanding of sexual activities and behaviours particularly as it relates to in- dividuals ...... hood sexual abuse and adult psychiatric.

  20. Validation of the femoral component placement during hip resurfacing: a comparison between the conventional jig, patient-specific template, and CT-based navigation.

    Science.gov (United States)

    Kitada, Makoto; Sakai, Takashi; Murase, Tsuyoshi; Hanada, Toshihisa; Nakamura, Nobuo; Sugano, Nobuhiko

    2013-06-01

    Appropriate insertion of a femoral guidewire is essential for hip resurfacing. A simulation study was planned using synthetic femoral bone models and the accuracy and precision of femoral guidewire alignment and insertion point were compared between conventional jigs, patient-specific templates, and computed tomography (CT) based navigation techniques. Anteversion, stem-shaft angle, and the three-dimensional insertion point were measured postoperative with CT. Errors between planned and postoperative measurement and precision were evaluated. There were no statistically significant differences in error for anteversion or insertion point, although the mechanical jig showed greater error in the stem-shaft angle than the others. Patient-specific template and CT-based navigation showed good precision with high intraclass correlation (ICC) (template, 0.908 to 1.000; navigation, 0.929 to 0.995) and small root mean square error (RMSE) (0.954 to 2.969; 1.468 to 3.213). The mechanical jig group performance was inferior to the others. Patient-specific templates and CT-based navigation had good accuracy and precision. The mechanical jig technique was inferior to the others. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Resurfacing Graphics

    Directory of Open Access Journals (Sweden)

    Prof. Patty K. Wongpakdee

    2013-06-01

    Full Text Available “Resurfacing Graphics” deals with the subject of unconventional design, with the purpose of engaging the viewer to experience the graphics beyond paper’s passive surface. Unconventional designs serve to reinvigorate people, whose senses are dulled by the typical, printed graphics, which bombard them each day. Today’s cutting-edge designers, illustrators and artists utilize graphics in a unique manner that allows for tactile interaction. Such works serve as valuable teaching models and encourage students to do the following: 1 investigate the trans-disciplines of art and technology; 2 appreciate that this approach can have a positive effect on the environment; 3 examine and research other approaches of design communications and 4 utilize new mediums to stretch the boundaries of artistic endeavor. This paper examines how visuals communicators are “Resurfacing Graphics” by using atypical surfaces and materials such as textile, wood, ceramics and even water. Such non-traditional transmissions of visual language serve to demonstrate student’s overreliance on paper as an outdated medium. With this exposure, students can become forward-thinking, eco-friendly, creative leaders by expanding their creative breadth and continuing the perpetual exploration for new ways to make their mark.

  2. Resurfacing Graphics

    Directory of Open Access Journals (Sweden)

    Prof. Patty K. Wongpakdee

    2013-06-01

    Full Text Available “Resurfacing Graphics” deals with the subject of unconventional design, with the purpose of engaging the viewer to experience the graphics beyond paper’s passive surface. Unconventional designs serve to reinvigorate people, whose senses are dulled by the typical, printed graphics, which bombard them each day. Today’s cutting-edge designers, illustrators and artists utilize graphics in a unique manner that allows for tactile interaction. Such works serve as valuable teaching models and encourage students to do the following: 1 investigate the trans-disciplines of art and technology; 2 appreciate that this approach can have a positive effect on the environment; 3 examine and research other approaches of design communications and 4 utilize new mediums to stretch the boundaries of artistic endeavor. This paper examines how visuals communicators are “Resurfacing Graphics” by using atypical surfaces and materials such as textile, wood, ceramics and even water. Such non-traditional transmissions of visual language serve to demonstrate student’s overreliance on paper as an outdated medium. With this exposure, students can become forward-thinking, eco-friendly, creative leaders by expanding their creative breadth and continuing the perpetual exploration for new ways to make their mark. 

  3. A Randomized Seven-Year Study on Performance of the Stemmed Metal M2a-Magnum and Ceramic C2a-Taper, and the Resurfacing ReCap Hip Implants.

    Science.gov (United States)

    Borgwardt, Arne; Borgwardt, Lotte; Zerahn, Bo; Daugaard, Henrik; Borgwardt, Lise; Ribel-Madsen, Søren

    2017-12-05

    The large-diameter metal-on-metal hip prostheses were expected to have low wear and reduced dislocation rate compared to the traditional metal-on-polyethylene implants. We compare 2 such prostheses, the ReCap resurfacing implant and the M2a-Magnum stemmed implant, with the C2a ceramic-on-ceramic stemmed implant as to clinical performance, serum concentrations of prosthesis metals, and the durability of the implants in a randomized, controlled clinical trial at 7 years of follow-up. All included patients had osteoarthritis. Preoperatively, the size of the implants was estimated from a magnetic resonance imaging (MRI) scan. Follow-up data included serum cobalt and chromium concentrations, Oxford and Harris Hip Scores, leg press and abduction force, 6-minute walk distance, WOMAC and SF-36 self-assessment scores, and from the 7th postoperative year also ultrasonography (US) examination of the soft tissue adjacent to the implant as well as MRI with metal artifact reduction sequence (MARS-MRI) when indicated. One hundred fifty-two hips in 146 patients were included. The serum cobalt and chromium concentrations were significantly higher for the 2 metal-on-metal prostheses than for the ceramic-on-ceramic, with the M2a-Magnum as the highest. No significant difference was found between the groups concerning physical performance measurements and scores as well as dislocations and prosthesis survival. Five revisions were done and concerned all groups, for reasons of pain, high serum cobalt and chromium concentrations, cystic fluid collection around the joint, and infection. Metal concentrations, US, and MARS-MRI contributed to the decision making regarding prosthesis revision. Metal concentrations were significantly higher for the metal-on-metal prostheses than for the ceramic-on-ceramic. The clinical performance was good in all 3 prosthesis groups. Metal concentrations, US, and MARS-MRI findings were of use to identify hips needing revision. ID Number in Clinical

  4. The Birmingham Irradiation Facility

    OpenAIRE

    French, R.S; Hodgson, P; Marin-Reyes, H

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. ca...

  5. The Birmingham Irradiation Facility

    OpenAIRE

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. c...

  6. The Birmingham Irradiation Facility

    International Nuclear Information System (INIS)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm 2 ) silicon sensors

  7. The Birmingham Irradiation Facility

    Energy Technology Data Exchange (ETDEWEB)

    Dervan, P. [The University of Liverpool, Department of Physics (United Kingdom); French, R.; Hodgson, P. [The University of Sheffield, Department of Physics and Astronomy (United Kingdom); Marin-Reyes, H., E-mail: h.marin-reyes@sheffield.ac.uk [The University of Sheffield, Department of Physics and Astronomy (United Kingdom); Wilson, J. [The University of Birmingham, School of Physics and Astronomy (United Kingdom)

    2013-12-01

    At the end of 2012 the proton irradiation facility at the CERN PS will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm{sup 2}) silicon sensors.

  8. The Birmingham Irradiation Facility

    Science.gov (United States)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-12-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm2) silicon sensors.

  9. The Birmingham Irradiation Facility

    CERN Document Server

    Dervan, P; Hodgson, P; Marin-Reyes, H; Wilson, J

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1 x 1 cm^2 ) silicon sensors.

  10. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  11. [History of hip arthroplasty].

    Science.gov (United States)

    Płomiński, Janusz; Kwiatkowski, Krzysztof

    2007-02-01

    The authors present the history of hip prosthesis in treatment of coxarthrosis. Despite eighty years of experience the problem of gaining good and long-term results still exist and is difficult to solve. Even changing the way on cementless stabilization of prosthesis doesn't has result in solving the problem of aseptic loosening of hip arthroplasty. Problems of wear derbies made the producers find new to reduce particulate debris. The future of hip arthroplasty is connected with hip resurfacing. Moreover, the higher number of primary hip plasty the more prosthesis are loosening. The treatment is far more difficult and more expensive.

  12. Cryovolcanic Resurfacing on Pluto

    Science.gov (United States)

    Singer, K. N.; Schenk, P.; White, O. L.; Moore, J. M.; McKinnon, W. B.; Grundy, W. M.; Spencer, J. R.; Stern, A.; Cook, J. C.; Nimmo, F.; Howard, A. D.; Cruikshank, D. P.; Beyer, R. A.; Umurhan, O. M.; Lauer, T.; Weaver, H. A., Jr.; Young, L. A.; Ennico Smith, K.

    2017-12-01

    Pluto displays several different young geologic terrains with few-to-no identifiable impact craters. Distinct terrains to the southwest of the informally named Sputnik Planitia may have been resurfaced by cryovolcanic processes, of a type and scale so far unique to Pluto [1,2]. The most prominent structures are two very large mounds with deep central depressions. The informally named Wright Mons stands 4 km high and the main mound spans 150 km and Piccard Mons is 7 km high and 225 km wide. Hummocky terrain with a characteristic wavelength of 8-12 km covers the flanks of Wright Mons and much of the surrounding terrain. Smaller boulders, blocks, slabs, or ridges on the order of a few km are superimposed on the hummocks. The large-scale slopes across the broad flanks of the Wright Mons are 3-5°. The central depression walls are typically 10°, but reach 20° in some locations. A number of other cavi or irregular depressions of various sizes (a few to 30 km) are scattered throughout the terrain and do not appear to be impact craters. There are few signs of potential individual flows but the large-scale hummocky texture is suggestive of viscous flow. We will explore a number of potential mechanisms for creation of Wright and Piccard Mons and the nearby terrains. These unique terrains present modeling challenges for building relatively young, large cryovolcanic constructs on outer solar system bodies. Tidal heating is thought to end early in Pluto-system history [3] and radiogenic heating levels are relatively low [4], although a subsurface ocean may still persist into the present day [5]. We will discuss the possible volcanic materials on Pluto and their mobility under different heating scenarios, as well as other possible emplacement processes. [1] Moore et al., (2016) Science 351, 1284-1293. [2] Singer et al. (2016) LPSC absract 47, 2276. [3] Cheng et al. (2014) Icarus 233, 242-258. [4] McKinnon et al. (1997) In: Stern, S.A., Tholen, D.J. (Eds.), Pluto and Charon

  13. Resultados preliminares da artroplastia do quadril metal-metal de superfície: análise dos primeiros 40 casos com seguimento médio de 3 anos Preliminary outcomes of hip metal-on-metal resurfacing arthroplasty: an analysis of the first 40 cases with mean follow-up time of 3 years

    Directory of Open Access Journals (Sweden)

    Mauricio de Moraes

    2008-01-01

    Full Text Available Quarenta quadris (39 pacientes foram submetidos à artroplastia total metal-metal de superficie "resurfacing" entre 2002 e 2005. Todos foram estudados e analisados clinicamente e radiograficamente. Foram utilizados critérios clínicos, no pré e pós-operatório, pela avaliação de D'Aubigné e Postel. Radiograficamente, as áreas de radiolucência ao redor do acetábulo foram classificadas de acordo com DeLee e Charnley e, no fêmur nas zonas descritas por Amstutz et al. A idade média foi de 54,40 anos. O seguimento mínimo foi de 14 meses e o máximo de 51(média de 37,36 meses. 94,44% dos resultados clínicos foram satisfatórios no pós-operatório. Ocorreram 2 casos de soltura asséptica. Não houve fratura do fêmur durante o seguimento. Os autores consideraram esta opção técnica e de implante satisfatória e, com bons resultados no seguimento médio de 3 anos.Forty hips (39 patients were submitted to metal-on-metal hip replacement (resurfacing between 2002 and 2005. Evaluation was provided by clinical examination and X-ray tests. The authors performed clinical evaluations before and after surgery. The specific criterion applied was the D'Aubigné and Postel's classification. X-ray images showed radiolucent lines around the acetabular component on the zones described by DeLee and Charnley and around the femoral component on the zones described by Amstutz et al. The mean age was 54.40 years. The minimum follow-up period was 14 months (range:12 to 51 months. The outcomes of 94.44% of the patients in the study were postoperatively rated as satisfactory. There were 2 cases of aseptic loose and no neck-femoral fractures during the follow-up period. The authors concluded that this technique and implant alternative is satisfactory, with good early outcomes in a mean follow-up time of three years.

  14. Reflections on a Degree Initiative: The UK's Birmingham Royal Ballet Dancers Enter the University of Birmingham

    Science.gov (United States)

    Benn, Tansin

    2003-01-01

    This paper provides an opportunity to share experiences and perceptions of the first 5 years of a degree programme for professional dancers. A partnership developed in the mid-1990s between the UK's Birmingham Royal Ballet and the University of Birmingham, Westhill (now School of Education), to provide a part-time, post-experience, flexible study…

  15. [Choice of hip prosthesis in patients younger than 50 years

    NARCIS (Netherlands)

    Schreurs, B.W.; Busch, V.J.; Veth, R.P.H.

    2007-01-01

    There is no agreement about the most ideal type of hip prosthesis to be used in patients younger than 50 years. The most commonly used hip prostheses in patients younger than 50 years are uncemented or resurfacing prostheses and to a lesser extent cemented prostheses. A good result of a hip

  16. Comparing return to sport activities after short metaphyseal femoral arthroplasty with resurfacing and big femoral head arthroplasties.

    Science.gov (United States)

    Karampinas, Panagiotis K; Papadelis, Eustratios G; Vlamis, John A; Basiliadis, Hlias; Pneumaticos, Spiros G

    2017-07-01

    Young patients feel that maintaining sport activities after total hip arthroplasty constitutes an important part of their quality of life. The majority of hip surgeons allow patients to return to low-impact activities, but significant caution is advised to taking part in high-impact activities. The purpose of this study is to compare and evaluate the post-operative return to daily living habits and sport activities following short-metaphyseal hip and high functional total hip arthroplasties (resurfacing and big femoral head arthroplasties). In a study design, 48 patients (55 hips) were enrolled in three different comparative groups, one with the short-metaphyseal arthroplasties, a second with high functional resurfacing arthroplasties and a third of big femoral head arthroplasties. Each patient experienced a clinical examination and evaluated with Harris Hip Score, WOMAC, Sf-36, UCLA activity score, satisfaction VAS, anteroposterior and lateral X-rays of the hip and were followed in an outpatient setting for 2 years. Statistical analysis revealed no notable differences between the three groups regarding their demographic data however significant differences have been found between preoperative and postoperative clinical scores of each group. Also, we fail to reveal any significant differences when comparing data of all three groups at the final 2 years postoperative control regarding their clinical scores. The overall outcome of all three groups was similar, all the patients were satisfied and returned to previous level of sport activities. Short metaphyseal hip arthroplasties in young patients intending to return to previous and even high impact sport activities, similar to high functional resurfacing, big femoral head arthroplasties. Short stems with hard on hard bearing surfaces might become an alternative to standard stems and hip resurfacing.

  17. Upgrade to the Birmingham Irradiation Facility

    OpenAIRE

    Dervan, P; French, R; Hodgson, P; Marin- Reyes; Parker, K; Wilson, J; Baca, M

    2015-01-01

    The Birmingham Irradiation Facility was developed in 2013 at the University of Birmingham using the Medical Physics MC40 cyclotron. It can achieve High Luminosity LHC (HL-LHC) fluences of 1015 (1 MeV neutron equivalent (neq)) cm-2 in 80 s with proton beam currents of 1 μA and so can evaluate effectively the performance and durability of detector technologies and new components to be used for the HL-LHC. Irradiations of silicon sensors and passive materials can be carried out in a temperature ...

  18. 75 FR 10692 - Television Broadcasting Services; Birmingham, AL

    Science.gov (United States)

    2010-03-09

    ...] Television Broadcasting Services; Birmingham, AL AGENCY: Federal Communications Commission. ACTION: Final... Television Commission, the licensee of noncommercial educational station WBIQ(TV), channel *10, Birmingham... Part 73 Television, Television broadcasting. 0 For the reasons discussed in the preamble, the Federal...

  19. 78 FR 75306 - Television Broadcasting Services; Birmingham, Alabama

    Science.gov (United States)

    2013-12-11

    ...] Television Broadcasting Services; Birmingham, Alabama AGENCY: Federal Communications Commission. ACTION... Television Commission (``AETC''), the licensee of station WBIQ(TV), channel *39, Birmingham, Alabama... freeze on the filing of petitions for rulemaking by television stations seeking channel substitutions in...

  20. Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    Marius Dettmer

    2015-01-01

    Full Text Available Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS from a young group of patients (n=52, age 48.9 ± 6.1 years who had received hip resurfacing (HR with a cohort of patients (n=73, age 48.2 ± 6.6 years who had received neck-preserving, short-stem implant total hip arthroplasty (THA. Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year in both groups (p<0.0001, η2=0.69; there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8 than MiniHip surgery (62.5 min ± 14.8, U=85.0, p<0.0001, η2=0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

  1. Pre-clinical evaluation of ceramic femoral head resurfacing prostheses using computational models and mechanical testing.

    Science.gov (United States)

    Dickinson, A S; Browne, M; Wilson, K C; Leffers, J R T; Taylor, A C

    2011-09-01

    Ceramic-on-ceramic hip resurfacing can potentially offer the bone-conserving advantages of resurfacing while eliminating metal ion release. Thin-walled ceramic resurfacing heads are conceivable following developments in the strength and reliability of ceramic materials, but verification of new designs is required. The present study aimed to develop a mechanical pre-clinical analysis verification process for ceramic resurfacing heads, using the DeltaSurf prosthesis design as a case study. Finite element analysis of a range of in vivo scenarios was used to design a series of physiologically representative mechanical tests, which were conducted to verify the strength of the prosthesis. Tests were designed to simulate ideal and worst-case in vivo loading and support, or to allow comparison with a clinically successful metallic device. In tests simulating ideal loading and support, the prosthesis sustained a minimum load of 39 kN before fracture, and survived 10 000 000 fatigue cycles of 0.534 kN to 5.34 kN. In worst-case tests representing a complete lack of superior femoral head bone support or pure cantilever loading of the prosthesis stem, the design demonstrated strength comparable to that of the equivalent metal device. The developed mechanical verification test programme represents an improvement in the state of the art where international test standards refer largely to total hip replacement prostheses. The case study's novel prosthesis design performed with considerable safety margins compared with extreme in vivo loads, providing evidence that the proposed ceramic resurfacing heads should have sufficient strength to perform safely in vivo. Similar verification tests should be designed and conducted for novel ceramic prosthesis designs in the future, leading the way to clinical evaluation.

  2. Postoperative Recovery of Mechanical Muscle Function in Hip Replacement Patients

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, Søren

    2011-01-01

    old hip patients.   MATERIAL AND METHODS Patients: Forty elderly patients (age 55 ± 6, BMI 27.5 ± 4.1) with unilateral osteoarthritis participated in this prospectively study and were randomized to either total or resurfacing hip replacement. All implants inserted by two senior surgeons using only...

  3. Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements

    Directory of Open Access Journals (Sweden)

    Howard JJ

    2016-08-01

    Full Text Available Jason J Howard1,2 1Division of Orthopedic Surgery, Department of Surgery, Sidra Medical and Research Center, 2Department of Orthopedic Surgery, Weill Cornell Medical College, Doha, Qatar Abstract: Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM, for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen. The purpose of this review was to investigate the balance between facilitating the introduction of new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment. The case of MoM hip replacement devices was used to frame the investigation and subsequent discussions. The regulatory approval processes and post-market surveillance requirements associated with three common MoM hip replacements (two resurfacings: the Birmingham and articular surface replacement and the articular surface replacement XL total hip replacement were investigated. With respect to modern MoM hip replacement devices, the balance between facilitating the introduction of these new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment was not achieved. The lessons learned from these experiences have application beyond joint replacements to the introduction of new medical technologies in

  4. Upgrade to the Birmingham Irradiation Facility

    Science.gov (United States)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Parker, K.; Wilson, J.; Baca, M.

    2015-10-01

    The Birmingham Irradiation Facility was developed in 2013 at the University of Birmingham using the Medical Physics MC40 cyclotron. It can achieve High Luminosity LHC (HL-LHC) fluences of 1015 (1 MeV neutron equivalent (neq)) cm-2 in 80 s with proton beam currents of 1 μA and so can evaluate effectively the performance and durability of detector technologies and new components to be used for the HL-LHC. Irradiations of silicon sensors and passive materials can be carried out in a temperature controlled cold box which moves continuously through the homogenous beamspot. This movement is provided by a pre-configured XY-axis Cartesian robot scanning system. In 2014 the cooling system and cold box were upgraded from a recirculating glycol chiller system to a liquid nitrogen evaporative system. The new cooling system achieves a stable temperature of -50 °C in 30 min and aims to maintain sub-0 °C temperatures on the sensors during irradiations. This paper reviews the design, development, commissioning and performance of the new cooling system.

  5. Upgrade to the Birmingham Irradiation Facility

    CERN Document Server

    Dervan, P; Hodgson, P; Marin- Reyes; Parker, K; Wilson, J; Baca, M

    2015-01-01

    The Birmingham Irradiation Facility was developed in 2013 at the University of Birmingham using the Medical Physics MC40 cyclotron. It can achieve High Luminosity LHC (HL-LHC) fluences of 10^15 (1 MeV neutron equivalent (neq)) cm^-2 in 80 s with proton beam currents of 1 μA and so can evaluate effectively the performance and durability of detector technologies and new components to be used for the HL-LHC. Irradiations of silicon sensors and passive materials can be carried out in a temperature controlled cold box which moves continuously through the homogenous beamspot. This movement is provided by a pre-configured XY-axis Cartesian robot scanning system. In 2014 the cooling system and cold box were upgraded from a recirculating glycol chiller system to a liquid nitrogen evaporative system. The new cooling system achieves a stable temperature of 50 1C in 30 min and aims to maintain sub-0 1C temperatures on the sensors during irradiations. This paper reviews the design, development, commissioning and perform...

  6. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

    The management of the patella in total knee arthroplasty still causes controversy. Whether or not to resurface the patella in primary total knee arthroplasty remains unclear. In this study we examined 220 consecutive total knee replacements, by a single surgeon, where the patella was routinely resurfaced using the inset technique. All patellae were suitable for resurfacing. Patellar thickness was not altered in 54.5% of patellae. In 97.2% the patella was within 2 mm of the original thickness. There were no significant complications. In this study we have found that the inset technique of patella resurfacing in total knee replacement is a simple and safe resurfacing procedure.

  7. CO2 laser resurfacing of the face and neck.

    Science.gov (United States)

    Goldman, M P

    2001-05-01

    Laser resurfacing with the short-pulsed, high-energy CO2 laser has been used to treat photodamaged skin and acne scars. Efficacy and safety have been demonstrated with this technique since 1992. Newer treatment methods, including sequential or combination treatment with the Er:YAG laser have led to increased efficacy with a decrease in adverse sequelae. This article details the author's experience with CO2 laser resurfacing and promotes the use of sequential CO2/Er:YAG laser resurfacing.

  8. Evaluation of the Birmingham IBS symptom questionnaire

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-07-01

    Full Text Available Abstract Background Irritable Bowel Syndrome (IBS is a chronic/common condition that causes a significant effect on the individual (reduced quality of life, society (time lost off work and health services. Comparison of studies evaluating the management of IBS has been hindered by the lack of a widely adopted validated symptom score. The aim of this study was to develop and validate a disease specific score to measure the symptoms of patients with IBS. Methods A self-administered 14-item symptom questionnaire (based on Rome II criteria was mailed to 533 persons included in a prevalence study of IBS. The reliability of each underlying dimension identified was measured by Cronbach's α. Validity was assessed by comparing symptom scores with concurrent IBS specific quality of life (QoL scores. Reproducibility was measured by the test-retest method and responsiveness measured by effect size. Results 379 (71% questionnaires were returned. The underlying dimensions identified were pain, diarrhoea and constipation. Cronbach's α was 0.74 for pain, 0.90 for diarrhoea and 0.79 for constipation. Pain and diarrhoea dimensions had good external validity (r = -0.3 to -0.6, constipation dimension had moderate external validity (r = -0.2 to -0.3. All dimensions were reproducible (ICCs 0.75 to 0.81. Effect sizes of 0.27 to 0.53 were calculated for those with a reported improvement in symptoms. Conclusion The Birmingham IBS Symptom Questionnaire has been developed and tested. It has been shown to be suitable for self-completion and acceptable to patients. The questionnaire has 3 internal dimensions which have good reliability, external validity and are responsive to a change in health status.

  9. Evaluation of the Birmingham IBS symptom questionnaire.

    Science.gov (United States)

    Roalfe, Andrea K; Roberts, Lesley M; Wilson, Sue

    2008-07-23

    Irritable Bowel Syndrome (IBS) is a chronic/common condition that causes a significant effect on the individual (reduced quality of life), society (time lost off work) and health services. Comparison of studies evaluating the management of IBS has been hindered by the lack of a widely adopted validated symptom score. The aim of this study was to develop and validate a disease specific score to measure the symptoms of patients with IBS. A self-administered 14-item symptom questionnaire (based on Rome II criteria) was mailed to 533 persons included in a prevalence study of IBS. The reliability of each underlying dimension identified was measured by Cronbach's alpha. Validity was assessed by comparing symptom scores with concurrent IBS specific quality of life (QoL) scores. Reproducibility was measured by the test-retest method and responsiveness measured by effect size. 379 (71%) questionnaires were returned. The underlying dimensions identified were pain, diarrhoea and constipation. Cronbach's alpha was 0.74 for pain, 0.90 for diarrhoea and 0.79 for constipation. Pain and diarrhoea dimensions had good external validity (r = -0.3 to -0.6), constipation dimension had moderate external validity (r = -0.2 to -0.3). All dimensions were reproducible (ICCs 0.75 to 0.81). Effect sizes of 0.27 to 0.53 were calculated for those with a reported improvement in symptoms. The Birmingham IBS Symptom Questionnaire has been developed and tested. It has been shown to be suitable for self-completion and acceptable to patients. The questionnaire has 3 internal dimensions which have good reliability, external validity and are responsive to a change in health status.

  10. Results of Equilibrium Resurfacing Monta Carlo Models on Venus

    Science.gov (United States)

    Bjonnes, E. E.; Hansen, V. L.; Swenson, J. B.

    2008-03-01

    Previous equilibrium resurfacing tests failed to include increments between 10 and 0.03%. We tested this parameter space and found that there is no statistical evidence that equilibrium resurfacing cannot meet the two key observations of Venus' impact crater data set.

  11. Laser systems for ablative fractional resurfacing

    DEFF Research Database (Denmark)

    Paasch, Uwe; Haedersdal, Merete

    2011-01-01

    Ablative fractional resurfacing (AFR) creates microscopic vertical ablated channels that are surrounded by a thin layer of coagulated tissue, constituting the microscopic treatment zones (MTZs). AFR induces epidermal and dermal remodeling, which raises new possibilities for the treatment...... of a variety of skin conditions, primarily chronically photodamaged skin, but also acne and burn scars. In addition, it is anticipated that AFR can be utilized in the laser-assisted delivery of topical drugs. Clinical efficacy coupled with minimal downtime has driven the development of various fractional...

  12. Current Status of Fractional Laser Resurfacing.

    Science.gov (United States)

    Carniol, Paul J; Hamilton, Mark M; Carniol, Eric T

    2015-01-01

    Fractional lasers were first developed based on observations of lasers designed for hair transplantation. In 2007, ablative fractional laser resurfacing was introduced. The fractionation allowed deeper tissue penetration, leading to greater tissue contraction, collagen production and tissue remodeling. Since then, fractional erbium:YAG resurfacing lasers have also been introduced. These lasers have yielded excellent results in treating photoaging, acne scarring, and dyschromia. With the adjustment of microspot density, pulse duration, number of passes, and fluence, the surgeon can adjust the treatment effects. These lasers have allowed surgeons to treat patients with higher Fitzpatrick skin types (types IV to VI) and greater individualize treatments to various facial subunits. Immunohistochemical analysis has demonstrated remodeling effects of the tissues for several months, producing longer lasting results. Adjuvant treatments are also under investigation, including concomitant face-lift, product deposition, and platelet-rich plasma. Finally, there is a short recovery time from treatment with these lasers, allowing patients to resume regular activities more quickly. Although there is a relatively high safety profile for ablative fractionated lasers, surgeons should be aware of the limitations of specific treatments and the associated risks and complications.

  13. Back to the basics: Birmingham, Alabama, measurement and scale

    Science.gov (United States)

    Handley, L.R.; Lockwood, C.M.; Handley, N.

    2005-01-01

    Back to the Basics: Birmingham, Alabama is the fourth in a series of workshops that focus on teaching foundational map reading and spatial differentiation skills. It is the second published exercise from the Back to the Basics series developed by the Wetland Education through Maps and Aerial Photography (WETMAAP) Program (see Journal of Geography 103, 5: 226-230). Like its predecessor, the current exercise is modified from the Birmingham Back to the Basics workshop offered during the annual National Council for Geographic Education meeting. The focus of this exercise is on scale and measurement, foundational skills for spatial thinking and analysis. ?? 2005 National Council for Geographic Education.

  14. Birmingham's new dental school and hospital - A real Peter Pan of dentistry.

    Science.gov (United States)

    Chapple, I L C

    2016-09-23

    A look at the history of Birmingham Dental Hospital which, since it was first founded in 1858 as Birmingham Dental Dispensary, has moved six times, the sixth move being to its new Pebble Mill site on 1 April 2016.

  15. Birmingham University and Teacher Training: Day Training College to Department of Education.

    Science.gov (United States)

    Thomas, J. B.

    1992-01-01

    Traces the development of teacher education in Birmingham, England, from the Victorian period through the 1920s. Describes the transition of Mason College and the Birmingham Day Training College into the education department of Birmingham University. Discusses women's education, teacher training for men, student life, faculty, and curriculum. (DK)

  16. Tuberculosis Microepidemics among Dispersed Migrants, Birmingham, UK, 2004–2013

    Science.gov (United States)

    Browne, Catherine; Khanom, Shaina; Evans, Jason T.; Smith, E. Grace; Hawkey, Peter M.; Kunst, Heinke; Welch, Steven B.; Dedicoat, Martin J.

    2015-01-01

    To determine if local transmission was responsible for rising tuberculosis incidence in a recently dispersed migrant community in Birmingham, UK, during 2004–2013, we conducted enhanced epidemiologic investigation of molecular clusters. This technique identified exact locations of social mixing and chains of apparent recent transmission, which can be helpful for directing resources. PMID:25695328

  17. Dorothy's Wars: School Leadership during the Birmingham Blitz

    Science.gov (United States)

    Rousmaniere, Kate

    2016-01-01

    This essay examines the school leadership experiences of an infant school head teacher in Birmingham, England, during the Second World War. Drawing on the letters of Dorothy Walker, the essay offers insights into school leadership wartime deprivations. The impact of an international war on the home front was not head teacher Dorothy Walker's only…

  18. Alabama University Professor's View of the Birmingham Bombing Trial.

    Science.gov (United States)

    Journal of Blacks in Higher Education, 2001

    2001-01-01

    Presents the views of Alabama university scholars regarding the historical significance of the 2001 trial of Thomas Blanton for his role in the Ku Klux Klan bombing of the Sixteenth Street Baptist church in Birmingham, Alabama thet killed four girls. Their discussions note the need to examine the American judicial system, the weak case against Mr.…

  19. 75 FR 3695 - Television Broadcasting Services; Birmingham, AL

    Science.gov (United States)

    2010-01-22

    ...] Television Broadcasting Services; Birmingham, AL AGENCY: Federal Communications Commission. ACTION: Proposed... Television Commission (``AETC''), the licensee of noncommercial educational station WBIQ (TV), channel *10... procedures for comments, see 47 CFR 1.415 and 1.420. List of Subjects in 47 CFR Part 73 Television...

  20. Plumes as a Mechanism for Equilibrium Resurfacing of Venus

    Science.gov (United States)

    Hansen, V. L.; Young, D. A.

    2004-03-01

    End member hypotheses catastrophic- and equilibrium-volcanic-resurfacing fall short in addressing Venus' crater database, and both assume crater removal by burial. We propose an alternative hypothesis that includes crater destruction by annealing.

  1. Positron imaging techniques for process engineering: recent developments at Birmingham

    Science.gov (United States)

    Parker, D. J.; Leadbeater, T. W.; Fan, X.; Hausard, M. N.; Ingram, A.; Yang, Z.

    2008-09-01

    For over 20 years the University of Birmingham has been using positron-emitting radioactive tracers to study engineering processes. The imaging technique of positron emission tomography (PET), widely used for medical applications, has been adapted for these studies, and the complementary technique of positron emission particle tracking (PEPT) has been developed. The radioisotopes are produced using the Birmingham MC40 cyclotron, and a variety of techniques are employed to produce suitable tracers in a wide range of forms. Detectors originally designed for medical use have been modified for engineering applications, allowing measurements to be made on real process equipment, at laboratory or pilot plant scale. This paper briefly reviews the capability of the techniques and introduces a few of the many processes to which they have been applied.

  2. Hip Replacement

    Science.gov (United States)

    Hip replacement is surgery for people with severe hip damage. The most common cause of damage is osteoarthritis. Osteoarthritis ... pain medicines, and exercise haven't helped, hip replacement surgery might be an option for you. During ...

  3. Equilibrium resurfacing of Venus: Results from new Monte Carlo modeling and implications for Venus surface histories

    Science.gov (United States)

    Bjonnes, E. E.; Hansen, V. L.; James, B.; Swenson, J. B.

    2012-02-01

    Venus' impact crater population imposes two observational constraints that must be met by possible model surface histories: (1) near random spatial distribution of ˜975 craters, and (2) few obviously modified impact craters. Catastrophic resurfacing obviously meets these constraints, but equilibrium resurfacing histories require a balance between crater distribution and modification to be viable. Equilibrium resurfacing scenarios with small incremental resurfacing areas meet constraint 1 but not 2, whereas those with large incremental resurfacing areas meet constraint 2 but not 1. Results of Monte Carlo modeling of equilibrium resurfacing ( Strom et al., 1994) is widely cited as support for catastrophic resurfacing hypotheses and as evidence against hypotheses of equilibrium resurfacing. However, the Monte Carlo models did not consider intermediate-size incremental resurfacing areas, nor did they consider histories in which the era of impact crater formation outlasts an era of equilibrium resurfacing. We construct three suites of Monte Carlo experiments that examine incremental resurfacing areas not previously considered (5%, 1%, 0.7%, and 0.1%), and that vary the duration of resurfacing relative to impact crater formation time (1:1 [suite A], 5:6 [suite B], and 2:3 [suite C]). We test the model results against the two impact crater constraints. Several experiments met both constraints. The shorter the time period of equilibrium resurfacing, or the longer the time of crater formation following the cessation of equilibrium resurfacing, the larger the possible areas of incremental resurfacing that satisfy both constraints. Equilibrium resurfacing is statistically viable for suite A at 0.1%, suite B at 0.1%, and suite C for 1%, 0.7%, and 0.1% areas of incremental resurfacing.

  4. Mainstreaming green roofs in urban regeneration, Birmingham, UK

    Energy Technology Data Exchange (ETDEWEB)

    Coyne, R. [Groundwork Birmingham and Solihull, Handsworth, Birmingham (United Kingdom)

    2006-07-01

    Historically, Birmingham, United Kingdom was an industrial metal finishing and car production centre. The city centre was redeveloped in the 1960s and 1970s. The new infrastructure was car-dominated with an elevated urban motorway, which forced pedestrians underground. In the 1980s, due to failing industry, rising unemployment and the negative image created by the concrete infrastructure, the city went into decline. In response, the city developed a strong redevelopment vision. This included policies such as removing the concrete collar, greatly expanding the city centre core and rebranding as a service sector centre. However, it was also determined that in addition to these policy transformations, increasing knowledge about the impact of development on the environment was also needed. The value of environmental protection and brownfield regeneration was emphasized. It was determined that green roofs would be able to provide benefits across a range of social and environmental issues including air quality, sustainable urban drainage, visual amenity and biodiversity. As such, a large grant to install the first green roofs in Birmingham city centre on 4 buildings was sought. The grant will be used for research on biodiversity, energy and water management and to demonstrate benefits to developers and decision makers. The main planning driver is mitigation for destruction of black redstart sites as brownfield sites are redeveloped. Simultaneously, measurable targets will be established for Birmingham City Council to adopt in order to deliver sustainable development.

  5. Outcome of Revision Total Hip Arthroplasty in Management of Failed Metal-on-Metal Hip Arthroplasty.

    Science.gov (United States)

    Rahman, Wael A; Amenábar, Tomás; Hetaimish, Bandar M; Safir, Oleg A; Kuzyk, Paul R; Gross, Allan E

    2016-11-01

    This is a retrospective review of the functional outcomes and complications of revision total hip arthroplasty (THA) of failed metal-on-metal (MoM) hip arthroplasty. A total of 20 revision THAs were performed in 19 patients. Of them, 2 cases were failed hip resurfacing, and 18 cases were failed (MoM) THA. The mean age at revision (THA) was 59.35 years (standard deviation [SD] 9.83). The mean follow-up was 45 months (SD 13.98). The indications of revision were aseptic loosening of acetabular component without adverse local tissue reaction (ALTR; 10 hips), aseptic loosening of the acetabular and femoral components without ALTR (1 hip), painful hip associated with ALTR (6 hips), iliopsoas impingement associated with a large-diameter femoral head or malpositioned acetabular component (3 hips). The acetabular components were revised in 18 hips using Trabecular Metal Modular cups. The femoral components were revised in 3 hips. A constrained acetabular liner was used in 5 hips. The Harris hip score significantly improved from 48.4 (SD 12.98) to 83.25 (SD 10.08). There were 2 complications (1 foot drop and 1 superficial infection) and 1 failure (recurrent dislocation) that required revision to a constrained liner. Early results of revision THA of failed MoM hip arthroplasty showed improvement in pain and functional outcome. No case of failed bone ingrowth was noted with the use of Trabecular Metal Modular cups. Extensive soft tissue and abductor muscles dysfunctions were common. A constrained acetabular component with repair of the hip abductors might be beneficial. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... resurfacing uncemented prosthesis. 888.3580 Section 888.3580 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made of...

  7. Early rehabilitation in Resurfacing, standard and large head THA patients

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Varmarken, Jens-Erik; Ovesen, Ole

    2009-01-01

      Introduction For patients in employment a fast rehabilitation is important. The reduced risk of dislocation when using a large-head metal-on-metal articulation theoretically offers a faster rehabilitation than a THA with a 28 mm articulation due to no restrictions. The larger surgical incision...... in the resurfacing patient may impair the early rehabilitation. We aimed to investigate early differences in rehabilitation parameters amongst the different groups. Materials and methods We randomized to resurfacing (n=20), standard 28 mm THA (n=19) and large head MoM THA (n=12). We recorded operation time, blood...... loss, incision length, length of stay and length of sick-absence. Clinical scores: WOMAC, HHS, UCLA activity and steps were recorded preoperatively, at 8 weeks and 6 months, with additional WOMAC at 3 and 6 weeks. Results Results reported for resurfacing, 28 mm and large head THA, respectively...

  8. Maximizing benefits and minimizing risk with CO2 laser resurfacing.

    Science.gov (United States)

    Fitzpatrick, Richard E

    2002-01-01

    Laser resurfacing using the high-energy, pulsed and scanned CO2 laser produces the most dramatic improvement in severe photo-induced facial rhytides and deeply atrophic scars. More recently, the use of short- and long-pulsed erbium lasers in conjunction with CO2 laser resurfacing has been shown to speed healing by removing the upper layer of thermally induced necrotic tissue. The Er:YAG lasers are more superficial ablative tools that inflict less residual thermal damage on the tissue, thus allowing healing to occur without the requisite internal clearance of excessive debris. With continued research and advances in laser surgery, cutaneous resurfacing will be further enhanced with improved outcomes and lessened morbidity.

  9. Hip Fracture

    Science.gov (United States)

    ... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

  10. Birmingham Rep, Youth and Community, and the Products and Possibilities of Precarity

    Science.gov (United States)

    Cochrane, Claire

    2017-01-01

    Birmingham Rep, a leading producing theatre based in the UK's "second city", has historically had a complex relationship with the cultural priorities of its home city. In recent years, Birmingham City Council has faced multiple challenges represented by debt burden, government-imposed cuts in public funding, scandals linked to failing…

  11. 40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.41 Section 81.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

  12. The Library of Birmingham Project: Lifelong Learning for the Digital Age

    Science.gov (United States)

    Blewitt, John; Gambles, Brian

    2010-01-01

    The Library of Birmingham (LoB) is a 193 million British pounds project designed to provide a new space for lifelong learning and knowledge growth, a physical and virtual portal for Birmingham's citizens to the wider world. In cooperation with a range of private, public, and third-sector bodies, as well as individual citizens, the library, due to…

  13. Hip pain

    Science.gov (United States)

    ... from a chair, walking, climbing stairs, and driving Hamstring strain Iliotibial band syndrome Hip flexor strain Hip ... and cool down afterward. Stretch your quadriceps and hamstrings. Avoid running straight down hills. Walk down instead. ...

  14. Hip joint replacement

    Science.gov (United States)

    Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... your activities. Most of the time, hip joint replacement is done in people age 60 and older. ...

  15. Resurfacing hemiarthroplasty compared to stemmed hemiarthroplasty for glenohumeral osteoarthritis

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Olsen, Bo S; Sorensen, Anne Kathrine

    2015-01-01

    PURPOSE: The aim of this study was to conduct a randomised, clinical trial comparing stemmed hemiarthroplasty and resurfacing hemiarthroplasty in the treatment of glenohumeral osteoarthritis. METHODS: A total of 40 shoulders (35 patients) were randomised to stemmed hemiarthroplasty or resurfacing...... hemiarthroplasty and evaluated three and 12 months postoperatively using the Constant-Murley score (CMS) and Western Ontario Osteoarthritis of the Shoulder (WOOS) index. RESULTS: There were no statistically significant differences in age, gender or pre-operative scores except for WOOS at baseline. Two patients...... to be inferior to those of stemmed hemiarthroplasty. It is unclear whether this reflects a real difference in effect or baseline differences due to the limited number of randomised patients. We suggest there is a need for a larger, more definitive trial....

  16. Native Patella Retention Versus Resurfacing in a Cohort of Staged Bilateral Total Knee Patients

    Directory of Open Access Journals (Sweden)

    Justin M Head

    2017-10-01

    Full Text Available Background: Patellar resurfacing in total knee arthroplasty remains a point of controversy within the literature and the generally followed paradigm varies among regions. Methods: In effort to elucidate a difference following the change from universal patellar resurfacing to universal non-resurfacing, 32 patients with bilateral TKA that included one resurfaced and one native patella were retrospectively reviewed at average follow up 21.4 months from the most recent surgery. Results: No difference was observed in patient satisfaction, KOOS-ADL score, and VAS scores. No complications or secondary patellar resurfacing occurred. Conclusions: Therefore, patients perceive no difference between knees with native patella retention or a resurfaced patella in regards to pain and function.

  17. Thermal injuries as a result of CO2 laser resurfacing.

    Science.gov (United States)

    Grossman, A R; Majidian, A M; Grossman, P H

    1998-09-01

    CO2 laser resurfacing of the face for fine wrinkles has gained great popularity over a short period of time. The use of the CO2 laser has proven to be effective in reducing or eliminating fine wrinkles. This tool in the surgeon's armamentarium has been added to those of dermabrasion and chemical peel. The theoretical advantage of the use of the CO2 laser for resurfacing has been better accuracy and reportedly more control of the depth of penetration. The use of the CO2 laser has been welcomed by many cosmetic surgeons. Until now, there have been few reported cases of complications with the use of the CO2 laser. To many, this would sound too good to be true; unfortunately, that is the case. The CO2 laser is a high-energy machine that can indeed cause thermal injury. This thermal injury can result in deep burns to the skin and hypertrophic scarring. We feel this is more common than is currently being reported, and we share our experience as a burn and wound care referral service. During an 18-month period, 20 consecutive patients were referred to our practice who had received injuries from the CO2 laser resurfacing laser. We present here in this review a summary of those injuries. The CO2 resurfacing laser is a very effective tool for the treatment of fine wrinkles, but it is not without the potential for serious complications. We urge caution with the use of the laser and prompt recognition and treatment of thermal injury to the skin.

  18. The history of neurosurgery at the University of Alabama at Birmingham.

    Science.gov (United States)

    Foreman, Paul M; Markert, James M; Diethelm, Arnold G; Hadley, Mark N

    2014-10-01

    : The Division of Neurosurgery at the University of Alabama at Birmingham was formally founded in 1954 under the leadership of James Garber Galbraith. The following 60 years would see neurosurgery at the forefront of the development of a nationally recognized medical center in the heart of Birmingham, Alabama. The Department of Neurosurgery now employs 14 faculty members, performs more than 4500 neurosurgical procedures annually, is active in clinical and laboratory research, and boasts a contemporary, comprehensive residency training program.

  19. The Effect of Prior Hip Arthroscopy on Patient-Reported Outcomes After Total Hip Arthroplasty: An Institutional Registry-Based, Matched Cohort Study.

    Science.gov (United States)

    Konopka, Joseph F; Buly, Robert L; Kelly, Bryan T; Su, Edwin P; McLawhorn, Alexander S

    2018-02-02

    A significant number of patients who undergo hip arthroscopy will subsequently undergo total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA), although limited evidence exists regarding effects of prior hip arthroscopy on the outcomes of these procedures. Of 5091 patients who underwent hip arthroscopy, we identified 69 patients who underwent subsequent THA (46) or HRA (23). Patients were matched to patients with no history of hip arthroscopy. Preoperative and 2-year postoperative Hip disability and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-12, Lower Extremity Activity Scale score, and satisfaction surveys were compared. Patients who underwent THA with history of arthroscopy had lower postoperative Hip disability and Osteoarthritis Outcome Score Pain (82 ± 16 vs 93 ± 9, P = .003), Stiffness (85 ± 16 vs 93 ± 15, P = .01), Sports and Recreation (71 ± 22 vs 88 ± 18, P = .003), Quality-of-Life (65 ± 22 vs 86 ± 11, P Hip arthroscopy before hip arthroplasty is associated with slightly lower results in several patient-reported outcomes. These results are relevant when assessing patients for hip arthroscopy and when counseling prospective arthroplasty patients with history of arthroscopy. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Is there added risk in resurfacing a femoral head with cysts?

    Directory of Open Access Journals (Sweden)

    Liu Fei

    2011-10-01

    Full Text Available Abstract Background Femoral head cysts have been identified as a risk factor for early femoral failures after metal-on-metal hip resurfacing arthroplasty (HRA based on limited scientific data. However, we routinely performed HRA if less than 1/3 of the femoral head appeared destroyed by cysts on the preoperative radiograph. This study was undertaken to analyze whether there was an added risk of early femoral failures in HRA when femoral head cysts were present. Methods This retrospective case-control study included 939 MOM HRAs operated by a single surgeon with use of the posterior minimally invasive surgical (MIS approach between November 2005 and January 2009. Patients with all diagnoses except osteonecrosis were included. Among them, 117 HRAs had femoral head cysts ≥ 1 cm identified in surgery. All cysts were treated with bone grafting using acetabular reamings packed into the cavitary defect (instead of filling the cysts with cement. The control group, which had no cyst observed at the time of surgery, was randomly selected from our database using computer algorithms to match those cases in the study group for the parameters of surgical date, age, gender, body mass index, diagnosis, femoral fixation method, and the size of the femoral component. Results The minimum follow-up was 24 months for both groups. The early femoral failure rate in the study group was 3/117 (2.6% and 0/117 in the control group; there was no statistical difference between these two groups (P = 0.08. In the study group, there were two femoral neck fractures (revised: both occurred in patients having a cyst size of 1 cm3; and there was one femoral component loosening at 3-year follow up in a patient having a cyst size of 2 cm3. Conclusion Although the risk of early femoral failures among the group with cysts appeared higher than the group without cysts, we could not demonstrate a significant statistical difference between the two groups. It is possible that bone

  1. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3590 Section 888.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be implanted...

  2. Aesthetic skin resurfacing with the high-energy ultrapulsed CO2 laser.

    Science.gov (United States)

    Weinstein, C; Roberts, T L

    1997-04-01

    CO2 laser resurfacing, using the new generation high-energy output pulsed lasers, provides a highly accurate method of resurfacing and rejuvenating facial skin. Its applications are widespread and well accepted by the general population (Color Figs. 3 to 8). Complications may occur, which may be minimized through adequate laser training and appreciation of the mechanisms of skin healing.

  3. Resurfacing asteroids from YORP spin-up and failure

    Science.gov (United States)

    Graves, Kevin J.; Minton, David A.; Hirabayashi, Masatoshi; DeMeo, Francesca E.; Carry, Benoit

    2018-04-01

    The spectral properties of S and Q-type asteroids can change over time due to interaction with the solar wind and micrometeorite impacts in a process known as 'space weathering.' Space weathering raises the spectral slope and decreases the 1 μm absorption band depth in the spectra of S and Q-type asteroids. Over time, Q-type asteroids, which have very similar spectra to ordinary chondrite meteorites, will change into S-type asteroids. Because there are a significant number of Q-type asteroids, there must be some process which is resurfacing S-type asteroids into Q-types. In this study, we use asteroid data from the Sloan Digital Sky Survey to show a trend between the slope through the g‧, r‧, and i‧ filters, called the gri-slope, and size that holds for all populations of S and Q-type asteroids in the inner solar system, regardless of orbit. We model the evolution of a suite of asteroids in a Monte Carlo YORP rotational evolution and space weathering model. We show that spin-up and failure from YORP is one of the key resurfacing mechanisms that creates the observed weathering trends with size. By varying the non-dimensional YORP coefficient and running time of the present model over the range 475-1425 Myr, we find a range of values for the space weathering timescale, τSW ≈ 19-80 Myr at 2.2 AU. We also estimate the time to weather a newly resurfaced Q-type asteroid into an S-complex asteroid at 1 AU, τQ → S(1AU) ≈ 2-7 Myr.

  4. Multi-phase volcanic resurfacing at Loki Patera on Io.

    Science.gov (United States)

    de Kleer, K; Skrutskie, M; Leisenring, J; Davies, A G; Conrad, A; de Pater, I; Resnick, A; Bailey, V; Defrère, D; Hinz, P; Skemer, A; Spalding, E; Vaz, A; Veillet, C; Woodward, C E

    2017-05-10

    The Jovian moon Io hosts the most powerful persistently active volcano in the Solar System, Loki Patera. The interior of this volcanic, caldera-like feature is composed of a warm, dark floor covering 21,500 square kilometres surrounding a much cooler central 'island'. The temperature gradient seen across areas of the patera indicates a systematic resurfacing process, which has been seen to occur typically every one to three years since the 1980s. Analysis of past data has indicated that the resurfacing progressed around the patera in an anti-clockwise direction at a rate of one to two kilometres per day, and that it is caused either by episodic eruptions that emplace voluminous lava flows or by a cyclically overturning lava lake contained within the patera. However, spacecraft and telescope observations have been unable to map the emission from the entire patera floor at sufficient spatial resolution to establish the physical processes at play. Here we report temperature and lava cooling age maps of the entire patera floor at a spatial sampling of about two kilometres, derived from ground-based interferometric imaging of thermal emission from Loki Patera obtained on 8 March 2015 ut as the limb of Europa occulted Io. Our results indicate that Loki Patera is resurfaced by a multi-phase process in which two waves propagate and converge around the central island. The different velocities and start times of the waves indicate a non-uniformity in the lava gas content and/or crust bulk density across the patera.

  5. Constraining Middle Pleistocene Glaciations in Birmingham, England; Using Optical Stimulated Luminescence (OSL) Dating.

    Science.gov (United States)

    Gibson, S. M.; Gibbard, P. L.; Bateman, M. D.; Boreham, S.

    2014-12-01

    Birmingham is built on a complex sequence of Middle Pleistocene sediments, representing at least three lowland glaciations (MIS12, MIS6, and MIS2). British Geological Survey mapping accounts 75% of the land mass as Quaternary deposits; predominantly glacial-sandy tills, glacial-fluvial sands, clays and organic silts and peats. Understanding the age of fluvial-glacial outwash, related to specific glaciations, is critical in establishing a Geochronology of Birmingham. Shotton (1953) found a series of Middle Pleistocene glacial sediments, termed the Wolstonian, intermediate in age between MIS11 and MIS5e Interglacial's. Uncertainty surrounding the relation to East Anglian sequences developed by Rose (1987) implies Birmingham sequences should be referred to MIS12. Despite this, younger Middle Pleistocene glacial sequences occur in Birmingham, yet uncertainty has deepened over our understanding of the complex, inaccessible sediments, especially as deposits have similar extent with MIS2 sequences. Five Optical Stimulated Luminescence (OSL) dates from three sites around Birmingham have been sampled. East of Birmingham, ice advanced from the Irish Sea and later the North East. In Wolston, a sample of outwash sand, associated with the Thurssington Till, is dated. In Meriden, two samples of outwash sands, associated with a distal Oadby Till, are dated. West of Birmingham, ice advanced from the Welsh Ice Sheet. In Seisdon, two samples of an Esker and outwash sand, associated with a Ridgeacre Till, are dated. Correlation of OSL dates provide an important constraint on understanding the history of Birmingham. Using GSI3D modeling to correlate geochronology and sedimentology, the significance of OSL dating can be understood within the complex sequences (and regional stratigraphy), complimented by Cosmogenic and Palynology dates taken in South West and North East. OSL dating on Birmingham's outwash sands, deposited by extensive repeated Middle Pleistocene glaciations, asserts the

  6. Recontouring, resurfacing, and scar revision in skin cancer reconstruction.

    Science.gov (United States)

    Brenner, Michael J; Perro, Christopher A

    2009-08-01

    Residual disfigurement is a common problem for patients who have undergone skin cancer reconstruction. Restoring form and function in these patients is an artistic and technical endeavor. The efficacy of surgical scar revision, dermabrasion, chemical peels, and laser resurfacing is predicated upon the skin's innate ability to regenerate over time in response to mechanical, chemical, and thermal or ablative stresses. The patient and surgeon should be accepting of a process that is often gradual and may proceed in stages. Achieving proficiency with the secondary procedures for improving scars and local flaps may allow the motivated surgeon to mold an initially passable surgical result into an excellent one.

  7. Hip Pain

    Science.gov (United States)

    ... diagnosis and decision making. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: ... http://www.mayoclinic.org/symptoms/hip-pain/basics/definition/SYM-20050684 . Mayo Clinic Footer Legal Conditions and ...

  8. Rose Hip

    Science.gov (United States)

    ... shows that taking rose hip powder mixed with apple juice does not affect weight or blood sugar ... Rose, Phool Gulab, Pink Rose, Poire d'oiseaux, Rosa alba, Rosa canina, Rosa centifolia, Rosa damascena, Rosa ...

  9. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, Carlo, E-mail: carlo.martinoli@libero.it [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Valle, Maura [Radiologia, Gaslini Children Hospital, Genova (Italy); Tagliafico, Alberto [Radiologia, National Institute for Cancer Research, Genoa (Italy)

    2012-12-15

    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.

  10. Thermal measurements of short-duration CO2 laser resurfacing

    Science.gov (United States)

    Harris, David M.; Fried, Daniel; Reinisch, Lou; Bell, Thomas; Lyver, Rex

    1997-05-01

    The thermal consequences of a 100 microsecond carbon-dioxide laser used for skin resurfacing were examined with infrared radiometry. Human skin was evaluated in a cosmetic surgery clinic and extirpated rodent skin was measured in a research laboratory. Thermal relaxation following single pulses of in vivo human and ex vivo animal skin were quantitatively similar in the 30 - 1000 msec range. The thermal emission from the area of the irradiated tissue increased monotonically with increasing incident laser fluence. Extremely high peak temperatures during the 100 microsecond pulse are attributed to plume incandescence. Ejecta thermal emission may also contribute to our measurements during the first several msecs. The data are combined into a thermal relaxation model. Given known coefficients, and adjusting tissue absorption to reflect a 50% water content, and thermal conductivity of 2.3 times that of water, the measured (both animal back and human forearm) and calculated values coincide. The high thermal conductance suggests preferential thermal conduction along the protein matrix. The clinical observation of a resurfacing procedure clearly shows thermal overlap and build-up is a result of sequential, adjacent pulses. A decrease of 4 - 6 degrees Celsius in surface temperature at the treatment site that appeared immediately post-Tx and gradually diminished over several days is possibly a sign of dermal convective and/or evaporative cooling.

  11. Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage.

    Science.gov (United States)

    Humada Álvarez, G; Simón Pérez, C; García Medrano, B; Faour Martín, O; Marcos Rodríguez, J J; Vega Castrillo, A; Martín Ferrero, M A

    The aim of this study is to show the results of scaphotrapeziotrapezoid (STT) joint osteoarthritis treatment performing resurfacing arthroplasty with scaphoid anchorage. An observational, descriptive and retrospective study was performed. Ten patients with isolated STT joint osteoarthritis were studied between 2013 and 2015. The mean follow-up time was 26months. Clinical results, functional and subjective scores were reviewed. The patients were satisfied, achieving an average of 2.1 (0-3) on the VAS score and 16 (2 to 28) in the DASH questionnaire, and returning to work in the first three months post-surgery. Recovery of range of motion compared to the contralateral wrist was 96% in extension, 95% in flexion, 87% in ulnar deviation and 91% in radial deviation. The average handgrip strength of the wrist was 95% and pinch strength was 95% compared to the contralateral side. There were no intraoperative complications or alterations in postoperative carpal alignment. Resurfacing arthroplasty is proposed as a good and novel alternative in treating isolated SST joint arthritis. Achieving the correct balance between the strength and mobility of the wrist, without causing carpal destabilisation, is important to obtain satisfactory clinical and functional results. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  12. Birmingham Urban Climate Change with Neighbourhood Estimates of Environmental Risk (buccaneer)

    Science.gov (United States)

    Bassett, R.; Thornes, J.; Cai, X.; Rees, R.

    2011-12-01

    The BUCCANEER project is a knowledge transfer partnership between the University of Birmingham and Birmingham City Council to help ensure that the city is prepared for the impacts of climate change. The project will equip service areas such as planners and health protection agencies with the necessary information and tools needed to adapt. UK climate projections indicate a 3.7oC temperature increase for Birmingham, UK by 2080 (medium emissions scenario). The 2003 heat-wave that caused over 2000 deaths in England and Wales will become an average summer by 2040. By the end of the century, the 2003 heat wave will be considered a cool summer. The dense urban fabric of Birmingham, the UK's second largest city, creates a warming effect when compared to surrounding rural areas. Past studies have found the nature of this urban heat island (UHI) to be related to city size, moisture availability, land-use, anthropogenic emissions, building materials and geometry. The UHI effect can lead to heat stress and air pollution problems which are a major health concern. Birmingham's UHI is not currently modelled. More specifically the UK climate projections treat Birmingham as a homogeneous slab of grassland. The inclusions of the urban areas in a climate model will show an intensification of the likely heat risk in future projections. In the present study, the JULES (Joint UK Land Environment Simulator) model has been setup and run for Birmingham and surrounding areas. The UHI was found to be greater than 3.5oC in Birmingham when modelled during heat waves. The model's performance is evaluated against data from two UK Met Office standard sites: Edgbaston (urban) and Winterbourne (rural). The temperatures predicted by the model over a 12 month (2010) simulation show a strong correlation with the observations. The model also reproduces the diurnal UHI intensity averaged over a year reasonably well. The model evaluation is also complemented by a data set of tiny-tag data logger

  13. Detection of incorrect manufacturer labelling of hip components

    Energy Technology Data Exchange (ETDEWEB)

    Durand-Hill, Matthieu; Henckel, Johann; Skinner, John; Hart, Alister [University College London, Institute of Orthopaedics, London (United Kingdom); Burwell, Matthew [Royal United Hospital, Bath (United Kingdom)

    2017-01-15

    We describe the case of a 53-year-old man who underwent a left metal-on-metal hip resurfacing in 2015. Component size mismatch (CSM) was suspected because of the patient's immediate post-operative mechanical symptoms and high metal ion levels. Surgical notes indicated the appropriate combinations of implants were used. However, we detected a mismatch using computed tomography. Revision was performed and subsequent measurements of explanted components confirmed the mismatch. To our knowledge, this case is the first report of a CT method being used in a patient to pre-operatively identify CSM. (orig.)

  14. A Star in the Western Sky: John Birmingham, Astronomer and Poet

    Science.gov (United States)

    Mohr, P.

    John Birmingham (1814-1884) of Millbrook, County Galway, was an outstanding amateur astronomer, now completely forgotten. He discovered the 1866 nova, T Coronae Borealis. Later his name was assigned to a feature near Anaxagoras on the Moon. In 1884 the Royal Irish Academy awarded him its Cunningham Gold Medal for his catalogue of the red variable stars. John Birmingham was not only an acute observer, he also wrote numerous semi-popular articles on many aspects of astronomy. He was also active in geology and railway surveying.

  15. Biologic resurfacing of the patella bone versus patellectomy

    Directory of Open Access Journals (Sweden)

    Motamedi M

    1995-04-01

    Full Text Available In the past years, there was a tendency to excise the patella in pathologic conditions affecting this bone. The patella has many critical effects in the function of the knee joint. For example, after its exicision the force of quadriceps muscle decreases by forty percent (40% and the knee joint becomes prone to early osteoarthritic changes. For these reasons, in the recent years the "biologic resurfacing of patella" has been used in pathologic conditions instead of its complete removal. In this new method after resection of the diseased part of the bone, the fascia of the quadriceps muscle, with its intact base, is used to cover the resected part of the bone. In practice, after pain relief, the active motion of the joint is started. Then the limb is placed in a splint or brace and after a period of 3 weeks, passive motion is begun.

  16. Resurfacing shoulder arthroplasty for the treatment of severe rheumatoid arthritis

    DEFF Research Database (Denmark)

    Voorde, Pia C Ten; Rasmussen, Jeppe V; Olsen, Bo S

    2015-01-01

    BACKGROUND AND PURPOSE: There is no consensus on which type of shoulder prosthesis should be used in patients with rheumatoid arthritis (RA). We describe patients with RA who were treated with shoulder replacement, regarding patient-reported outcome, prosthesis survival, and causes of revision......, and we compare outcome after resurfacing hemi-arthroplasty (RHA) and stemmed hemi-arthroplasty (SHA). PATIENTS AND METHODS: We used data from the national Danish Shoulder Arthroplasty Registry and included patients with RA who underwent shoulder arthroplasty in Denmark between 2006 and 2010. Patient-reported...... outcome was obtained 1-year postoperatively using the Western Ontario Osteoarthritis of the Shoulder index (WOOS), and rates of revision were calculated by checking revisions reported until December 2011. The patient-reported outcome of RHA was compared to that of SHA using regression analysis...

  17. Hip Problems in Infants

    Science.gov (United States)

    ... A hip problem in infants is known as developmental dysplasia of the hip (DDH). It is when the ball of the ... later in life? Resources International Hip Dysplasia Institute, Developmental Dysplasia of the Hip (DDH) International Hip Dysplasia Institute, Hip-Healthy Swaddling ...

  18. Defining the Learning Curve for Hip Arthroscopy: A Threshold Analysis of the Volume-Outcomes Relationship.

    Science.gov (United States)

    Mehta, Nabil; Chamberlin, Peter; Marx, Robert G; Hidaka, Chisa; Ge, Yile; Nawabi, Danyal H; Lyman, Stephen

    2018-01-01

    Hip arthroscopy has emerged as a successful option for the treatment of femoroacetabular impingement and related hip disorders, but the procedure is technically challenging. To define the learning curve through which surgeons become proficient at hip arthroscopy. Cohort study; level of evidence, 3. The authors identified hip arthroscopy procedures performed by surgeons through a New York State database (Statewide Planning and Research Cooperative System) and followed those cases for additional hip surgery (total hip arthroplasty, hip resurfacing, or ipsilateral hip arthroscopy) within 5 years of the original procedure. Career volume for each case was calculated as the number of hip arthroscopy procedures that the surgeon had performed. Volume strata were identified via the stratum-specific likelihood ratio method. A Cox proportional hazards model was used to measure the effect of surgeon career volume on risk of additional hip surgery, adjusting for the following patient characteristics: age, sex, race/ethnicity, insurance type, and concurrent diagnosis of hip osteoarthritis. Among 8041 hip arthroscopies performed by 251 surgeons, 989 (12.3%) cases underwent additional hip surgery within 5 years. Four strata of surgeon career volume associated with distinct frequencies of reoperation were identified: cases in the lowest stratum (0-97) had the highest frequency of additional surgery (15.4%). Frequencies declined for cases in the medium (98-388), high (389-518), and highest (≥519) strata (13.8%, 10.1%, and 2.6%, respectively). There was an increased risk of subsequent surgery in each stratum when compared with the highest stratum (hazard ratio [95% CI]: low volume, 3.22 [2.29-4.54]; medium, 3.40 [2.41-4.82]; high, 2.81 [1.86-4.25]; P learning curve for hip arthroscopy was unexpectedly demanding. Cases performed by surgeons with career volumes ≥519 had significantly lower risk of subsequent hip surgery than those performed by lower-volume surgeons.

  19. The resurfacing history of Mars - A synthesis of digitized, viking-based geology

    Science.gov (United States)

    Tanaka, Kenneth L.; Isbell, Nancy K.; Scott, David H.; Greeley, Ronald; Guest, John E.

    1988-01-01

    A global geologic map series of Mars was digitized at high resolution (1.846 sq km/pixel). It was found that the surface of Mars is predominantly volcanic. A resurfacing history was constructed by estimating the total extent of the geologic units. Eolian resurfacing was prevalent during the Late Amazonian Epoch, affecting 4.9 x 10 to the 6th sq km. It was found that resurfacing rates vary according to the absolute-age scheme used and generally decrease with time. Resurfacing rates were approximately 1000 sq km/yr during the Middle Noachian Epoch, one hundred to several hundred sq km/yr during the Late Noachian to Late Hesperian Epochs, and tens of sq km/yr or less during the Amazonian Period.

  20. Structural-Geometric Functionalization of the Additively Manufactured Prototype of Biomimetic Multispiked Connecting Ti-Alloy Scaffold for Entirely Noncemented Resurfacing Arthroplasty Endoprostheses

    Science.gov (United States)

    Rogala, Piotr; Patalas, Adam

    2017-01-01

    The multispiked connecting scaffold (MSC-Scaffold) prototype, inspired by the biological system of anchorage of the articular cartilage in the periarticular trabecular bone by means of subchondral bone interdigitations, is the essential innovation in fixation of the bone in resurfacing arthroplasty (RA) endoprostheses. The biomimetic MSC‐Scaffold, due to its complex geometric structure, can be manufactured only using additive technology, for example, selective laser melting (SLM). The major purpose of this work is determination of constructional possibilities for the structural-geometric functionalization of SLM‐manufactured MSC‐Scaffold prototype, compensating the reduced ability—due to the SLM technological limitations—to accommodate the ingrowing bone filling the interspike space of the prototype, which is important for the prototype bioengineering design. Confocal microscopy scanning of components of the SLM‐manufactured prototype of total hip resurfacing arthroplasty (THRA) endoprosthesis with the MSC‐Scaffold was performed. It was followed by the geometric measurements of a variety of specimens designed as the fragments of the MSC-Scaffold of both THRA endoprosthesis components. The reduced ability to accommodate the ingrowing bone tissue in the SLM‐manufactured prototypes versus that in the corresponding CAD models has been quantitatively determined. Obtained results enabled to establish a way of compensatory structural‐geometric functionalization, allowing the MSC‐Scaffold adequate redesigning and manufacturing in additive SLM technology. PMID:28785159

  1. Structural-Geometric Functionalization of the Additively Manufactured Prototype of Biomimetic Multispiked Connecting Ti-Alloy Scaffold for Entirely Noncemented Resurfacing Arthroplasty Endoprostheses

    Directory of Open Access Journals (Sweden)

    Ryszard Uklejewski

    2017-01-01

    Full Text Available The multispiked connecting scaffold (MSC-Scaffold prototype, inspired by the biological system of anchorage of the articular cartilage in the periarticular trabecular bone by means of subchondral bone interdigitations, is the essential innovation in fixation of the bone in resurfacing arthroplasty (RA endoprostheses. The biomimetic MSC‐Scaffold, due to its complex geometric structure, can be manufactured only using additive technology, for example, selective laser melting (SLM. The major purpose of this work is determination of constructional possibilities for the structural-geometric functionalization of SLM‐manufactured MSC‐Scaffold prototype, compensating the reduced ability—due to the SLM technological limitations—to accommodate the ingrowing bone filling the interspike space of the prototype, which is important for the prototype bioengineering design. Confocal microscopy scanning of components of the SLM‐manufactured prototype of total hip resurfacing arthroplasty (THRA endoprosthesis with the MSC‐Scaffold was performed. It was followed by the geometric measurements of a variety of specimens designed as the fragments of the MSC-Scaffold of both THRA endoprosthesis components. The reduced ability to accommodate the ingrowing bone tissue in the SLM‐manufactured prototypes versus that in the corresponding CAD models has been quantitatively determined. Obtained results enabled to establish a way of compensatory structural‐geometric functionalization, allowing the MSC‐Scaffold adequate redesigning and manufacturing in additive SLM technology.

  2. [Hip fractures].

    Science.gov (United States)

    Weisová, Drahomíra; Salášek, Martin; Pavelka, Tomáš

    2013-01-01

    Hip fractures are ranked among the frequent injuries. These fractures have been often coupled with high energy trauma in children and in patients with normal bone structure, low energy trauma and osteoporotic fracture (fragility fracture) is typical in elder patients. Hip fractures are divided into five groups: femoral head fracture, femoral neck fracture, pertrochanteric, intertrochateric and subtrochanteric fracture. Surgical treatment is indicated in all patients unless contraindications are present. Long bed rest has been accompanied by a high risk of development of thromboembolic disease, pneumonia and bed sore. Healing in the wrong position and nonunions are often the result of conservative treatment. Screw osteosynthesis is performed in isolated femoral head factures. Three cannulated screws or a DHS plate (dynamic hip screw) are used in fractures of the femoral neck with normal femoral head perfusion, total hip replacement is recommended in elder patients and in case of loss of blood supply of the femoral head. Pertrochanteric and intertrochanteric fractures can be stabilized by the femoral nails (PFN, PFN A, PFH - proximal femoral nail), nails are suitable for minimally invasive insertion and provide higher stability in the shaft, or plates (DHS) designed for stable pertronchanteric and intertrochanteric fractures. Subtrochanteric fractures can be fixed also intramedullary (nails - PFN long, PFN A long) and extramedullary (plates - DCS dynamic condylar screw, proximal femoral LCP - locking compression plate). Open reduction with internal plate fixation is advantageous for pathological fractures, as biopsy sampling can be performed. Hip fracture rehabilitation is integral part of the treatment, including walking on crutches or with a walker with partial weight bearing for at least six weeks.

  3. Jogging after total hip arthroplasty.

    Science.gov (United States)

    Abe, Hirohito; Sakai, Takashi; Nishii, Takashi; Takao, Masaki; Nakamura, Nobuo; Sugano, Nobuhiko

    2014-01-01

    Jogging has been classified as a high-impact sport, and jogging after total hip arthroplasty (THA) has not been well documented. To investigate the participation rate for postoperative jogging as well as jogging parameters and the influence of jogging on implant stability and bearing wear. Case-control study; Level of evidence, 3. Included in this study were 804 hips in 608 patients (85 men, 523 women) who underwent THA between 2005 and 2011 with follow-up longer than 1 year. The mean patient age was 62 years (range, 26-98 years), and mean follow-up duration was 4.8 years (range, 2.3-7.8 years). Hip resurfacing arthroplasty (HRA) was performed in 81 patients and conventional THA in 527 patients. During routine postsurgical visits, patients were given a questionnaire concerning preoperative and postoperative jogging routines. For joggers, frequency, distance, duration, and velocity of jogging were recorded. Patients who did not jog postoperatively were asked to provide reasons for not jogging. Radiographs concerning implant migration and polyethylene wear were evaluated with specialized software, and serum cobalt and chromium ion concentrations were investigated for patients with metal-on-metal articulation. A total of 33 patients (5.4%) performed jogging preoperatively, and 23 patients (3.8%) performed jogging postoperatively. Of the 23 who jogged postoperatively, conventional THA was performed in 13 patients and HRA in 10 patients. Postoperatively, joggers trained a mean of 4 times (range, 1-7 times) per week, covering a mean distance of 3.6 km (range, 0.5-15 km) in a mean time of 29 minutes (range, 5-90 minutes) per session and at a mean speed of 7.7 km/h (range, 3-18 km/h). No patient complained of pain or showed serum cobalt and chromium ion elevation greater than 7 ppb. No hip showed loosening, abnormal component migration, or excessive wear at a mean 5-year follow-up. There were 74 postoperative non-joggers with an interest in jogging. The reasons given for

  4. Clinical and radiological evolution of Intervened patients of total arthroplasty of hip with prostheses of resuperficialization metal-metal - Preliminary report

    International Nuclear Information System (INIS)

    Galvan Villamarin, Fernando; Bernal Torres, Fabio A; Paez, Jose Mauricio and others

    2006-01-01

    The articular degeneration of the hip in young patients requires including therapeutical alternatives for the management of this population. The resurfacing prostheses with metal-metal surfaces is an alternative for this type of patients. Reports with short and medium follow up are very promising, besides the different studies of laboratory that bear, the theoretical bases for their success. In this descriptive study, observational cases series type is described the radiological and clinical evolution of patients intervened of total arthroplasty of hip with resurfacing prostheses metal-metal in the hospital el Tunal of Bogota. The results of 31 hips are presented (27 patients) with an age average of 50 years old and a medium follow up of 16 months, with a good post surgical functional result with a median of 96 in the Harris Scores. The complications presented in the patient series are described and their relation with the different factors analyzed

  5. Listening to Students: Customer Journey Mapping at Birmingham City University Library and Learning Resources

    Science.gov (United States)

    Andrews, Judith; Eade, Eleanor

    2013-01-01

    Birmingham City University's Library and Learning Resources' strategic aim is to improve student satisfaction. A key element is the achievement of the Customer Excellence Standard. An important component of the standard is the mapping of services to improve quality. Library and Learning Resources has developed a methodology to map these…

  6. Medieval and Renaissance Music Conference, Birmingham 3.–6. 7. 2014

    Czech Academy of Sciences Publication Activity Database

    Mráčková, Veronika; Baťa, J.

    2014-01-01

    Roč. 51, 3-4 (2014), s. 414-417 ISSN 0018-7003. [Medieval and Renaissance Music Conference. Birmingham, 03.07.2014-06.07.2014] Institutional support: RVO:68378076 Keywords : conference * medieval * music Subject RIV: AL - Art, Architecture, Cultural Heritage

  7. Safety and efficacy of high fluence CO2 laser skin resurfacing with a single pass.

    Science.gov (United States)

    Khosh, M M; Larrabee, W F; Smoller, B

    1999-01-01

    Carbon dioxide (CO2) laser skin resurfacing has nearly replaced more traditional methods of superficial skin rejuvenation. Post-treatment erythema is the most common side effect of this method of skin resurfacing. Sublethal thermal damage to the dermis has been proposed as an etiology for post laser erythema. Recent developments in laser resurfacing technology have aimed at minimizing thermal damage to the dermis. To determine depth of skin ablation, extent of thermal injury, and ideal laser parameters for the FeatherTouch laser system. To assess the safety and efficacy of laser resurfacing at high energy fluences with a single pass. Laser resurfacing was performed in the preauricular skin of five patients undergoing rhytidectomy. A total of 60 sites were tested with fluences of 7 to 17 Joules/cm2. Histologic evaluation of excised skin showed maximal thermal injury to be restricted to 60 microns in the papillary dermis. The reticular dermis showed no evidence of injury. Based on these findings, laser resurfacing at 17 J/cm2 (70 watts) was performed on 30 patients (in the periorbital area, a maximum of 9 J/cm2 or 36 watts was used). Follow up ranged between 12 and 18 months. Based on histologic comparison of average and high fluence laser resurfacing, high fluence laser resurfacing did not cause added thermal damage to the reticular dermis. In the clinical group, no major complications such as scarring, scleral show, infection or ectropion were encountered. Transient hyperpigmentation was noted in three patients. Overall patient satisfaction was good to excellent. Post-treatment erythema lasted an average of 4 weeks. We conclude that CO2 laser resurfacing of the face (excluding the periorbital region) can be performed safely and effectively, with the FeatherTouch laser, at 17 J/cm2 with one pass. In our group of patients, laser resurfacing with a single pass at 17 J/cm2 caused less post-operative erythema than two or more passes at 9 J/cm2.

  8. Potential role of resurfacing Subtropical Underwater in ENSO evolution

    Science.gov (United States)

    Qu, T.; Chi, J.

    2017-12-01

    Results from a model of the Estimating the Circulation and Climate of the Ocean (ECCO) have shown that the resurfacing of high salinity Subtropical Underwater contributes to the sea surface salinity variability in the equatorial Pacific. On interannual time scale, this contribution can account for as much as 25% of the surface freshwater flux anomalies and is believed to play a role in ENSO evolution. Having these results in mind, this study investigates the surface salinity budget and its primary controls in the equatorial Pacific using ECCO output for the period 1993-2016. Particular attention is paid to 2014/2015 and 2015/2016. Preliminary analyses of the model results suggest that enhanced subsurface processes and in particular enhanced entrainment of Subtropical Underwater are primarily responsible for the positive sea surface salinity anomalies in the central equatorial Pacific during 2014/2015, which represents an opposite phase of El Niño. These subsurface processes weakened during 2015/2016, diretly contributing to the development of the 2015/2016 El Niño. The mechanisms controlling these subsurface processes are discussed.

  9. Histological evaluation of vertical laser channels from ablative fractional resurfacing

    DEFF Research Database (Denmark)

    Skovbølling Haak, Christina; Illes, Monica; Paasch, Uwe

    2011-01-01

    Ablative fractional resurfacing (AFR) represents a new treatment potential for various skin conditions and new laser devices are being introduced. It is important to gain information about the impact of laser settings on the dimensions of the created laser channels for obtaining a safe...... and efficient treatment outcome. The aim of this study was to establish a standard model to document the histological tissue damage profiles after AFR and to test a new laser device at diverse settings. Ex vivo abdominal pig skin was treated with a MedArt 620, prototype fractional carbon dioxide (CO(2)) laser...... measurements for each laser setting (n = 28). AFR created cone-shaped laser channels. Ablation depths varied from reaching the superficial dermis (2 mJ, median 41 μm) to approaching the subcutaneous fat (144 mJ, median 1,943 μm) and correlated to the applied energy levels in an approximate linear relation (r(2...

  10. Hip Replacement Surgery

    Science.gov (United States)

    ... Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB Download ... What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or diseased ...

  11. Hip replacement - discharge

    Science.gov (United States)

    ... discharge; Total hip replacement - discharge; Hip hemiarthroplasty - discharge; Osteoarthritis - hip replacement discharge ... such as downhill skiing or contact sports like football and soccer. But you should be able to ...

  12. Hip fracture - discharge

    Science.gov (United States)

    ... Philadelphia, PA: Elsevier; 2017:chap 55. Read More Broken bone Hip fracture surgery Hip pain Leg MRI scan Osteoporosis - overview Patient Instructions Getting your home ready - knee or hip surgery Osteomyelitis - discharge Review ...

  13. Relaxation of Summer Gasoline Volatility Standard for Jefferson and Shelby counties, Alabama (“the Birmingham area”) Final action

    Science.gov (United States)

    The EPA is taking final action to relax the federal volatility (RVP) standard applicable to gasoline supplied to the Birmingham area from 7.8 pounds per square inch (psi) to 9.0 psi during the summer ozone season.

  14. The TAPin electronic libraries project and the experience at the University of Birmingham

    Directory of Open Access Journals (Sweden)

    Tracy K. Mulvaney

    1997-01-01

    Full Text Available The TAPin Project and its implementation at the University of Birmingham is described. Local issues and key features of a hybrid approach to Networked Learner Support are addressed. The methods of NLS adopted included electronic mail and the Internet. The key role in NLS played by subject librarians is stressed. Transfer of skills to learners by means of targeted individual training and a web guide is discussed.

  15. Philanthropy in Birmingham and Sydney, 1860-1914: class, gender and race

    OpenAIRE

    Harvey, E. A.

    2011-01-01

    This thesis considers philanthropic activities directed towards new mothers and destitute children both “at home” and in a particular colonial context. Philanthropic encounters in Birmingham and Sydney are utilised as a lens through which to explore the intersections between discourses of race, gender and class in metropole and colony. Moreover, philanthropic and missionary efforts towards women and children facilitate a broader discussion of ideas of citizenship and nation. Du...

  16. Geology of the Birmingham, Gadsden, and Montgomery 10 x 20 NTMS Quadrangles, Alabama

    International Nuclear Information System (INIS)

    Copeland, C.W.; Beg, M.A.

    1979-04-01

    This document is a facsimile edition (with accompanying maps) of geologic reports on the Birmingham, Gadsden, and Montgomery 1 0 x 2 0 NTMS quadrangles prepared for SRL by the Geological Survey of Alabama. The purpose of these reports is to provide background geologic information to aid in the interpretation of NURE geochemical reconnaissance data. Each report includes descriptions of economic mineral localities as well as a mineral locality map and a geologic map

  17. Geology of the Birmingham, Gadsden, and Montgomery 10 x 20 NTMS quadrangles, Alabama

    International Nuclear Information System (INIS)

    Copeland, C.W.; Beg, M.A.

    1979-04-01

    This document is a facsimile edition (with accompanying maps) of geologic reports on the Birmingham, Gadsden, and Montgomery 1 0 x 2 0 NTMS quadrangles prepared for SRL by the Geological Survey of Alabama. Purpose of these reports is to provide background geologic information to aid in the interpretation of NURE geochemical reconnaissance data. Each report includes descriptions of economic mineral localities as well as a mineral locality map and a geologic map

  18. Hip arthroplasty for treatment of advanced osteonecrosis: comprehensive review of implant options, outcomes and complications

    Directory of Open Access Journals (Sweden)

    Waewsawangwong W

    2016-06-01

    Full Text Available Warit Waewsawangwong, Pirapat Ruchiwit, James I Huddleston, Stuart B Goodman Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA Abstract: Surgical treatment for late stage (post-collapse osteonecrosis of the femoral head is controversial. In these situations, the outcome of joint preservation procedures is poor. There are several arthroplasty options for late-stage disease. The clinical outcomes of hemiarthroplasty and hemiresurfacing are unpredictable because of progressive acetabular cartilage degeneration. Total hip resurfacing may be associated with further vascular insult to the femoral head and early failure of the implant. Total hip replacement with metal-on-conventional polyethylene bearing surfaces has been the gold standard, but implant survivorship is limited in young active patients due to wear and osteolysis. Newer alternative bearing surfaces may have improved wear characteristics, but their durability must be confirmed in longer-term studies. Keywords: hip arthroplasty, advanced osteonecrosis, implant options, outcomes, complications

  19. Partial resurfacing with varus osteotomy for an osteochondral defect of the femoral head

    NARCIS (Netherlands)

    van Stralen, Renée A.; Haverkamp, Daniël; van Bergen, Christiaan J. A.; Eijer, Henk

    2009-01-01

    Osteochondral defects of the femoral head represent a major challenge and various modern treatment options exist. We report a 16-year-old male with a large (3 x 3cm) osteochondral defect of the femoral head that was treated with a partial resurfacing prosthesis combined with a high varus osteotomy,

  20. The Plains of Aphrodite: Geohistory and Modes of Volcanic Resurfacing, Venus

    Science.gov (United States)

    Hansen, V. L.; Young, D. A.; Lang, N. P.; Bleamaster, B. F., III

    2002-03-01

    Geologic mapping of four contiguous VMAPs that cross the planitiae of Northern Aphrodite provides clues for plains surface evolution. Two modes of resurfacing emerge: relatively long and extensive flows sourced dominantly from coronae and, formation of a thin, lacey volcanic shield layer.

  1. Evaluation of periprosthetic bone mineral density and postoperative migration of humeral head resurfacing implants

    DEFF Research Database (Denmark)

    Mechlenburg, Inger; Klebe, Thomas Martin; Døssing, Kaj Verner

    2014-01-01

    BACKGROUND: Implant migration, bone mineral density (BMD), length of glenohumeral offset (LGHO), and clinical results were compared for the Copeland (Biomet Inc, Warsaw, IN, USA) and the Global C.A.P. (DePuy Int, Warsaw, IN, USA) humeral head resurfacing implants (HHRIs). METHODS: The study...

  2. Hip prostheses in young adults. Surface prostheses and short-stem prostheses.

    Science.gov (United States)

    Gallart, X; Riba, J; Fernández-Valencia, J A; Bori, G; Muñoz-Mahamud, E; Combalia, A

    The poor results obtained in young patients when using a conventional prosthesis led to the resurgence of hip resurfacing to find less invasive implants for the bone. Young patients present a demand for additional activity, which makes them a serious challenge for the survival of implants. In addition, new information technologies contribute decisively to the preference for non-cemented prostheses. Maintaining quality of life, preserving the bone and soft tissues, as well as achieving a very stable implant, are the goals of every hip orthopaedic surgeon for these patients. The results in research point to the use of smaller prostheses, which use the metaphyseal zone more and less the diaphyseal zone, and hence the large number of the abovementioned short stem prostheses. Both models are principally indicated in the young adult. Their revision should be a more simple operation, but this is only true for hip resurfacing, not for short stems. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Should we resurface the patella in total knee replacement? Experience with the Nex Gen prothesis.

    Science.gov (United States)

    Tabutin, J; Banon, F; Catonne, Y; Grobost, J; Tessier, J L; Tillie, B

    2005-10-01

    Patellar resurfacing is a controversial issue in primary total knee replacement. So, we took advantage of a large study to try and answer this question. An open prospective multicentric study was conducted about the outcome of the Nex Gen Total Knee prosthesis with clinical and radiological follow-up at regular intervals (1, 2 and 5 years). The data were centrally collected and analyzed by independent observers. A total of whole 5,915 cases were included (487 in the French group); incidences of patello-femoral pain were observed in both French and international groups and compared between cases with or without resurfaced patellae. Only osteoarthritic cases were selected for this particular study. Statistical analysis was performed using a Pearson's Chi-square test with a 95% confidence interval. The frequency of preoperative pain was significantly higher in the French group; 85.1% versus 66.6% (p<0.05). No patello-femoral pain appeared in preoperatively painless patients in the French group. The frequency of lateral patellar release was similar in both groups. 35.7% of the patellae were resurfaced in the international group versus 98.8% in the French one. At 2 years, patello-femoral pain was observed in 6.3% of cases in the former group versus 0.7% in the latter one. The risk of having patello-femoral pain was 9.45 times higher in the international group. When considering resurfaced cases in both groups the risk of having anterior knee pain was not significantly different (p=0.35). In the French group, one case out of nine (11.1%) with patello-femoral pain had not been resurfaced, while 129 cases out of 151 (85.4%) had not had a resurfacing in the international group. This emphasizes the effect of patellar implant on pain. Although patello-femoral pain is multifactorial, this analysis tool is powerful in getting rid of the "center effect " (cf Swedish register). Even if a longer follow-up for confirmation is needed, our data favor patellar resurfacing with this

  4. Fractional CO 2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2014-01-01

    Full Text Available Background: While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between. Aim: The aim of the present study is to assess the efficacy and safety of fractional CO 2 laser resurfacing in atrophic facial acne scars. Materials and Methods: Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO 2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ′excellent′ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ′good′ and ′poor′ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted. Results: Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3% while 15 (25% and 19 patients (31.7% demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks. Conclusions: Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar

  5. Matthew Murray Photographs and interviews Tribute Bands and Acts, photographed in Birmingham and the Black Country

    OpenAIRE

    Murray, Matthew

    2004-01-01

    POPPELGANGER!\\ud A Tribute to Tribute Bands: \\ud Photographs by Matthew Murray\\ud \\ud \\ud Did you know that you can see 'Christina Aguilera' performing in Redditch,\\ud 'Eminem' in Stourbridge, or even 'Freddie Mercury' at The Hunters Moon pub\\ud in Nechells, Birmingham? Matthew Murray's irresistible photos capture the urge to break out of our humdrum daily lives by dressing up in spandex and bursting into song, to wild applause. His witty exhibition affectionately portrays the lucky few that ...

  6. Incidence of Heterotopic Ossification after Surface and Conventional Total Hip Arthroplasty: A Comparative Study Using Anterolateral Approach and Indomethacin Prophylaxis

    Directory of Open Access Journals (Sweden)

    Dario Regis

    2013-01-01

    Full Text Available The incidence and severity of heterotopic ossification (HO in two homogeneous groups of patients that received surface replacement arthroplasty (SRA and conventional total hip arthroplasty (THA were evaluated retrospectively. Thirty-nine patients undergoing 42 hip resurfacing procedures and 41 primary cementless THAs through an anterolateral approach received a 10-day course of 150 mg/die of indomethacin postoperatively. The median surgical time was 190 minutes and 156 minutes, respectively (. At a minimum 1-year followup, the development of HO was assessed on standard X-ray using Brooker grading. Ectopic bone formation was detected in five cases (11.9%, two Brooker grade I and three grade II in the SRA group and in 14 hips (34.1%, 12 grade I and two grade II treated with conventional THA, but the difference was not significant (. No clinically relevant periprosthetic ossification (Brooker III or IV occurred in both groups. Although the difference was not statistically significant, the incidence of HO after SRA was lower than conventional THA. More extensive soft tissue trauma, bone debris, and longer operative time in hip resurfacing are not likely to be absolute risk factors for HO. Further investigations including larger patient populations are needed to confirm these findings.

  7. Hip joint replacement - slideshow

    Science.gov (United States)

    ... medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the sharing features ... M. Editorial team. Related MedlinePlus Health Topics Hip Replacement A.D.A.M., Inc. is accredited by ...

  8. Hip replacement - precautions

    Science.gov (United States)

    ... page, please enable JavaScript. After you have hip replacement surgery, you will need to be careful how ... to Expect at Home After you have hip replacement surgery, you will need to be careful how ...

  9. Hip Implant Systems

    Science.gov (United States)

    ... Orthopaedic Surgeons Information about Soft Tissue Imaging and Metal Ion Testing Information for All Health Care Professionals who Provide Treatment to Patients with a Metal-on-Metal Hip Implant Metal-on-Metal Hip ...

  10. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    with apparently unilateral right developmental dysplasia (left hip center-edge angles greater than 20 degrees), 26 patients with apparently unilateral left developmental dysplasia (right hip center-edge angles greater than 20 degrees), 68 patients with bilateral developmental dysplasia, and 34 patients...... "gold" standard]). See the Guidelines for Authors for a complete description of levels of evidence....

  11. Edge loading in metal-on-metal hips: low clearance is a new risk factor.

    Science.gov (United States)

    Underwood, Richard J; Zografos, Angelos; Sayles, Ritchie S; Hart, Alister; Cann, Philippa

    2012-03-01

    The revision rate of large head metal-on-metal and resurfacing hips are significantly higher than conventional total hip replacements. The revision of these components has been linked to high wear caused by edge loading; which occurs when the head-cup contact patch extends over the cup rim. There are two current explanations for this; first, there is loss of entrainment of synovial fluid resulting in breakdown of the lubricating film and second, edge loading results in a large local increase in contact pressure and consequent film thickness reduction at the cup rim, which causes an increase in wear. This paper develops a method to calculate the distance between the joint reaction force vector and the cup rim--the contact patch centre to rim (CPCR) distance. However, the critical distance for the risk of edge loading is the distance from the contact patch edge to rim (CPER) distance. An analysis of explanted hip components, divided into edge worn and non-edge-worn components showed that there was no statistical difference in CPCR values, but the CPER value was significantly lower for edge worn hips. Low clearance hips, which have a more conformal contact, have a larger diameter contact patch and thus are more at risk of edge loading for similarly positioned hips.

  12. The Birmingham Urban Climate Laboratory-A high density, urban meteorological dataset, from 2012-2014.

    Science.gov (United States)

    Warren, Elliott L; Young, Duick T; Chapman, Lee; Muller, Catherine; Grimmond, C S B; Cai, Xiao-Ming

    2016-06-07

    There is a paucity of urban meteorological observations worldwide, hindering progress in understanding and mitigating urban meteorological hazards and extremes. High quality urban datasets are required to monitor the impacts of climatological events, whilst providing data for evaluation of numerical models. The Birmingham Urban Climate Laboratory was established as an exemplar network to meet this demand for urban canopy layer observations. It comprises of an array of 84 wireless air temperature sensors nested within a coarser array of 24 automatic weather stations, with observations available between June 2012 and December 2014. data routinely underwent quality control, follows the ISO 8601 naming format and benefits from extensive site metadata. The data have been used to investigate the structure of the urban heat island in Birmingham and its associated societal and infrastructural impacts. The network is now being repurposed into a testbed for the assessment of crowd-sourced and satellite data, but the original dataset is now available for further analysis, and an open invitation is extended for its academic use.

  13. Rising inability to obtain needed health care among homeless persons in Birmingham, Alabama (1995-2005).

    Science.gov (United States)

    Kertesz, Stefan G; Hwang, Stephen W; Irwin, Jay; Ritchey, Ferris J; Lagory, Mark E

    2009-07-01

    Homeless persons depend disproportionately on the health-care safety net for medical services. National reports identify financial strains to this safety net. Whether this has affected homeless persons is unknown. We quantified changes in the proportion of homeless persons reporting unmet need for health care in Birmingham, Alabama, comparing two periods, 1995 and 2005. We assessed whether a period effect was independent of characteristics of persons surveyed. Analysis of two surveys conducted with identical methods among representative samples of homeless persons in 1995 (n = 161) and 2005 (n = 161). Report of unmet need (inability to obtain care when needed) was the dependent variable. Two survey periods (1995 and 2005) were compared, with multivariable adjustment for sociodemographic and health characteristics. Reasons for unmet need were determined among the subset of persons reporting unmet need. Unmet need for health care was more common in 2005 (54%) than in 1995 (32%) (p health-care needs was reported among Birmingham's homeless from 1995 to 2005. This period effect was independent of population characteristics and may implicate a local safety net inadequacy. Additional data are needed to determine if this represents a national trend.

  14. The Impact of Three Evidence-Based Programmes Delivered in Public Systems in Birmingham, UK

    Directory of Open Access Journals (Sweden)

    Michael Little

    2012-12-01

    Full Text Available The Birmingham Brighter Futures strategy was informed by epidemiological data on child well-being and evidence on “what works,” and included the implementation and evaluation of three evidence-based programmes in regular children’s services systems, as well as an integrated prospective cost-effectiveness analysis (reported elsewhere. A randomised controlled trial (RCT of the Incredible Years BASIC parenting programme involved 161 children aged three and four at risk of a social-emotional or behavioural disorder. An RCT of the universal PATHS social-emotional learning curriculum involved children aged four–six years in 56 primary schools. An RCT of the Level 4 Group Triple-P parenting programme involved parents of 146 children aged four–nine years with potential social-emotional or behavioural disorders. All three studies used validated standardised measures. Both parenting programme trials used parentcompletedmeasures of child and parenting behaviour. The school-based trial used teacher reports of children’s behaviour, emotions, and social competence.Incredible Years yielded reductions in negative parenting behaviours among parents, reductions in child behaviour problems, and improvements in children’s relationships. In the PATHS trial, modest improvements in emotional health and behavioural development after one year disappeared by the end of year two. There were no effects for Triple-P. Much can be learned from the strengths and limitations of the Birmingham experience.

  15. HIPs at Ten

    Science.gov (United States)

    Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

    2017-01-01

    2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

  16. Bursitis of the Hip

    Science.gov (United States)

    ... difficile (C. diff.) InfectionHerpes Home Diseases and Conditions Bursitis of the Hip Condition Bursitis of the Hip Share Print Table of Contents1. ... Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is bursitis of the hip? Bursitis is the painful swelling ...

  17. The Hip Restoration Algorithm

    Science.gov (United States)

    Stubbs, Allston Julius; Atilla, Halis Atil

    2016-01-01

    Summary Background Despite the rapid advancement of imaging and arthroscopic techniques about the hip joint, missed diagnoses are still common. As a deep joint and compared to the shoulder and knee joints, localization of hip symptoms is difficult. Hip pathology is not easily isolated and is often related to intra and extra-articular abnormalities. In light of these diagnostic challenges, we recommend an algorithmic approach to effectively diagnoses and treat hip pain. Methods In this review, hip pain is evaluated from diagnosis to treatment in a clear decision model. First we discuss emergency hip situations followed by the differentiation of intra and extra-articular causes of the hip pain. We differentiate the intra-articular hip as arthritic and non-arthritic and extra-articular pain as surrounding or remote tissue generated. Further, extra-articular hip pain is evaluated according to pain location. Finally we summarize the surgical treatment approach with an algorithmic diagram. Conclusion Diagnosis of hip pathology is difficult because the etiologies of pain may be various. An algorithmic approach to hip restoration from diagnosis to rehabilitation is crucial to successfully identify and manage hip pathologies. Level of evidence: V. PMID:28066734

  18. Standard guidelines of care: CO 2 laser for removal of benign skin lesions and resurfacing

    Directory of Open Access Journals (Sweden)

    Krupashankar D

    2008-03-01

    Full Text Available Resurfacing is a treatment to remove acne and chicken pox scars, and changes in the skin due to ageing. Machines : Both ablative and nonablative lasers are available for use. CO 2 laser is the gold standard in ablative lasers. Detailed knowledge of the machines is essential. Indications for CO 2 laser: Therapeutic indications: Actinic and seborrheic keratosis, warts, moles, skin tags, epidermal and dermal nevi, vitiligo blister and punch grafting, rhinophyma, sebaceous hyperplasia, xanthelasma, syringomas, actinic cheilitis angiofibroma, scar treatment, keloid, skin cancer, neurofibroma and diffuse actinic keratoses. CO 2 laser is not recommended for the removal of tattoos. Aesthetic indications: Resurfacing for acne, chicken pox and surgical scars, periorbital and perioral wrinkles, photo ageing changes, facial resurfacing. Physicians′ qualifications: Any qualified dermatologist (DVD or MD may practice CO 2 laser. The dermatologist should possess postgraduate qualification in dermatology and should have had specific hands-on training in lasers either during postgraduation or later at a facility which routinely performs laser procedures under a competent dermatologist/plastic surgeon, who has experience and training in using lasers. For the use of CO 2 lasers for benign growths, a full day workshop is adequate. As parameters may vary in different machines, specific training with the available machine at either the manufacturer′s facility or at another centre using the machine is recommended. Facility: CO 2 lasers can be used in the dermatologist′s minor procedure room for the above indications. However, when used for full-face resurfacing, the hospital operation theatre or day care facility with immediate access to emergency medical care is essential. Smoke evacuator is mandatory. Preoperative counseling and Informed consent Detailed counseling with respect to the treatment, desired effects, possible postoperative complications, should be

  19. Nano-analyses of wear particles from metal-on-metal and non-metal-on-metal dual modular neck hip arthroplasty.

    Science.gov (United States)

    Xia, Zhidao; Ricciardi, Benjamin F; Liu, Zhao; von Ruhland, Christopher; Ward, Mike; Lord, Alex; Hughes, Louise; Goldring, Steven R; Purdue, Edward; Murray, David; Perino, Giorgio

    2017-04-01

    Increased failure rates due to metallic wear particle-associated adverse local tissue reactions (ALTR) is a significant clinical problem in resurfacing and total hip arthroplasty. Retrieved periprosthetic tissue of 53 cases with corrosion/conventional metallic wear particles from 285 revision operations for ALTR was selected for nano-analyses. Three major classes of hip implants associated with ALTR, metal-on-metal hip resurfacing arthroplasty (MoM HRA) and large head total hip replacement (MoM LHTHA) and non-metal-on-metal dual modular neck total hip replacement (Non-MoM DMNTHA) were included. The size, shape, distribution, element composition, and crystal structure of the metal particles were analyzed by conventional histological examination and electron microscopy with analytic tools of 2D X-ray energy dispersive spectrometry and X-ray diffraction. Distinct differences in size, shape, and element composition of the metallic particles were detected in each implant class which correlate with the histological features of severity of ALTR and variability in implant performance. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. [Avascular necrosis of the hip - diagnosis and treatment].

    Science.gov (United States)

    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. © Georg Thieme Verlag KG Stuttgart · New York.

  1. "Active" and "Passive" Lava Resurfacing Processes on Io: A Comparative Study of Loki Patera and Prometheus

    Science.gov (United States)

    Davies, A. G.; Matson, D. L.; Leone, G.; Wilson, L.; Keszthelyi, L. P.

    2004-01-01

    Studies of Galileo Near Infrared Mapping Spectrometer (NIMS) data and ground based data of volcanism at Prometheus and Loki Patera on Io reveal very different mechanisms of lava emplacement at these two volcanoes. Data analyses show that the periodic nature of Loki Patera s volcanism from 1990 to 2001 is strong evidence that Loki s resurfacing over this period resulted from the foundering of a crust on a lava lake. This process is designated passive , as there is no reliance on sub-surface processes: the foundering of the crust is inevitable. Prometheus, on the other hand, displays an episodicity in its activity which we designate active . Like Kilauea, a close analog, Prometheus s effusive volcanism is dominated by pulses of magma through the nearsurface plumbing system. Each system affords views of lava resurfacing processes through modelling.

  2. Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder

    DEFF Research Database (Denmark)

    Rasmussen, J V; Polk, A; Sorensen, A K

    2014-01-01

    In this study, we evaluated patient-reported outcomes, the rate of revision and the indications for revision following resurfacing hemiarthroplasty of the shoulder in patients with osteoarthritis. All patients with osteoarthritis who underwent primary resurfacing hemiarthroplasty and reported...... to the Danish Shoulder Arthroplasty Registry (DSR), between January 2006 and December 2010 were included. There were 772 patients (837 arthroplasties) in the study. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate patient-reported outcome 12 months (10 to 14) post......-operatively. The rates of revision were calculated from the revisions reported to the DSR up to December 2011 and by checking deaths with the Danish National Register of Persons. A complete questionnaire was returned by 688 patients (82.2%). The mean WOOS was 67 (0 to 100). A total of 63 hemiarthroplasties (7...

  3. Can gait deviation index be used efectively for the evaluation of gait pathology in total hip arthroplasty

    DEFF Research Database (Denmark)

    Jensen, Carsten; Rosenlund, Signe; Nielsen, Dennis Brandborg

    In this poster, the Gait Deviation Index (GDI) was used as a convenient method to evaluate pre-to-postoperative gait quality changes after total hip arthroplasty and identify factors which might be predictive of outcome. Design: Three-dimensional gait data from a randomized clinical trial was used...... to determine changes in gait quality in participants walking at self-selected speed. Upon completion of the first assessment, the participants were randomly assigned to either resurfacing hip arthroplasty or conventional hip arthroplasty. The outcome was changes in overall gait quality measured with GDI during...... limbs; 0.3 [95%CI: -2.3 to 1.7]. However, the score for the two groups (pooled data) improved after surgery by 4.4 [95%CI: 1.8 to 7.0]. The single level regression analysis identified the preoperative GDI score as a strong predictor of outcome (p

  4. Crater density differences: Exploring regional resurfacing, secondary crater populations, and crater saturation equilibrium on the moon

    Science.gov (United States)

    Povilaitis, R Z; Robinson, M S; van der Bogert, C H; Hiesinger, Harald; Meyer, H M; Ostrach, Lillian

    2017-01-01

    The global population of lunar craters >20 km in diameter was analyzed by Head et al., (2010) to correlate crater distribution with resurfacing events and multiple impactor populations. The work presented here extends the global crater distribution analysis to smaller craters (5–20 km diameters, n = 22,746). Smaller craters form at a higher rate than larger craters and thus add granularity to age estimates of larger units and can reveal smaller and younger areas of resurfacing. An areal density difference map generated by comparing the new dataset with that of Head et al., (2010) shows local deficiencies of 5–20 km diameter craters, which we interpret to be caused by a combination of resurfacing by the Orientale basin, infilling of intercrater plains within the nearside highlands, and partial mare flooding of the Australe region. Chains of 5–30 km diameter secondaries northwest of Orientale and possible 8–22 km diameter basin secondaries within the farside highlands are also distinguishable. Analysis of the new database indicates that craters 57–160 km in diameter across much of the lunar highlands are at or exceed relative crater densities of R = 0.3 or 10% geometric saturation, but nonetheless appear to fit the lunar production function. Combined with the observation that small craters on old surfaces can reach saturation equilibrium at 1% geometric saturation (Xiao and Werner, 2015), this suggests that saturation equilibrium is a size-dependent process, where large craters persist because of their resistance to destruction, degradation, and resurfacing.

  5. Comparison of four different lasers for acne scars: Resurfacing and fractional lasers.

    Science.gov (United States)

    You, Hi-Jin; Kim, Deok-Woo; Yoon, Eul-Sik; Park, Seung-Ha

    2016-04-01

    Acne scars are common and cause cosmetic problems. There is a multitude of treatment options for acne scars, including dermabrasion, chemical peeling, and fillers, but the advent of laser technology has greatly improved the treatment of acne scars. Although several laser systems are available, studies comparing their efficacy are limited. This study compares the results of treatments using resurfacing (carbon dioxide, CO2; erbium-doped yttrium aluminum garnet, Er:YAG) versus fractional (nonablative fractional laser, NAFL; ablative fractional laser, AFL) lasers. A retrospective photographic analysis of 58 patients who underwent laser treatment for facial atrophic acne scars was performed. Clinical improvement was assessed by six blinded investigators with a scale graded from 0 to 10. Adverse events were also noted. Mean improvement scores of the CO2, Er:YAG, NAFL, and AFL groups were 6.0, 5.8, 2.2, and 5.2, respectively. The NAFL group showed a significantly lower score than the other groups. The mean number of treatments was significantly greater in the fractional laser groups than in the resurfacing laser groups. The resurfacing laser groups had a prolonged recovery period and high risk of complications. The Er:YAG laser caused less erythema or pigmentation compared to the CO2 laser. Although the CO2 laser, Er:YAG laser, and AFL improved the acne scars, the CO2 laser had a greater downtime. Three consecutive AFL treatments are as effective as a single treatment with resurfacing lasers, with shorter social downtime periods and less adverse effects. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Scar resurfacing with high-energy, short-pulsed and flashscanning carbon dioxide lasers.

    Science.gov (United States)

    Bernstein, L J; Kauvar, A N; Grossman, M C; Geronemus, R G

    1998-01-01

    Scars have a significant effect on a person's physical and social being. Many treatment modalities for scar improvement such as surgical scar revision, electrosurgical planing, chemical peeling, filler substance implantation, and dermabrasion have been developed. Recently, the resurfacing carbon dioxide (CO2) laser systems have proven to be a useful and safe treatment in the treatment of facial rhytides and acne scarring. The purpose of this study was to evaluate the resurfacing CO2 lasers in the treatment of various surgical, traumatic, acne, and varicella scars. Thirty subjects, aging between 14 and 84 years, with surgical, traumatic, acne, or varicella scars were evaluated. Two types of resurfacing laser systems were utilized in this study, a high-energy, short-pulsed CO2 laser and a continuous wave CO2 laser with an optico-mechanical computer flash-scanner. Post-surgical scars were treated with laser resurfacing between 4 and 6 weeks after scar formation. Traumatic, acne, and varicella scars were treated after scar maturation (range, 1-10 years). Scar improvement was evaluated by photographic analysis of before and after images by four independent health care workers using a quartile scale of improvement ( 75%) as well as optical profilometry using silicone surface impressions in 12 scars. Twenty of 24 surgical scars had greater than 75% improvement, and 24 of 24 had greater than 50% improvement by photographic analysis. All six traumatic, acne and varicella scars had greater than 50% improvement. Optical profilometry and surface topography maps reveal a significant flattening of related and depressed scars. The high-energy, short-pulsed CO2 laser and the continuous wave CO2 laser with flash-scanning attachment are safe and effective as a treatment modality for scar revision. In general, elevated scars improve more dramatically than depressed scars.

  7. La Escuela de Birmingham: La sintaxis de la cotidianidad como producción social de la conciencia

    Directory of Open Access Journals (Sweden)

    Blanca Muñoz

    2009-01-01

    Full Text Available Este ensayo comprende una aproximación teórica a las distintas aportaciones que desde el culturalismo de la Escuela de Birmingham se han configurado para dar respuesta a la problemática de la construcción social de la cotidianidad en el contexto histórico del capitalismo tardío. Asimismo, también intenta establecer una comparación entre las contribuciones de los autores que componen la “primera generación” (E.P. Thompson, R. Williams, Stuart Hall y R. Hoggart de la Escuela de Birmingham, y los de la “segunda generación”, con las perspectivas teóricas propuestas desde la Escuela de Frankfurt. This essay includes a theoretical approximation to the different contributionthat from the culturalismo of the School of Birmingham have been formed togive response to the problematics of the social construction of the commonnesin the historical context of the late capitalism. Likewise, also it tries to establisha comparison between the contributions of the authors who compose the “firsgeneration” (E.P. Thompson, R. Williams, Stuart Hall y R. Hoggart of theSchool of Birmingham, and those of the “second generation”, with thetheoretical perspectives proposed from Frankfurt's School.

  8. The Art of ATLAS; multimedia installation by Neal Hartman and Claudia Marcelloni at Thinktank science museum in Birmingham, UK.

    CERN Multimedia

    Claudia Marcelloni

    2010-01-01

    The Art of ATLAS is an multimedia installation, developed by Neal Hartman and Claudia Marcelloni about the physicists, engineers and technicians behind the ATLAS Experiment. The installation will been shown at Planetarium entrance of the Thinktank science museum in Birmingham, UK from October 2010 until January 2011.

  9. 78 FR 47778 - Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Birmingham...

    Science.gov (United States)

    2013-08-06

    ... Employment and Training Administration Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Birmingham, Alabama; Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Service Program Delivery Division San Francisco, California; Verizon Business Networks...

  10. Art and Sonic Mining in the Archives: Methods for Investigating the Wartime History of Birmingham School of Art

    Science.gov (United States)

    Vaughan, Sian

    2018-01-01

    "Absconditi Viscus" (or "Hidden Entries") is a series of sound compositions based on the history of Birmingham School of Art during the First World War. Sound artist Justin Wiggan explored the concept of historical sonic information that although lost could still potentially permeate the archival record and the fabric of the…

  11. Extremism and Neo-Liberal Education Policy: A Contextual Critique of the Trojan Horse Affair in Birmingham Schools

    Science.gov (United States)

    Arthur, James

    2015-01-01

    This paper offers new insights into the effects of neo-liberal education policies on some Muslim majority schools in Birmingham. It critically reveals how the implementation of neo-liberal education policies, pursued by both Labour and Conservative Governments, has contributed to the failure of some mechanisms of school leadership and governance.…

  12. A new patient classification for laser resurfacing and peels: predicting responses, risks, and results.

    Science.gov (United States)

    Fanous, Nabil

    2002-01-01

    Traditional classifications for skin treatment modalities are based on skin characteristics, the most important being skin color. Other factors are considered as well, such as oiliness, thickness, pathology, and sensitivity. While useful, these classifications are occasionally inadequate in predicting and explaining the outcome of some peels, dermabrasions, or laser resurfacing procedures. Why, for example, would a Korean patient with a light white skin inadvertently develop more hyperpigmentation than his darker skinned French counterpart? The new classification introduced here is based on the racial and genetic origins of patients. It suggests that racial genetic predisposition is the determining factor in human response to skin injury, including skin treatments. This classification takes into account both skin and features, rather than skin alone. It offers a new approach in evaluating patients scheduled for skin peels or laser resurfacing, in the hope of helping physicians to better predict reactions, select the appropriate type and intensity of the skin treatment and, ultimately, better control the outcome. Six categories (sub-races) are described: Nordics, Europeans, Mediterraneans, Indo-Pakistanis, Africans, and Asians. The reaction of each sub-race to peels, laser resurfacing, or dermabrasion is analyzed. The risks associated with each group are noted. This new classification provides physicians with a practical way to evaluate patients prior to treatment, with a view to determining each patient's suitability, postoperative reaction, the likelihood of complications, and likely result.

  13. The use of a prosthetic inlay resurfacing as a salvage procedure for a failed cartilage repair.

    Science.gov (United States)

    Dhollander, Aad Alfons Maria; Almqvist, Karl Fredrik; Moens, Kris; Vandekerckhove, Pieter-Jan; Verdonk, René; Verdonk, Peter; Victor, Jan

    2015-08-01

    This study was designed to describe the clinical and radiographical outcome of the HemiCAP(®) resurfacing system as a salvage treatment for a failed index cartilage procedure. Fourteen patients were treated consecutively and clinically prospectively followed for a mean period of 26.1 ± 12.8 months. All patients were previously treated for their cartilage lesion. Radiographical data were analysed based on the Kellgren and Lawrence system. The patients involved in this study demonstrated a gradual clinical improvement in time. However, radiographically significant osteoarthritic changes were observed during the follow-up period. The position of the HemiCAP(®) resurfacing system was adequate in all cases, and no signs of loosening were observed during the follow-up period. The HemiCAP(®) resurfacing system is feasible as a salvage treatment for a failed index cartilage procedure and resulted in a gradual clinical improvement. However, the favourable clinical outcome was not confirmed by the radiographical findings. IV.

  14. Progressive glenoid bone loss caused by erosion in humeral head resurfacing.

    Science.gov (United States)

    Werner, B S; Stehle, J; Abdelkawi, A; Plumhoff, P; Hudek, R; Gohlke, F

    2017-12-01

    Cementless surface replacement of the shoulder represents an alternative to conventional stemmed anatomic prostheses. Glenoid erosion is a well-known complication in hemiarthroplasty. However, there is limited data concerning radiographic evaluation and prognostic factors for this phenomenon. The aim of our study was to determine the development of glenoid erosion following shoulder resurfacing using a new measurement technique and detect potential prognostic factors. We performed a retrospective analysis on 38 shoulders undergoing humeral head resurfacing with a mean follow-up of 65.4 ± 43 months. Clinical and radiographic evaluation followed a standardized protocol including pre- and postoperative Constant score, active range of motion, and X‑rays in true anteroposterior view. Three independent observers performed measurements of glenoid erosion. We found good interobserver reliability for glenoid erosion measurements (intraclass correlation coefficient [ICC] 0.74-0.78). Progressive glenoid erosion was present in all cases, averaging 5.5 ± 3.9 mm at more than 5 years' follow-up. Male patients demonstrated increased glenoid bone loss within the first 5 years (p erosion was 37%. Glenoid erosion can be routinely expected in patients undergoing humeral head resurfacing. Painful glenoid erosion leads to deterioration in functional outcome and necessitates revision surgery in a high percentage of cases.

  15. The Birmingham bone anchored hearing aid programme: paediatric experience and results.

    Science.gov (United States)

    Powell, R H; Burrell, S P; Cooper, H R; Proops, D W

    1996-01-01

    Over a five-year period, 34 patients have been referred to the Birmingham bone anchored hearing aid programme, paediatric section, of who 21 are now wearing the bone anchored hearing aid (BAHA) and four are awaiting surgery for fitting of the BAHA. Of the patients assessed, found to be suitable and who proceeded to surgery for the BAHA, 44 per cent had Treacher Collins syndrome, 28 per cent had bilateral atresia or microtia, 16 per cent had Goldenhaar's syndrome, four per cent (one patient) had branchio-otorenal syndrome and eight per cent had chronic suppurative otitis media. This paper presents objective and subjective data collected from these patients. It is shown that the BAHA is a very effective hearing aid for children with congenital hearing loss.

  16. Report of Block Field Experience at Jefferson County Department of Health Bureau of Nutrition, Birmingham, Alabama.

    Science.gov (United States)

    1985-01-01

    but fractures most commonly are seen in the thoracic and lumbar vertebrae , the hip bones and the wrists. What are the symptoms? There are few or no...symptoms until the * disease is well advanced. Those commonly seen are the result of com- pression fractures of the thoracic and lumbar vertebrae . These...white females in this country have had one or more osteoporotic fractures. When the 4fracture affects the hip bones, 50% of the elderly will never fully

  17. Viscous relaxation as a prerequisite for tectonic resurfacing on Ganymede: Insights from numerical models of lithospheric extension

    Science.gov (United States)

    Bland, Michael T.; McKinnon, William B.

    2018-01-01

    Ganymede’s bright terrain formed during a near-global resurfacing event (or events) that produced both heavily tectonized and relatively smooth terrains. The mechanism(s) by which resurfacing occurred on Ganymede (e.g., cryovolcanic or tectonic), and the relationship between the older, dark and the younger, bright terrain are fundamental to understanding the geological evolution of the satellite. Using a two-dimensional numerical model of lithospheric extension that has previously been used to successfully simulate surface deformation consistent with grooved terrain morphologies, we investigate whether large-amplitude preexisting topography can be resurfaced (erased) by extension (i.e., tectonic resurfacing). Using synthetically produced initial topography, we show that when the total relief of the initial topography is larger than 25–50 m, periodic groove-like structures fail to form. Instead, extension is localized in a few individual, isolated troughs. These results pose a challenge to the tectonic resurfacing hypothesis. We further investigate the effects of preexisting topography by performing suites of simulations initialized with topography derived from digital terrain models of Ganymede’s surface. These include dark terrain, fresh (relatively deep) impact craters, smooth bright terrain, and a viscously relaxed impact crater. The simulations using dark terrain and fresh impact craters are consistent with our simulations using synthetic topography: periodic groove-like deformation fails to form. In contrast, when simulations were initialized with bright smooth terrain topography, groove-like deformation results from a wide variety of heat flow and surface temperature conditions. Similarly, when a viscously relaxed impact crater was used, groove-like structures were able to form during extension. These results suggest that tectonic resurfacing may require that the amplitude of the initial topography be reduced before extension begins. We emphasize that

  18. Developmental dysplasia of the hip

    Science.gov (United States)

    ... dislocation of the hip joint; Developmental hip dysplasia; DDH; Congenital dysplasia of the hip; Congenital dislocation of ... during pregnancy can increase a baby's risk of DDH. Other risk factors include: Being the first child ...

  19. Hip fracture surgery

    Science.gov (United States)

    ... allows your surgeon to use an x-ray machine to see how well the parts of your hip bone line up. The surgeon ... allows your surgeon to use an x-ray machine to see how well the parts of your hip bone line up. The surgeon ...

  20. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (genu valgum, the ankles (ankle valgus, calcaneal valgus and the spine (scoliosis especially at the lumbar level. The most spectacular are at the hip level, that is why we made an analytical evaluation only for this joint. To show the importance of physiotherapy for children with hip dysplasia we started from the hypothesis: untimely treatment for children with hip dysplasia has improved results in functional recovery and in obtaining a better stability, without the necessity of orthopedics or surgical interventions. The research methods used in this study are: the observation method, the bibliographic study method, the experimental method, the graphics method and the statistical mathematical method to process the data and to represent the results graphically. In the end, the results obtained are significantly different from the initial evaluations and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient improves stability and biomechanical parameters for the hip.

  1. High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis

    DEFF Research Database (Denmark)

    Laursen, Jens Ole

    2017-01-01

    pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients...

  2. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Kester Diederik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-27

    The intent of this report is to document a procedure used at LANL for HIP bonding aluminum cladding to U-10Mo fuel foils using a formed HIP can for the Domestic Reactor Conversion program in the NNSA Office of Material, Management and Minimization, and provide some details that may not have been published elsewhere. The HIP process is based on the procedures that have been used to develop the formed HIP can process, including the baseline process developed at Idaho National Laboratory (INL). The HIP bonding cladding process development is summarized in the listed references. Further iterations with Babcock & Wilcox (B&W) to refine the process to meet production and facility requirements is expected.

  3. Trends in Primary and Revision Hip Arthroplasty Among Orthopedic Surgeons Who Take the American Board of Orthopedics Part II Examination.

    Science.gov (United States)

    Eslam Pour, Aidin; Bradbury, Thomas L; Horst, Patrick K; Harrast, John J; Erens, Greg A; Roberson, James R

    2016-07-01

    A certified list of all operative cases performed within a 6-month period is a required prerequisite for surgeons taking the American Board of Orthopaedic Surgery Part II oral examination. Using the American Board of Orthopaedic Surgery secure Internet database database containing these cases, this study (1) assessed changing trends for primary and revision total hip arthroplasty (THA) and (2) compared practices and early postoperative complications between 2 groups of examinees, those with and without adult reconstruction fellowship training. Secure Internet database was searched for all 2003-2013 procedures with a Current Procedural Terminology code for THA, hip resurfacing, hemiarthroplasty, revision hip arthroplasty, conversion to THA, or removal of hip implant (Girdlestone, static, or dynamic spacer). Adult reconstruction fellowship-trained surgeons performed 60% of the more than 33,000 surgeries identified (average 28.1) and nonfellowship-trained surgeons performed 40% (average 5.2) (P revision surgeries for infection (71% vs 29%)(P revision surgeries (29% vs 35.5%) (P revision hip arthroplasties are often performed by surgeons without adult reconstruction fellowship training. Complications are less frequently reported by surgeons with larger volumes of joint replacement surgery who perform either primary or more complex cases. Primary hip arthroplasty is increasingly performed by surgeons early in practice who have completed an adult reconstructive fellowship after residency training. This trend is even more pronounced for more complex cases such as revision or management of infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Transmastoid Approach for Resurfacing the Superior Semicircular Canal Dehiscence with a Dumpling Structure

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Ma

    2015-01-01

    Full Text Available Background: Superior semicircular canal dehiscence (SSCD is gradually recognized by otologists in recent years. The patients with SSCD have a syndrome comprising a series of vestibular symptoms and hearing function disorders which can be cured by the operation. In this study, we evaluated the characteristics of patients with SSCD and determined the effectiveness of treating this syndrome by resurfacing the canal via the transmastoid approach using a dumpling structure. Methods: Patients with SSCD, confirmed by high-resolution computed tomography and hospitalized at Beijing Tongren Hospital between November 2009 and October 2012, were included in the study. All of the patients underwent the unilateral transmastoid approach for resurfacing the canal, and received regular follow-up after surgery. Data from preoperative medical records and postoperative follow-up were comparatively analyzed to evaluate the effect of surgery. Results: In total, 10 patients and 13 ears (three left ears, four right ears, three bilateral ears were evaluated in the study, which included 7 men and 3 women. Different symptoms and distinctive manifestations of vestibular evoked myogenic potential were found in these patients. After surgery, 4 patients had complete resolution, 5 had partial resolution, and 1 patient, with bilateral SSCD, had aggravation. None of the patients suffered from serious complications such as sensorineural hearing loss, facial paralysis, cerebrospinal fluid leakage, or intracranial hypertension. Conclusions: In patients with unilateral SSCD, resurfacing the canal via the transmastoid approach using a dumpling structure is an effective and safe technique. However, more consideration is needed for patients with bilateral SSCD.

  5. Resurfacing of pitted facial scars with a pulsed Er:YAG laser.

    Science.gov (United States)

    Kye, Y C

    1997-10-01

    Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed Er:YAG laser has been shown to be a highly effective treatment for several kinds of pitted facial scars. The purpose of this study was to assess the efficacy and safety of pulsed Er:YAG laser skin resurfacing for pitted facial scars. Four patients with small pox scars, five patients with chicken pox scars, and 21 patients with acne scars were included in this study. All patients were skin type III and IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2-4 weeks prior to the laser treatment. The pulsed Er:YAG laser with 2-mm handpiece at the setting of 500 mJ/pulse, 3.5-4.5 W was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0.05%, and hydrocortisone 1% cream was recommended for 2-4 weeks. Facial photographs were obtained at baseline and 2-week intervals postoperatively with a 35-mm single lense reflex camera equipped with a lense mounted ring flash. The results of treatment were evaluated for the changes of skin texture and color at 2 weeks, 1 month, and 3 months. Three patients with acne scars agreed to skin biopsy. Three months after laser treatment, all patients with small pox and chicken pox scars were improved about 55%, and patients with acne scars were improved about 40% on average. Pulsed Er:YAG laser skin resurfacing is an effective and safe treatment for pitted facial scars.

  6. Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

    Directory of Open Access Journals (Sweden)

    Erlenwein J

    2017-09-01

    Full Text Available Joachim Erlenwein,1,* Martin Müller,1,* Deborah Falla,1,2 Michael Przemeck,3 Michael Pfingsten,1 Stefan Budde,4 Michael Quintel,1 Frank Petzke1 1Department of Anesthesiology, Pain Clinic, University Medical Center Göttingen, Georg August University of Göttingen, Göttingen, Germany; 2Centre of Precision Rehabilitation for Spinal Pain (CPR Spine, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK; 3Department of Anesthesiology and Intensive Care, Annastift, Hannover, 4Department of Orthopedic Surgery, Medical School Hannover, Hannover, Germany *These authors contributed equally to this work Purpose: The development of persistent postoperative pain may occur following surgery, including total hip replacement. Yet, the prevalence may depend on the definition of persistent pain. This observational cohort study explored whether the prevalence of persistent pain after total hip replacement differs depending on the definition of persistent pain and evaluated the impact of ongoing pain on the patient’s quality of life 6 months after surgery.Patients and methods: Pre- and postoperative characteristics of 125 patients undergoing elective total hip replacement were assessed and 104 patients were available for the follow-up interview, 6 months after surgery.Results: Six months after surgery, between 26% and 58% of patients still reported hip pain – depending on the definition of persistent pain. Patients with moderate-to-severe persistent pain intensity (>3 on a numerical rating scale were more restricted in their daily life activities (Chronic Pain Grade – disability score but did not differ in reported quality of life (Short-Form 12 from those with no pain or milder pain intensity. Maximal preoperative pain intensity and body mass index were the only independent factors influencing daily function 6 months after total hip replacement.Conclusion: These

  7. Do Place and Time Make a Difference? Examining Quality of Life Among Homeless Persons in Northwest Arkansas and Birmingham.

    Science.gov (United States)

    O'Connor, Gail; Fitzpatrick, Kevin

    2017-04-01

    This study examines the role that life chances and choices play in determining quality of life among homeless people. Given the prominent negative impact of homelessness, this paper specifically examines the impact of length of time homeless and location on adverse quality of life. OLS regression examined quality of life among 264 homeless adults living in Northwest Arkansas and Birmingham, Alabama. Analysis shows no significant impact of life choices on quality of life but a significant impact of life chances including strong social ties and mastery of fate, on adverse quality of life. Length of time homeless was related to adverse quality of life, but location was not, indicating that the homeless experience with regards to subjective quality of life did not vary significantly between Birmingham and Northwest Arkansas.

  8. Advancing City Sustainability via Its Systems of Flows: The Urban Metabolism of Birmingham and Its Hinterland

    Directory of Open Access Journals (Sweden)

    Susan E. Lee

    2016-03-01

    Full Text Available Cities are dependent on their hinterlands for their function and survival. They provide resources such as people, materials, water, food and energy, as well as areas for waste disposal. Over the last 50 years, commerce and trade has become increasingly global with resources sourced from further afield often due to cheap labour costs, better transportation and a plentiful supply of energy and raw materials. However, the use and transportation of resources is becoming increasingly unsustainable as the global population increases, raw materials become increasing scarce, and energy costs rise. This paper builds on research undertaken in the Liveable Cities Programme on the resource flows of Birmingham, UK. It investigates how people, material, and food flows interact within regional, national, and international hinterlands through road and rail transportation and assesses their sustainability across all three pillars (economic, social, and environmental. The type and weight of goods is highlighted together with their costs and energy used. For a city to move with greatest effect towards sustainability it needs to: (i source as much as it can locally, to minimise transportation and energy costs; (ii adopt such principles as the “circular economy”; and (iii provide clean and efficient means to move people, especially public transportation.

  9. The Regional Autopsy Center: The University of Alabama at Birmingham Experience.

    Science.gov (United States)

    Atherton, Daniel Stephen; Reilly, Stephanie

    2017-09-01

    Rates of autopsied deaths have decreased significantly for the last several decades. It may not be practical for some institutions to maintain the facilities and staffing required to perform autopsies. In recent years, the University of Alabama at Birmingham (UAB) has established contracts to perform autopsies for several regional institutions including the Alabama Department of Forensic Sciences (ADFS), the United States Veterans Affairs, the local prison system, local community hospitals, and with families for private autopsy services. Contracts and autopsy data from 2004 to 2015 were obtained and reviewed. Since 2004, the number of UAB hospital autopsies trended slightly downward. On average, UAB hospital cases comprised most yearly cases, and the ADFS was the second largest contributor of cases. Income generated from outside autopsies performed from 2006 to 2015 totaled just more than 2 million dollars, and most of the income was generated from referred ADFS cases. This study provides evidence that a centralized institution (regional autopsy center [RAC]) can provide regional autopsy service in a practical, feasible, and economically viable manner, and a RAC can benefit both the referring institutions as well as the RAC itself.

  10. Factors associated with work productivity among people with COPD: Birmingham COPD Cohort.

    Science.gov (United States)

    Rai, Kiran K; Adab, Peymané; Ayres, Jon G; Siebert, W Stanley; Sadhra, Steven S; Sitch, Alice J; Fitzmaurice, David A; Jordan, Rachel E

    2017-12-01

    Patients with chronic obstructive pulmonary disease (COPD) are more likely to take time off work (absenteeism) and report poor performance at work (presenteeism) compared to those without COPD. Little is known about the modifiable factors associated with these work productivity outcomes. To assess the factors associated with work productivity among COPD patients. Cross-sectional analysis of baseline data from a subsample (those in paid employment) of the Birmingham COPD Cohort study. Absenteeism was defined by self-report over the previous 12 months. Presenteeism was assessed using the Stanford Presenteeism Scale. Logistic regression analysis was used to assess the effects of sociodemographic, clinical and occupational characteristics on work productivity. Among 348 included participants, increasing dyspnoea was the only factor associated with both absenteeism and presenteeism (p for trendwork productivity among patients with COPD. Future studies should evaluate interventions aimed at managing breathlessness and reducing occupational exposures to VGDF on work productivity among patients with COPD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Management of type III female genital mutilation in Birmingham, UK: a retrospective audit.

    Science.gov (United States)

    Paliwal, Priya; Ali, Sarah; Bradshaw, Sally; Hughes, Alison; Jolly, Kate

    2014-03-01

    to audit clinical management of women with type III female genital mutilation (FGM) according to local guidelines. Secondary objectives were to describe the population that uses the service and compare obstetric outcomes of intrapartum deinfibulation and antenatal deinfibulation. retrospective audit. a hospital midwifery-led FGM specialist service in Birmingham, UK. 253 women with type III FGM who gave birth between January 2008 and December 2009 METHODS: retrospective case analysis using patient records. proportion of women managed according to locally agreed criteria for the management of FGM; obstetric outcomes including perineal tears, episiotomy rates, estimated blood loss, infant APGAR scores and indications for caesarean section. 91 (36%) women booked into antenatal care after 16 weeks gestation. Only 26 (10.3%) were managed fully according to guidelines. The area with poorest performance was child protection, where the presence of normal genitalia was documented in only 52 (38.8%) of medical notes following birth of a female infant. The majority of women (214, 84.6%) had been deinfibulated in a previous pregnancy. Of the 39 infibulated at booking, only 9 (23.1%) were deinfibulated antenatally, the rest opted for intrapartum deinfibulation. Women who had intrapartum deinfibulation had a higher average blood loss and more tears than those deinfibulated antenatally, although this was not statistically significant. alternative systems should be considered to improve documentation of child protection related information. Further research is needed to confirm or refute the adverse findings among those that delayed deinfibulation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Economically and environmentally informed policy for road resurfacing: tradeoffs between costs and greenhouse gas emissions

    Science.gov (United States)

    Reger, Darren; Madanat, Samer; Horvath, Arpad

    2014-10-01

    As road conditions worsen, users experience an increase in fuel consumption and vehicle wear and tear. This increases the costs incurred by the drivers, and also increases the amount of greenhouse gases (GHGs) that vehicles emit. Pavement condition can be improved through rehabilitation activities (resurfacing) to reduce the effects on users, but these activities also have significant cost and GHG emission impacts. The objective of pavement management is to minimize total societal (user and agency) costs. However, the environmental impacts associated with the cost-minimizing policy are not currently accounted for. We show that there exists a range of potentially optimal decisions, known as the Pareto frontier, in which it is not possible to decrease total emissions without increasing total costs and vice versa. This research explores these tradeoffs for a system of pavement segments. For a case study, a network was created from a subset of California’s highways using available traffic data. It was shown that the current resurfacing strategy used by the state’s transportation agency, Caltrans, does not fall on the Pareto frontier, meaning that significant savings in both total costs and total emissions can be achieved by switching to one of the optimal policies. The methods presented in this paper also allow the decision maker to evaluate the impact of other policies, such as reduced vehicle kilometers traveled or better construction standards.

  13. Implications of the Utopia Gravity Anomaly for the Resurfacing of the Northern Plains of Mars

    Science.gov (United States)

    Banerdt, W. B.

    2004-01-01

    Whereas the surface units of the northern plain of Mars generally exhibit ages ranging from late Hesperian to Amazonian, interpretation of precise topographic measurements indicate that the age of the underlying "basement" is early Noachian, or almost as old as the southern highlands. This suggests that widespread but relatively superficial resurfacing has occurred throughout the northern plains since the end of early heavy bombardment. In this abstract I examine some of the possible implications of the subsurface structure inferred for the Utopia basin from gravity data on the nature of this resurfacing. The large, shallow, circular depression in Utopia Planitia has been identified as a huge impact basin, based on both geological evidence and detailed analysis of MOLA topography. Its diameter (approx. 3000 km) is equivalent to that of the Hellas basin, as is its inferred age (early Noachian). However, whereas Hellas is extremely deep with rough terrain and large slopes, the Utopia basin is a smooth, shallow, almost imperceptible bowl. Conversely, Utopia displays one of the largest (non-Tharsis-related) positive geoid anomalies on Mars, in contrast to a much more subdued negative anomaly over Hellas.

  14. Polydeoxyribonucleotide improves wound healing of fractional laser resurfacing in rat model.

    Science.gov (United States)

    Yu, Mi; Lee, Jun Young

    2017-02-01

    Polydeoxyribonucleotide (PDRN) is an active compound that can promote wound healing. PDRN stimulates wound healing by enhancing angiogenesis and increasing fibroblast growth rates. Laser skin resurfacing is a popular cosmetic procedure for skin rejuvenation. Despite excellent improvement of photo-damaged skin and acne scarring, it is accompanied with drawbacks, such as prolonged erythema and crusting. This study was designed to assess the effect of PDRN on wounds induced by fractional laser resurfacing. Twelve male rats aged 8 weeks were randomly assigned to the PDRN treatment group and the control group. Wounds were induced using a fractional ablative CO 2 laser. The treatment group received daily injections of PDRN and the control group received injections of the vehicle. Wound healing assessed by clinical features and histopathologic findings. The process of wound healing was faster in the treatment group than in the control group. In the histopathological examination, the granulation tissue thickness score of the treatment group was significantly higher than that of the control group. Results of immunohistochemical staining showed a marked increase of VEGF-positive cells and PECAM-1/CD31-positive microvessels in the treatment group. PDRN may be a beneficial option to promote wound healing after laser treatment.

  15. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

    McWalter, Patricia; Hassan Ahmed

    2007-01-01

    Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

  16. Resultados de artroplastia total de joelho com e sem implante de recapeamento (resurfacing patelar Results of total knee replacement with/without resurfacing of the patella

    Directory of Open Access Journals (Sweden)

    Abdul Khan

    2012-01-01

    Full Text Available OBJETIVO: Estudar a diferença de dor, estalido e crepitação patelofemoral no pós-operatório em pacientes com ou sem recapeamento patelar após 5 anos, os quais tinham dor patelofemoral antes da cirurgia. Estudar a incidência de dor, estalido e crepitação patelofemoral depois de pateloplastia em ambos os grupos. MÉTODOS: Revisão retrospectiva de 765 pacientes submetidos a artroplastia total do joelho (ATJ com ou sem recapeamento patelar. Os pacientes foram perguntados sobre dor pré e pós-operatória, 5 anos depois da cirurgia. Foram examinados por enfermeiro especializado 5 anos, após a cirurgia para verificar estalidos ou crepitação patelofemoral (PF. RESULTADOS: 688 pacientes (89,9% tinham dor PF pré-operatória. De 688 pacientes, 449 tinham recapeamento patelar (R e 239 não tinham (NR. Trinta e seis pacientes do grupo NR tinham pateloplastia. A incidência de dor PF pós-operatória foi 13,3% no grupo R e 13,6% no grupo NR. A incidência de estalido PF pós-operatório no grupo R foi 10,4% e apenas 1,3% no grupo NR (estatisticamente significante, p OBJECTIVE: To study the difference of post-op patellofemoral pain, clunk and crepitus in patients with/without resurfacing at 5 years who had pre-op patellofemoral pain. To study the incidence of post-operative patellofemoral pain, clunk and crepitus following patelloplasty in both the groups. METHODS: Retrospective review of 765 patients who had total knee replacement with/without resurfacing.Patients were asked about both pre-operative pain and also post-operative pain 5 years after the operation. Patients were examined by a specialist nurse at 5 years post-operatively to check for any patellofemoral clunk/crepitus. RESULTS: 688 patients (89.9% had preoperative PF pain. Of 688 patients, 449 had patellar resurfacing and 239 had not (NR. Thirty-six patients from the NR group had patelloplasty. The incidence of postoperative PF pain was 13.3% in the R group and 13.6% in the NR group

  17. Hip Labral Tear

    Science.gov (United States)

    ... are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid loading your ...

  18. Imaging of hip arthroplasty

    International Nuclear Information System (INIS)

    Breitenseher, M.J.; Mayerhoefer, M.; Gottsauner-Wolf, F.; Krestan, C.; Imhof, H.; Toma, C.D.

    2002-01-01

    Hip arthroplasty has become a common and still increasing procedure for the treatment of osteoarthritis, advanced head necrosis, post-inflammatory arthritis or rheumatoid arthritis.Radiography is the most important imaging modality for monitoring the normal, asymptomatic hip arthroplasty. Radiographs are obtained at the end of a surgical treatment, to exclude complications like fracture or component misplacement. In the follow-up radiographs are used for the diagnosis of loosening and infection of the hip arthroplasty as well as soft tissue ossification. Together with the history and clinical information, the analysis of morphological findings allows to find the grade of loosening. MRI has been advocated in the diagnosis of infection, in particular in the localisation of soft tissue involvement.Imaging, especially by radiographs, is used for the evaluation of the normal and complicated follow-up of hip arthroplasty. (orig.) [de

  19. Athletic Hip Injuries.

    Science.gov (United States)

    Lynch, T Sean; Bedi, Asheesh; Larson, Christopher M

    2017-04-01

    Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement. These disorders can happen in isolation but frequently occur in combination. To add to the diagnostic challenge, numerous intra-articular disorders and extra-articular soft-tissue restraints about the hip can serve as pain generators, in addition to referred pain from the lumbar spine, bowel, bladder, and reproductive organs. Athletic hip conditions can be debilitating and often require a timely diagnosis to provide appropriate intervention.

  20. Treatment of osteochondral defects of the talus with a metal resurfacing inlay implant after failed previous surgery: a prospective study

    NARCIS (Netherlands)

    van Bergen, C. J. A.; van Eekeren, I. C. M.; Reilingh, M. L.; Sierevelt, I. N.; van Dijk, C. N.

    2013-01-01

    We have evaluated the clinical effectiveness of a metal resurfacing inlay implant for osteochondral defects of the medial talar dome after failed previous surgical treatment. We prospectively studied 20 consecutive patients with a mean age of 38 years (20 to 60), for a mean of three years (2 to 5)

  1. Comparison of high-energy pulsed carbon dioxide laser resurfacing and dermabrasion in the revision of surgical scars.

    Science.gov (United States)

    Nehal, K S; Levine, V J; Ross, B; Ashinoff, R

    1998-06-01

    Both dermabrasion and high-energy pulsed carbon dioxide (CO2) laser resurfacing can improve the appearance of surgical scars. Although the results of these two procedures have been compared using historical data, a prospective evaluation has never been performed in humans. To prospectively compare the clinical effects of dermabrasion and high-energy pulsed CO2 laser resurfacing in the revision of surgical scars. Facial surgical scars in four patients were prospectively revised using a split scar model. One half of the scar was dermabraded and the other half was resurfaced with the high-energy pulsed CO2 laser. Comparisons of the two treatment modalities were performed through clinical assessment, photographic evaluation, and textural analysis of the scars. The high-energy pulsed CO2 laser-resurfaced halves of the scar were bloodless with less postoperative crusting in comparison with the dermabraded halves. Reepithelialization time and degree and duration of postoperative erythema were similar for both treatment halves. Photographic evaluation and textural analysis showed comparable improvement in the clinical appearance and surface texture of the scars with both treatment modalities. Both the high-energy pulsed CO2 laser and dermabrasion can achieve comparable clinical improvement in the revision of surgical scars. The high-energy pulsed CO2 laser offers the advantage of a bloodless field and a more precise method of tissue ablation. Postoperative erythema, however, is an expected finding with both treatment modalities.

  2. Implant Optimisation for Primary Hip Replacement in Patients over 60 Years with Osteoarthritis: A Cohort Study of Clinical Outcomes and Implant Costs Using Data from England and Wales.

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

    Full Text Available Hip replacement is one of the most commonly performed surgical procedures worldwide; hundreds of implant configurations provide options for femoral head size, joint surface material and fixation method with dramatically varying costs. Robust comparative evidence to inform the choice of implant is needed. This retrospective cohort study uses linked national databases from England and Wales to determine the optimal type of replacement for patients over 60 years undergoing hip replacement for osteoarthritis.Implants included were the commonest brand from each of the four types of replacement (cemented, cementless, hybrid and resurfacing; the reference prosthesis was the cemented hip procedure. Patient reported outcome scores (PROMs, costs and risk of repeat (revision surgery were examined. Multivariable analyses included analysis of covariance to assess improvement in PROMs (Oxford hip score, OHS, and EQ5D index (9159 linked episodes and competing risks modelling of implant survival (79,775 procedures. Cost of implants and ancillary equipment were obtained from National Health Service procurement data.EQ5D score improvements (at 6 months were similar for all hip replacement types. In females, revision risk was significantly higher in cementless hip prostheses (hazard ratio, HR = 2.22, p<0.001, when compared to the reference hip. Although improvement in OHS was statistically higher (22.1 versus 20.5, p<0.001 for cementless implants, this small difference is unlikely to be clinically important. In males, revision risk was significantly higher in cementless (HR = 1.95, p = 0.003 and resurfacing implants, HR = 3.46, p<0.001, with no differences in OHS. Material costs were lowest with the reference implant (cemented, range £1103 to £1524 and highest with cementless implants (£1928 to £4285. Limitations include the design of the study, which is intrinsically vulnerable to omitted variables, a paucity of long-term implant survival data (reflecting the

  3. Dataset of the livability performance of the city of Birmingham, UK, as measured by its citizen wellbeing, resource security, resource efficiency and carbon emissions.

    Science.gov (United States)

    Leach, Joanne M; Lee, Susan E; Boyko, Christopher T; Coulton, Claire J; Cooper, Rachel; Smith, Nicholas; Joffe, Hélène; Büchs, Milena; Hale, James D; Sadler, Jonathan P; Braithwaite, Peter A; Blunden, Luke S; De Laurentiis, Valeria; Hunt, Dexter V L; Bahaj, AbuBakr S; Barnes, Katie; Bouch, Christopher J; Bourikas, Leonidas; Cavada, Marianna; Chilvers, Andrew; Clune, Stephen J; Collins, Brian; Cosgrave, Ellie; Dunn, Nick; Falkingham, Jane; James, Patrick; Kwami, Corina; Locret-Collet, Martin; Medda, Francesca; Ortegon, Adriana; Pollastri, Serena; Popan, Cosmin; Psarikidou, Katerina; Tyler, Nick; Urry, John; Wu, Yue; Zeeb, Victoria; Rogers, Chris D F

    2017-12-01

    This data article presents the UK City LIFE 1 data set for the city of Birmingham, UK. UK City LIFE 1 is a new, comprehensive and holistic method for measuring the livable sustainability performance of UK cities. The Birmingham data set comprises 346 indicators structured simultaneously (1) within a four-tier, outcome-based framework in order to aid in their interpretation (e.g., promote healthy living and healthy long lives, minimize energy use, uncouple economic vitality from CO2 emissions) and (2) thematically in order to complement government and disciplinary siloes (e.g., health, energy, economy, climate change). Birmingham data for the indicators are presented within an Excel spreadsheet with their type, units, geographic area, year, source, link to secondary data files, data collection method, data availability and any relevant calculations and notes. This paper provides a detailed description of UK city LIFE 1 in order to enable comparable data sets to be produced for other UK cities. The Birmingham data set is made publically available at http://epapers.bham.ac.uk/3040/ to facilitate this and to enable further analyses. The UK City LIFE 1 Birmingham data set has been used to understand what is known and what is not known about the livable sustainability performance of the city and to inform how Birmingham City Council can take action now to improve its understanding and its performance into the future (see "Improving city-scale measures of livable sustainability: A study of urban measurement and assessment through application to the city of Birmingham, UK" Leach et al. [2]).

  4. Dataset of the livability performance of the city of Birmingham, UK, as measured by its citizen wellbeing, resource security, resource efficiency and carbon emissions

    Directory of Open Access Journals (Sweden)

    Joanne M. Leach

    2017-12-01

    Full Text Available This data article presents the UK City LIFE1 data set for the city of Birmingham, UK. UK City LIFE1 is a new, comprehensive and holistic method for measuring the livable sustainability performance of UK cities. The Birmingham data set comprises 346 indicators structured simultaneously (1 within a four-tier, outcome-based framework in order to aid in their interpretation (e.g., promote healthy living and healthy long lives, minimize energy use, uncouple economic vitality from CO2 emissions and (2 thematically in order to complement government and disciplinary siloes (e.g., health, energy, economy, climate change. Birmingham data for the indicators are presented within an Excel spreadsheet with their type, units, geographic area, year, source, link to secondary data files, data collection method, data availability and any relevant calculations and notes. This paper provides a detailed description of UK city LIFE1 in order to enable comparable data sets to be produced for other UK cities. The Birmingham data set is made publically available at http://epapers.bham.ac.uk/3040/ to facilitate this and to enable further analyses. The UK City LIFE1 Birmingham data set has been used to understand what is known and what is not known about the livable sustainability performance of the city and to inform how Birmingham City Council can take action now to improve its understanding and its performance into the future (see “Improving city-scale measures of livable sustainability: A study of urban measurement and assessment through application to the city of Birmingham, UK” Leach et al. [2].

  5. Patellar resurfacing versus nonresurfacing in total knee arthroplasty for osteoarthritis: experience at a tertiary care institution in Pakistan

    Directory of Open Access Journals (Sweden)

    Lakdawala RH

    2012-02-01

    Full Text Available Akil Fazal1, Riaz H Lakdawala21Clinical Fellow, NYU Hospital for Joint Disease, New York, US; 2Associate Professor and Chief, Section of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To determine the effect of patellar resurfacing in patients offered total knee arthroplasty for osteoarthritis.Design: Randomized control study.Place and duration of study: The Aga Khan University Hospital, Karachi, Pakistan from January 3, 2005 to January 9, 2010.Patients and methods: Patients undergoing primary total knee arthroplasty for osteoarthritis were assigned to either the patellar resurfacing or nonresurfacing arm using systematic sampling. This consisted of patients undergoing unilateral and bilateral knee arthroplasty. Preoperatively, Knee Society Knee and Function Scores were calculated. After a minimum of 3 years postoperatively Knee Society Knee and Function Scores as well as the Clinical Anterior Knee Pain Rating were calculated and analysis done to check for differences.Results: Seventy-five patients were recruited in each arm; 135 patients had bilateral and 15 had unilateral knee arthroplasty. The mean preoperative knee score was 40.4 for the resurfacing group and 40.60 for the nonresurfacing group (P = 0.45. This improved postoperatively to 93.67 and 94.23 respectively, with no difference between the two groups (P = 0.67. The mean preoperative function score was 45.50 for resurfaced patellae and 45.83 for nonresurfaced. This improved to 89.67 and 90.50, respectively, again with no difference (P = 0.51. Postoperative Clinical Anterior Knee Pain Rating was a mean of 0.1 for resurfaced and 0.13 for nonresurfaced patellas, with no difference on analysis (P = 0.06. However, patients who had bilateral knee arthroplasty had a slightly higher Clinical Anterior Knee Pain Rating than those who had single knee surgery (P = 0.046 irrespective of whether the patellar was resurfaced or not.Conclusion: In

  6. Understanding the dispensary workflow at the Birmingham Free Clinic: a proposed framework for an informatics intervention.

    Science.gov (United States)

    Fisher, Arielle M; Herbert, Mary I; Douglas, Gerald P

    2016-02-19

    The Birmingham Free Clinic (BFC) in Pittsburgh, Pennsylvania, USA is a free, walk-in clinic that serves medically uninsured populations through the use of volunteer health care providers and an on-site medication dispensary. The introduction of an electronic medical record (EMR) has improved several aspects of clinic workflow. However, pharmacists' tasks involving medication management and dispensing have become more challenging since EMR implementation due to its inability to support workflows between the medical and pharmaceutical services. To inform the design of a systematic intervention, we conducted a needs assessment study to identify workflow challenges and process inefficiencies in the dispensary. We used contextual inquiry to document the dispensary workflow and facilitate identification of critical aspects of intervention design specific to the user. Pharmacists were observed according to contextual inquiry guidelines. Graphical models were produced to aid data and process visualization. We created a list of themes describing workflow challenges and asked the pharmacists to rank them in order of significance to narrow the scope of intervention design. Three pharmacists were observed at the BFC. Observer notes were documented and analyzed to produce 13 themes outlining the primary challenges pharmacists encounter during dispensation at the BFC. The dispensary workflow is labor intensive, redundant, and inefficient when integrated with the clinical service. Observations identified inefficiencies that may benefit from the introduction of informatics interventions including: medication labeling, insufficient process notification, triple documentation, and inventory control. We propose a system for Prescription Management and General Inventory Control (RxMAGIC). RxMAGIC is a framework designed to mitigate workflow challenges and improve the processes of medication management and inventory control. While RxMAGIC is described in the context of the BFC

  7. Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

    Science.gov (United States)

    Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

    2015-09-01

    Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  8. Assessment of the Item Selection and Weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

    Science.gov (United States)

    MAHR, ALFRED D.; NEOGI, TUHINA; LAVALLEY, MICHAEL P.; DAVIS, JOHN C.; HOFFMAN, GARY S.; MCCUNE, W. JOSEPH; SPECKS, ULRICH; SPIERA, ROBERT F.; ST.CLAIR, E. WILLIAM; STONE, JOHN H.; MERKEL, PETER A.

    2013-01-01

    Objective To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items. Methods This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any “other” items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R2 to predict the PGA. Results We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on ≥5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG. PMID:18512722

  9. Systematic assessment of apraxia and functional predictions from the Birmingham Cognitive Screen.

    Science.gov (United States)

    Bickerton, Wai-Ling; Riddoch, M Jane; Samson, Dana; Balani, Alex Bahrami; Mistry, Bejal; Humphreys, Glyn W

    2012-05-01

    The validity and functional predictive values of the apraxia tests in the Birmingham Cognitive Screen (BCoS) were evaluated. BCoS was developed to identify patients with different forms of praxic deficit using procedures designed to be inclusive for patients with aphasia and/or spatial neglect. Observational studies were conducted from a university neuropsychological assessment centre and from acute and rehabilitation stroke care hospitals throughout an English region. Volunteers from referred patients with chronic acquired brain injuries, a consecutive hospital sample of patients within 3 months of stroke (n=635) and a population based healthy control sample (n=100) were recruited. The main outcome measures used were the Barthel Index, the Nottingham Extended Activities of Daily Living Scale as well as recovery from apraxia. There were high inter-rater reliabilities and correlations between the BCoS apraxia tasks and counterpart tests from the literature. The vast majority (88.3%) of the stroke survivors were able to complete the screen. Pantomime and gesture recognition tasks were more sensitive in differentiating between individuals with left hemisphere damage and right hemisphere damage whereas the Multistep Object Use test and the imitation task had higher functional correlates over and above effects of hemiplegia. Together, the initial scores of the four tasks enabled predictions with 75% accuracy, the recovery of apraxia and independence level at 9 months. As a model based assessment, BCoS offers a quick and valid way to detect apraxia and predict functional recovery. It enables early and informative assessment of most stroke patients for rehabilitation planning.

  10. Complications in Hip Arthroscopy

    Science.gov (United States)

    Nakano, Naoki; Khanduja, Vikas

    2016-01-01

    Summary Background Recent developments in hip arthroscopic techniques and technology have made it possible in many cases to avoid open surgical dislocation for treating a variety of pathology in the hip. Although early reports suggest favourable results’ using hip arthroscopy and it has been shown to be a relatively safe procedure, complications do exist and can sometimes lead to significant morbidity. Methods This is a review article. The aim of this manuscript is to present the most frequent and/or serious complications that could occur at or following hip arthroscopy and some guidelines to avoid these complications. Conclusion Most complications of hip arthroscopy are minor or transient but serious complications can occur as well. A lot of complication e.g. acetabular labral puncture go unreported. Appropriate education and training, precise and meticulous surgical technique with correct instrumentation, the right indication in the right patient and adherence to advice from mentors and experienced colleagues are all essential factors for a successful outcome. Level of evidence: V. PMID:28066747

  11. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

    Science.gov (United States)

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-08-13

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

  12. Mock-up experiment at Birmingham University for BNCT project of Osaka University--Neutron flux measurement with gold foil.

    Science.gov (United States)

    Tamaki, S; Sakai, M; Yoshihashi, S; Manabe, M; Zushi, N; Murata, I; Hoashi, E; Kato, I; Kuri, S; Oshiro, S; Nagasaki, M; Horiike, H

    2015-12-01

    Mock-up experiment for development of accelerator based neutron source for Osaka University BNCT project was carried out at Birmingham University, UK. In this paper, spatial distribution of neutron flux intensity was evaluated by foil activation method. Validity of the design code system was confirmed by comparing measured gold foil activities with calculations. As a result, it was found that the epi-thermal neutron beam was well collimated by our neutron moderator assembly. Also, the design accuracy was evaluated to have less than 20% error. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. 100-μsec pulsed CO2 laser resurfacing of lower eyelids: erythema and rhytides reduction

    Science.gov (United States)

    Bell, Thomas; Harris, David M.; Schachter, Daniel; Burkart, John

    1997-05-01

    Lower eyelid skin is very thin with a low density of adnexal structures. Attempts to remove rhytides and improve surface appearance with chemical peels and dermabrasion have been disappointing. Laser resurfacing offers a new modality that may improve the outcome. We evaluated a very short duration (100 microsecond(s) ec) pulsed carbon-dioxide laser (Tru-PulseTM) in terms of healing time (duration of erythema) and efficacy (wrinkle reduction). Female patients aged 35 - 75 received laser resurfacing in a variety of cosmetic zones but only data from lower lids are reported here. Dosimetry varied from total fluences of 5 to 20 J/cm2 (9 mm2 spot, 250 - 500 mJ pulse, 1 to 4 passes). Patients followed a strict regime of post-op wound care. Pre-treatment and follow-up photographs were taken in a studio with constant photographic parameters. Projected 35 mm slides were evaluated side-by-side for clinical improvement and presence of erythema. Within the first 4 days post-op all (100%) lower eyelids exhibited erythema and swelling, at 7 days: 71%, 12 days: 60%, 3 weeks: 25%, and one (1) month or longer 7%. In our sample the longest duration of post-op lower lid erythema lasted 5 weeks. Most patients experienced 70 -80% wrinkle reduction with a range of 0 - 100%. Regression analysis was used to evaluate the relationships between percent wrinkle reduction and the treatment, demographic, and evaluation variables. There was a significant trend for wrinkles to improve over the 3 to 9 month evaluation period. Older patients improved slightly more than younger patients. There was no relationship between total energy density and wrinkle reduction.

  14. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

    S.M. Bierma-Zeinstra (Sita); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); A. Prins (Ad); J.S. Lameris; A.Z. Ginai (Abida)

    2000-01-01

    textabstractOBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general

  15. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

    Bierma-Zeinstra, S. M.; Bohnen, A. M.; Verhaar, J. A.; Prins, A.; Ginai-Karamat, A. Z.; Laméris, J. S.

    2000-01-01

    To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a

  16. HIP DYSPLASIA IN TORNJAK

    Directory of Open Access Journals (Sweden)

    Hrvoje Milošević

    2012-07-01

    Full Text Available Canine hip dysplasia (CHD is a hereditary developmental anomaly, most frequent in large dog breeds. Clinical confirmation of the disorder is based on hip X-ray imaging. Twenty Tornjak dogs aged between 9-36 months, and weighted from 35-42 kg were examined for CHD. Scoring was performed according to six clearly defined radiographic parameters by Flueckiger method (5. Dysplastic changes of various severity were observed in 11 dogs, while in 9 dogs changes were absent. The study describes 4 CHD cases of varying degrees of severity. The results indicate the presence of CHD in Bosnian Tornjak. Determining the incidence of dysplasia in this autochthonous breed requires a more detailed study, which will enable determination of the prevalence of dysplasia and analysis of the relationship to other dog breeds. Key words: canine hip dysplasia, Bosnian Tornjak

  17. Research and Development in Net Shape Manufacturing Held in Birmingham, United Kingdom, 24-26 March 1999

    National Research Council Canada - National Science Library

    2000-01-01

    .... The papers covered all major areas of net shape processing and manufacturing: powder injection molding, net shape forging, sheet and roll forming, extrusion, HIPping, casting, rapid prototyping (tooling...

  18. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E

    2017-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18......-65 years) were included if they were referred to a physical therapist to gather pre-operative data and were then diagnosed during arthroscopy. Results of pre-operative patient history and physical tests were collected and compared to arthroscopy. Data of 77 active patients (mean age: 37 years) were...

  19. Hip Arthroscopy in The Athlete

    OpenAIRE

    Byrd, J.W. Thomas

    2007-01-01

    Sports related injuries to the hip have received relatively little attention, in the part because the clinical assessment, imaging studies, and surgical techniques are less sophisticated. The evolution of hip arthroscopy has offered a less invasive technique that allows for recognition and treatment of hip pathologies that previously went unrecognized. The success of hip arthoscopy is dependent on proper patient selection based on the patient's history and diagnosis. The purpose of this clini...

  20. The digital global geologic map of Mars: chronostratigraphic ages, topographic and crater morphologic characteristics, and updated resurfacing history

    Science.gov (United States)

    Tanaka, K.L.; Robbins, S.J.; Fortezzo, C.M.; Skinner, J.A.; Hare, T.M.

    2014-01-01

    A new global geologic map of Mars has been completed in a digital, geographic information system (GIS) format using geospatially controlled altimetry and image data sets. The map reconstructs the geologic history of Mars, which includes many new findings collated in the quarter century since the previous, Viking-based global maps were published, as well as other discoveries that were made during the course of the mapping using new data sets. The technical approach enabled consistent and regulated mapping that is appropriate not only for the map's 1:20,000,000 scale but also for its widespread use by diverse audiences. Each geologic unit outcrop includes basic attributes regarding identity, location, area, crater densities, and chronostratigraphic age. In turn, units are grouped by geographic and lithologic types, which provide synoptic global views of material ages and resurfacing character for the Noachian, Hesperian, and Amazonian periods. As a consequence of more precise and better quality topographic and morphologic data and more complete crater-density dating, our statistical comparisons identify significant refinements for how Martian geologic terrains are characterized. Unit groups show trends in mean elevation and slope that relate to geographic occurrence and geologic origin. In comparison with the previous global geologic map series based on Viking data, the new mapping consists of half the number of units due to simpler, more conservative and globally based approaches to discriminating units. In particular, Noachian highland surfaces overall have high percentages of their areas now dated as an epoch older than in the Viking mapping. Minimally eroded (i.e., pristine) impact craters ≥3 km in diameter occur in greater proportion on Hesperian surfaces. This observation contrasts with a deficit of similarly sized craters on heavily cratered and otherwise degraded Noachian terrain as well as on young Amazonian surfaces. We interpret these as reflecting the

  1. Skin resurfacing improved with a new dual wavelength Er:YAG/CO2 laser system: a comparative study.

    Science.gov (United States)

    Trelles, M A; García-Solana, L; Calderhead, R G

    1999-06-01

    The efficacy of a new dual wavelength Er:YAG and CO2 laser system was tested for skin resurfacing results on rabbits' ears and human facial skin. The dual wavelength laser delivers simultaneous pulses of low-energy CO2 and high-energy Er:YAG energies. Theoretically, combining the strengths of both laser types in one console should lead to improved clinical outcome. The use of the laser for skin resurfacing and remodeling has dramatically increased over the past few years. The CO2 laser was the first laser to be used in this field, followed more recently by the E:YAG laser. Both lasers offer unique advantages and disadvantages. The present study consists of an ear chamber experiment, conducted on eight rabbits, to examine vascular network formation, after laser resurfacing with a standard CO2 laser and the Er:YAG/CO2 laser. Resurfacing was also performed on human patients with the Er:YAG/CO2 laser and the results were compared with previously published results of CO2 laser resurfacing. Significant advantages, including an attenuation in the degree of edema and erythema and a shorter reepithelialization time compared to results with conventional CO2 systems, were observed with the Er:YAG/CO2 system. Improved tissue reorganization and good clinical results in nine of the ten patients (six ratings of "very good" and three "good") were observed. The clinical outcome of the remaining patient was rated as "fair." Minimal side effects were reported and observed in only three patients. The learning curve required to maximize the efficiency of the system is steep, however, requiring a thorough understanding of the different laser/tissue interactions associated with the two wavelengths. It is the authors' opinion that the dual wavelength Er:YAG/CO2 laser system offers a particularly efficient and flexible system to perform standard CO2 procedures for skin resurfacing with an improved clinical outcome, as well as other applications with the CO2 or Er:YAG energy delivered

  2. Do large heads enhance stability and restore native anatomy in primary total hip arthroplasty?

    Science.gov (United States)

    Lombardi, Adolph V; Skeels, Michael D; Berend, Keith R; Adams, Joanne B; Franchi, Orlando J

    2011-06-01

    Dislocation remains a serious complication in hip arthroplasty. Resurfacing proponents tout anatomic femoral head restoration as an advantage over total hip arthroplasty. However, advances in bearings have expanded prosthetic head options from traditional sizes of 22, 26, 28, and 32 mm to diameters as large as 60 mm. Large heads reportedly enhance stability owing to increased range of motion before impingement and increased jump distance to subluxation. Available larger diameter material combinations include metal- or ceramic-on-highly crosslinked polyethylene and metal-on-metal, each with distinct advantages and disadvantages. We sought to determine (1) if using larger diameter heads has lowered our dislocation rate; and (2) how closely an anatomic metal-on-metal bearing with diameters to 60 mm replicates native femoral head size. We retrospectively reviewed 2020 primary arthroplasties performed with large heads (≥ 36 mm) in 1748 patients and noted dislocation incidence. In a prospective subset of 89 cases using anatomic heads, native femoral head diameter was measured intraoperatively with calipers by an independent observer and later compared with implanted size. One dislocation has occurred in 2020 hips for an incidence of 0.05%. The prosthetic head averaged 0.7 mm larger than the native head with 68 of 89 (76%) reconstructed to within ± 2 mm of native size. Larger diameter heads have contributed to lower dislocation rates and large-diameter metal-on-metal articulation can provide close anatomic restoration in primary THA.

  3. Large-diameter metal-on-metal total hip arthroplasties: a page in orthopedic history?

    Science.gov (United States)

    Singh, Gurpal; Meyer, Heiko; Ruetschi, Marcel; Chamaon, Kathrin; Feuerstein, Bernd; Lohmann, Christoph H

    2013-11-01

    Large-diameter metal-on-metal (MoM) bearings evolved from the success of hip resurfacing. These implants were used in revision surgery in cases with well-fixed acetabular cups but loose or failed femoral stems, to avoid cup revision. Early data showed low rates of dislocation and potentially low wear profiles due to better fluid film lubrication. The risk of impingement was also thought to be low due to the increased head-neck ratio. Subsequently large-diameter MoM heads gained popularity in primary hip replacement. Recent data has emerged on the unacceptably high revision rates among patients with large-diameter MoM total hip arthroplasties (THAs), high blood levels of metal ions, and adverse tissue reactions. The head-neck (cone-taper) modular interface probably represents the weak link in large metal heads that have been used on conventional tapers. Increased torque of the large head, micromotion, and instability at the cone-taper interface, synergistic interactions between corrosion and wear, edge loading, low clearance, and psoas impingement are the likely causes for early failure of these prostheses. Copyright © 2013 Wiley Periodicals, Inc.

  4. Ultrasound: Infant Hip

    Science.gov (United States)

    ... the womb (breech position) babies with a family history of DDH Also, DDH occurs more frequently in girls than boys and among first-born infants. Doctors will consider all of these factors when deciding whether a baby's hips should be checked by ultrasound. In addition, a ...

  5. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    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. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Combined fractional resurfacing (10600 nm/1540 nm): Tridimensional imaging evaluation of a new device for skin rejuvenation.

    Science.gov (United States)

    Mezzana, Paolo; Valeriani, Maurizio; Valeriani, Roberto

    2016-11-01

    In this study were described the results, by tridimensional imaging evaluation, of the new "Combined Fractional Resurfacing" technique with the first fractional laser that overtakes the limits of traditional ablative, nonablative fractional resurfacing by combining CO 2 ablative and GaAs nonablative lasers. These two wavelengths can work separately or in a mixed modality to give the best treatment choice to all the patients. In this study, it is demonstrated that the simultaneous combination of the CO 2 wavelength (10600 nm) and GaAs wavelength (1540 nm) reduced the downtime, reduced pain during the treatment, and produced better results on fine wrinkles reduction and almost the same results on pigmentation as seen with 3D analysis by Antera (Miravex).

  7. Breast milk metal ion levels in a young and active patient with a metal-on-metal hip prosthesis.

    Science.gov (United States)

    Nelis, Raymond; de Waal Malefijt, Jan; Gosens, Taco

    2013-01-01

    Metal-on-metal resurfacing arthroplasty of the hip has been used increasingly over the last 10 years in younger active patients. The dissolution of the metal wear particles results in measurable increases in cobalt and chromium ions in the serum and urine of patients with a metal-on-metal bearing. We measured the cobalt, chromium, and molybdenum ion levels in urine; serum; and breast milk in a young and active patient with a metal-on-metal hip prosthesis after a pathologic fracture of the femoral neck. Metal-on-metal hip prosthesis leads to increasing levels of molybdenum in breast milk in the short-term follow-up. There are no increasing levels of chromium and cobalt ions in breast milk. Besides the already known elevated concentrations in serum of chromium and cobalt after implantation of a metal-on-metal hip prosthesis, we found no increasing levels of chromium and cobalt in urine. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Preliminary findings on the reliability and validity of the Cantonese Birmingham Cognitive Screen in patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Pan X

    2015-09-01

    Full Text Available Xiaoping Pan,1,* Haobo Chen,1,2,* Wai-Ling Bickerton,2 Johnny King Lam Lau,2 Anthony Pak Hin Kong,3 Pia Rotshtein,2 Aihua Guo,1 Jianxi Hu,1 Glyn W Humphreys4 1Department of Neurology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China; 2School of Psychology, University of Birmingham, Birmingham, UK; 3Department of Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA; 4Department of Experimental Psychology, University of Oxford, Oxford, UK *These authors contributed equally to this work Background: There are no currently effective cognitive assessment tools for patients who have suffered stroke in the People’s Republic of China. The Birmingham Cognitive Screen (BCoS has been shown to be a promising tool for revealing patients’ poststroke cognitive deficits in specific domains, which facilitates more individually designed rehabilitation in the long run. Hence we examined the reliability and validity of a Cantonese version BCoS in patients with acute ischemic stroke, in Guangzhou.Method: A total of 98 patients with acute ischemic stroke were assessed with the Cantonese version of the BCoS, and an additional 133 healthy individuals were recruited as controls. Apart from the BCoS, the patients also completed a number of external cognitive tests, including the Montreal Cognitive Assessment Test (MoCA, Mini Mental State Examination (MMSE, Albert’s cancellation test, the Rey–Osterrieth Complex Figure Test, and six gesture matching tasks. Cutoff scores for failing each subtest, ie, deficits, were computed based on the performance of the controls. The validity and reliability of the Cantonese BCoS were examined, as well as interrater and test–retest reliability. We also compared the proportions of cases being classified as deficits in controlled attention, memory, character writing, and praxis, between patients with and without spoken language impairment

  9. Pop-up Library at the University of Birmingham: Extending the Reach of an Academic Library by Taking "The Library" to the Students

    Science.gov (United States)

    Barnett, James; Bull, Stephen; Cooper, Helen

    2016-01-01

    Aligning with student engagement and promotional strategies, a Pop-Up Library project was initiated at the University of Birmingham. This involved setting up temporary, staffed stalls in different locations across campus in order to informally communicate with students and effectively take "the Library" to them. This article discusses…

  10. Hip Muscle Activity during Isometric Contraction of Hip Abduction

    Science.gov (United States)

    Fujisawa, Hiroyuki; Suzuki, Hiroto; Yamaguchi, Emi; Yoshiki, Hiromi; Wada, Yui; Watanabe, Aya

    2014-01-01

    [Purpose] This study aimed to determine the effect of varying hip flexion angle on hip muscle activity during isometric contraction in abduction. [Subjects] Twenty-seven healthy men (mean age=21.5 years, SD=1.2) participated in this study. [Methods] Surface electromyography (EMG) was recorded of the upper portion of the gluteus maximus (UGM), lower portion of the gluteus maximus (LGM), tensor fasciae latae (TFL), and gluteus medius (GMed) during isometric contraction under two measurement conditions: hip flexion angle (0, 20, 40, 60, and 80 degrees) and abduction of the hip joint at 20, 40, 60, and 80% maximum strength. Integrated EMG (IEMG) were calculated and normalized to the value of maximum voluntary contraction (MVC). [Results] Results indicated that the IEMG of both the UGM and LGM increased significantly with increases in hip flexion angle, whereas the IEMG of the TFL decreased significantly. The maximum activities of the UGM and the LGM were 85.7 ± 80.8%MVC and 38.2 ± 32.9%MVC at 80 degrees of hip flexion, respectively, and that of the TFL was 71.0 ± 39.0%MVC at 40 degrees of hip flexion. [Conclusion] The IEMG of the GMed did not change with increases in hip flexion angle. Hip flexion angle affected the activity of the GM and TFL during isometric contraction in abduction. PMID:24648628

  11. Hip Muscle Activity during Isometric Contraction of Hip Abduction.

    Science.gov (United States)

    Fujisawa, Hiroyuki; Suzuki, Hiroto; Yamaguchi, Emi; Yoshiki, Hiromi; Wada, Yui; Watanabe, Aya

    2014-02-01

    [Purpose] This study aimed to determine the effect of varying hip flexion angle on hip muscle activity during isometric contraction in abduction. [Subjects] Twenty-seven healthy men (mean age=21.5 years, SD=1.2) participated in this study. [Methods] Surface electromyography (EMG) was recorded of the upper portion of the gluteus maximus (UGM), lower portion of the gluteus maximus (LGM), tensor fasciae latae (TFL), and gluteus medius (GMed) during isometric contraction under two measurement conditions: hip flexion angle (0, 20, 40, 60, and 80 degrees) and abduction of the hip joint at 20, 40, 60, and 80% maximum strength. Integrated EMG (IEMG) were calculated and normalized to the value of maximum voluntary contraction (MVC). [Results] Results indicated that the IEMG of both the UGM and LGM increased significantly with increases in hip flexion angle, whereas the IEMG of the TFL decreased significantly. The maximum activities of the UGM and the LGM were 85.7 ± 80.8%MVC and 38.2 ± 32.9%MVC at 80 degrees of hip flexion, respectively, and that of the TFL was 71.0 ± 39.0%MVC at 40 degrees of hip flexion. [Conclusion] The IEMG of the GMed did not change with increases in hip flexion angle. Hip flexion angle affected the activity of the GM and TFL during isometric contraction in abduction.

  12. Partial humeral head resurfacing and Latarjet coracoid transfer for treatment of recurrent anterior glenohumeral instability.

    Science.gov (United States)

    Moros, Chris; Ahmad, Christopher S

    2009-08-01

    Bone deficiencies of either the humeral head or glenoid fossa may cause recurrent shoulder instability following soft tissue stabilization procedures. The engaging Hill-Sachs lesion, a major risk factor for instability, has been identified in a majority of patients with recurrent anterior instability. Guidance for surgical management of large humeral head deficiency presents few available options, with even fewer clinical data to support any one technique. Anteroinferior glenoid deficiency has also been a well-documented source of recurrent instability. The Latarjet coracoid transfer procedure corrects the glenoid defect by restoring the architecture of the inferior rim. Although coracoid transfer addresses containment on the glenoid, a concomitant large humeral head defect is at risk for engagement on the corrected glenoid. This article describes a case of a 50-year-old man presenting with recurrent right shoulder dislocations status post-open stabilization procedure 10 years prior. Radiologic evaluation demonstrated a large Hill-Sachs lesion with adjacent chondral derangement and a nonunion bony Bankart lesion. The Arthrosurface HemiCap humeral head resurfacing prosthesis (Arthrosurface Inc, Franklin, Massachusetts) was used to address the Hill-Sachs lesion with a Latarjet coracoid transfer procedure. We were unable to identify examples in the literature of the HemiCap used in the correction of a Hill-Sachs lesion for recurrent anterior instability. The HemiCap prosthesis has the benefit of correcting the Hill-Sachs lesion and adjacent chondral defect while preserving uninvolved articular surface. The combination of surgical interventions produced a successful result.

  13. Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham's Healthcare Leadership Academy.

    Science.gov (United States)

    Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N

    2014-05-01

    The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.

  14. The imperial welfare state? Decolonisation, education and professional interventions on immigrant children in Birmingham, 1948–1971

    DEFF Research Database (Denmark)

    Ydesen, Christian; Myers, Kevin

    2016-01-01

    with the narrative about the resilience of a post-war British history which sees 1945 as a moment of profound rupture symbolized by the demise of Empire, the development of a universal welfare state, the coming of mass immigration that brought with it social problems whose management presaged a distinctive British...... multiculturalism. Due to its influential impact on the development of immigrant education policies in England and because of its extensive education archive the article uses the Birmingham Local Education Administration (LEA) as an empirical and historical case. The significant British Nationality Act of 1948...... and the Immigration Act of 1971 serve as demarcations of the period treated. The article concludes that the immigrant child, and the child’s background, were consistently presented as educational problems and as the cause of both poor academic attainment and a more intangible unwillingness to assimilate. In this lens...

  15. Leadership lessons in global nursing and health from the Nightingale Letter Collection at the University of Alabama at Birmingham.

    Science.gov (United States)

    Harper, Doreen C; Davey, Kimberly S; Fordham, Pamela N

    2014-03-01

    This article analyzes the components of Florence Nightingale's visionary leadership for global health and nursing within the historical context of Great Britain's colonization of India. The descriptive study used the qualitative approach of narrative analysis to analyze selected letters in the Nightingale Letter Collection at the University of Alabama at Birmingham that Nightingale wrote to or about Dr. Thomas Gillham Hewlett, a physician and health officer in Bombay, India. The authors sought to increase understanding of Nightingale's visionary leadership for global nursing and health through a study of the form and content of the letters analyzed as temporally contextualized data, focusing on how the narratives are composed and what is conveyed. Several recurring themes central to Nightingale's leadership on global nursing and health emerge throughout these letters, including health and sanitation reform, collaborative partnerships, data-driven policy development, and advocacy for public health. These themes are illustrated through her letters to and testimony about Dr. Thomas Gillham Hewlett in her vivid descriptions of health education and promotion, data-driven policy documents, public health and sanitation advice, and collaboration with citizens, medicine, policy makers, and governments to improve the health and welfare of the people of India. The focus on leadership in nursing as a global construct highlights the lessons learned from University of Alabama at Birmingham's Nightingale Letter Collection that has relevance for the future of nursing and health care, particularly Nightingale's collaboration with policy leaders, her analysis of data to set policy agendas, and public health reform centered on improving the health and well-being of underserved populations.

  16. Studies of hip impingement diagnosis

    OpenAIRE

    Yazdi Far, Mahshid

    2014-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Hip impingement is a hip associated abnormality which develops among young and middle-aged individuals. It reduces the activity of those affected and if it is not detected at early stage, it can result in osteoarthritis. In this thesis a reliable framework for studying impingement detection is developed. Current clinical methods in detecting hip impingement involve measuring three angles, fir...

  17. SIGN HIP construct: Achieving hip fracture fixation without using an ...

    African Journals Online (AJOL)

    At the 6 week follow-up, there was 1 (1.5%) case of infection and 8 (11.8%) cases of varus collapse. Conclusion: Using the SIGN Hip Construct, hip fracture fixation can be achieved safely without an image intensifier. This implant may be a good alternative in developing countries where access to fluoroscopy is limited or ...

  18. Hip sonography in the newborn

    International Nuclear Information System (INIS)

    Riboni, G.; Serantoni, S.; De Simoni, M.; Bascape', P.; Facchini, R.; Pirovano, G.

    1991-01-01

    The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

  19. Hip-Hop Education Resources

    Science.gov (United States)

    Hall, Marcella Runell

    2009-01-01

    Hip-hop music and culture are often cited as being public pedagogy, meaning the music itself has intrinsic educational value. Non-profit organizations and individual educators have graciously taken the lead in utilizing hip-hop to educate. As the academy continues to debate its effectiveness, teachers and community organizers are moving forward.…

  20. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  1. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis.

    Science.gov (United States)

    López-López, José A; Humphriss, Rachel L; Beswick, Andrew D; Thom, Howard H Z; Hunt, Linda P; Burston, Amanda; Fawsitt, Christopher G; Hollingworth, William; Higgins, Julian P T; Welton, Nicky J; Blom, Ashley W; Marques, Elsa M R

    2017-11-02

    Objective  To compare the survival of different implant combinations for primary total hip replacement (THR). Design  Systematic review and network meta-analysis. Data sources  Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register. Review methods  Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination. Conclusions  Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies. Systematic review registration  PROSPERO CRD42015019435. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  2. The efficacy of patellar decompression for improving anterior knee pain following total knee arthroplasty without patellar resurfacing.

    Science.gov (United States)

    Lee, Gun Woo; Lee, Sun-Mi; Jang, Soo-Jin; Son, Jung-Hwan

    2013-04-01

    Anterior knee pain remains common following total knee arthroplasty (TKA). In this study, we evaluated the efficacy of patellar decompression via drilling for the treatment of anterior knee pain following TKA without patellar resurfacing. A prospective cohort study was performed in 271 consecutive patients who underwent primary total knee replacement with patellar decompression (study group, n = 131) or without decompression (control group, n = 140). The patients were assessed according to the Knee Society rating, clinical anterior knee pain score, and British Orthopaedic Association patient-satisfaction score in each group. Each assessment was performed without the examiner knowing whether the patella had been decompressed. Radiographic evaluations were also performed according to the Knee Society scoring system for functional activity and our own severity grade system for patellofemoral articular change. There were no adverse events following patellar decompression. The overall prevalence of anterior knee pain was not significantly different between groups (p = 0.71). However, patients presenting pain over grade II after the operation in the study group were statistically low (p = 0.01). The overall postoperative knee scores were higher in the study group, but there were no significant differences between groups (p = 0.0731). Analyses of the radiographs revealed similar postoperative outcomes in both groups of knees. As we observed significantly lower rates of anterior knee pain and no patellar complications following patellar decompression via drilling in TKA without patellar resurfacing, we recommend performing patellar decompression in cases of total knee replacement without patellar resurfacing.

  3. Current Insights Regarding Metal-on-Metal Bearings for Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Catherine Van Der Straeten

    2017-09-01

    Full Text Available Modern small diameter metal-on-metal (MoM bearings for total hip arthroplasty (THA have been developed in the nineteen-eighties to address the problem of polyethylene wear related osteolysis. Subsequently large diameter MoM hip resurfacings (HRA were designed for young and active patients to preserve bone and avoid dislocation. Large diameter MoM THA were originally meant as an easy femoral component-only revision solution for femoral neck fractures in HRA, but were then advocated for primary THA as well. In the last decade however, increasing numbers of revisions for adverse local tissues reactions (ALTR to metal debris have been reported. These ALTR are due to excessive wear of the MoM bearings, usually related to malpositioning of the components leading to edge loading, or in rare cases to metal sensitivity. Besides the immunological reactions, metal particles and ions have a potential local and systemic toxicity. Wear and tribocorrosion at the taper-trunnion connections of MoM THA but also THA with polyethylene and ceramic bearings have also been recognized as a cause of ALTR with extensive tissue destruction. Despite the fact that the long-term survivorship and functional results of certain MoM HRA are excellent and better than THA in the young and active patients group, MoM bearings have become very unpopular and are likely to be replaced by bearing couples of other materials.

  4. Clinical diagnosis of hip pain.

    Science.gov (United States)

    Plante, Matthew; Wallace, Roxanne; Busconi, Brian D

    2011-04-01

    This article reviews the evaluation of the hip including the clinical history and physical examination. As our understanding of hip pathology evolves, and arthroscopic and other minimally invasive operative techniques improve, the focus is shifting toward earlier identification of hip pathology. Risk factors for the development of arthritis are now well established and include femoral acetabular impingement, labral tearing, developmental dysplasia, and slipped capital femoral epiphysis. Emerging treatment options may address these conditions in the early stages and prevent or slow the progression of hip degeneration. It is vitally important to elucidate intra-articular versus extra-articular pathology of hip pain in every step of the patient encounter: history, physical examination, and imaging. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Total hip arthroplasty for surgical management of advanced tuberculous hip arthritis: Case report

    OpenAIRE

    Tan, Shi Ming; Chin, Pak Lin

    2015-01-01

    Tuberculosis (TB) arthritis of the hip is a debilitating disease that often results in severe cartilage destruction and degeneration of the hip. In advanced cases, arthrodesis of the hip confers benefits to the young, high-demand and active patient. However, many of these patients go on to develop degenerative arthritis of the spine, ipsilateral knee and contralateral hip, necessitating the need for a conversion to total hip arthroplasty. Conversion of a previously fused hip to a total hip ar...

  6. Hip abductor muscle volume in hip osteoarthritis and matched controls.

    Science.gov (United States)

    Zacharias, A; Pizzari, T; English, D J; Kapakoulakis, T; Green, R A

    2016-10-01

    Hip abductor muscle strength and function is negatively impacted by the presence of hip osteoarthritis (OA). This study aimed to quantify differences in hip abductor muscle volume, fatty infiltration and strength in a unilateral hip OA population when compared to a control group. Impact of radiographic severity of OA on these variables was also examined. Volumes of gluteus maximus (GMax), medius (GMed) minimus (GMin) and tensor fascia lata (TFL) was measured using MRI and muscle volume asymmetry between limbs was calculated. Fatty infiltrate within muscles was graded using the Goutallier classification system. Hip abduction and rotation strength was tested using a dynamometer. Differences between groups or limbs were analysed using t-tests and differences in fatty infiltration using non-parametric tests. A statistically significant decrease in muscle volume was identified in GMax (P abduction and internal rotation strength was reduced in the OA group. Increased levels of fatty infiltration were identified in the affected limbs of the OA group for GMax (P = 0.01) and GMin (P = 0.04). Gluteal muscle atrophy, increased gluteal fatty infiltration and hip strength deficits were evident in the affected hips of OA participants. Since severity of OA was related to the extent of atrophy and fatty deposits, rehabilitation programs targeting these muscles could reverse or halt the progression of these structural and functional deficits. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  7. Extensive risk analysis of mechanical failure for an epiphyseal hip prothesis: a combined numerical-experimental approach.

    Science.gov (United States)

    Martelli, S; Taddei, F; Cristofolini, L; Gill, H S; Viceconti, M

    2011-02-01

    There has been recent renewed interest in proximal femur epiphyseal replacement as an alternative to conventional total hip replacement. In many branches of engineering, risk analysis has proved to be an efficient tool for avoiding premature failures of innovative devices. An extensive risk analysis procedure has been developed for epiphyseal hip prostheses and the predictions of this method have been compared to the known clinical outcomes of a well-established contemporary design, namely hip resurfacing devices. Clinical scenarios leading to revision (i.e. loosening, neck fracture and failure of the prosthetic component) were associated with potential failure modes (i.e. overload, fatigue, wear, fibrotic tissue differentiation and bone remodelling). Driving parameters of the corresponding failure mode were identified together with their safe thresholds. For each failure mode, a failure criterion was identified and studied under the most relevant physiological loading conditions. All failure modes were investigated with the most suitable investigation tool, either numerical or experimental. Results showed a low risk for each failure scenario either in the immediate postoperative period or in the long term. These findings are in agreement with those reported by the majority of clinical studies for correctly implanted devices. Although further work is needed to confirm the predictions of this method, it was concluded that the proposed risk analysis procedure has the potential to increase the efficacy of preclinical validation protocols for new epiphyseal replacement devices.

  8. Clinical Evaluation of Fused/Ankylosed Hip with Severe Flexion Deformity after Conversion to Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Saroj Kumar Suwal

    2016-06-01

    Conclusions: THA is an effective treatment for ankylosed hip with severe flexion deformity although complications are noted more than routine hip arthroplasties. Keywords: ankylosed hip; fused hip; severe flexion deformity; total hip arthroplasty. | PubMed

  9. Results of total hip arthroplasty using a bionic hip stem.

    Science.gov (United States)

    Fokter, Samo K; Sarler, Taras; Strahovnik, Andrej; Repše-Fokter, Alenka

    2015-06-01

    The trabecular-orientated bionic hip stem was designed to mimic the natural force transmission through the femur in total hip arthroplasty, resulting in supposedly longer prosthesis survivability. The aim of this study was to compare the second-generation bionic hip stem to a standard uncemented hip stem. A group of 18 patients (21 hips) who underwent total hip arthroplasty with a bionic stem (bionic group) was compared with a historic group of 12 patients (12 hips) treated with standard anatomic hip stem (control group). During the first year after the procedure, the densitometric measurements of the bone around the prosthesis were taken. Radiographic and clinical assessments were additionally performed preoperatively and at the three month, six month, one year and three year follow-ups in the bionic group. In the bionic group, one patient was revised for aseptic loosening and 16 patients (19 hips) were available to the final follow-up. A significant decrease of bone mineral density was found in Gruen zones 3, 4 and 5 in the bionic group, and in zone 7 in both groups. The bionic group had a significantly higher bone mineral density in Gruen zone 1 at the one year follow-up. At the final follow-up, all prostheses were radiologically stable in both groups. Provided that a good implant position is achieved, comparable short-term results can be obtained using a bionic stem. Still, a decrease of bone mineral density in Gruen zone 7 occurred in both groups. Further studies are required to determine survivability of the bionic stem.

  10. The pelvis and hips

    International Nuclear Information System (INIS)

    Berquist, T.H.; Coventry, M.B.

    1985-01-01

    Radiographic evaluation of joint replacements requires close communication between the radiologist and referring physician. Routine films, radioisotope scans, and subtraction arthrography (including aspiration and injection of the pseudocapsule) may be indicated in different clinical situations. This paper summarizes the accuracy of these modalities. Most patients present with pain. One must exclude loosening, infection, and other problems. The arthrogram is most useful in defining anatomy and most causes of hip pain. Culture studies and diagnostic injections add to the versatility of subtraction arthrography and increase its accuracy. If plain films are negative, a Tc-99m scan can be obtained. If this is negative, loosening is unlikely. If pain persists or if the scan is positive, an arthrogram should be performed. Pain may be secondary to bursitis rather than loosening, and the arthrogram will assist in diagnosis and treatment. When films suggest loosening, arthrography is the procedure of choice to confirm the diagnosis and to exclude infection

  11. Hip complications following chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J. [Saint Bartholomew`s Hospital, London (United Kingdom)

    1995-12-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author).

  12. Hip complications following chemoradiotherapy

    International Nuclear Information System (INIS)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J.

    1995-01-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author)

  13. [Modified mini-Hardinge access for hip prosthesis implantation in the supine position].

    Science.gov (United States)

    Mazoochian, F; Schmidutz, F; Fottner, A; Jansson, V

    2014-04-01

    Total hip arthroplasty with a minimal-incision technique that can be performed in the widely used supine position. The accustomed and good overview of this position allows safe positioning of the implant and combines this with the advantage of a soft tissue preserving technique. All standard instruments and implants can be further applied. Primary and secondary coxarthrosis, femoral head necrosis. Revision surgery, severe anatomic deformity, implantation of hip resurfacing arthroplasty. Supine position. The skin incision runs from the innominate tubercle proximally and falls slightly in the dorsal direction (20-30°). Incision of the iliotibial tract and exposure of the vastogluteal muscle sling. Starting from the greater trochanter, the sinewy onset of the minimal and medium gluteal muscle is split with an arched-shaped incision, which also falls proximally in the dorsal direction. Exposition of the joint capsule, longitudinal incision and resection of the ventrolateral parts. Dislocation of the hip by a combined adduction and external rotation movement. Osteotomy of the femoral neck and resection of the femoral head are performed in a figure-of-four position without adduction. To prepare the acetabulum and to insert the cup, the leg is placed in neutral position with a slight flexion of 20° in the hip. Preparation of the femur and implantation of the stem is again performed in a figure-of-four position in adduction. Reduction of the hip and stepwise wound closure. Mobilization on postoperative day 1. Starting with half weight bearing and after completed wound healing rapid increase to full weight bearing. Intensive physiotherapy and rehabilitation. Thrombosis prophylaxis according to guidelines. The mini-incision approach has successfully been used in our clinic for years. Between September 2004 and November 2005, the less-invasive technique was evaluated in a randomized controlled trial with 51 patients (52 hips). Compared to the standard approach a

  14. To debride or not to debride? That is the question: rethinking char removal in ablative CO2 laser skin resurfacing.

    Science.gov (United States)

    Niamtu, Joe

    2008-09-01

    The treatment standard for laser skin resurfacing (LSR) includes aggressively wiping away the char with moist gauze before and after each pass to prevent heat buildup and lateral tissue damage from existing char. No published study has addressed not debriding between passes with traditional higher fluence, high-density, multipass CO(2) LSR in humans. The objective was to disprove the dogma that wiping away the laser char between treatment passes is necessary. A total of 158 patients were treated over a 23-month period with multipass, nondebrided CO(2) laser resurfacing (6 J/cm(2), density 6). A small series of split-face studies were performed by debriding one side and not debriding the other side after each pass, and 89 full-face patients were treated without debriding any char between two or three passes. Histologic and photographic studies were performed in selected patients to determine the differences between debrided and nondebrided techniques. None of the nondebrided patients experienced significant complications. Operative times were shortened as was postlaser pain and erythema. Histologic analysis showed that three passes of 6 J/cm(2) with a density of 6 produces extremely similar epidermal and dermal changes regardless of debriding between passes or not. This is the first study in humans using high-energy, high-density, multipass LSR without debriding between passes. The authors have indicated no significant interest with commercial supporters.

  15. The effect of wiping on skin resurfacing in a pig model using a high energy pulsed CO2 laser system.

    Science.gov (United States)

    Ross, E V; Mowlavi, A; Barnette, D; Glatter, R D; Grevelink, J M

    1999-02-01

    The impact of wiping in laser skin resurfacing has not been systematically studied. We examined the effects of wiping during single- and multiple-pass high energy pulsed CO2 laser skin resurfacing in a farm pig. Consequences of wiping were evaluated with regard to depth of residual thermal damage, tissue necrosis, and fibroplasia. Also, the impact of wiping on gross wound healing was observed. Wounds were followed for 21 days and biopsies were obtained on postoperative days 0, 1, and 21. Immediate postoperative biopsies of single-pass wounds showed equivalent residual thermal damage regardless of wiping; in contrast, biopsies from multiple-pass sites without wiping showed more extensive and variable residual thermal damage than wiped sites. On postoperative day one, single pass sites without wiping were grossly less erythematous than wiped sites, and biopsies showed less extensive necrosis and inflammation. In contrast, multiple pass sites without wiping were grossly more erythematous than corresponding wiped sites, and biopsies revealed significantly increased and variable necrosis. After 21 days, multiple pass sites without wiping were grossly more erythematous and showed a thicker band of fibroplasia microscopy. For single pass wounds, not wiping decreased the level of wounding. In contrast, not wiping in multiple pass wounds significantly increased the depth and variability of residual thermal damage and necrosis, resulting in prolonged healing.

  16. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  17. Hip Muscle Activity during Isometric Contraction of Hip Abduction

    OpenAIRE

    Fujisawa, Hiroyuki; Suzuki, Hiroto; Yamaguchi, Emi; Yoshiki, Hiromi; Wada, Yui; Watanabe, Aya

    2014-01-01

    [Purpose] This study aimed to determine the effect of varying hip flexion angle on hip muscle activity during isometric contraction in abduction. [Subjects] Twenty-seven healthy men (mean age=21.5 years, SD=1.2) participated in this study. [Methods] Surface electromyography (EMG) was recorded of the upper portion of the gluteus maximus (UGM), lower portion of the gluteus maximus (LGM), tensor fasciae latae (TFL), and gluteus medius (GMed) during isometric contraction under two measurement con...

  18. Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change.

    Science.gov (United States)

    Thornes, John Edward; Fisher, Paul Anthony; Rayment-Bishop, Tracy; Smith, Christopher

    2014-03-01

    Although there has been some research on the impact of extreme weather on the number of ambulance call-out incidents, especially heat waves, there has been very little research on the impact of cold weather on ambulance call-outs and response times. In the UK, there is a target response rate of 75% of life threatening incidents (Category A) that must be responded to within 8 min. This paper compares daily air temperature data with ambulance call-out data for Birmingham over a 5-year period (2007-2011). A significant relationship between extreme weather and increased ambulance call-out and response times can clearly be shown. Both hot and cold weather have a negative impact on response times. During the heat wave of August 2003, the number of ambulance call-outs increased by up to a third. In December 2010 (the coldest December for more than 100 years), the response rate fell below 50% for 3 days in a row (18 December-20 December 2010) with a mean response time of 15 min. For every reduction of air temperature by 1°C there was a reduction of 1.3% in performance. Improved weather forecasting and the take up of adaptation measures, such as the use of winter tyres, are suggested for consideration as management tools to improve ambulance response resilience during extreme weather. Also it is suggested that ambulance response times could be used as part of the syndromic surveillance system at the Health Protection Agency.

  19. Indicadores de stress nutricional en una población infantil de la ciudad industrial de Wolverhampton, Birmingham, Inglaterra

    Directory of Open Access Journals (Sweden)

    Ponce, Paola

    2005-01-01

    Full Text Available La revolución industrial brindó a Inglaterra importantes desarrollos en el campo del transporte, comercio e industria. Por otro lado, también generó nuevos problemas sociales y medioambientales tales como polución atmosférica, superpoblación de areas urbanas sin adecuados recursos sanitarios, servicios cloacales y condiciones de trabajo extenuantes e inhumanas. Como los niños son los miembros más vulnerables de la sociedad, es esperado que sean los más severamente afectados por estas condiciones de vida limitantes y consequentemente muestren más indicadores de stress. El objetivo de este trabajo es analizar la presencia de enfermedades relacionadas con deficiencias vitamínicas tales como raquitismo, escorbuto, criba orbitalia e hipoplasia dentaria así como evaluar su prevalencia e interpretar sus posibles causas en una población infantil de 56 individuos que datan del S. XIX de la ciudad de Wolverhampton, en Birmingham, Inglaterra.

  20. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study

    Science.gov (United States)

    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

  1. Hip Fractures among Older Adults

    Science.gov (United States)

    ... this page: About CDC.gov . Home & Recreational Safety Older Adult Falls Important Facts about Falls Costs of Falls Hip Fractures Among Older Adults Older Adult Falls Programs Compendium of Effective Fall Interventions, 3rd Edition ...

  2. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.

    2015-01-01

    fracture (ICD10: S720, S721, S722 and S729) were identified from 1 January 1995 to 31 December 2011. Hip fracture patients were matched 1:1 on age, gender and year of fracture to a non-hip fracture control. An individual's education attainment was defined as basic, secondary or higher, and their income...... and year of fracture, and education and year of fracture, to describe whether the association of income or education with rates of hip fracture changed over time. Results: There were 69,774 hip fracture patients and 69,709 controls (both mean age 81.2 years) with complete data on income and education. Both...

  3. Developmental Dysplasia of the Hip

    Science.gov (United States)

    ... to deepen the hip socket (if it's too shallow) or to shorten the thighbone or realign it. ... and treatment, consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided by The Nemours ...

  4. Monoarticular Hip Involvement in Pseudogout

    Directory of Open Access Journals (Sweden)

    Figen Kocyigit

    2015-01-01

    Full Text Available Pseudogout is the acutest form of arthritis in the elderly. Although clinical manifestations vary widely, polyarticular involvement is typical mimicking osteoarthritis or rheumatoid arthritis. Monoarticular involvement is relatively rare and is generally provoked by another medical condition. There are reported cases of hip involvement by pseudogout in monoarticular form. However, all of the cases were presented as septic arthritis. In this report, we present a case of monoarticular hip involvement mimicking soft tissue abscess. We confirmed the pseudogout diagnosis after ultrasonographic evaluation of the involved hip joint and pathological and biochemical analysis of synovial fluid analysis. Diagnosis is important to avoid unnecessary medical and surgical treatment in cases of the bizarre involvement of hip in pseudogout.

  5. Artroplastía de superficie en cadera. Resultados iniciales favorables en pacientes selectos. [Hip resurfacing arthroplasty: favorable initial results in selected patients

    Directory of Open Access Journals (Sweden)

    Fernando Martín Comba

    2013-12-01

    Full Text Available In­tro­duc­ción El objetivo del presente trabajo es reportar los resultados clínicos y radiológicos iniciales de una serie consecutiva de pacientes selectos tratados en nuestra institución con un único diseño de artroplastia de superficie, comparando además la tasa de revisión temprana con un grupo control de pacientes tratados en el mismo lapso con una artroplastia total de cadera no cementada. Material y ­Métodos Cuarenta y siete pacientes de sexo masculino (49 caderas con diagnóstico de artrosis de cadera que fueron tratados quirúrgicamente con una artroplastia híbrida de superficie, entre noviembre de 2006 y julio de 2009. La edad promedio fue de 44,5 años (rango de 21 a 57. En todos los casos, la indicación de la artroplastia de superficie se realizó en pacientes jóvenes con alta expectativa funcional y siguiendo estrictos criterios de selección radiológicos. Se efectuó un seguimiento clínico y un meticuloso análisis radiológico. Resultados La escala funcional posoperatoria de Merle D’Aubigné-Postel fue, en promedio, de 17,3 puntos a los 43 meses de seguimiento promedio (rango 24-62 meses. El 85% de los pacientes refirió que practicaba alguna actividad deportiva con una escala UCLA promedio de 9,5 (rango 8-10. Un paciente requirió una cirugía de revisión (2,04% por fractura de cuello femoral. No existieron diferencias estadísticamente significativas en cuanto a la tasa de revisión temprana comparando con el grupo control (p = 0,55. Conclusiones En nuestra experiencia inicial con artroplastia de superficie, obtuvimos resultados a corto plazo favorables, en una serie de hombres con artrosis y alta demanda funcional, estrictamente seleccionados.

  6. Influence of Hip Joint Position on Muscle Activity during Prone Hip Extension with Knee Flexion.

    Science.gov (United States)

    Suehiro, Tadanobu; Mizutani, Masatoshi; Okamoto, Mitsuhisa; Ishida, Hiroshi; Kobara, Kenichi; Fujita, Daisuke; Osaka, Hiroshi; Takahashi, Hisashi; Watanabe, Susumu

    2014-12-01

    [Purpose] This study investigated the selective activation of the gluteus maximus during a prone hip extension with knee flexion exercise, with the hip joint in different positions. [Subjects] The subjects were 21 healthy, male volunteers. [Methods] Activities of the right gluteus maximus, right hamstrings, bilateral lumbar erector spinae, and bilateral lumbar multifidus were measured using surface electromyography during a prone hip extension with knee flexion exercise. Measurements were made with the hip joint in each of 3 positions: (1) a neutral hip joint position, (2) an abduction hip joint position, and (3) an abduction with external rotation hip joint position. [Results] Gluteus maximus activity was significantly higher when the hip was in the abduction with external rotation hip joint position than when it was in the neutral hip joint and abduction hip joint positions. Gluteus maximus activity was also significantly higher in the abduction hip joint position than in the neutral hip joint position. Hamstring activity was significantly lower when the hip was in the abduction with external rotation hip joint position than when it was in the neutral hip joint and abduction hip joint positions. [Conclusion] Abduction and external rotation of the hip during prone hip extension with knee flexion exercise selectively activates the gluteus maximus.

  7. Numerical evaluation of bone remodelling and adaptation considering different hip prosthesis designs.

    Science.gov (United States)

    Levadnyi, Ievgen; Awrejcewicz, Jan; Gubaua, José Eduardo; Pereira, Jucélio Tomás

    2017-12-01

    The change in mechanical properties of femoral cortical bone tissue surrounding the stem of the hip endoprosthesis is one of the causes of implant instability. We present an analysis used to determine the best conditions for long-term functioning of the bone-implant system, which will lead to improvement of treatment results. In the present paper, a finite element method coupled with a bone remodelling model is used to evaluate how different three-dimensional prosthesis models influence distribution of the density of bone tissue. The remodelling process begins after the density field is obtained from a computed tomography scan. Then, an isotropic Stanford model is employed to solve the bone remodelling process and verify bone tissue adaptation in relation to different prosthesis models. The study results show that the long-stem models tend not to transmit loads to proximal regions of bone, which causes the stress-shielding effect. Short stems or application in the calcar region provide a favourable environment for transfer of loads to the proximal region, which allows for maintenance of bone density and, in some cases, for a positive variation, which causes absence of the aseptic loosening of an implant. In the case of hip resurfacing, bone mineral density changes slightly and is closest to an intact femur. Installation of an implant modifies density distribution and stress field in the bone. Thus, bone tissue is stimulated in a different way than before total hip replacement, which evidences Wolff's law, according to which bone tissue adapts itself to the loads imposed on it. The results suggest that potential stress shielding in the proximal femur and cortical hypertrophy in the distal femur may, in part, be reduced through the use of shorter stems, instead of long ones, provided stem fixation is adequate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Imaging of the hip

    International Nuclear Information System (INIS)

    Karantanas, A.

    2012-01-01

    Full text: Standard radiographs represent the basic tool of hip joint imaging. For detailed analysis of abnormalities related to bone marrow, articular cartilage, labrum and periarticular soft tissues, MRI has become the method of choice. MR arthrography is superior to standard MRI with regard to depicting the intra-articular abnormalities. CT is supporting plain radiographs for accurate depiction of subtle bone details. Ultrasound is commonly used in postoperative hematoma, bursitis, initial diagnosis of cysts and solid soft tissue tumors as well as for image guided injections and biopsies. Bone scintigraphy is suitable for the mapping of multifocal disease, such as osseous metastatic deposits. PET and PET/CT may be able to differentiate malignant neoplasm and infection from other abnormalities. A common disorder often requested for evaluation, is osteoarthritis. MRI is able to depict early degenerative changes which are occult on plain radiographs. CT- or MR arthrography provide a better evaluation of these changes but should only be performed in cases in which conservative surgery is considered to offer a significant clinical improvement for the patient. These cases include cam type femoroacetabular impingement and traumatic chondrolysis. MRI is an imaging technique that allows direct visualization of the bone marrow. Marrow disorders of the hip may induce a variety of imaging findings and frequently are not detected by conventional radiographic techniques until they have reached an advanced clinical stage. The excellent spatial and contrast resolution provided by MRI facilitates early detection and evaluation of various disorders allowing thus prompt treatment. Imaging findings may alter or guide the correct treatment. In addition, the association of marrow changes and pain such as in osteonecrosis and osteoarthritis is clinically relevant. For imaging the bone marrow, we use a combination of pulse sequences, including T1-w spin echo, PD/T2-w turbo spin echo

  9. Influence of the hip flexion angle on isokinetic hip rotator torque and acceleration time of the hip rotator muscles.

    Science.gov (United States)

    Baldon, Rodrigo de M; Furlan, Leonardo; Serrão, Fábio V

    2013-10-01

    The purpose of this study was to verify the influence of the hip flexion angle on isokinetic rotator torque and acceleration times of the hip medial and lateral rotator muscles. Twenty-one healthy women were included in this study. The hip rotator function was evaluated at 3 different hip flexion angles (10°, 40°, and 90°). The results showed that both eccentric and concentric hip lateral rotator torques were greater at 40° of hip flexion when compared with 90°. Moreover, both the eccentric and concentric hip medial rotator torques were greater at 90° of hip flexion than at 40° and 10°, and greater at 40° than at 10°. In addition, both the eccentric and concentric hip medial to lateral rotator torque ratios were greater at 90° of hip flexion than at 40° and 10°, and greater at 40° than at 10°. Finally, the acceleration times of the hip medial rotator muscles were smaller at 90° of hip flexion than at 10° and smaller at 40° than at 10°. The current results highlight the importance of evaluating the hip rotator muscles at different hip flexion angles to comprehensively assess their functions.

  10. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  11. Osteochondritis Dissecans of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Linden, B. [Hoeglands Hospital, Eksjoe (Sweden). Dept. of Orthopedic Surgery; Jonsson, K. [Univ. Hospital, Lund (Sweden). Center for Medical Imaging and Physiology; Redlund-Johnell, I. [Univ. Hospital, Malmoe (Sweden). Dept. of Diagnostic Radiology

    2003-03-01

    Purpose: To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment. Material and Methods: Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calve-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography. Results: All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis. Conclusions: OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatic treatment is recommended.

  12. Osteochondritis Dissecans of the Hip

    International Nuclear Information System (INIS)

    Linden, B.; Jonsson, K.; Redlund-Johnell, I.

    2003-01-01

    Purpose: To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment. Material and Methods: Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calve-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography. Results: All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis. Conclusions: OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatic treatment is recommended

  13. Including the urban heat island in spatial heat health risk assessment strategies: a case study for Birmingham, UK

    Directory of Open Access Journals (Sweden)

    Thornes John E

    2011-06-01

    Full Text Available Abstract Background Heatwaves present a significant health risk and the hazard is likely to escalate with the increased future temperatures presently predicted by climate change models. The impact of heatwaves is often felt strongest in towns and cities where populations are concentrated and where the climate is often unintentionally modified to produce an urban heat island effect; where urban areas can be significantly warmer than surrounding rural areas. The purpose of this interdisciplinary study is to integrate remotely sensed urban heat island data alongside commercial social segmentation data via a spatial risk assessment methodology in order to highlight potential heat health risk areas and build the foundations for a climate change risk assessment. This paper uses the city of Birmingham, UK as a case study area. Results When looking at vulnerable sections of the population, the analysis identifies a concentration of "very high" risk areas within the city centre, and a number of pockets of "high risk" areas scattered throughout the conurbation. Further analysis looks at household level data which yields a complicated picture with a considerable range of vulnerabilities at a neighbourhood scale. Conclusions The results illustrate that a concentration of "very high" risk people live within the urban heat island, and this should be taken into account by urban planners and city centre environmental managers when considering climate change adaptation strategies or heatwave alert schemes. The methodology has been designed to be transparent and to make use of powerful and readily available datasets so that it can be easily replicated in other urban areas.

  14. DIETARY PATTERNS AND DIET QUALITY AMONG DIVERSE OLDER ADULTS: THE UNIVERSITY OF ALABAMA AT BIRMINGHAM STUDY OF AGING

    Science.gov (United States)

    HSIAO, P.Y.; MITCHELL, D.C.; COFFMAN, D.L.; ALLMAN, R.M.; LOCHER, J.L.; SAWYER, P.; JENSEN, G.L.; HARTMAN, T.J.

    2013-01-01

    Objectives To characterize dietary patterns among a diverse sample of older adults (≥ 65 years). Design: Cross-sectional. Setting: Five counties in west central Alabama. Participants Community-dwelling Medicare beneficiaries (N=416; 76.8 ± 5.2 years, 56% female, 39% African American) in the University of Alabama at Birmingham (UAB) Study of Aging. Measurements Dietary data collected via three, unannounced 24-hour dietary recalls was used to identify dietary patterns. Foods were aggregated into 13 groups. Finite mixture modeling (FMM) was used to classify individuals into three dietary patterns. Differences across dietary patterns for nutrient intakes, sociodemographic, and anthropometric measurements were examined using chi-square and general linear models. Results Three dietary patterns were derived. A “More healthful” dietary pattern, with relatively higher intakes of fruit, vegetables, whole grains, eggs, nuts, legumes and dairy, was associated with lower energy density, higher quality diets as determined by Healthy Eating Index (HEI)-2005 scores and higher intakes of fiber, folate, vitamins C and B6, calcium, iron, magnesium, and zinc. The “Western-like” pattern was defined by an intake of starchy vegetables, refined grains, meats, fried poultry and fish, oils and fats and was associated with lower HEI-2005 scores. The “Low produce, high sweets” pattern was characterized by high saturated fat, and low dietary fiber and vitamin C intakes. The strongest predictors of better diet quality were female gender and non-Hispanic white race. Conclusion The dietary patterns identified may provide a useful basis on which to base dietary interventions targeted at older adults. Examination of nutrient intakes regardless of the dietary pattern suggests that older adults are not meeting nutrient recommendations and should continue to be encouraged to choose high quality diets. PMID:23299373

  15. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis

    Science.gov (United States)

    Kermani, TA; Cuthbertson, D; Carette, S; Hoffman, GS; Khalidi, NA; Koening, CL; Langford, CA; McKinnon-Maksimowicz, K; McAlear, CA; Monach, PA; Seo, P; Warrington, KJ; Ytterberg, SR; Merkel, PA; Matteson, EL

    2016-01-01

    Objective To evaluate the performance of the Birmingham Vasculitis Activity Score (BVAS) in the assessment of disease activity in giant cell arteritis (GCA). Methods Patients with GCA enrolled in a prospective, multicenter, longitudinal study with symptoms of active vasculitis during any visit were included. Spearman’s rank correlation was used to explore the association of the BVAS with other measures of disease activity. Results During a mean (SD) follow-up of 2.3 (1.6) years, symptoms of active GCA were present in 236 visits in 136 subjects (100 female, 74%). Median (range) BVAS1 (new/worse symptoms) was 1 (0–10) and median (range) BVAS2 (persistent symptoms) was 0 (0–5). Median (range) physician global assessment (PGA) was 4 (0–9) for disease activity in the past 28 days and 2 (0–9) for activity on the day of the visit. Important ischemic manifestations of active vasculitis not captured by the BVAS included tongue/jaw claudication (27%), upper extremity claudication (15%), lower extremity claudication (5%), carotidynia (7%), ischemic retinopathy (5%). During 25 visits (11%) with active disease, all symptoms of active vasculitis were captured in the “Other” category yet still resulted in a BVAS 1 and BVAS 2 of 0. BVAS1 moderately correlated with PGA for the past 28 days (Spearman’s correlation 0.50) and physician-rated disease activity for the past 28 days (Spearman’s correlation 0.46). Conclusions The BVAS has limited utility in GCA. Patients with active GCA can have a BVAS of 0. Many important ischemic symptoms attributable to active vasculitis are not captured in the composite score. PMID:27036388

  16. Emerging topics on the hip: Ligamentum teres and hip microinstability

    International Nuclear Information System (INIS)

    Cerezal, Luis; Arnaiz, Javier; Canga, Ana; Piedra, Tatiana; Altónaga, José R.; Munafo, Ricardo; Pérez-Carro, Luis

    2012-01-01

    Microinstability and ligament teres lesions are emergent topics on the hip pathology. These entities are an increasingly recognized cause of persistent hip pain and should be considered in the differential diagnosis of the patient with hip pain. Conventional (non-arthrographic) CT and MR have a very limited role in the evaluation of these entities. CTa and MRa have emerged as the modalities of choice for pre-operative imaging of ligamentum teres injuries and microinstability. To date, pre-operative imaging detection of these pathologies is not widespread but with appropriate imaging and a high index of suspicion, preoperative detection should improve. This article discusses current concepts regarding anatomy, biomechanics, clinical findings, diagnosis and treatment of ligament teres lesions and microinstability.

  17. Emerging topics on the hip: ligamentum teres and hip microinstability.

    Science.gov (United States)

    Cerezal, Luis; Arnaiz, Javier; Canga, Ana; Piedra, Tatiana; Altónaga, José R; Munafo, Ricardo; Pérez-Carro, Luis

    2012-12-01

    Microinstability and ligament teres lesions are emergent topics on the hip pathology. These entities are an increasingly recognized cause of persistent hip pain and should be considered in the differential diagnosis of the patient with hip pain. Conventional (non-arthrographic) CT and MR have a very limited role in the evaluation of these entities. CTa and MRa have emerged as the modalities of choice for pre-operative imaging of ligamentum teres injuries and microinstability. To date, pre-operative imaging detection of these pathologies is not widespread but with appropriate imaging and a high index of suspicion, preoperative detection should improve. This article discusses current concepts regarding anatomy, biomechanics, clinical findings, diagnosis and treatment of ligament teres lesions and microinstability. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. The impact of proximal femoral morphology on failure strength with a mid-head resection short-stem hip arthroplasty.

    Science.gov (United States)

    Olsen, Michael; Al Saied, Mohamed; Morison, Zachary; Sellan, Michael; Waddell, James P; Schemitsch, Emil H

    2014-12-01

    Mid-head resection short-stem hip arthroplasty is a conservative alternative to conventional total hip replacement and addresses proximal fixation challenges in patients not suitable for hip resurfacing. It is unclear whether proximal femoral morphology impacts the ultimate failure load of mid-head resection implanted femurs, thus the aim of this study was to investigate the effect of native neck-shaft angle (NSA) and coronal implant alignment on proximal femoral strength. In total, 36 synthetic femurs with two different proximal femoral morphologies were utilized in this study. Of them, 18 femurs with a varus NSA of 120° and 18 femurs with a valgus NSA of 135° were each implanted with a mid-head resection prosthesis. Femurs within the two different femoral morphology groups were divided into three equal coronal implant alignment groups: 10° valgus, 10° varus or neutral alignment. Prepared femurs were tested for stiffness and to failure in axial compression. There was no significant difference in stiffness nor failure load between femurs implanted with valgus-, varus- or neutrally aligned implants in femurs with a NSA of 120° (p = 0.396, p = 0.111, respectively). Femurs implanted in valgus orientation were significantly stiffer and failed at significantly higher loads than those implanted in varus alignment in femurs with a NSA of 135° (p = 0.001, p = 0.007, respectively). A mid-head resection short-stem hip arthroplasty seems less sensitive to clinically relevant variations of coronal implant alignment and may be more forgiving upon implantation in some femoral morphologies, however, a relative valgus component alignment is recommended. © IMechE 2014.

  19. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Shahryar Noordin

    2010-10-01

    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  20. Excess mortality following hip fracture

    DEFF Research Database (Denmark)

    Abrahamsen, B; van Staa, T; Ariely, R

    2009-01-01

    Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlig......Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter...... and excess mortality rates for hip fracture. Although a lack of consistent study design precluded any formal meta-analysis or pooled analysis of the data, we have shown that hip fracture is associated with excess mortality (over and above mortality rates in nonhip fracture/community control populations......) during the first year after fracture ranging from 8.4% to 36%. In the identified studies, individuals experienced an increased relative risk for mortality following hip fracture that was at least double that for the age-matched control population, became less pronounced with advancing age, was higher...

  1. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Minhas, M.S.

    2010-01-01

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  2. Evaluation of the patient with hip pain.

    Science.gov (United States)

    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.

  3. Developmental hip dysplasia in adolescence

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available The authors define adolescence and developmental dysplasia of the hip (DDH. Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications. The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

  4. MRI of the hip joint

    International Nuclear Information System (INIS)

    Czerny, C.; Noebauer-Huhmann, I.M.; Imhof, H.

    2005-01-01

    Magnetic resonance imaging (MRI) is performed to diagnose many pathologic conditions affecting the hip joint. Either conventional MRI (without contrast enhancement of the joint cavity) or MR arthrography is used to detect and most accurately differentiate hip joint pathologies. Conventional MRI is performed in cases of bone marrow edema, necrosis, arthrosis and especially the so-called ''activated arthrosis'', as well as in inflammatory and tumorous entities. MR arthography, which has only recently become available for use, is excellently suited for diagnosing lesions of the acetabular labrum, cartilage lesions, and free articular bodies. This article provides an overview about MRI characteristics and their accuracy of hip joint diseases and the impact on the therapeutic procedure. (orig.)

  5. Properties of Rose Hip Marmalades

    Directory of Open Access Journals (Sweden)

    Oktay Yildiz

    2012-01-01

    Full Text Available Rose hip, also known as wild rose, is a summer fruit. The aim of this research is to present physical, chemical, rheological, sensory and antioxidant properties of rose hip marmalades. Rose hips cultivated in Turkey are processed into pulp and then marmalade is made by using vacuum evaporator or classical method. For the purposes of this investigation, marmalades produced on a factory scale using two methods were compared to commercial marmalades purchased on market. The marmalades exhibited high levels of antioxidant activity as well as total phenolic content. The consistency indices for the marmalades were determined to be between 64.2 and 321 Pa·s^n. Colour parameters, namely L, a, b, were measured and correlations between the examined parameters were calculated.

  6. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  7. Cementless Hydroxyapatite Coated Hip Prostheses

    Science.gov (United States)

    Herrera, Antonio; Mateo, Jesús; Gil-Albarova, Jorge; Lobo-Escolar, Antonio; Ibarz, Elena; Gabarre, Sergio; Más, Yolanda

    2015-01-01

    More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality. PMID:25802848

  8. Deciding to have knee or hip replacement

    Science.gov (United States)

    ... 000368.htm Deciding to have knee or hip replacement To use the sharing features on this page, ... a decision. Who Benefits From Knee or hip Replacement Surgery? The most common reason to have a ...

  9. Risks of hip and knee replacement

    Science.gov (United States)

    ... lose blood during and after hip or knee replacement surgery. Some people need a blood transfusion during ... higher during and soon after hip or knee replacement surgery. Sitting or lying down for long periods ...

  10. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial.

    Science.gov (United States)

    Lee, Jin Woong; Kim, Beom Joon; Kim, Myeung Nam; Mun, Seog Kyun

    2011-07-01

    Ablative carbon dioxide (CO(2) ) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma (PRP) is known to enhance wound healing and has applications in many areas of medicine. To evaluate the synergistic effects of autologous PRP with CO(2) fractional resurfacing for acne scars. A split-face trial was conducted in 14 Korean participants with acne scars. All participants received one session of ablative CO(2) fractional resurfacing. Immediately after resurfacing, facial halves were randomly assigned to receive treatment with autologous PRP injections on one side (experimental side) and normal saline injections on the other side (control side). The participants were monitored for degree of recovery and resurfacing-associated adverse events, including prolonged erythema, edema, and other effects on days 0, 2, 4, 6, 8, 15, and 30. The intensity of erythema was objectively measured using a chromometer at the same time intervals. After one additional treatment session using the same protocol, two independent dermatologists evaluated clinical improvement using a quartile grading scale. All participants completed the study. Erythema on the experimental side improved faster than on the control side and was significantly less at day 4 (p=.01). This difference was confirmed using a chromometer (p=.049). Total duration of erythema was an average of 10.4±2.7 days on the control side and 8.6±2.0 days on the experimental side (p=.047). Edema also improved faster on the experimental side than on the control side. The total duration of edema was an average of 7.1±1.5 days on the control side and 6.1±1.1 days on the experimental side (p=.04). Participants were also assessed for duration of post-treatment crusting, with a mean of 6.8±1.0 days on the control side and 5.9±1

  11. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip joint...

  12. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    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 implanted...

  13. An evaluation of Birmingham Own Health® telephone care management service among patients with poorly controlled diabetes. a retrospective comparison with the General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Adab Peymané

    2011-09-01

    Full Text Available Abstract Background Telephone-based care management programmes have been shown to improve health outcomes in some chronic diseases. Birmingham Own Health® is a telephone-based care service (nurse-delivered motivational coaching and support for self-management and lifestyle change for patients with poorly controlled diabetes, delivered in Birmingham, UK. We used a novel method to evaluate its effectiveness in a real-life setting. Methods Retrospective cohort study in the UK. 473 patients aged ≥ 18 years with diabetes enrolled onto Birmingham Own Health® (intervention cohort and with > 90 days follow-up, were each matched by age and sex to up to 50 patients with diabetes registered with the General Practice Research Database (GPRD to create a pool of 21,052 controls (control cohort. Controls were further selected from the main control cohort, matching as close as possible to the cases for baseline test levels, followed by as close as possible length of follow-up (within +/-30 days limits and within +/-90 days baseline test date. The aim was to identify a control group with as similar distribution of prognostic factors to the cases as possible. Effect sizes were computed using linear regression analysis adjusting for age, sex, deprivation quintile, length of follow-up and baseline test levels. Results After adjusting for baseline values and other potential confounders, the intervention showed significant mean reductions among people with diabetes of 0.3% (95%CI 0.1, 0.4% in HbA1c; 3.5 mmHg (1.5, 5.5 in systolic blood pressure, 1.6 mmHg (0.4, 2.7 in diastolic blood pressure and 0.7 unit reduction (0.3, 1.0 in BMI, over a mean follow-up of around 10 months. Only small effects were seen on average on serum cholesterol levels (0.1 mmol/l reduction (0.1, 0.2. More marked effects were seen for each clinical outcome among patients with worse baseline levels. Conclusions Despite the limitations of the study design, the results are consistent with the

  14. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Visser, J.D.; Jonkers, A.; Klasen, H.J. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis); Hillen, B. (Rijksuniversiteit Groningen (Netherlands). Lab. voor Anatomie en Embryologie)

    1982-06-26

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip joint can be measured by means of computed tomography.

  15. Ultrasonography of the hip and lower extremity.

    Science.gov (United States)

    Malanga, Gerard A; Dentico, Richard; Halperin, Jonathan S

    2010-08-01

    Musculoskeletal ultrasonographic evaluation of the proximal lower limb includes the evaluation of the soft tissue structures, including tendons, ligaments, or muscles, and the bony structures of this region, include the hip, pubic symphysis, and sacroiliac joints. The evaluation of the hip or proximal lower limb region can be performed in an efficient and systematic manner. Ultrasonography of the lateral hip, intra-articular hip, medial thigh, and posterior thigh are discussed in the article. Copyright 2010 Elsevier Inc. All rights reserved.

  16. Hip Dislocation or Subluxation After Hip Arthroscopy: A Systematic Review.

    Science.gov (United States)

    Duplantier, Neil L; McCulloch, Patrick C; Nho, Shane J; Mather, Richard C; Lewis, Brian D; Harris, Joshua D

    2016-07-01

    To determine patient- and surgery-specific characteristics of patients sustaining postarthroscopic hip dislocation or subluxation. A systematic review of multiple medical databases was registered with PROSPERO and performed using Preferred Reporting Items for Systemic Reviews and Meta-Analysis guidelines. Level I to IV clinical outcome studies reporting the presence of hip dislocation or subluxation after hip arthroscopy were eligible. Length of follow-up was not an exclusion criterion. All patient- and surgery-specific variables were extracted from each, specifically evaluating osseous morphology and resection details; labral, iliopsoas, ligamentum teres, and capsular management; generalized ligamentous laxity; instability direction and mechanism; management; and outcome. Study authors were individually contacted to assess most recent outcome. Ten articles with 11 patients were analyzed (mean patient age: 36.6 ± 12.3 years). There were 9 hip dislocations and 2 subluxations. Mean time between surgery and dislocation was 3.2 ± 4.0 months (range: recovery room to 14 months). Anterior was the most frequent dislocation direction (8 cases). Acetabular undercoverage (preoperative dysplasia or iatrogenic rim over-resection) was observed in 5 cases. Labral debridement was performed in 5 cases, iliopsoas tenotomy in 3 cases, and ligamentum teres debridement in 1 case. A "T" capsulotomy was created in 1 case (isolated interportal in other 10 cases). Capsular closure was performed in 2 cases (both interportal). Generalized ligamentous laxity was diagnosed in 1 case. A combination of external rotation and extension was observed in 5 of the 6 cases reporting the mechanism of anterior dislocation. Four cases were successfully treated with closed reduction; 4 required total hip arthroplasty; and 3 required revision capsulorrhaphy. Postarthroscopic hip instability was observed in patients with acetabular undercoverage (including iatrogenic resection), labral debridement

  17. Treatment of tuberculosis of the hip.

    African Journals Online (AJOL)

    Key Words: tuberculosis, hip, treatment. Between September 1986 and December 1993,. 57 patients were seen with tuberculosis of the hip at Kenyatta National Hospital. The diagnosis was proven by ... LA 7cetahtiltdm and femoral head with early subluxation. FIG 2 Radiograph showing stabltciation of a ttihercltlolu hip.

  18. Hip-Hop and the Academic Canon

    Science.gov (United States)

    Abe, Daudi

    2009-01-01

    Over the last 30 years, the hip-hop movement has risen from the margins to become the preeminent force in US popular culture. In more recent times academics have begun to harness the power of hip-hop culture and use it as a means of infusing transformative knowledge into the mainstream academic discourse. On many college campuses, hip-hop's…

  19. Neurosurgical injuries resulting from the 2011 tornados in Alabama: the experience at the University of Alabama at Birmingham Medical Center.

    Science.gov (United States)

    Miller, Joseph H; Zywicke, Holly A; Fleming, James B; Griessenauer, Christoph J; Whisenhunt, Thomas R; Okor, Mamerhi O; Harrigan, Mark R; Pritchard, Patrick R; Hadley, Mark N

    2013-06-01

    The April 27, 2011, tornados that affected the southeastern US resulted in 248 deaths in the state of Alabama. The University of Alabama at Birmingham (UAB) Medical Center, the largest Level I trauma center in the state, triaged and treated a large number of individuals who suffered traumatic injuries during these events, including those requiring neurosurgical assessment and treatment. A retrospective review of all adult patients triaged at UAB Medical Center during the April 27, 2011, tornados was conducted. Those patients who were diagnosed with and treated for neurosurgical injuries were included in this cohort. The Division of Neurosurgery at UAB Medical Center received 37 consultations in the 36 hours following the tornado disaster. An additional patient presented 6 days later, having suffered a lumbar spine fracture that ultimately required operative intervention. Twenty-seven patients (73%) suffered injuries as a direct result of the tornados. Twenty-three (85%) of these 27 patients experienced spine and spinal cord injuries. Four patients (15%) suffered intracranial injuries and 2 patients (7%) suffered combined intracranial and spinal injuries. The spinal fractures that were evaluated and treated were predominantly thoracic (43.5%) and lumbar (43.5%). The neurosurgery service performed 14 spinal fusions, 1 ventriculostomy, 2 halo placements, 1 diagnostic angiogram, 1 endovascular embolectomy, and 1 wound debridement and lavage. Twenty-two patients (81.5%) were neurologically intact at discharge and all but 4 had 1 year of follow-up. Three patients had persistent deficits from spinal cord injuries and there was 1 death in a patient with multisystem injuries in whom no procedures were performed. Two patients experienced postoperative complications in the form of 1 wound infection and 1 stroke. The April 27, 2011, tornados in Alabama produced significant neurosurgical injuries that primarily involved the spine. There were a disproportionate number of

  20. Realization process of structures in Great Britain: The case of the commercial centre Martineu Place in Birmingham

    Directory of Open Access Journals (Sweden)

    Nedeljković Milan

    2003-01-01

    Full Text Available The topic of this paper is the presentation of the Martineau Place Commercial Centre project in Birmingham. Through detailed elucidations of the participants’ role (investor, project team, contractor particular attention has been paid to the realization process of this significant development. The very complex project of construction value of just under 20 million and realized in the period of increased economic uncertainty in the years 2001 and 2002 has been envisaged within the framework of macro trends influencing its realization. The Martineau Place Project Developer was Land Securities, assessed as the largest British Development and Estate Company in 2002. The building has been developed for commercial purposes according to the free market demands with the aim to be sold or rented to unknown users. The elucidations of the architect’s status and role in Great Britain, as well as the design and realization process of commercial buildings under free market conditions might be of interest for domestic readers, given the transitional business mode of our country. Information is offered as to the architect’s fee and related to it, the role of one of the professional architects’ associations (RIBA in setting "guidelines" for its members as to the percentage of the fee accounting depending upon the type and scope of the job. In light of Serbia’s engineers’ chamber founding, the British experience is rather valuable. The feasibility study, the design phase furthermore the main project phase, tender, contract and the construction phase are given as the chief design and realization phases of the project. Each of these phases is specific and differs in certain details from our practice. The tender participation procedure and the contract engagement are analyzed. In the construction stage, a large number of highly specialized firms and subcontractors were engaged to supply product and provide services. The way they were integrated in the

  1. Clicky hip alone is not a true risk factor for developmental dysplasia of the hip.

    Science.gov (United States)

    Nie, K; Rymaruk, S; Paton, R W

    2017-11-01

    A clicky hip is a common referral for clinical and sonographic screening for developmental dysplasia of the hip (DDH). There is controversy regarding whether it represents a true risk factor for pathological DDH. Therefore a 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological DDH. A total of 362 infants from 1997 to 2016 were referred with clicky hips to our 'one-stop' paediatric hip screening clinic. Hips were assessed clinically for instability and by ultrasound imaging using a simplified Graf/Harcke classification. Dislocated or dislocatable hips were classified as Graf Type IV hips. The mean age at presentation was 13.8 weeks (12.8 to 14.7). In all 351 out of 362 children (97.0%) had Graf Type I hips (normal) that required no treatment. Nine children (2.5%) had Graf Type II hips but all resolved to Graf Type I hips on follow-up scans. One child (0.3%) had Graf Type III hip dysplasia and one child (0.3%) had an irreducible hip dislocation. The two pathological hips were associated with unilateral limited hip abduction. Mean referrals increased from 12.9 to 23.3 each year (p = 0.002) from the first decade of the study to the second, driven by increasing primary care referrals (5.5 versus 16.7 per year, p hips required no treatment other than reassurance to parents. Clicky hips with a normal hip examination should be considered a variant of normal childhood and not a risk factor for DDH. However, an abnormal hip examination including unilateral limited hip abduction should prompt urgent further investigations. Cite this article: Bone Joint J 2017;99-B:1533-6. ©2017 The British Editorial Society of Bone & Joint Surgery.

  2. Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

    obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger...... for women than men, but is evident in both genders. In this 'viewpoint', we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys....

  3. Hip-Hop Pop Art

    Science.gov (United States)

    Talley, Clarence, Sr.

    2011-01-01

    Art has a way of helping students better understand and appreciate the world around them, particularly the things that are most important to them. Hip hop is one of those generational genres that capture the attention of young students like few other things do. Drawing on this genre to get students to create art is an excellent way to demonstrate…

  4. X-Ray Exam: Hip

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Hip KidsHealth / For Parents / X-Ray Exam: ... darker. An X-ray technician takes the X-rays. An X-ray technician in the radiology department of a ...

  5. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

    Wangen, Helge; Havelin, Leif I.; Fenstad, Anne M

    2017-01-01

    . Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

  6. Imaging of hip joint arthroplasty

    International Nuclear Information System (INIS)

    Mayerhoefer, M.E.; Fruehwald-Pallamar, J.; Czerny, C.

    2009-01-01

    The hip joint is the largest joint in the human body and consequently, its evaluation by diagnostic imaging is highly important. This includes imaging of hip joint arthroplasty, which is used to avoid joint immobility following a wide spectrum of diseases, such as end-stage degenerative disease, avascular necrosis of the femoral head or post-traumatic fractures. Conventional radiography is still the standard imaging modality for the evaluation of hip arthroplasty both directly following surgery and for periodical follow-up. In the majority of cases conventional radiography enables adequate assessment of early and late complications that can arise following hip arthroplasty, such as loosening, prosthetic or periprosthetic fracture, luxation, infection and soft tissue calcification. If the diagnosis cannot be established by means of radiography, advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), with or without injection of contrast media, may provide additional information. This is particularly true for the depiction of inflammatory processes. Regardless of the imaging modality used patients' clinical symptoms must also be taken into account in order to establish the correct diagnosis. (orig.) [de

  7. HIP IMPLANT ANALYSIS WITH CATIA

    Directory of Open Access Journals (Sweden)

    Florin CIOFU

    2017-12-01

    Full Text Available CATIA V5R16 is a product of Dassault Systemes, one of the most widely used CAD/CAM/ CAE systems worldwide, with applications in various fields, from the automotive, aerospace, automotive and medical industries. The paper aims to improve the technical, technological and medical knowledge related to the activity of the hip prosthesis.

  8. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients.

    Science.gov (United States)

    Crooks, Valorie A; Cameron, Keri; Chouinard, Vera; Johnston, Rory; Snyder, Jeremy; Casey, Victoria

    2012-11-21

    Medical tourism is the term that describes patients' international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients' decision-making in and experiences of these same procedures in their home countries. Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives. Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients' pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal

  9. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2012-11-01

    Full Text Available Abstract Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1 comfortable health-related decision-makers; (2 unwavering in their views about procedure necessity and urgency; and (3 firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on

  10. Metal on metal surface replacement of the hip. Experience of the McMinn prothesis.

    Science.gov (United States)

    McMinn, D; Treacy, R; Lin, K; Pynsent, P

    1996-08-01

    The historical failure of surface replacement has been due to the production of wear debris with subsequent bone resorption, loosening, and failure. To avoid these problems, a surface replacement using a metal on metal bearing allowing thin components and femoral design and instrumentation to avoid varus alignment has been designed. Two hundred thirty-five joints have been resurfaced with this prosthesis in almost 5 years. There have been no femoral neck fractures and no dislocations. There have been 4 designs differing in the method of fixation. In the press fit group, 6 of 70 hips had to be revised for aseptic loosening. In the cemented group, debonding of the cup occurred in 3 of 43 cases. Six patients had hydroxyapatite coated components and have had excellent clinical outcomes. The current design uses a peripherally expanded hydroxyapatite coated cup and a cemented metal head; 116 of this design have been implanted during a 19-month period with excellent outcome. Despite short followup the authors are hopeful that the combination of a polar metal on metal bearing with appropriate fixation will yield a method of preserving bone stock in the younger patient requiring arthroplasty.

  11. [Atraumatic hip pain in young adults].

    Science.gov (United States)

    González Murillo, M; Turcu, V; De Nicolás Navas, M B; Yeguas Bermejo, A

    2016-01-01

    Hip pain in the young adult is a disabling pathophysiological process may be related to multiple etiologies. The process must be determined in order to make a diagnosis and follow-up treatment. The case is presented of a 29 year old woman with anemia, atraumatic hip pain on the right side, and a limp of one month onset. The differential diagnosis includes infectious, rheumatological, tumor, avascular necrosis of hip, hip impingement, hip dysplasia, osteoarthritis and other syndromes. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. The natural history of inflammatory pseudotumors in asymptomatic patients after metal-on-metal hip arthroplasty.

    Science.gov (United States)

    Almousa, Sulaiman A; Greidanus, Nelson V; Masri, Bassam A; Duncan, Clive P; Garbuz, Donald S

    2013-12-01

    Although pseudotumors have been reported in 32% of asymptomatic metal-on-metal hips, the natural history of asymptomatic pseudotumors is unknown. The purpose of this study was to assess changes over time in asymptomatic pseudotumors and the effect of revision on pseudotumor mass. Followup ultrasound was performed a mean of 25.8 months (range, 21-31 months) after the detection of 15 pseudotumors and five isolated fluid collections in a cohort of 20 asymptomatic patients (13 metal-on-metal, three metal-on-polyethylene, and four hip resurfacings) [42]. Changes in pseudotumors and fluid collections size and nature, and serum ion levels were determined. Among the 15 nonrevised patients, pseudotumors increased in size in six (four solid and two cystic) of 10 patients, three of which had clinically important increases (13-148 cm(3); 28-74 cm(3); 47-104 cm(3)). Three pseudotumors (one solid and two cystic) disappeared completely (the largest measured 31 cm(3)). One solid pseudotumor decreased in size (24 to 18 cm(3)). In five revised patients, pseudotumors completely disappeared in four patients. The fifth patient had two masses that decreased from 437 cm(3) to 262 cm(3) and 43 cm(3) to 25 cm(3). All revision patients had a reduction of chromium (40.42 μ/L to 2.69 μ/L) and cobalt ions (54.19 μ/L to 0.64 μ/L). Of five isolated fluid collections, four completely disappeared (two metal-on-metal and two metal-on-polyethylene) and one (metal-on-metal) increased from 26 cm(3) to 136 cm(3). Our observations suggest pseudotumors frequently increase in size in asymptomatic patients with occasional remission of small masses. Revision resulted in remission of pseudotumors.

  13. Evolution of the hip and pelvis.

    Science.gov (United States)

    Hogervorst, Tom; Bouma, Heinse W; de Vos, John

    2009-08-01

    Man's evolution features two unique developments: growing a huge brain and upright gait. Their combination makes the pelvis the most defining skeletal element to read human evolution. Recent revival in joint preserving hip surgery have brought to attention morphological variations of the human hip that appear similar to hips of extant mammals. In man, such variations can produce hip osteoarthrosis through motion. We reviewed the evolution of the hip and pelvis with special interest in morphology that can lead to motion induced osteoarthrosis in man. The combination of giving birth to big brained babies and walking upright has produced marked differences between the sexes in pelvis and hip morphology, each having their characteristic mode of hip impingement and osteoarthrosis.

  14. Hip Imaging in Athletes: Sports Imaging Series.

    Science.gov (United States)

    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.

  15. Combination of microneedle radiofrequency (RF), fractional RF skin resurfacing and multi-source non-ablative skin tightening for minimal-downtime, full-face skin rejuvenation.

    Science.gov (United States)

    Kaplan, Haim; Kaplan, Lilach

    2016-12-01

    In the recent years, there is a growth in demand for radiofrequency (RF)-based procedures to improve skin texture, laxity and contour. The new generation of systems allow non-invasive and fractional resurfacing treatments on one platform. The aim of this study was to evaluate the safety and efficacy of a new treatment protocol using a multisource RF, combining 3 different modalities in each patient: [1] non-ablative RF skin tightening, [2] fractional skin resurfacing, and [3] microneedling RF for non-ablative coagulation and collagen remodelling. 14 subjects were enrolled in this study using EndyMed PRO ™ platform. Each patient had 8 non-ablative treatments and 4 fractional treatments (fractional skin resurfacing and Intensif). The global aesthetic score was used to evaluate improvement. All patients had improvement in skin appearance. About 43% had excellent or very good improvement above 50%, 18% had good improvement between 25 and 50%, and the rest 39% had a mild improvement of < 25%. Downtime was minimal and no adverse effect was reported. Our data show significant improvement of skin texture, skin laxity and wrinkle reduction achieved using RF treatment platform.

  16. Hip fractures. Epidemiology, risk factors, falls, energy absorption, hip protectors, and prevention

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...

  17. Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain

    DEFF Research Database (Denmark)

    Rafn, Bolette S; Tang, Lars; Nielsen, Peter Martin

    2016-01-01

    OBJECTIVE: To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. DESIGN: Cross-sectional study. SETTING: Clinical assessments at Sports Orthopaedic Research...... Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. PARTICIPANTS: Twenty-four male soccer players with unilateral long-standing hip and groin pain. INTERVENTIONS: The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion......, adduction, abduction, isometric hip flexion-modified Thomas test, and eccentric hip adduction). MAIN OUTCOME MEASURES: Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). RESULTS: In 4 tests (isometric hip adduction...

  18. Metal ion concentrations in body fluids after implantation of hip replacements with metal-on-metal bearing--systematic review of clinical and epidemiological studies.

    Directory of Open Access Journals (Sweden)

    Albrecht Hartmann

    Full Text Available INTRODUCTION: The use of metal-on-metal (MoM total hip arthroplasty (THA increased in the last decades. A release of metal products (i.e. particles, ions, metallo-organic compounds in these implants may cause local and/or systemic adverse reactions. Metal ion concentrations in body fluids are surrogate measures of metal exposure. OBJECTIVE: To systematically summarize and critically appraise published studies concerning metal ion concentrations after MoM THA. METHODS: Systematic review of clinical trials (RCTs and epidemiological studies with assessment of metal ion levels (cobalt, chromium, titanium, nickel, molybdenum in body fluids after implantation of metalliferous hip replacements. Systematic search in PubMed and Embase in January 2012 supplemented by hand search. Standardized abstraction of pre- and postoperative metal ion concentrations stratified by type of bearing (primary explanatory factor, patient characteristics as well as study quality characteristics (secondary explanatory factors. RESULTS: Overall, 104 studies (11 RCTs, 93 epidemiological studies totaling 9.957 patients with measurement of metal ions in body fluids were identified and analyzed. Consistently, median metal ion concentrations were persistently elevated after implantation of MoM-bearings in all investigated mediums (whole blood, serum, plasma, erythrocytes, urine irrespective of patient characteristics and study characteristics. In several studies very high serum cobalt concentrations above 50 µg/L were measured (detection limit typically 0.3 µg/L. Highest metal ion concentrations were observed after treatment with stemmed large-head MoM-implants and hip resurfacing arthroplasty. DISCUSSION: Due to the risk of local and systemic accumulation of metallic products after treatment with MoM-bearing, risk and benefits should be carefully balanced preoperatively. The authors support a proposed "time out" for stemmed large-head MoM-THA and recommend a restricted

  19. Metal Ion Concentrations in Body Fluids after Implantation of Hip Replacements with Metal-on-Metal Bearing – Systematic Review of Clinical and Epidemiological Studies

    Science.gov (United States)

    Hartmann, Albrecht; Hannemann, Franziska; Lützner, Jörg; Seidler, Andreas; Drexler, Hans; Günther, Klaus-Peter; Schmitt, Jochen

    2013-01-01

    Introduction The use of metal-on-metal (MoM) total hip arthroplasty (THA) increased in the last decades. A release of metal products (i.e. particles, ions, metallo-organic compounds) in these implants may cause local and/or systemic adverse reactions. Metal ion concentrations in body fluids are surrogate measures of metal exposure. Objective To systematically summarize and critically appraise published studies concerning metal ion concentrations after MoM THA. Methods Systematic review of clinical trials (RCTs) and epidemiological studies with assessment of metal ion levels (cobalt, chromium, titanium, nickel, molybdenum) in body fluids after implantation of metalliferous hip replacements. Systematic search in PubMed and Embase in January 2012 supplemented by hand search. Standardized abstraction of pre- and postoperative metal ion concentrations stratified by type of bearing (primary explanatory factor), patient characteristics as well as study quality characteristics (secondary explanatory factors). Results Overall, 104 studies (11 RCTs, 93 epidemiological studies) totaling 9.957 patients with measurement of metal ions in body fluids were identified and analyzed. Consistently, median metal ion concentrations were persistently elevated after implantation of MoM-bearings in all investigated mediums (whole blood, serum, plasma, erythrocytes, urine) irrespective of patient characteristics and study characteristics. In several studies very high serum cobalt concentrations above 50 µg/L were measured (detection limit typically 0.3 µg/L). Highest metal ion concentrations were observed after treatment with stemmed large-head MoM-implants and hip resurfacing arthroplasty. Discussion Due to the risk of local and systemic accumulation of metallic products after treatment with MoM-bearing, risk and benefits should be carefully balanced preoperatively. The authors support a proposed „time out“ for stemmed large-head MoM-THA and recommend a restricted indication for hip

  20. Ultrasound-Guided Hip Arthrocentesis in a Child with Hip Pain and Fever

    Directory of Open Access Journals (Sweden)

    James H. Moak

    2012-09-01

    Full Text Available Children presenting to the emergency department with hip pain and fever are at risk for significant morbidity due to septic arthritis. Distinguishing between septic arthritis and other causes of hip pain may be challenging. Sonographic visualization of the hip with real-time ultrasound-guided arthrocentesis may allow faster differentiation between etiologies, hastening definitive therapy and improving analgesia. This report describes the use of hip sonography in a case of Lyme arthritis. The authors review the medical literature in support of bedside hip sonography and discuss how to perform ultrasound-guided hip arthrocentesis. Clinical findings in septic and Lyme arthritis are also described.

  1. BILATERAL PATHOLOGICAL HIP DISLOCATION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Yuriy E. Garkavenko

    2017-03-01

    Full Text Available Introduction. Pathological dislocation of the hip is one of the most severe complications of acute hematogenous osteomyelitis. The program of treatment for children with pathological hip dislocation is complex, but it has been sufficiently developed and implemented very successfully. At the same time, the available literature provides no cases of treating children with bilateral pathological hip dislocations after hematogenous osteomyelitis. There is no information on the incidence of such cases or in regards to remote functional results. Materials and methods. The results of the treatment of 18 children with bilateral pathological dislocation of the hip after hematogenous osteomyelitis are presented, which constituted 23.1% of the total number of patients (78 who underwent surgery in 2000–2016 for the diagnosis of pathological hip dislocation. Both hip joints were surgically operated on in 12 patients, while one hip joint was operated on in 6 patients. To assess the anatomical and functional state of hip joints, the clinical and roentgenological diagnostic techniques were used. Results and discussion. To stabilize and restore the function of the hip joints, 18 children underwent 30 surgical interventions: simple open hip reduction (19 and open hip reduction with hip arthroplasty with one (6 or two (5 demineralized osteochondral allogeneic grafts. The decision regarding the possibility of performing surgical intervention on the second hip joint was made only after a child's check-up examination was complete and after positive information about the anatomical and functional state of the operated hip joint was obtained. According to these criteria, 14 (77.8% children underwent surgical treatment of the second hip joint 1–1.5 years after the course of conservative measures to restore the range of motion in the previously operated hip joint. Over a period of 1–12 years, 17 patients were examined, 10 of which underwent an operation on both

  2. Chronic Periprosthetic Hip Joint Infection

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Søballe, Kjeld

    2016-01-01

    INTRODUCTION: Limited information is available regarding the treatment strategy and prognosis of non-selected patients treated for chronic periprosthetic hip joint infection. Such information is important as no head-to-head studies on treatment strategies are available. The purpose of this study...... is to report on the treatment strategy and prognosis of a non-selected, consecutive patient population. METHODS: We identified 130 patients in the National Patient Registry, consecutively treated for a chronic periprosthetic hip joint infection between 2003-2008 at 11 departments of orthopaedic surgery. We...... chart review with a minimum of 5 years follow-up by the nationwide electronic patient record system. RESULTS: After primary revision surgery, 53 patients (41%) had a spacer in situ, 64 (50%) had a resection arthroplasty and 13 (9%) did not have the infected implant removed. 63% were re...

  3. Hip fractures in old men

    International Nuclear Information System (INIS)

    Martinez Rondanelli, Alfredo

    2005-01-01

    Describe 289 hip fractures that were admitted at Hospital Universitario del Valle between November 1, 2003 and June 30, 2004. The patients had the first appointment at 2.7 days after the fallen, 60% the patients were women, at he age average were 75 years. In the hospital 228 patients were operated (79%). The surgery was realized in average at the twelve days after than they were admitted at the hospital. The days in the hospital were in average 17.5 days. The index of Katz at the admission was 3.96 and the Parker index was 6.56. The mortality in the hospital was of 30 patients (11%). The following during six months was in 114 patients of the people that were operated; we found loss of initial reduction the hip fracture in 10% and infection in 4%

  4. The Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. STUDY POPULATION: The DHR is a Danish nationwide arthroplasty register established in January 1995...... complications. Completeness of primary and revision surgery is evaluated annually and validation of a number of variables has been carried out. DESCRIPTIVE DATA: A total of 139,525 primary THAs and 22,118 revisions have been registered in the DHR between January 1, 1995 and December 31, 2014. Since 1995....... All Danish orthopedic departments - both public and private - report to the register, and registration is compulsory. MAIN VARIABLES: The main variables in the register include civil registration number, indication for primary and revision surgery, operation date and side, and postoperative...

  5. Editorial Commentary: Anatomical Vandalism of the Hip? Hip Capsular Repair Seems a Sound Adjunct to Hip Arthroscopic Surgery.

    Science.gov (United States)

    van Arkel, Richard J; Jeffers, Jonathan R T; Amis, Andrew A

    2017-02-01

    The study "Contribution of the Pubofemoral Ligament to Hip Stability: A Biomechanical Study" by Martin, Khoury, Schröder, Johnson, Gómez-Hoyos, Campos, and Palmer found that cutting the hip capsular ligament allowed a large increase in femoral internal rotation, particularly in the flexed hip, causing subluxation to occur. In addition to providing new data on the role of the pubofemoral ligament, it raises the question of whether hip joint surgeons should repair the capsule-what are the likely consequences?-and whether any beneficial effects persist in long-term clinical follow-ups. For now, hip capsular repair seems a sound adjunct to hip arthroscopic surgery. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing? A Radiographic Review.

    Science.gov (United States)

    Matz, Jacob; Howard, James L; Morden, David J; MacDonald, Steven J; Teeter, Matthew G; Lanting, Brent A

    2017-03-01

    Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA. A retrospective radiographic review of 970 knees pre-TKA and post-TKA was completed to correlate the radiographic and clinical outcomes of changing the PFO using a posterior-stabilized single knee design with patellar resurfacing. A total of 970 patients were reviewed. Postoperatively, the anterior femoral offset, anteroposterior femoral size, and anterior patellar offset were changed in 40%, 60%, and 71% of knees, respectively, compared to preoperative values. The Western Ontario and McMasters Osteoarthritis Index total score as well as subscale scores for pain and function were not significantly affected by an increase or decrease in PFO. Similarly, Knee Society Scores and range of motion were not significantly affected. Increased anterior patellar offset was, however, associated with increased postoperative patellar tilt. Postoperative patellar tilt was not correlated with adverse patient satisfaction scores or loss of range of motion. Changes in PFO (decreased, maintained, or increased) are common post-TKA and are not associated with a difference in clinical outcomes. Increases in anterior patellar offset led to increased patellar tilt, which was not associated with adverse patient satisfaction scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Gross and microscopic findings in patients submitted to nonablative full-face resurfacing using intense pulsed light: a preliminary study.

    Science.gov (United States)

    Hernández-Pérez, Enrique; Ibiett, Erick Valencia

    2002-08-01

    Intense pulsed light (IPL) is a noncoherent, nonlaser, filtered flashlamp emitting a broadband visible light that has been shown to be effective in photoepilation, as well as in a number of vascular and pigmented lesions of the skin. Their efficacy has also been reported recently in the treatment of photodamaged facial skin. In the last condition, however, there are few studies showing the clinical and microscopic changes produced by IPL. To assess the gross and microscopic changes that occur in photodamaged skin submitted to nonablative full-face resurfacing (NAFFR) using IPL. Five women were submitted to five NAFFR sessions using IPL, one every 2 weeks. Skin biopsies and photographs were taken on all of the patients before the first procedure and after the last one, as well as weekly clinical assessment. Data concerning skin features (wrinkles, oiliness, thickness, dilated pores, and general appearance) were all assessed. Microscopic improvement of the aging features in the epidermis and dermis were all assessed. For the statistical analysis a t test for small samples was used. All the patients showed clinical and microscopic improvement in every one of the parameters assessed. The t test for small samples showed a statistically significant difference (P Facial photodamage was clinically and microscopically improved using IPL. Use of IPL as a rejuvenating method seems to be promising, with minimal side effects, a wide safety margin, and minimal downtime.

  8. A Pilot Study of Skin Resurfacing Using the 2,790-nm Erbium:YSGG Laser System

    Directory of Open Access Journals (Sweden)

    Jong Won Rhie

    2015-01-01

    Full Text Available BackgroundThe erbium:yttrium scandium gallium garnet (Er:YSGG laser differs from other laser techniques by having a faster and higher cure rate. Since the Er:YSGG laser causes an appropriate proportion of ablation and coagulation, it has advantages over the conventional carbon dioxide (CO2 laser and the erbium-doped yttrium aluminum garnet (Er:YAG laser, including heating tendencies and explosive vaporization. This research was conducted to explore the effects and safety of the Er:YSGG laser.MethodsTwenty patients participated in the pilot study of a resurfacing system using a 2,790-nm Er:YSGG laser. All patients received facial treatment by the 2,790-nm Er:YSGG laser system (Cutera twice with a 4-week interval. Wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture were measured.ResultsStudy subjects included 15 women and five men. Re-epithelization occurred in all subjects 3 to 4 days after treatment, and wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture within 6 months of treatment.ConclusionsThe 2,790-nm YSGG laser technique had fewer complications and was effective in the improvement of scars, pores, wrinkles, and skin tone and color with one or two treatments. We expect this method to be effective for people with acne scars, pore scars, deep wrinkles, and uneven skin texture and color.

  9. Prospective, pilot evaluation of the performance of nanofractional radiofrequency for improvement of skin texture via skin resurfacing.

    Science.gov (United States)

    Bohnert, Krista; Dorizas, Andrew; Sadick, Neil

    2018-02-01

    The latest generation of radiofrequency, nanofractional radiofrequency, allows the heat energy to be delivered through the use of pins or needles as electrodes, facilitating increased efficacy and reduced pain, downtime, and side effects. The objective of this prospective pilot clinical study was to evaluate the efficacy of nanofractional radiofrequency in skin resurfacing. Seventeen subjects were enrolled in the study, and each received three nanofractional radiofrequency (160-pin tip) treatments in the facial area at 3-week intervals. Follow-up visits were scheduled at 1 and 2 months after the final treatment. Clinical photography, patient, and investigator assessments were conducted during the treatment visits and follow-up. All subjects completed the study. At the 1- and 2-month follow-up, there was a moderate to significant improvement (2.6 and 3.5, respectively, P = .01) according to the investigator global esthetic improvement scale rating. Most subjects reported that they were satisfied or very satisfied with the outcome and level of comfort. Nanofractional radiofrequency is a safe and effective strategy for improving texture, tone, and skin laxity with high patient satisfaction and tolerable safety profile. © 2017 Wiley Periodicals, Inc.

  10. Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation

    DEFF Research Database (Denmark)

    Hedelund, Lene; Moreau, Karen Estell R; Beyer, Ditte M

    2010-01-01

    fractional laser treatment of acne scars. Ten patients with acne scars were included. Two intraindividual areas of similar size and appearance within contralateral anatomical regions were randomized to (1) 3-monthly laser treatments with a StarLux 1,540-nm fractional handpiece, and (2) no treatment. Blinded...... appeared more even and smooth than untreated control areas (4.5, 2-6.5, versus 6.5, 4.5-8, P=0.0156, at 4 weeks; 4.5, 2.5-6.5, versus 6.5, 4.5-8, at 12 weeks; P=0.0313). Patients were satisfied with the treatment (5.5, 1-7, after 12 weeks) and five of the ten patients evaluated their acne scars......The efficacy of nonablative fractional laser resurfacing of acne scars has been described in case reports and uncontrolled trials. The present study is the first randomized controlled trial in this field. The aim of this study was to examine the efficacy and adverse effects of 1,540-nm nonablative...

  11. Treatment of cosmetic tattoos using carbon dioxide ablative fractional resurfacing in an animal model: a novel method confirmed histopathologically.

    Science.gov (United States)

    Wang, Chia-Chen; Huang, Chuen-Lin; Sue, Yuh-Mou; Lee, Shao-Chen; Leu, Fur-Jiang

    2013-04-01

    Treating cosmetic tattoos using quality-switched lasers is difficult. We used carbon dioxide ablative fractional resurfacing (CO2 AFR) to remove cosmetic tattoos and examined the pathophysiologic mechanisms involved in this technique in an animal model. Twelve rats were tattooed on their backs with white and flesh-colored pigments. Half of each tattoo was treated with CO2 AFR (5 sessions at 1-month intervals), and the other half was the untreated control. An independent observer reviewed photographic documentation of clinical response. Serial skin samples obtained at baseline and at various times after laser treatment were evaluated using histologic and immunohistochemical methods. Four rats had excellent responses to laser treatment and eight had good responses. White and flesh-colored tattoos had similar clearance rates and tissue reactions. Histologic analysis showed immediate ablation of tattoo pigments in the microscopic ablation zones. Tattoo pigments in the microscopic coagulation zones migrated to the epidermis and became part of the microscopic exudative necrotic debris appearing on day 2 that was exfoliated after 5 days. Increased fibronectin expression around the microscopic treatment zones during the extrusion of tattoo pigments indicated that wound healing facilitates this action. CO2 AFR successfully removes cosmetic tattoos. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  12. Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation

    DEFF Research Database (Denmark)

    Hedelund, Lene; Moreau, Karen Estell R; Beyer, Ditte M

    2010-01-01

    The efficacy of nonablative fractional laser resurfacing of acne scars has been described in case reports and uncontrolled trials. The present study is the first randomized controlled trial in this field. The aim of this study was to examine the efficacy and adverse effects of 1,540-nm nonablative...... fractional laser treatment of acne scars. Ten patients with acne scars were included. Two intraindividual areas of similar size and appearance within contralateral anatomical regions were randomized to (1) 3-monthly laser treatments with a StarLux 1,540-nm fractional handpiece, and (2) no treatment. Blinded...... appeared more even and smooth than untreated control areas (4.5, 2-6.5, versus 6.5, 4.5-8, P=0.0156, at 4 weeks; 4.5, 2.5-6.5, versus 6.5, 4.5-8, at 12 weeks; P=0.0313). Patients were satisfied with the treatment (5.5, 1-7, after 12 weeks) and five of the ten patients evaluated their acne scars...

  13. A Hip Implant Energy Harvester

    Science.gov (United States)

    Pancharoen, K.; Zhu, D.; Beeby, S. P.

    2014-11-01

    This paper presents a kinetic energy harvester designed to be embedded in a hip implant which aims to operate at a low frequency associated with body motion of patients. The prototype is designed based on the constrained volume available in a hip prosthesis and the challenge is to harvest energy from low frequency movements (< 1 Hz) which is an average frequency during free walking of a patient. The concept of magnetic-force-driven energy harvesting is applied to this prototype considering the hip movements during routine activities of patients. The magnetic field within the harvester was simulated using COMSOL. The simulated resonant frequency was around 30 Hz and the voltage induced in a coil was predicted to be 47.8 mV. A prototype of the energy harvester was fabricated and tested. A maximum open circuit voltage of 39.43 mV was obtained and the resonant frequency of 28 Hz was observed. Moreover, the power output of 0.96 μW was achieved with an optimum resistive load of 250Ω.

  14. Cover Story: The Miseducation of Hip-Hop.

    Science.gov (United States)

    Evelyn, Jamilah

    2000-01-01

    Some higher education officials believe that hip-hop music is eating away at the morals, and ultimately the classroom experience, of today's college students. Discusses why the gap exists between student and faculty attitudes toward hip-hop, how hip-hop music represents blackness, how people perceive hip-hop youth, the positive side of hip-hop,…

  15. Physiopathology and biomechanics of hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available Several factors seem to play a relevant role in the pathogenesis of hip osteoarthritis. Among these, an altered biomechanic and neuromuscular integrity of the hip joint should be considered. This is a review of the recent international literature concerning the role of loads and strengths acting on the hip joint, in order to better understand the pathogenesis and the physiopathology of the hip osteoarthritis. The study of these factors might be important to prevent the development of the osteoarthritis and might suggest the conservative treatment. In particular, the role of the balance among the muscles working in maintaining the equilibrium of the acting strengths is matter of discussion. The articular and neuromuscular dysfunction might induce an altered load distribution in the hip, particularly on the articular cartilage surface, and seems to favour the development of hip osteoarthritis...

  16. Hip Surgery Candidates: A Comparative Study of Hip Osteoarthritis and Prior Hip Fracture Patient Characteristics

    OpenAIRE

    Marks, Ray

    2008-01-01

    Aim: To assess similarities and differences in patient-related characteristics before and after surgery for painful disabling hip osteoarthritis among elderly subgroups with and without a trauma history. Method: First, a cohort of 1000 hospitalized patients were assessed for trends in: perceived duration of the condition, pain intensity, functional performance ability, walking distance, body mass, and comorbidity characteristics among other factors. Then, the most salient of these patient-rel...

  17. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  18. Imaging findings of anterior hip dislocations

    International Nuclear Information System (INIS)

    Pfeifer, Kyle; Leslie, Michael; Menn, Kirsten; Haims, Andrew

    2017-01-01

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  19. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    OpenAIRE

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric re...

  20. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

    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.

  1. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

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

    2015-07-01

    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.

  2. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

    Directory of Open Access Journals (Sweden)

    Maya S. Krastanova

    2015-09-01

    Full Text Available Introduction: In relation to the study reporting the effects of applying phased complex rehabilitation in patients with total hip arthroplasty, it has been concluded that the everyday clinical practice in Bulgaria does not apply complex examination, giving an objective picture about the extent of functional status of patients with trauma and diseases of the hip. Aim: The main goal of this report is to present a test which incorporates all known and routine research and in which the total number of points determines the functional status of patients with trauma and diseases of the hip. Material and Methods: Based on the Hip dysfunction and Osteoarthritis Outcome Score, the Harris Hip Score modified test, scale D’Aubigne and Postel and Iowa’s test for complex functional evaluation of the hip joint, we have developed a test including information about the degree of pain; goniometry and manual muscle testing of the hip; locomotor test – type of gait and adjuvants; test for Daily Activities of Life. The test has been developed on the basis of expert assessment by doctors and physiotherapists of the proposed indicators for evaluation and determination of the weighting factors’ contribution to the general condition of the patient. Conclusion: The developed and tested method of complex functional assessment of the hip joint enables our colleagues, dealing with trauma and diseases of the hip, to use it in various research and scientific projects, as well as in general medical practice.

  3. Managing hip pain in the athlete.

    Science.gov (United States)

    Prather, Heidi; Colorado, Berdale; Hunt, Devyani

    2014-11-01

    Hip and groin pain is commonly experienced by athletes. The differential diagnosis should include both intra-articular and extra-articular sources for pain and dysfunction. A comprehensive history and physical examination can guide the evaluation of hip pain and the potential need for further diagnostics. Treatment of athletes with hip disorders includes education, addressing activities of daily living, pain-modulating medications or modalities, exercise and sports modification, and therapeutic exercise. Surgical techniques for prearthritic hip disorders are expanding and can offer appropriate patients a successful return to athletic endeavors when conservative measures are not effective. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Secondary capsular laxity of the hip.

    Science.gov (United States)

    Blakey, Caroline M; Field, Michael H; Singh, Parminder J; Tayar, Rene; Field, Richard E

    2010-01-01

    We describe a hip condition with a recognisable pattern of clinical signs and radiological findings thought to result from chronic capsular injury. Between June 2006 and October 2009, ten patients (11 hips), four men and six women, were identified with an abnormality of external rotation at the hip joint. A detailed history and clinical examination was undertaken for each patient. Dynamic magnetic resonance imaging of symptomatic and control hips were evaluated for bony and soft tissue appearances. The relative positions of the femoral head and the acetabulum were assessed through a range of hip rotation. In affected hips, a loss of normal log roll recoil was observed. Three distortions of the iliofemoral ligament were identified on axial MR images; thinning at the lateral insertion of the ligament, attenuation of the iliofemoral ligament most noticeably on maximum external rotation (60º) and the appearance of laxity despite full external rotation. Stability of the hip is dependent on the interaction of bony and soft tissue structures. Hip instability is recognised in dysplasia and is known to lead to premature degeneration of the joint. Chronic capsular injury may destabilise previously asymptomatic hips with subsequent development of pain in young, active patients.

  5. The effect of accounting for biarticularity in hip flexor and hip extensor joint torque representations.

    Science.gov (United States)

    Lewis, M G C; Yeadon, M R; King, M A

    2018-02-01

    Subject-specific torque-driven models have ignored biarticular effects at the hip. The aim of this study was to establish the contribution of monoarticular hip flexors and hip extensors to total hip flexor and total hip extensor joint torques for an individual and to investigate whether torque-driven simulation models should consider incorporating biarticular effects at the hip joint. Maximum voluntary isometric and isovelocity hip flexion and hip extension joint torques were measured for a single participant together with surface electromyography. Single-joint and two-joint representations were fitted to the collected torque data and used to determine the maximum voluntary joint torque capacity. When comparing two-joint and single-joint representations, the single-joint representation had the capacity to produce larger maximum voluntary hip flexion torque (larger by around 9% of maximum torque) and smaller maximum voluntary hip extension torque (smaller by around 33% of maximum torque) with the knee extended. Considering the range of kinematics found for jumping movements, the single-joint hip flexors had the capacity to produce around 10% additional torque, while the single joint hip extensors had about 70% of the capacity of the two-joint representation. Two-joint representations may overcome an over-simplification of single-joint representations by accounting for biarticular effects, while building on the strength of determining subject-specific parameters from measurements on the participant. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Eccentric hip abductor weakness in patients with symptomatic external snapping hip

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Thorborg, Kristian; Søballe, K

    2012-01-01

    . Eccentric hip abduction strength was 16% lower in patients with external snapping hip compared with healthy matched controls (1.50 ± 0.47 Nm/kg versus 1.82 ± 0.48 Nm/kg, P = 0.01). No other strength differences were measured between patients and controls (P > 0.05). Eccentric hip abductor weakness...

  7. Resolving controversies in hip fracture care: the need for large collaborative trials in hip fractures

    NARCIS (Netherlands)

    Bhandari, Mohit; Sprague, Sheila; Schemitsch, Emil H.; Einhorn, Thomas; Guyatt, Gordon H.; Haidukewych, George; Keating, John; Koval, Kenneth; Rosen, Clifford; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Motsitsi, Silas; Pei, Fuxing; Yang, Tian-fu; Zhou, Zong-ke; Arora, Shobha; Babhulkar, Sushrut; Bhargava, Rakesh; Desai, Mohan M.; Dhillon, Mandeep S.; Gill, Harpreet Singh; Goel, S. C.; Reddy, A. V. Gurava; Jain, Anil K.; Kalore, Niraj V.; Kammatkar, Nitin; Kumar, Vijay; Malhorta, Rajesh; Marthandam, S. S. K.; Pankaj, Amite; Patinharayil, Gopinathan; Rai, B. Sachidanand; Ramteke, Alankar Ambadas; Sancheti, Parag K.; Thakkar, Navin N.; Thomas, George S.; Robinson, Dror; Steinberg, Ely; Higuchi, Fujio; Kawamura, Sumito; Ohashi, Hirotsugu; Sawaguchi, Takeshi; Park, Myung-Sik; Yun, Ho Hyun; Poduval, Murali; Siddiqui, Ahmed; Chang, Je-Ken; Wang, Gwo-Jaw; Chen, Chung-Hwan; Fu, Yin-Chih; Lu, Yen-Mou; Acaroglu, Emre; Alpasian, Mumtaz; Atilla, Bulent; Ayvaz, Mehmet; Caglar, Omur; Tokgozoglu, Mazhar; Gray, Peter Campbell; Harris, Ian; O'Sullivan, Michael; Page, Richard Samuel; Parker, David; Richardson, Martin; Solomon, Michael; Tetsworth, Kevin; Walker, Richard; Williams, Simon; Devane, Peter; Broos, Paul; Djurdjevic, Dragan; Brink, Ole; Jalovaara, Pekka; Ristiniemi, Jukka; Blum, Jochen; Bonnaire, Felix; Gerich, Tosten G.; Herrwerth, Volker; Klein, Michael; Knopp, Werner; Krettek, Christian; Mueller-Daniels, Holger; Ochs, Uwe; Oestern, Hans-Joerg; Pohlemann, Tim; Schandelmaier, Peter; Schreiber, Thomas; Seekamp, Andreas; Stuermer, Klaus Michael; Walde, Tim; Walde, Hans-Joachim; Weise, Kuno; Synnott, Keith; Grosso, Elena; Moroni, Antonio; Albers, G. H. Robert; de Ridder, Victor; Goslings, J. Carel; Haaglanden, M. C.; Heetveld, Martin J.; Jukema, Gerolt N.; Poolman, Rudolf W.; Rhemrev, S.; Segers, Michiel J. M.; Simmermacher, Roger; van der Elst, Maarten; van der Vis, Harm; van Vugt, Arie; Verhofstad, Michael H. J.; Bugge, Wilhelm; Figved, Wender; Frihagen, Frede; Madsen, Jan Erik; Nordsletten, Lars; Solheim, Ludvig Fjeld; Giannoudis, Peter V.; Kanakaris, Nikolaos; Parker, Martyn; Willett, Keith; Ekholm, Carl; Larsson, Sune; Rogmark, Cecilia; Abuzgaya, Fathi Hadi; Ackerman, Carel W.; Adachi, Jonathan Rick; Adili, Anthony; Bogoch, Earl A.; Bohm, Eric; Botsford, Deke John; Bourne, Robert B.; Buckley, Richard E.; Coles, Chad P.; Daniels, Timothy; de Beer, Justin; Devereaux, P. J.; Duffy, Paul; Farrokhyar, Forough; Feibel, Robert J.; Flores, Luis A.; Frank, Cyril B.; Glazebrook, Mark; Goetz, Thomas J.; Gordon, John A.; Gross, Michael; Guyatt, Gordon; Heron, Tim; Hoey, Steven; Josefchak, Robert G.; Kaminker, Richard S.; Karanicolas, Paul Jack; Kendall, Richard; Kim, Paul R.; Korbyl, Robert; Korley, Robert; Kreder, Hans J.; Kwan, Stephen; Laflamme, Yves; Leighton, Ross K.; Leone, James; Lincoln, Lawrence; MacCon, Kieran; Martin, David C.; Mastogiacomo, Frank; Mathew, George; McAllister, Patrick; McCormack, Robert G.; McKerrell, Jeffrey G.; Moro, Jaydeep K.; Murnaghan, John J.; Naudie, Douglas; O'Brien, Peter J.; O'Farrell, Terrance A.; Ogilvie, Rick A.; Oliver, John; Panagiotopoulos, Kostantinos; Perey, Bertrand; Perlau, Robert J. R.; Peterson, Devin C.; Petrisor, Brad; Pototschnik, Ralph; Pugh, David; Puloski, Shannon K. T.; Rerri, Bernard E.; Rittenhouse, Bryan R.; Rogakou, Cleo C.; Rosen, Leonard; Russell, Robert; Salo, Paul T.; Sanders, David; Smit, Arno; Song, John Young; Southcott, W. Peter; Tountas, Apostolos; Venugopal, Vikram; Waddell, James P.; Wai, Eugene; Walter, Stephen; Willits, Kevin; Yach, Jeff D.; Zalzal, Paul; Zarzour, Zane; Agarwal, Animesh; Anglen, Jeffrey O.; Appel, Marc; Archdeacon, Michael T.; Ballard, William Timothy; Barzideh, Sam; Berry, Daniel J.; Bezwada, Hari P.; Bhattacharyya, Timothy; Blotter, Robert H.; Bouxsein, Mary Larsen; Brown, Gregory A.; Brown, Thomas E.; Camuso, Matthew R.; Cole, Peter A.; Conflitti, Joseph M.; Crist, Brett D.; Davila, Maria Guerrero; Della Rocca, Gregory; Devinney, Dennis Scott; DiMaio, Frank R.; Dirschl, Doug; Duffy, Gervan; Duwelius, Paul; Egol, Kenneth J.; Ellis, Thomas; Ferguson, Tania; Finnegan, Maureen; Garino, Jonathan P.; Gill, Gurdev S.; Gorczyca, John; Gruen, Gary S.; Haidukewych, George John; Hak, David J.; Hammerberg, Mark; Harris, Adam; Harris, Mitchel; Iorio, Richard; Jadhav, Avinash; Jennings, James E.; Jeray, Kyle J.; Jiranek, William; Karges, David; Kregor, Phil; Kwartowitz, Mark A.; Lammens, Peter; Le, Theodore Toan; Leach, Patrick B.; LeCroy, Charles Michael; Levin, Paul; Lewis, Courtland; Liporace, Frank; Lorich, Dean; Louis, Steven; Lozman, Jeffrey; Lyden, John; Macaulay, William B.; Mansour, Edward Shawn; Marcus, Randall Evan; Markel, David; Masonis, John; Meinberg, Eric; Meldrum, Daniel; Meldrum, Russell; Moon, Charles N.; Moore, Thomas; Mormino, Matthew A.; Navid, David; Obremskey, William; Parvizi, Javad; Patney, Michael J.; Phieffer, Laura S.; Prayson, Michael; Probe, Robert; Prokuski, Laura; Reddix, Robert N.; Reilly, Mark C.; Ricci, William; Roberts, Craig S.; Sems, Andy; Sekundiak, Todd; Schmidt, Andrew; Schwappach, John; Sirkin, Michael; Stewart, Rena L.; Strauss, Elton; Switzer, Julie A.; Taunt, Charles J.; Tejwani, Nirmal; Vallier, Heather A.; Waldman, Barry; Web, Larry; Williams, Joseph; Wilson, Frederic; Wright, George; Ziran, Bruce; Zura, Robert D.; Torga-Spak, Roger; Reyes, Mario; Pesantez, Rodrigo; Barquet, Antonio

    2009-01-01

    Hip fractures are a significant cause of morbidity and mortality worldwide and the burden of disability associated with hip fractures globally vindicate the need for high-quality research to advance the care of patients with hip fractures. Historically, large, multi-centre randomized controlled

  8. The effect of asymmetrical limited hip flexion on seating posture, scoliosis and windswept hip distortion.

    Science.gov (United States)

    Ágústsson, Atli; Sveinsson, Þórarinn; Rodby-Bousquet, Elisabet

    2017-12-01

    Postural asymmetries with seating problems are common in adults with cerebral palsy. To analyse the prevalence of asymmetrical limited hip flexion (90°. Asymmetrical limited hip flexion affects the seating posture and is associated with scoliosis and windswept hip distortion. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Perceived loading and muscle activity during hip strengthening exercises

    DEFF Research Database (Denmark)

    Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian

    2013-01-01

    OBJECTIVE: Decreased hip muscle strength is frequently reported in patients with hip injury or pathology. Furthermore, soccer players suffering from groin injury show decreased strength of hip muscles. Estimating 10-repetition maximum can be time-consuming and difficult, thus, using the Borg...... hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG). METHODS: EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women...... resistance training of the hip adductor and hip abductor muscles. Although elastic resistance and exercise machine seem equally effective for recruiting muscle activity of the hip adductors, the elastic resistance condition was able to demonstrate greater muscle recruitment than the exercise machine during...

  10. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Milind M Chaudhary

    2015-01-01

    Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term.

  11. Unilateral hip osteoarthritis: can we predict the outcome of the other hip?

    Energy Technology Data Exchange (ETDEWEB)

    Vossinakis, I.C. [General Hospital of Volos, Orthopaedic Department, Volos (Greece); Georgiades, G. [General Hospital of Tripoli, Tripoli Greece, Orthopaedic Department, Athens (Greece); Hartofilakidis, G. [University of Athens Medical School, Department of Orthopaedics, Athens (Greece); Kafidas, D.

    2008-10-15

    The objective of this study was to define, in unilateral hip osteoarthritis (OA), factors predicting the outcome of the other hip. We examined the anteroposterior radiographs of the pelvis of 95 white patients with unilateral idiopathic (56 patients) or secondary to congenital hip diseases (39 patients) OA. The other hip was free from symptoms (pain or limping) at the initial examination and without radiographic evidence of OA; it was what we call a ''normal'' hip. Two parameters were evaluated: (1) the type of osteoarthritis of the involved hip and (2) the range of four radiographic indices of the contralateral hip: the sourcil inclination (weight-bearing surface), the acetabular angle, the Wiberg's center-edge angle, and the neck-shaft angle. Follow-up radiographs for the hips that remained OA-free were available for 10 to 35 years and for those that developed OA, at the time of initial symptoms, range 2 to 31 years. Logistic regression analysis showed that the presence of idiopathic OA in one hip had a statistically significant effect on the development of OA on the other hip (p<0.001). Minor deviations of radiographic indices of the contralateral hip is not a predictive factor for its outcome. When the radiographic indices are examined together with the pathology of the involved hip, only WBS was shown to have a significant effect to the development of OA and its type (p < 0.001). The following conclusions can be drawn from this study: 1. Patient with idiopathic OA of one hip is at increased risk of developing OA in the other hip. 2. The outcome of the other hip cannot be predicted only on the basis of the evaluation of its radiographic indices. 3. Among the different indices, WBS seems to have a strong influence toward the development of OA. (orig.)

  12. The association between hip fracture and hip osteoarthritis: A case-control study

    Directory of Open Access Journals (Sweden)

    Englund Martin

    2010-11-01

    Full Text Available Abstract Background There have been reports both supporting and refuting an inverse relationship between hip fracture and hip osteoarthritis (OA. We explore this relationship using a case-control study design. Methods Exclusion criteria were previous hip fracture (same side or contralateral side, age younger than 60 years, foreign nationality, pathological fracture, rheumatoid arthritis and cases were radiographic examinations were not found in the archives. We studied all subjects with hip fracture that remained after the exclusion process that were treated at Akureyri University Hospital, Iceland 1990-2008, n = 562 (74% women. Hip fracture cases were compared with a cohort of subjects with colon radiographs, n = 803 (54% women to determine expected population prevalence of hip OA. Presence of radiographic hip OA was defined as a minimum joint space of 2.5 mm or less on an anteroposterior radiograph, or Kellgren and Lawrence grade 2 or higher. Possible causes of secondary osteoporosis were identified by review of medical records. Results The age-adjusted odds ratio (OR for subjects with hip fracture having radiographic hip OA was 0.30 (95% confidence interval [95% CI] 0.12-0.74 for men and 0.33 (95% CI 0.19-0.58 for women, compared to controls. The probability for subjects with hip fracture and hip OA having a secondary cause of osteoporosis was three times higher than for subjects with hip fracture without hip OA. Conclusion The results of our study support an inverse relationship between hip fractures and hip OA.

  13. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty.

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-11-18

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties.

  14. Fasilitas Pelatihan dan Pergelaran Seni Tari Hip Hop di Surabaya

    OpenAIRE

    Yanuar, Sandy

    2014-01-01

    Fasilitas Pelatihan dan Pergelaran Seni Tari Hip Hop di Surabaya merupakan fasilitas yang disediakan bagi semua penari Hip Hop di Surabaya untuk berlatih menari dan mempertunjukan tarian Hip Hop. Fasilitas ini tersedia bagi semua penari Hip Hop termasuk penari difable, mengingat kaum difable juga dapat menari Hip Hop. Namun karena di Surabaya belum memiliki fasilitas yang memadai bagi semua penari Hip Hop termasuk penari difable untuk menari dan memiliki tempat pertunjukan yang berkarakter Hi...

  15. Infection after primary hip arthroplasty

    Science.gov (United States)

    2011-01-01

    Background and purpose The aim of the present study was to assess incidence of and risk factors for infection after hip arthroplasty in data from 3 national health registries. We investigated differences in risk patterns between surgical site infection (SSI) and revision due to infection after primary total hip arthroplasty (THA) and hemiarthroplasty (HA). Materials and methods This observational study was based on prospective data from 2005–2009 on primary THAs and HAs from the Norwegian Arthroplasty Register (NAR), the Norwegian Hip Fracture Register (NHFR), and the Norwegian Surveillance System for Healthcare–Associated Infections (NOIS). The Norwegian Patient Register (NPR) was used for evaluation of case reporting. Cox regression analyses were performed with revision due to infection as endpoint for data from the NAR and the NHFR, and with SSI as the endpoint for data from the NOIS. Results The 1–year incidence of SSI in the NOIS was 3.0% after THA (167/5,540) and 7.3% after HA (103/1,416). The 1–year incidence of revision due to infection was 0.7% for THAs in the NAR (182/24,512) and 1.5% for HAs in the NHFR (128/8,262). Risk factors for SSI after THA were advanced age, ASA class higher than 2, and short duration of surgery. For THA, the risk factors for revision due to infection were male sex, advanced age, ASA class higher than 1, emergency surgery, uncemented fixation, and a National Nosocomial Infection Surveillance (NNIS) risk index of 2 or more. For HAs inserted after fracture, age less than 60 and short duration of surgery were risk factors of revision due to infection. Interpretation The incidences of SSI and revision due to infection after primary hip replacements in Norway are similar to those in other countries. There may be differences in risk pattern between SSI and revision due to infection after arthroplasty. The risk patterns for revision due to infection appear to be different for HA and THA. PMID:22066562

  16. Burnishing Techniques Strengthen Hip Implants

    Science.gov (United States)

    2010-01-01

    In the late 1990s, Lambda Research Inc., of Cincinnati, Ohio, received Small Business Innovation Research (SBIR) awards from Glenn Research Center to demonstrate low plasticity burnishing (LPB) on metal engine components. By producing a thermally stable deep layer of compressive residual stress, LPB significantly strengthened turbine alloys. After Lambda patented the process, the Federal Aviation Administration accepted LPB for repair and alteration of commercial aircraft components, the U.S. Department of Energy found LPB suitable for treating nuclear waste containers at Yucca Mountain. Data from the U.S. Food and Drug Administration confirmed LPB to completely eliminate the occurrence of fretting fatigue failures in modular hip implants.

  17. HIP Joining of Cemented Carbides

    Energy Technology Data Exchange (ETDEWEB)

    Derby, B.; Miodownik, M.

    1999-04-01

    Hot Isostatic Pressing (HIP) is investigated as a technique for joining the cermet WC-15% Co to itself. Encapsulation of the specimens prior to HIPing was carried out using steel encapsulation, glass encapsulation and self encapsulation. The bonds were evaluated using a four point bend method. It is shown that the glass and steel encapsulation methods have a number of inherent problems which make them inappropriate for near net shape processing. In contrast the novel self encapsulation method, described for the first time in this communication, is both simple and effective, producing joined material with bulk strength. The concept of self encapsulation is potentially widely applicable for joining composite materials.

  18. Safe and effective one-session fractional skin resurfacing using a carbon dioxide laser device in super-pulse mode: a clinical and histologic study.

    Science.gov (United States)

    Trelles, Mario A; Shohat, Michael; Urdiales, Fernando

    2011-02-01

    Carbon dioxide (CO(2)) laser ablative fractional resurfacing produces skin damage, with removal of the epidermis and variable portions of the dermis as well as associated residual heating, resulting in new collagen formation and skin tightening. The nonresurfaced epidermis helps tissue to heal rapidly, with short-term postoperative erythema. The results for 40 patients (8 men and 32 women) after a single session of a fractional CO(2) resurfacing mode were studied. The treatments included resurfacing of the full face, periocular upper lip, and residual acne scars. The patients had skin prototypes 2 to 4 and wrinkle degrees 1 to 3. The histologic effects, efficacy, and treatment safety in various clinical conditions and for different phototypes are discussed. The CO(2) laser for fractional treatment is used in super-pulse mode. The beam is split by a lens into several microbeams, and super-pulse repetition is limited by the pulse width. The laser needs a power adaptation to meet the set fluence per microbeam. Laser pulsing can operate repeatedly on the same spot or be moved randomly over the skin, using several passes to achieve a desired residual thermal effect. Low, medium, and high settings are preprogrammed in the device, and they indicate the strength of resurfacing. A single treatment was given with the patient under topical anesthesia. However, the anesthesia was injected on areas of scar tissue. Medium settings (2 Hz, 30 W, 60 mJ) were used, and two passes were made for dark skins and degree 1 wrinkles. High settings (2 Hz, 60 W, 120 mJ) were used, and three passes were made for degree 3 wrinkles and scar tissue. Postoperatively, resurfaced areas were treated with an ointment of gentamycin, Retinol Palmitate, and DL-methionine (Novartis; Farmaceutics, S.A., Barcelona, Spain). Once epithelialization was achieved, antipigment and sun protection agents were recommended. Evaluations were performed 15 days and 2 months after treatment by both patients and

  19. A Randomized Controlled Trial of Skin Care Protocols for Facial Resurfacing: Lessons Learned from the Plastic Surgery Educational Foundation’s Skin Products Assessment Research Study

    Science.gov (United States)

    Pannucci, Christopher J.; Reavey, Patrick L.; Kaweski, Susan; Hamill, Jennifer B.; Hume, Keith M.; Wilkins, Edwin G.; Pusic, Andrea L.

    2011-01-01

    Background The Skin Products Assessment Research (SPAR) Committee was created by the Plastic Surgery Educational Foundation (PSEF) in 2006. SPAR study aims were to (1) develop an infrastructure for PSEF-conducted, industry sponsored research in facial aesthetic surgery and (2) test the research process by comparing outcomes of the Obagi Nu-Derm System (ONDS) versus conventional therapy as treatment adjuncts for facial resurfacing procedures. Methods The SPAR study was designed as a multi-center, double-blind, randomized controlled trial (RCT). The study was conducted in women with Fitzpatrick type I-IV skin, moderate to severe facial photo damage, and peri-ocular and/or peri-oral fine wrinkles. Patients underwent chemical peel or laser facial resurfacing and were randomized to ONDS or a standard care regimen. The study endpoints were time to re-epithelization, erythema, and pigmentation changes. Results Fifty-six women were enrolled and 82% were followed beyond re-epithelization. There were no significant differences in mean time to re-epithelialization between ONDS and control groups. The ONDS group had a significantly higher median erythema score on day of surgery (after 4 weeks of product use) which did not persist after surgery. Test-retest photo evaluations demonstrated that both inter- and intra-rater reliability were adequate for primary study outcomes. Conclusions In a clinical RCT, we demonstrated no significant difference in time to re-epithelization between patients who used the ONDS or a standard care regimen as an adjunct to facial resurfacing procedures. The SPAR research team has also provided a discussion of future challenges for PSEF sponsored clinical research for readers of this article. PMID:21364435

  20. Results of fractional ablative facial skin resurfacing with the erbium:yttrium-aluminium-garnet laser 1 week and 2 months after one single treatment in 30 patients.

    Science.gov (United States)

    Trelles, Mario A; Mordon, Serge; Velez, Mariano; Urdiales, Fernando; Levy, Jean Luc

    2009-03-01

    The erbium:yttrium-aluminium-garnet (Er:YAG) laser has recently been used in the fractional resurfacing of photo-aged skin. Our study evaluated the results after one single session of fractional resurfacing with Er:YAG. Thirty women participated in the study, with an average age of 46 years, skin types from II to IV, and wrinkle grades I to III. The 2,940 nm Er:YAG system used (Pixel, Alma Laser, Israel) had variable pulse durations (1 ms to 2 ms) and energy densities (800 mJ/cm(2) to 1,400 mJ/cm(2)) which, together with the number of passes (four to eight), were selected as a function of wrinkle severity. All patients received only one treatment. Postoperative side effects were evaluated. The number of wrinkles was documented with clinical photography and was scored. Histological assessment was carried out on two patients before and 2 months after treatment. All patients completed the study. Of the patients, 93% reported good or very good improvement of the degree of their wrinkles, with a satisfaction index of 83%. Pain was not a problem during treatment, and there were no side effects except for in one phototype IV patient, who had hyperpigmentation. Histology 2 months after the single treatment demonstrated younger morphology of both the epidermis and dermis, with improvement of the pretreatment typical elastotic appearance. At the parameters used in our study, only one treatment session of Er:YAG laser could achieve effective skin rejuvenation, with effects recognized in both the dermis and, more importantly, the epidermis. This regimen offers an interesting alternative to the conventional approach of multi-session fractional resurfacing.

  1. A randomized controlled trial of skin care protocols for facial resurfacing: lessons learned from the Plastic Surgery Educational Foundation's Skin Products Assessment Research study.

    Science.gov (United States)

    Pannucci, Christopher J; Reavey, Patrick L; Kaweski, Susan; Hamill, Jennifer B; Hume, Keith M; Wilkins, Edwin G; Pusic, Andrea L

    2011-03-01

    The Skin Products Assessment Research Committee was created by the Plastic Surgery Educational Foundation in 2006. The Skin Products Assessment Research study aims were to (1) develop an infrastructure for Plastic Surgery Educational Foundation-conducted, industry-sponsored research in facial aesthetic surgery and (2) test the research process by comparing outcomes of the Obagi Nu-Derm System versus conventional therapy as treatment adjuncts for facial resurfacing procedures. The Skin Products Assessment Research study was designed as a multicenter, double-blind, randomized, controlled trial. The study was conducted in women with Fitzpatrick type I to IV skin, moderate to severe facial photodamage, and periocular and/or perioral fine wrinkles. Patients underwent chemical peel or laser facial resurfacing and were randomized to the Obagi Nu-Derm System or a standard care regimen. The study endpoints were time to reepithelialization, erythema, and pigmentation changes. Fifty-six women were enrolled and 82 percent were followed beyond reepithelialization. There were no significant differences in mean time to reepithelialization between Obagi Nu-Derm System and control groups. The Obagi Nu-Derm System group had a significantly higher median erythema score on the day of surgery (after 4 weeks of product use) that did not persist after surgery. Test-retest photographic evaluations demonstrated that both interrater and intrarater reliability were adequate for primary study outcomes. The authors demonstrated no significant difference in time to reepithelialization between patients who used the Obagi Nu-Derm System or a standard care regimen as an adjunct to facial resurfacing procedures. The Skin Products Assessment Research team has also provided a discussion of future challenges for Plastic Surgery Educational Foundation-sponsored clinical research for readers of this article.

  2. Does Hip Arthroscopy Have a Role in the Treatment of Developmental Hip Dysplasia?

    Science.gov (United States)

    Kirsch, Jacob M; Khan, Moin; Bedi, Asheesh

    2017-09-01

    Indications for hip arthroscopy in mildly dysplastic patients with a symptomatic hip remain controversial. This article provides a concise review of the available literature evaluating the role of hip arthroscopy in treating symptomatic dysplasia. Potential indications for hip arthroscopy in isolation are reviewed. Emerging evidence on the role of hip arthroscopy based on patient-specific pathomorphology is highlighted. Hip arthroscopy in isolation may be helpful for select dysplastic patients with dynamic impingement or microinstability. Isolated arthroscopic treatment of intra-articular pathology resulting from static overload is unlikely to be successful in the long term and may be detrimental. Arthroscopic procedures for individuals with mild dysplasia in the absence of frank instability may be effective; however, great caution should be exercised when approaching dysplastic patients with symptomatic hips. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Biomechanics of the Hip Capsule and Capsule Management Strategies in Hip Arthroscopy.

    Science.gov (United States)

    Nepple, Jeffrey J; Smith, Matthew V

    2015-12-01

    Recent advances in our understanding of the function of the hip capsule have clarified its importance to normal hip function and kinematics. The iliofemoral ligament is the primary stabilizing structure for controlling anterior translation and external rotation of the hip, and is violated by the arthroscopic interportal capsulotomy. Microinstability of the hip occurring after surgical trauma remains a poorly defined clinical entity. In certain at-risk populations, capsular repair should be considered as part of an arthroscopic hip procedure to achieve optimal outcomes and avoid iatrogenic instability (dislocation or microinstability). Despite a lack of conclusive evidence-based indications, we recommend capsular repair in the settings of borderline hip dysplasia (or dysplastic variants such as increased femoral anteversion), hip hypermobility, connective tissue disorders, and traumatic or atraumatic instability. With careful attention to arthroscopic capsular management, adequate exposure can be achieved and reproducibly allow for an effective capsular repair when indicated.

  4. Pertunjukan Teater Karo Hip Hop Kontemporer KAI

    Directory of Open Access Journals (Sweden)

    Silvia Anggreni Purba

    2013-11-01

    Pertunjukan Teater Karo Hip Hop Kontemporer KAI. The performance of Karo Theater collaborated with Hip Hop stems from a simple idea to collaborate Karo cultural traditions with popular culture. The performances can be enjoyed without having limitation on the language and culture. The process of combining two different cultures is a form of hybrid culture, and it may occur due to the globalization process. Through the process of deposition of the observations and strong impression, this performance is then brought into the form of Hip Hop as a preferred form which is energetic, personal and global. This performance is part of a modern tragedy with its destructive character which has explored the emotion and has presented it to the audiences. The exploration of Karo cultural tradition and Hip Hop dance as a language of symbols is able to reinforce words. The movement is not revealed by the verbal phrase but is presented through the movement of Hip Hop dance. The interpretation of the legend and texts into movement is carried out through the training process at the laboratory as a searching process and experiment, and afterward can be realized by considering the basic elements of Hip Hop, Karo cultural elements and performance. Karo Hip Hop Theatre is expected to become a preferred aesthetic form of a modern theater without losing its tradition form. Keyword: a contemporary Karo theater, Hip Hop, hybrid culture.

  5. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and reeducating gait. The specific objectives of the study consist of the particularization of the recovery programs based on age, illness stage (dysplasia or luxation and either surgical or non-surgical intervention. To show the importance of physiotherapy in gait rehabilitation of a child with hip dislocation we started from the hypothesis: using an adequate rehabilitation program after an individualized methodology, optimizes the functional recovery and ensures the gains of hip stability and the formation of an engram of gait as close as it could be to the normal one. We present a case of neurological congenital hip dislocation where the treatment initiated early is showing good results. Results obtained are significantly different and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient has better biomechanical results for the hip.

  6. Total hip arthroplasty: an editiorial comment.

    Science.gov (United States)

    Peterson, L F

    1977-09-01

    Total hip arthroplasty has become an accepted method of management of severe painful problems of the hip. It has undergone some dramatic changes, the major thrust now being to more nearly match the mechanical characteristics of the implant to the bone and cartilage they replace.

  7. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  8. Hip-hop and urban studies

    NARCIS (Netherlands)

    Jaffe, R.

    2014-01-01

    How can urban studies research engage fruitfully with hip-hop? This contribution responds to the essays by David Beer and Martin Lamotte on ‘street music’, urban ethnography and ghettoized communities. It discusses how a social science engagement with hip-hop texts might differ from cultural studies

  9. CT and MRI of hip arthroplasty

    International Nuclear Information System (INIS)

    Cahir, J.G.; Toms, A.P.; Marshall, T.J.; Wimhurst, J.; Nolan, J.

    2007-01-01

    Plain films are the initial imaging method of choice for evaluation of hip arthroplasty. Recent advances in technology and imaging techniques have largely overcome the problems of beam hardening in computed tomography (CT) and magnetic susceptibility artefact in magnetic resonance imaging (MRI). CT and MRI have now become useful imaging techniques in the assessment of hip arthroplasty

  10. History of hip arthroscopy: challenges and opportunities.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2011-04-01

    Hip arthroscopy began with resection of pathologies and later progressed to repair of different tissues. There is an increasing impetus for reconstruction of biologic joints; although this has occurred with other joints, hip arthroscopic procedures are now headed in this direction. Thus, despite considerable initial challenges, multiple opportunities are now available in this fertile field. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Avascular necrosis of the hip

    International Nuclear Information System (INIS)

    Lang, P.; Genant, H.K.; Lindquist, T.; Chafetz, N.; Steiger, P.; Sanny, J.; Rhodes, M.L.; Rothman, S.L.G.; Delamarter, R.; Kilgus, D.

    1988-01-01

    T1-weighted (repetition time [TR] = 450 msec, echo time [TE] = 20 msec), T2-weighted (TR = 1,800 msec, TE = 20 and 80 msec), and T2*-weighted gradient-echo gradient recalled acquisition in a steady state, TR = 70 msec, TE = 30 msec, theta = 15 0 ) MR images (General Electric Signa, 1.5 T) were generated in 11 patients with avascular necrosis of the hip. Three-dimensional MR image reconstruction was performed on an independent imaging system (IIS, Dimensional Medicine Inc). Pelvic and femoral bone contours were computed based on either the T1-weighted or the T2*-weighted images. Three-dimensional displays of necrotic zones and areas of granulation tissue were computed on the basis of the T2-weighted images. The tissues were simultaneously displayed in the three-dimensional images using different colors and transparencies. The three-dimensional MR images generated demonstrated the extent of the necrotic zone and adjacent granulation tissue and their position relative to the weight-bearing surface. They may soon prove to be useful in preoperative planning and intraoperative localization of complex surgical interventions in avascular necrosis of the hip

  12. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  13. Perceived loading and muscle activity during hip strengthening exercises

    DEFF Research Database (Denmark)

    Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian

    2013-01-01

    OBJECTIVE: Decreased hip muscle strength is frequently reported in patients with hip injury or pathology. Furthermore, soccer players suffering from groin injury show decreased strength of hip muscles. Estimating 10-repetition maximum can be time-consuming and difficult, thus, using the Borg...... category rating 10 scale (Borg CR10 scale) can be a useful tool for estimating the intensity of exercise. The aims of this study were 1) to investigate the feasibility of the use of the Borg CR10 scale for rating strength training intensity of the hip abductor and hip adductor muscles, and 2) to compare...... hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG). METHODS: EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women...

  14. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement

    Science.gov (United States)

    Sakellariou, Vasileios I.; Christodoulou, Michael; Sasalos, Gregory; Babis, George C.

    2014-01-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is challenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term. PMID:25386570

  15. Hip instability: a review of hip dysplasia and other contributing factors

    Science.gov (United States)

    Kraeutler, Matthew J.; Garabekyan, Tigran; Pascual-Garrido, Cecilia; Mei-Dan, Omer

    2016-01-01

    Summary Background Hip instability has classically been associated with developmental dysplasia of the hip (DDH) in newborns and children. However, numerous factors may contribute to hip instability in children, adolescents, and adults. Purpose This review aims to concisely present the literature on hip instability in patients of all ages in order to guide health care professionals in the appropriate diagnosis and treatment of the various disorders which may contribute to an unstable hip. Methods We reviewed the literature on the diagnosis and surgical management of hip dysplasia and other causes of hip instability. Conclusions Multiple intra- and extra-articular variables may contribute to hip instability, including acetabular bony coverage, femoral torsion, femoroacetabular impingement, and soft tissue laxity. Physical examination and advanced imaging studies are essential to accurately diagnose the pathology contributing to a patient’s unstable hip. Conservative management, including activity modification and physical therapy, may be used as a first-line treatment in patients with intra-articular hip pathology. Patients who continue to experience symptoms of pain or instability should proceed with arthroscopic or open surgical treatment aimed at correcting the underlying pathology. Level of evidence V. PMID:28066739

  16. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement.

    Science.gov (United States)

    Sakellariou, Vasileios I; Christodoulou, Michael; Sasalos, Gregory; Babis, George C

    2014-09-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is challenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  17. Assessment of the hip reduction angle for predicting osteoarthritis of the hip in the Labrador Retriever.

    Science.gov (United States)

    Corfield, G S; Read, R A; Eastley, K A; Richardson, J L; Robertson, I D; Day, R

    2007-06-01

    Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.

  18. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  19. Effect of position and alteration in synergist muscle force contribution on hip forces when performing hip strengthening exercises.

    Science.gov (United States)

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

    2009-01-01

    Understanding the magnitude and direction of joint forces generated by hip strengthening exercises is essential for appropriate prescription and modification of these exercises. The purpose of this study was to evaluate hip joint forces created across a range of hip flexion and extension angles during two hip strengthening exercises: prone hip extension and supine hip flexion. A musculoskeletal model was used to estimate hip joint forces during simulated prone hip extension and supine hip flexion under a control condition and two altered synergist muscle force conditions. Decreased strength or activation of specific muscle groups was simulated by decreasing the modeled maximum force values by 50%. For prone hip extension, the gluteal muscle strength was decreased in one condition and the hamstring muscle strength in the second condition. For supine hip flexion, the strength of the iliacus and psoas muscles was decreased in one condition, and the rectus femoris, tensor fascia lata, and sartorius muscles in the second condition. The hip joint forces were affected by hip joint position and partially by alterations in muscle force contribution. For prone hip extension, the highest net resultant force occurred with the hip in extension and the gluteal muscles weakened. For supine hip flexion, the highest resultant forces occurred with the hip in extension and the iliacus and psoas muscles weakened. Clinicians can use this information to select exercises to provide appropriate prescription and pathology-specific modification of exercise.

  20. Self-management behaviour and support among primary care COPD patients: cross-sectional analysis of data from the Birmingham Chronic Obstructive Pulmonary Disease Cohort.

    Science.gov (United States)

    Khan, Ainee; Dickens, Andrew P; Adab, Peymane; Jordan, Rachel E

    2017-07-20

    Self-management support for chronic obstructive pulmonary disease (COPD) patients is recommended by UK national guidelines, but extent of implementation is unknown. We aimed to describe self-management behaviour and support among COPD patients and explore behaviour associated with having a self-management plan. We undertook cross-sectional analysis of self-reported data from diagnosed COPD patients in the Birmingham COPD Cohort study. Questionnaire items relevant to self-management behaviour, knowledge of COPD, receipt of self-management plans and advice from healthcare professionals were examined. Multiple regression models were used to identify behaviour associated with having a self-management plan. One-thousand seventy-eight participants (676 males, 62.7%, mean age 69.8 (standard deviation 9.0) years) were included. The majority reported taking medications as instructed (940, 94.0%) and receiving annual influenza vaccinations (962, 89.2%). Only 400 (40.4%) participants had self-management plans, 538 (49.9%) reported never having received advice on diet/exercise and 110 (42.7%) current smokers had been offered practical help to stop smoking in the previous year. General knowledge about COPD was moderate (mean total Bristol COPD Knowledge Questionnaire score: 31.5 (standard deviation 10.7); max score 65), corresponding to 48.5% of questions answered correctly. Having a self-management plan was positively associated with self-reported adherence to medication (odds ratio 3.10, 95% confidence interval 1.43 to 6.72), attendance at a training course (odds ratio 2.72, 95% confidence interval 1.81 to 4.12), attendance at a support group (odds ratio 6.28, 95% confidence interval 2.96 to 13.35) and better disease knowledge (mean difference 4.87, 95% confidence interval 3.16 to 6.58). Primary care healthcare professionals should ensure more widespread implementation of individualised self-management plans for all patients and improve the lifestyle advice provided. CALL FOR

  1. Hip joint mobility in dancers: preliminary report.

    Science.gov (United States)

    Drężewska, Marlena; Gałuszka, Renata; Sliwiński, Zbigniew

    2012-01-01

    The aim of this study was to evaluate the impact of dancing on hip joint mobility and to assess the relationship between active movements of the hips and injuries among dancers, which may be important in planning rehabilitation in this group. The sample comprised 49 dancers (37 women and 12 men) aged 15 to 32 years. The participants were the professional dancers of the Kielce Dance Theatre and members of two youth jazz dance teams from the Kielce Dance Theatre. The active range of motion of the hips was measured in three planes using a goniometer in order to assess the influence of dance training on hip joint mobility. A questionnaire-based survey was also conducted. The range of flexion, extension and external rotation was significantly greater in the group of long-time dancers (p <0.05). There was a significantly greater range of flexion, abduction and external rotation in previously injured hip joints (p<0.05). 1. Injuries to hip joints in dancers may result in increased ranges of motion, which may lead to disturbances of joint stability. 2. Being a long-time dancer and the female gender were associated with an increased range of hip joint motion.

  2. Mechanical Evaluation of Polymer Composite Hip Protectors

    Directory of Open Access Journals (Sweden)

    Jose Daniel Diniz Melo

    2010-01-01

    Full Text Available Hip fractures often result in serious health implications, particularly in the geriatric population, and have been related to long-term morbidity and death. In most cases, these fractures are caused by impact loads in the area of the greater trochanter, which are produced in a fall. This work is aimed at developing hip protectors using composite materials and evaluating their effectiveness in preventing hip fractures under high impact energy (120 J. The hip protectors were developed with an inner layer of energy absorbing soft material and an outer rigid shell of fiberglass-reinforced polymer composite. According to the experimental results, all tested configurations proved to be effective at reducing the impact load to below the average fracture threshold of proximal femur. Furthermore, an addition of Ethylene Vinyl Acetate (EVA to the impacted area of the composite shell proved to be beneficial to increase impact strength of the hip protectors. Thus, composite hip protectors proved to be a viable alternative for a mechanically efficient and cost-effective solution to prevent hip fractures.

  3. Pain in the hip joint

    Directory of Open Access Journals (Sweden)

    Yuri Aleksandrovich Olyunin

    2013-01-01

    Full Text Available Pathological changes that develop in the hip joints (HJ have different origins and mechanisms of development, but their main manifestation is pain. The nature of this pain cannot be well established on frequent occasions. The English-language medical literature currently classifies such disorders as greater trochanter pain syndrome (GTPS. Its major signs are chronic pain and local palpatory tenderness in the outer part of HJ. The development of GTPS may be associated with inflammation of the synovial bursae situated in the greater tronchanter, as well as with tendinitis, myorrhexis, iliotibial band syndrome, and other local changes in the adjacent tissues or with systemic diseases. So GTPS may be characterized as regional pain syndrome that frequently mimics pain induced by different diseases, including myofascial pain syndrome, osteoarthrosis, spinal diseases, etc.

  4. Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis.

    Science.gov (United States)

    Feng, Dong-Xu; Zhang, Kun; Zhang, Yu-Min; Nian, Yue-Wen; Zhang, Jun; Kang, Xiao-Min; Wu, Shu-Fang; Zhu, Yang-Jun

    2016-08-01

    Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results. At a mean follow-up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow-up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain-free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow-up in any patient, nor had any revision surgery been required. Bilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and

  5. Traumatic hip dislocation; a South East Nigeria hospital experience ...

    African Journals Online (AJOL)

    Background: Hip dislocation is a relatively common orthopaedic emergency. The hip is an inherently stable joint and substantial force is required for dislocation to occur. Thus hip dislocation is said to follow motor vehicle accidents with more than 90% of hip dislocations being posterior. Thompson and Epstein grade I and II ...

  6. Romani Music - Roma and the Hip-hop Culture

    OpenAIRE

    Dočkal, Tomáš

    2007-01-01

    This thesis is focused on Romani music and its importance for the Romani culture. It examines the popularity of hip-hop among the young Romani generation and Romani hip- hip production. It attempts to define the role of hip-hop culture in young Romanies' lives.

  7. Radiation injury of both hip joints. A case report

    International Nuclear Information System (INIS)

    Tanaka, Naohiro; Enomoto, Hiroshi; Okano, Kunihiko; Osaki, Makoto; Goto, Hisataka; Shindo, Hiroyuki

    2008-01-01

    We report a 70-year-old female patient with a history of pelvic irradiation for the treatment of vaginal cancer. The interval from irradiation to the onset of pain in the hip was 23 months (right hip) and 46 months (left hip). Radiogram and MRI showed rapid and wide changes in the femoral neck and hip joints after the onset of pain. (author)

  8. The legacy of chlorinated solvents in the Birmingham aquifer, UK: observations spanning three decades and the challenge of future urban groundwater development.

    Science.gov (United States)

    Rivett, Michael O; Turner, Ryan J; Glibbery Née Murcott, Penny; Cuthbert, Mark O

    2012-10-01

    Licensed abstraction well data collected during 1986-2008 from a total of 77 wells mainly located at industrial sites combined with historic land use data from 1975 has allowed insight into the legacy of chlorinated solvent contamination in the Birmingham aquifer that underlies the UK's second largest city. This legacy, expected to be reasonably symptomatic of those occurring in other urban aquifers, was characterised by: dominance of parent solvents, particularly TCE (trichloroethene) that widely exceeded drinking-water quality criteria; greater TCE occurrence in wells in proximity to increased historic land use by the metal/engineering solvent-user industry (the relationship providing a first-pass indicator of future resource development potential); regional groundwater vulnerability controls; well abstraction changes (over months to decades) influential of observed concentration transients and anticipated plume capture or release; persistence of contamination over decades (with less soluble PCE (perchloroethene) showing increased persistence relative to TCE) that was reasonably ascribed to slow contaminant release from DNAPL (dense non-aqueous phase liquid) sources and, or low permeability layers; presence of dechlorination products arising from solvent (bio)degradation, although this key attenuation process appeared to have moderate to weak influence regionally on plumes; and, inadvertent, but significant solvent mass removal from the aquifer by industrial abstractions. Key challenges to realising future urban groundwater development were identified based on the observed legacy and well capture zone simulations. Despite the extensive contamination of the aquifer, it should still be possible to develop wells of high (several megalitres per day) capacity for drinking water supply (or other lower grade uses) without the requirement for solvent treatment. In those areas with higher risk of contamination, our dataset, together with application of emergent risk

  9. The hip abductors at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  10. The ligamentum teres of the adult hip.

    Science.gov (United States)

    Bardakos, N V; Villar, R N

    2009-01-01

    Advances in hip arthroscopy have renewed interest in the ligamentum teres. Considered by many to be a developmental vestige, it is now recognised as a significant potential source of pain and mechanical symptoms arising from the hip joint. Despite improvements in imaging, arthroscopy remains the optimum method of diagnosing lesions of the ligamentum teres. Several biological or mechanical roles have been proposed for the ligament. Unless these are disproved, the use of surgical procedures that sacrifice the ligamentum teres, as in surgical dislocation of the hip, should be carefully considered. This paper provides an update on the development, structure and function of the ligamentum teres, and discusses associated clinical implications.

  11. 14th September 2010 - UK Birmingham University Vice Chancellor D. Eastwood signing the guest book with Director for Accelerators and Technology S. Myers (CERN-HI-1009225 13-22)

    CERN Multimedia

    Maximilien Brice

    2010-01-01

    (CERN-HI-1009225 02-12): visiting the LHC superconducting magnet test hall with Beams Department Head P. Collier; (CERN-HI-1009225 27-34): visiting the ATLAS visitor centre with Collaboration Spokesperson F. Gianotti and Deputy D. Charlton, University of Birmingham. D.Eastwood is accompnied by Pro-Vice-Chancellor and Head of College (Engineering and Physical Sciences) N. Weatherill and Head of School, School of Physics & Astronomy A.Schofield.

  12. The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles

    OpenAIRE

    Chan, Mandy KY; Chow, Ka Wai; Lai, Alfred YS; Mak, Noble KC; Sze, Jason CH; Tsang, Sharon MH

    2017-01-01

    Background Core stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application o...

  13. Outcome after early mobilization following hip reconstruction in children with developmental hip dysplasia and luxation.

    Science.gov (United States)

    Gather, Katharina Susanne; von Stillfried, Eva; Hagmann, Sebastien; Müller, Sebastian; Dreher, Thomas

    2018-02-20

    Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia. This challenging treatment may be associated with complications. Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction. Twenty-seven children (3.4±2.0 years), including 33 hips with developmental hip dysplasia (DDH) and dislocation of the hip (Tönnis grade 1 to 4), who underwent hip reconstruction (Dega acetabuloplasty, varisation-derotation osteotomy and facultative open reduction) were retrospectively included in this study. Postoperatively the patients were placed in an individual foam shell with 30 degrees of hip abduction, hip extension, and neutral rotation. Early mobilization physiotherapy was performed within the first few days after the surgery under epidural anaesthesia. Full weight bearing was allowed after 3-4 weeks. All children received a clinical examination and radiographic evaluation before and after surgical intervention. The follow-up period was 12.3±2.9 months. On average, the postoperative acetabular index decreased significantly from 36.9 to 21.7 degrees and the center-edge angle increased from 9.9 to 28.6 degrees. All hips had reached Tönnis grade 1 at the time of the last follow-up. No complications such as dislocation of the bone wedge, avascular necrosis of the acetabulum or femur, lack of non-union, or nerve injury, were reported. In this cohort study, hip reconstruction was successful according to clinical and radiographic outcome parameters after early mobilization without cast therapy. Early mobilization may be used as an alternative treatment option after hip reconstruction in DDH.

  14. Hip Distraction Without a Perineal Post: A Prospective Study of 1000 Hip Arthroscopy Cases.

    Science.gov (United States)

    Mei-Dan, Omer; Kraeutler, Matthew J; Garabekyan, Tigran; Goodrich, Jesse A; Young, David A

    2018-03-01

    Hip arthroscopy has traditionally been performed with a perineal post, resulting in various groin-related complications, including pudendal nerve neurapraxias, vaginal tears, and scrotal necrosis. To assess the safety of a technique for hip distraction without the use of a perineal post. Case series; Level of evidence, 4. We prospectively analyzed a consecutive cohort of 1000 hips presenting to a dedicated hip preservation clinic; all patients had hip pain and were subsequently treated with hip arthroscopy. Demographic variables, hip pathology, and lateral center edge angle were recorded for each case. In the operating room, the patient's feet were placed in traction boots in a specifically designed distraction setup, and the operative table was placed in varying degrees of Trendelenburg. With this technique, enough resistance is created by gravity and friction between the patient's body and the bed to allow for successful hip distraction without the need for a perineal post. In a subset of 309 hips (n = 281 patients), the degrees of Trendelenburg as well as the distraction force were analyzed. The mean ± SD Trendelenburg angle used among the subset of 309 hips was 11° ± 2°. The mean initial distraction force necessary was 90 ± 28 lb, which decreased to 65 ± 24 lb by 30 minutes after traction initiation ( P edge angle ( P < .01). No groin-related complications occurred among the entire cohort of patients, including soft tissue or nerve-related complications. The rate of deep venous thrombosis was 2 in 1000. The use of the Trendelenburg position and a specially designed distraction setup during hip arthroscopy allows for safe hip distraction without a perineal post, thereby eliminating groin-related soft tissue and nerve complications. Certain patient variables can be used to estimate the required distraction force and inclination angle with this method.

  15. Influence of Hip Joint Position on Muscle Activity during Prone Hip Extension with Knee Flexion

    OpenAIRE

    Suehiro, Tadanobu; Mizutani, Masatoshi; Okamoto, Mitsuhisa; Ishida, Hiroshi; Kobara, Kenichi; Fujita, Daisuke; Osaka, Hiroshi; Takahashi, Hisashi; Watanabe, Susumu

    2014-01-01

    [Purpose] This study investigated the selective activation of the gluteus maximus during a prone hip extension with knee flexion exercise, with the hip joint in different positions. [Subjects] The subjects were 21 healthy, male volunteers. [Methods] Activities of the right gluteus maximus, right hamstrings, bilateral lumbar erector spinae, and bilateral lumbar multifidus were measured using surface electromyography during a prone hip extension with knee flexion exercise. Measurements were mad...

  16. 21 CFR 888.3390 - Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented or uncemented prosthesis. 888.3390 Section 888.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 888.3390 Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis is a two-part...

  17. 21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... metal/polyacetal cemented prosthesis. 888.3380 Section 888.3380 Food and Drugs FOOD AND DRUG... Devices § 888.3380 Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis is a two...

  18. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults.

    NARCIS (Netherlands)

    Arvin, M.; Hoozemans, M.J.M.; Burger, B.J.; Rispens, S.M.; Verschueren, S.; van Dieen, J.H.; Pijnappels, M.A.G.M.

    2015-01-01

    We experimentally investigated whether unilateral hip abductor muscle fatigue affected gait control and hip position sense in older adults. Hip abductor muscles were fatigued unilaterally in side-lying position in 17 healthy older adults (mean age 73.2 SD 7.7 years). Hip joint position sense was

  19. Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2010-01-01

    Full Text Available Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1. We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  20. Total Hip Arthroplasty after Treatment of Pseudojoint Infection in a Patient with a Highly Dislocated Hip

    Directory of Open Access Journals (Sweden)

    Kyung-Soon Park

    2013-01-01

    Full Text Available Infection at the pseudoacetabulum in a patient with a high hip dislocation has not been reported previously in the English literature. We report a case of total hip arthroplasty in a 28-year-old female who presented to us with hip pain following debridement of the infected pseudojoint in a case of neglected developmental dysplasia of the hip. The infection was treated with thorough debridement and drainage. However, even after achieving complete infection control, this patient complained of disabling right hip joint pain. Total hip arthroplasty with subtrochanteric osteotomy was performed to relieve the pain and improve gait. After surgery, the patient's symptoms were relieved. We consider that in this case of acute pseudojoint infection simple arthrotomy and debridement combined with irrigation and drainage provide effective treatment. But muscle weakness and more increased joint laxity can cause hip pain even after infection control. So total hip arthroplasty is likely to be necessary after the infection has been controlled in a patient with a highly dislocated hip.

  1. [Effect of ceramic on ceramic total hip arthroplasty in Crowe IV developmental dysplasia of the hip].

    Science.gov (United States)

    Sun, Jing-Yang; Zhou, Yong-Gang; Du, Yin-Qiao; Piao, Shang; Wang, Sen; Gao, Zhi-Sen; Wu, Wen-Ming; Ma, Hai-Yang

    2018-02-25

    To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe IV developmental dysplasia of the hip(DDH). From April 2008 to December 2015, 137 hips of 111 Crowe IV DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon, which consists of 85 unilateral hips and 26 bilateral hips. The average age of the patients was(38.88±10.83) years old ranging from 18 to 68 years old. The mean follow-up was(41.16±21.50) months ranging from 12 to 96 months. All the patients were evaluated by Harris Hip Score. Radiographic evaluations were made preoperatively and during follow-up. Harris scores, the incidence of complications such as ceramic fracture, squeaking, dislocation were observed. The mean preoperative Harris score was 56.54±15.67, the mean postoperative Harris score was 88.30±6.86( P =0.017). Periprosthetic osteolysis was not deteced around any cup. No ceramic fracture occurred. There were 3 cases of revision surgery due to infection, losening of the stem and limb length discrepancy, respectively; 3 cases of dislocation occurred. Seventy-seven patients were recorded the gait and the hip mobility, the hip flexion of 69 patients were above 120 degrees. Ceramic on ceramic bearing showed an encouraging result in Crowe IV DDH total hip arthroplasty. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

  2. MR imaging of the hip

    International Nuclear Information System (INIS)

    Kramer, J.

    2006-01-01

    Full text: MRI has been shown to gain increasing importance in recent years in the evaluation of disorders of the hip and pelvis. Nowadays, conventional or fast spin echo (T1, Turbo (Fast) T2 (or PD)) MR imaging sequences are used most commonly to examine the hip and pelvis. Three dimensional (3D) gradient echo (GE) imaging allows acquisition of very thin (1 mm) sections. MR imaging with fat suppression technique (STIR, TIRM, FAT SAT T2) represent an effective screening technique for the assessment of fluid, hemorrhage, pus, or tumor in the marrow, joint or soft tissues. These techniques increase the sensitivity for the detection of a variety of pathologic processes. Fat suppression MR imaging, when combined with intravenous (or intraarticular) administration of a gadolinium compound, also is effective and often is employed when evaluating neoplastic or infectious diseases (intravenous injection), abnormalities of articular cartilage or labrum, or possible intraarticular osteocartilaginous bodies (intraarticular injection). A lesion of the acetabular labrum based is one cause of chronic hip pain in patients with developmental dysplasia of the hips, as well as in patients with a history of hip trauma or femoroacetabular impingement. MR imaging and, in particular, MR arthrography, however, have been shown to be highly accurate in the detection of subtle intraarticular abnormalities such as labral lesion. Conventional MR imaging has shown poor accuracy in detecting labral lesions, due to its inability to depict small tears and the difficulty in determining if intralabral signal abnormalities extend to the surface of the labrum. MR arthrography, however has been shown to overcome these difficulties and to have excellent accuracy in detecting labral pathology. As labral abnormalities are believed to be a precursor of osteoarthritis, orthopedic surgeons believe that surgical intervention will be influenced substantially by the type, extension and location of labral

  3. Atraumatic Anterior Dislocation of the Hip Joint

    Directory of Open Access Journals (Sweden)

    Tadahiko Ohtsuru

    2015-01-01

    Full Text Available 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.

  4. Idiopathic chondrolysl;s, of the hip

    African Journals Online (AJOL)

    stimulating hormone, cortisol and salicylate values; and tests for suspected haemoglobinopathies, .... range of movement exercises. Her affected hip became free of pain, but mobility did not improve significantly. Discussion. Golding2 and Mankin el al.

  5. Abduction contracture of the hip in children.

    Science.gov (United States)

    Shen, Y S

    1975-11-01

    Nine cases of abduction contracture of the hip in children from contracture of the gluteus maximus muscle are reported. Division of the aponeurosis glutens maximus over the greater trochanter always permitted full adduction.

  6. Hip-hop, Onegin - pop! / Tatjana Aleksandrova

    Index Scriptorium Estoniae

    Aleksandrova, Tatjana, 1945-

    2004-01-01

    Erateatrikooli KS, mida juhib Svetlana Krassman, lavastus A. Pushkini poeemi "Jevgeni Onegin" motiividel. Noortelavastuse muusikalises seades kasutatakse klassikalise muusika aranzheeringuid ja räppi, kostüümidraamat koos hip-hop rõivastiiliga

  7. Traction-related problems after hip arthroscopy

    DEFF Research Database (Denmark)

    Frandsen, Lone; Lund, Bent; Grønbech Nielsen, Torsten

    2017-01-01

    . The questionnaire included questions on patients' perceptions of traction-related problems in the groin area, at the knee and ankle and how patients had coped with these problems. A total of 100 consecutive patients undergoing hip arthroscopy filled out the questionnaire. Primary findings of this study were that 74......% of patients reported some sort of traction-related problems after hip arthroscopy. About 32% of the patients had problems in the groin area and 49% of the patients complained of symptoms in the knee joint. A total of 37% of the patients had experienced problems from the traction boot in the ankle area....... The complications were found to be temporary and disappeared after 2-4 weeks. Five patients still had complaints after 3 months. All five patients had a pre-existing knee injury prior to undergoing hip arthroscopy. Traction-related problems after hip arthroscopy are a challenge and our study showed that 74...

  8. MR imaging of normal hip anatomy.

    Science.gov (United States)

    Chang, Connie Y; Huang, Ambrose J

    2013-02-01

    Understanding normal anatomy of the hip is important for diagnosing its pathology. MR arthrography is more sensitive for the detection of intra-articular pathology than noncontrast MR imaging. Important elements of the osseous structures on MR imaging include the alignment and the marrow. Acetabular ossicles may be present. Normal variations involving the cartilage include the supra-acetabular fossa and the stellate lesion. Important muscles of the hip are the sartorius, rectus femoris, iliopsoas, gluteus minimus and medius, adductors, and hamstrings. The iliofemoral, ischiofemoral, and pubofemoral ligaments represent thickenings of the joint capsule that reinforce and stabilize the hip joint. Normal variations in the labrum include labral sulcus and absent labrum. The largest nerves in the hip and thigh are the sciatic nerve, the femoral nerve, and the obturator nerve. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Epidemiology of hip fracture: Worldwide geographic variation

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2011-01-01

    Full Text Available Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.

  10. Imaging findings in external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamurthy, Ganesh; Connolly, Bairbre L. [The Hospital for Sick Children, Image Guided Therapy, Diagnostic Imaging, Toronto (Canada); Narayanan, Unni [The Hospital for Sick Children, Pediatric Orthopedic Surgery, Toronto (Canada); Babyn, Paul S. [The Hospital for Sick Children, Diagnostic Imaging, Toronto (Canada)

    2007-12-15

    We describe a case of external snapping hip diagnosed by dynamic sonography. The case prompted us to retrospectively review the imaging findings of children who clinically had presented with snapping hip. From this review we identified the features on MRI and CT of either thickening of the iliotibial band or thickening of the anterior edge of the gluteus maximus muscle as the cause of snapping and atrophy of the bulk of gluteus maximus muscle as an important secondary sign associated with snapping. (orig.)

  11. Hip fracture audit: the Nottingham experience.

    Science.gov (United States)

    Gunasekera, N; Boulton, C; Morris, C; Moran, C

    2010-12-01

    The hip fracture audit in Nottingham started in May 1999. Using our data, we have developed the Nottingham Hip Fracture score and are able to predict long-term survival. High quality data collection is best achieved by trained staff dedicated to data collection and analysis. We have found it very cost-effective to train audit clerks in basic data analysis and statistical techniques, allowing for rapid analysis of data. We have developed a pre-operative scoring system to predict 30-day mortality for patients undergoing hip fracture surgery and the score is calculated for all patients over 65 years. In 2008, our audit data were used to assess mortality associated with hip fractures in the geriatric population at 5 years, and to identify the influence of pre-operative age, cognitive state, mobility and residential status on long-term survival. This study allows us to identify patients with a higher chance of long-term survival and consider surgical management that may provide a better long-term outcome. The prevalence of hip fracture in our population has steadily increased over the past decade and we are able to report a fall in the 30-day mortality and the 1-year mortality with time. Using the Nottingham Hip Fracture score which identifies patients pre-operatively that are at high risk of mortality has proved extremely useful in clinical practise. The United Kingdom National Hip Fracture Database was established in 2007 to improve the quality and cost-effectiveness of care for hip fracture patients. Variation in quality of care should be reduced between units and best practise adopted throughout the health service.

  12. Correlation of the Type and Form of Hip Osteoarthritis Progression with Forms of the Hip-Spine Syndrome

    Directory of Open Access Journals (Sweden)

    H.V. Gaiko

    2015-08-01

    Slow-progressing form and hyperplastic type of hip osteoarthritis by Bombelli corresponds to the true form of hip-spine syndrome. Fast-progressing form and hypoplastic type of hip osteoarthritis by Bombelli corresponds to the reversible form of hip-spine syndrome. Such relationships contribute to a better understanding of the pathogenesis of hip-spine syndrome and the development of effective methods for the prevention and treatment of this severe orthopedic pathology.

  13. Hip joint pain in children with cerebral palsy and developmental dysplasia of the hip: why are the differences so huge?

    OpenAIRE

    Grzegorzewski, Andrzej; Jóźwiak, Marek; Pawlak, Maciej; Modrzewski, Tadeusz; Buchcic, Piotr; Masłoń, Adrian

    2014-01-01

    Backgrounds Non-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future? Methods Material included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children ...

  14. Reverse hybrid total hip arthroplasty

    Science.gov (United States)

    Wangen, Helge; Havelin, Leif I; Fenstad, Anne M; Hallan, Geir; Furnes, Ove; Pedersen, Alma B; Overgaard, Søren; Kärrholm, Johan; Garellick, Göran; Mäkelä, Keijo; Eskelinen, Antti; Nordsletten, Lars

    2017-01-01

    Background and purpose The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty Register Association (NARA) has already published 2 papers describing results of reverse hybrid THAs in different age groups. Based on data collected over 2 additional years, we wanted to perform in depth analyses of not only the reverse hybrid concept but also of the different cup/stem combinations used. Patients and methods From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk of revision. The main endpoint was revision for any reason. We also performed specific analyses regarding the different reasons for revision and analyses regarding the cup/stem combinations used in more than 500 cases. Results We found a higher rate of revision for reverse hybrids than for cemented THAs, with an adjusted relative risk of revision (RR) of 1.4 (95% CI: 1.3–1.5). At 10 years, the survival rate was 94% (CI: 94–95) for cemented THAs and 92% (95% CI: 92–93) for reverse hybrids. The results for the reverse hybrid THAs were inferior to those for cemented THAs in patients aged 55 years or more (RR =1.1, CI: 1.0–1.3; p revision due to periprosthetic femoral fracture for reverse hybrids than for cemented THAs in patients aged 55 years or more (RR =3.1, CI: 2.2–4.5; p revision than cemented THAs in patients aged 55 or more. The difference in survival was mainly caused by a higher incidence of early revision due to periprosthetic femoral fracture in the reversed hybrid THAs. PMID:28095724

  15. Diagnosis of infection after total hip arthroplasty

    International Nuclear Information System (INIS)

    Itasaka, Toshio; Kawai, Akira; Sato, Toru; Mitani, Shigeru; Inoue, Hajime

    2001-01-01

    Forty-eight total hip arthroplasties for which revision surgery was performed were reviewed to determine the accuracy of laboratory tests, plain radiographs, hip aspiration, and technetium-99m MDP and gallium-67 scans in demonstrating the presence or absence of infection of the prosthesis. Six of the 48 hips were diagnosed as having an infection at the revision surgery. The erythrocyte sedimentation rate and the C-reactive protein levels were significantly higher in the patients with infected prostheses. The difference in the white blood cell count was not significant. There was no significant relationship between the presence of infection and the severity of loosening and instability of the implants diagnosed by plain radiographs. The accuracy of hip aspiration in diagnosing the infection was 83%, with a sensitivity of 40% and a specificity of 92%. The accuracy of technetium-99m MDP bone scan was 79%, with a sensitivity of 83%, and a specificity of 79%. Gallium-67 scan had an accuracy of 96%, a sensitivity of 67%, and a specificity of 100%. The findings in the present study indicated that diagnostic tests consisting of laboratory tests and plain radiography, followed by hip aspiration and sequential use of technetium-99m MDP and gallium-67 scintigraphies, are suitable for differentiation between mechanical loosening and infection of total hip arthroplasty. (author)

  16. Diagnosis of infection after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Itasaka, Toshio; Kawai, Akira; Sato, Toru; Mitani, Shigeru; Inoue, Hajime [Okayama Univ. (Japan). School of Medicine

    2001-07-01

    Forty-eight total hip arthroplasties for which revision surgery was performed were reviewed to determine the accuracy of laboratory tests, plain radiographs, hip aspiration, and technetium-99m MDP and gallium-67 scans in demonstrating the presence or absence of infection of the prosthesis. Six of the 48 hips were diagnosed as having an infection at the revision surgery. The erythrocyte sedimentation rate and the C-reactive protein levels were significantly higher in the patients with infected prostheses. The difference in the white blood cell count was not significant. There was no significant relationship between the presence of infection and the severity of loosening and instability of the implants diagnosed by plain radiographs. The accuracy of hip aspiration in diagnosing the infection was 83%, with a sensitivity of 40% and a specificity of 92%. The accuracy of technetium-99m MDP bone scan was 79%, with a sensitivity of 83%, and a specificity of 79%. Gallium-67 scan had an accuracy of 96%, a sensitivity of 67%, and a specificity of 100%. The findings in the present study indicated that diagnostic tests consisting of laboratory tests and plain radiography, followed by hip aspiration and sequential use of technetium-99m MDP and gallium-67 scintigraphies, are suitable for differentiation between mechanical loosening and infection of total hip arthroplasty. (author)

  17. Developing a sustainable hip service in Cambodia.

    Science.gov (United States)

    Holt, Jacquelyn A; Aird, James J; Gollogly, James G; Ngiep, Ou C; Gollogly, Sohrab

    2014-01-01

    Initial report on establishment of a hip service in Phnom Penh, Cambodia at Children's Surgical Centre. We describe indications for total hip replacement (THR) and initial results. A database was established to collect data and track patients for follow up. Initial data collected included; diagnosis, implant used, post-operative complications. As the service developed, pre- and postoperative Harris hip scores were included. High rate of avascular necrosis (AVN) as the initial diagnosis. Five years post initiation of the hip service, 95 patients have received 116 THRs; including 10 revisions, 12 bilateral procedures. Complications/failures requiring revision involved four prosthetic femoral neck fractures, two aseptic acetabular component, two late infections, one instability. One failure, a periprosthetic acetabular fracture, required removal of all prosthetics. Complications not requiring revision, included three post-op foot drops, three superficial wound infections, one Vancouver B1 periprosthetic femur fracture. Average age was 41. Overall implant survival is 85% at three years. AVN was the most common indication for THR: many patients had a history of hip trauma, and/or prolonged steroids from traditional healers for pain. Problems with specific implants were addressed by the company. A different stem is now routinely used, no further fractures have been reported. Acetabular loosening, thought to be due to poor technique, has been addressed by focused training. Infection rate is monitored, and microbiology resources are improving. Developing an affordable hip arthroplasty service in a country like Cambodia is challenging. Developing a local registry has helped to identify complications and modify techniques.

  18. The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles.

    Science.gov (United States)

    Chan, Mandy Ky; Chow, Ka Wai; Lai, Alfred Ys; Mak, Noble Kc; Sze, Jason Ch; Tsang, Sharon Mh

    2017-07-21

    Core stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application of core exercises to promote training and rehabilitation outcome of the hip region. The aim of the present study was to examine the effects of abdominal core activation, which is monitored directly by surface electromyography (EMG), on hip muscle activation while performing different hip exercises, and to explore whether participant characteristics such as gender, physical activity level and contractile properties of muscles, which is assessed by tensiomyography (TMG), have confounding effect to the activation of hip muscles in enhanced core condition. Surface EMG of bilateral internal obliques (IO), upper gluteus maximus (UGMax), lower gluteus maximus (LGMax), gluteus medius (GMed) and biceps femoris (BF) of dominant leg was recorded in 20 young healthy subjects while performing 3 hip exercises: Clam, side-lying hip abduction (HABD), and prone hip extension (PHE) in 2 conditions: natural core activation (NC) and enhanced core activation (CO). EMG signals normalized to percentage of maximal voluntary isometric contraction (%MVIC) were compared between two core conditions with the threshold of the enhanced abdominal core condition defined as >20%MVIC of IO. Enhanced abdominal core activation has significantly promoted the activation level of GMed in all phases of clam exercise (P activity level and TMG parameters were not major covariates to activation of hip muscles under enhanced core condition. Abdominal core activation enhances the hip muscles recruitment in Clam, HABD and PHE

  19. Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

    Science.gov (United States)

    Jackson, K A; Glyn-Jones, S; Batt, M E; Arden, N K; Newton, J L

    2015-01-01

    Objective Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with activity-related hip pain who are at risk of early hip OA is currently lacking. The purpose of this study was to gain expert consensus on which key clinical measures might help predict the risk of early hip OA in individuals presenting with activity-related hip pain. The agreed measures would constitute a standardised approach to initial clinical assessment to help identify these individuals. Methods This Dephi study used online surveys to gain concordance of expert opinion in a structured process of ‘rounds’. In this study, we asked ‘What outcome measures are useful in predicting hip OA in activity-related hip pain?’ The Delphi panel consisted of experts from sport and exercise medicine, orthopaedics, rheumatology, physiotherapy and OA research. Results The study identified key clinical measures in the history, examination and investigations (plain anteroposterior radiograph and femoroacetabular impingement views) that the panel agreed would be useful in predicting future risk of hip OA when assessing activity-related hip pain. The panel also agreed that certain investigations and tests (eg, MR angiography) did not currently have a role in routine assessment. There was a lack of consensus regarding the role of MRI, patient-reported outcome measures (PROMs) and certain biomechanical and functional assessments. Conclusions We provide a standardised approach to the clinical assessment of patients with activity-related hip pain. Assessment measures rejected by the Delphi panel were newer, more expensive investigations that currently lack evidence. Assessment measures that did not reach consensus include MRI and PROMs. Their role remains ambiguous and would benefit from further

  20. Do cobalt and chromium levels predict osteolysis in metal-on-metal total hip arthroplasty?

    Science.gov (United States)

    Renner, Lisa; Schmidt-Braekling, Tom; Faschingbauer, Martin; Boettner, Friedrich

    2016-12-01

    Serum metal ions are part of the regular follow-up routine of patients with metal-on-metal total hip arthroplasties (MoM-THA). Increased cobalt levels have been suggested to indicate implant failure and corrosion. (1) Is there a correlation between the size of the osteolysis measured on a CT scan and metal ion levels? (2) Can metal ion levels predict the presence of osteolysis in MoM-THA? (3) Are cobalt and chromium serum levels or the cobalt-chromium-ratio diagnostic for osteolysis? CT scans of patients (n = 75) with a unilateral MoM-THA (Birmingham Hip System, Smith & Nephew, TN, USA) implanted by a single surgeon were reviewed to determine the presence of osteolysis. Statistical analysis was performed to detect its association with metal ion levels at the time of the imaging exam. The incidence of osteolysis was the same in men and women (35.6 vs 35.7 %). The cobalt-chromium-ratio correlates with the size of the osteolysis on the CT scan and the femoral component size in the overall study population (p = 0.050, p = 0.001) and in men (p = 0.002, p = 0.001) but not in women (p = 0.312, p = 0.344). The AUC for the cobalt-chromium-ratio to detect osteolysis was 0.613 (p = 0.112) for the overall population, 0.710 for men (p = 0.021) and 0.453 (p = 0.684) for women. The data suggest that a cut off level of 1.71 for the cobalt-chromium-ratio has a sensitivity of 62.5 % and specificity of 72.4 % to identify male patients with osteolysis. The disproportional increase of cobalt over chromium, especially in male patients with large component sizes can not be explained by wear alone and suggests that other processes (corrosion) might contribute to metal ion levels and might be more pronounced in patients with larger component sizes.

  1. Surf Aces Resurfaced

    DEFF Research Database (Denmark)

    Carter, Dale

    2013-01-01

    The rise of the American counter-culture between the early- to mid-1960s and early- to mid-1970s was closely associated with the growth of environmentalism. This article explores how both informed popular music, a form of expression which during these years became not only a prominent form of ent...... 1967, the group’s leader Brian Wilson and lyricist Van Dyke Parks collaborated on a collection of songs embodying such progressive thinking, even though the music of The Beach Boys had previously shown no such ambitions. In the short term their efforts foundered as the risk-averse logic...

  2. Correlations between the Harris Hip Score and the Visual Analogue Scale in the assessment of total hip replacement in hip dysplasia

    OpenAIRE

    S.G Zuh; Ö. Nagy; Ancuța Zazgyva; O.M. Russu; I. Gergely; T.S. Pop

    2014-01-01

    Total hip replacement is one of the most frequently performed orthopaedic interventions that can significantly improve the functional status and the quality of life of patients suffering from hip arthrosis. Recently patient satisfaction and patient-reported results of total hip arthroplasty are increasingly emphasised as important tools for the assessments of these interventions. For patients with arthrosis secondary to hip dysplasia, these evaluations can be more difficult, due to younger ag...

  3. Do hip prosthesis related infection codes in administrative discharge registers correctly classify periprosthetic hip joint infection?

    DEFF Research Database (Denmark)

    Lange, Jeppe; Pedersen, Alma B; Troelsen, Anders

    2015-01-01

    ) periprosthetic hip joint infection diagnosis code in the Danish National Patient Register. METHODS: Patients were identified with an ICD-10 discharge diagnosis code of T84.5 ("Infection and inflammatory reaction due to internal joint prosthesis") in association with hip-joint associated surgical procedure codes...

  4. HIP HOP for HIV Awareness: Using Hip Hop Culture to Promote Community-Level HIV Prevention

    Science.gov (United States)

    Hill, Mandy J.; Hallmark, Camden J.; McNeese, Marlene; Blue, Nike; Ross, Michael W.

    2014-01-01

    The goal of this paper was to determine the effectiveness of the HIP HOP for HIV Awareness intervention, an innovative model utilising an exchange of an HIV test for a hip hop concert ticket, in a metropolitan city among African American youth and young adults. A subset of intervention participants participated in standardised testing, sex…

  5. Invariant hip moment pattern while walking with a robotic hip exoskeleton

    Science.gov (United States)

    Lewis, Cara L.; Ferris, Daniel P.

    2011-01-01

    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 minutes of the powered condition and the unpowered condition. After completing three 30-minute 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

  6. Hip and ankle range of motion and hip muscle strength in young female ballet dancersand controls

    Science.gov (United States)

    Bennell, K.; Khan, K. M.; Matthews, B.; De Gruyter, M.; Cook, E.; Holzer, K.; Wark, J. D.

    1999-01-01

    OBJECTIVES: To compare the hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls. METHODS: Subjects were 77 dancers and 49 controls (mean (SD) age 9.6 (0.8) and 9.6 (0.7) years respectively). Supine right active hip external rotation (ER) and internal rotation (IR) were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. The measure of ER achieved from below the hip during turnout (non-hip ER) was calculated by subtracting hip ER range from turnout range, and hip ER:IR was derived by dividing ER range by IR range. Range of right weight bearing ankle dorsiflexion was measured in a standing lunge using two methods: the distance from the foot to the wall (in centimetres) and the angle of the shank to the vertical via an inclinometer (in degrees). Right calf muscle range was measured in weight bearing using an inclinometer. A manual muscle tester was used to assess right isometric hip flexor, internal rotator, external rotator, abductor, and adductor strength. RESULTS: Dancers had less ER (pballetic training. 


 PMID:10522638

  7. Atrophy of hip abductor muscles is related to clinical severity in a hip osteoarthritis population.

    Science.gov (United States)

    Zacharias, Anita; Green, Rodney A; Semciw, Adam; English, Daniel J; Kapakoulakis, Theo; Pizzari, Tania

    2018-02-15

    Osteoarthritis mainly affects weight-bearing joints such as the hip and knee and is the most common form of arthritis. Greater muscle atrophy with fatty infiltration of gluteal muscles and decreased hip abduction strength has previously been identified with increasing severity of radiological hip OA. However, it is well documented that radiographic findings of OA do not always correlate with clinical severity. The aim of this secondary analysis was to examine whether atrophy and strength of gluteus maximus (GMax), medius (GMed), minimus (GMin), and tensor fascia lata (TFL) is associated with the clinical severity of OA. Twenty participants with unilateral hip OA and 20 age- and sex-matched asymptomatic controls were classified on the basis of clinical severity (mild, moderate-severe and asymptomatic groups) using the Oxford hip score. Muscle volumes of GMax, GMed, GMin, and TFL were determined using magnetic resonance imaging and expressed as asymmetry between limbs. A hand-held dynamometer was used to identify hip rotation and abduction strength. Regression analyzes were used to identify the association between muscle asymmetry and patient-reported severity of hip OA. Both symptomatic groups (mild and moderate-severe) demonstrated significant asymmetry in GMax (P abduction strength was reduced in both symptomatic groups. Gluteal muscle atrophy was associated with the clinical severity of OA. Clinical severity could be a useful tool for clinicians interpreting likely gluteal muscle changes and planning rehabilitation strategies for hip OA patients. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  8. Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

    NARCIS (Netherlands)

    Jackson, K. A.; Glyn-Jones, S.; Batt, M. E.; Arden, N. K.; Newton, J. L.; Allen, N.; Ao, Y.-F.; Barker, K.; Beasley, I.; Bennell, K.; Botha, N.; Doherty, M.; Cowie, C.; Hawkes, R.; Jaques, R.; Kemp, S.; Lohmander, S.; Mackinnon, A.-L.; Miller, S.; Palmer, A.; Rossiter, M.; Roos, E.; Yoshimura, N.

    2015-01-01

    Objective: Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with

  9. Reliability and Validity of the Hip Stability Isometric Test (HipSIT): A New Method to Assess Hip Posterolateral Muscle Strength.

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; das Neves Rodrigues, Helena Larissa; de Freitas, Bruno Wesley; de Paula Lima, Pedro Olavo

    2017-12-01

    Study Design Cross-sectional study. Background The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. Objectives To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). Methods The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. Results The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (Pstrength deficits in women with PFP. J Orthop Sports Phys Ther 2017;47(12):906-913. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7274.

  10. Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty

    DEFF Research Database (Denmark)

    Karimi, Dennis; Kallemose, Thomas; Troelsen, Anders

    2018-01-01

    INTRODUCTION: In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown...... that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA. MATERIALS AND METHODS: In this prospective two center...... cohort study, 95 consecutive patients (106 hips) met the inclusion criteria. One observer performed radiographic measurements for malformations and radiographic OA. Inter- and intraobserver variability was assessed. RESULTS: From 95 patients (male n = 52 and female n = 43) age ranged from 35 to 59 years...

  11. Automatic assessment of volume asymmetries applied to hip abductor muscles in patients with hip arthroplasty

    Science.gov (United States)

    Klemt, Christian; Modat, Marc; Pichat, Jonas; Cardoso, M. J.; Henckel, Joahnn; Hart, Alister; Ourselin, Sebastien

    2015-03-01

    Metal-on-metal (MoM) hip arthroplasties have been utilised over the last 15 years to restore hip function for 1.5 million patients worldwide. Althoug widely used, this hip arthroplasty releases metal wear debris which lead to muscle atrophy. The degree of muscle wastage differs across patients ranging from mild to severe. The longterm outcomes for patients with MoM hip arthroplasty are reduced for increasing degrees of muscle atrophy, highlighting the need to automatically segment pathological muscles. The automated segmentation of pathological soft tissues is challenging as these lack distinct boundaries and morphologically differ across subjects. As a result, there is no method reported in the literature which has been successfully applied to automatically segment pathological muscles. We propose the first automated framework to delineate severely atrophied muscles by applying a novel automated segmentation propagation framework to patients with MoM hip arthroplasty. The proposed algorithm was used to automatically quantify muscle wastage in these patients.

  12. Imaging of the hip: a systematic approach to the young adult hip.

    Science.gov (United States)

    Chiamil, Sara Muñoz; Abarca, Claudia Astudillo

    2016-01-01

    Great advances in knowledge and understanding of the biomechanics of the hip, both in arthroscopic procedures and imaging techniques, have expanded and improved the diagnosis of pathologies of the young adult hip. The anatomy of the hip joint is complex due to its morphology and orientation. The inter-pretation of the images requires deep knowledge of the osseous and soft tissue anatomy: muscles, tendons, ligaments, vessels and nerves. There are multiple imaging tools. Diagnostic techniques have different utilities and often are complementary. In this article the various diagnostic imaging techniques for evaluation of hip pathologies are discussed, their indications and usefulness, with emphasis on those resolved arthroscopically. Young adult hip disorders are increasingly diagnosed and treated as arthroscopic procedures improved. Radiology is a fundamental contribution in the diagnostic process. Plain radiography (X-ray) is always the initial examination. V.

  13. Successful treatment of tattoo-induced pseudolymphoma with sequential ablative fractional resurfacing followed by Q-switched Nd: Yag 532 nm laser

    Directory of Open Access Journals (Sweden)

    Tan Siyun Lucinda

    2013-01-01

    Full Text Available Decorative tattooing has been linked with a range of complications, with pseudolymphoma being unusual and challenging to manage. We report a case of tattoo-induced pseudolymphoma, who failed treatment with potent topical and intralesional steroids. She responded well to sequential treatment with ablative fractional resurfacing (AFR followed by Q-Switched (QS Nd:YAG 532 nm laser. Interestingly, we managed to document the clearance of her tattoo pigments after laser treatments on histology and would like to highlight the use of special stains such as the Grocott′s Methenamine Silver (GMS stain as a useful method to assess the presence of tattoo pigment in cases where dense inflammatory infiltrates are present.

  14. Successful Treatment of Tattoo-Induced Pseudolymphoma with Sequential Ablative Fractional Resurfacing Followed by Q-Switched Nd: YAG 532 nm Laser

    Science.gov (United States)

    Lucinda, Tan Siyun; Hazel, Oon Hwee Boon; Joyce, Lee Siong Siong; Hon, Chua Sze

    2013-01-01

    Decorative tattooing has been linked with a range of complications, with pseudolymphoma being unusual and challenging to manage. We report a case of tattoo-induced pseudolymphoma, who failed treatment with potent topical and intralesional steroids. She responded well to sequential treatment with ablative fractional resurfacing (AFR) followed by Q-Switched (QS) Nd:YAG 532 nm laser. Interestingly, we managed to document the clearance of her tattoo pigments after laser treatments on histology and would like to highlight the use of special stains such as the Grocott's Methenamine Silver (GMS) stain as a useful method to assess the presence of tattoo pigment in cases where dense inflammatory infiltrates are present. PMID:24470721

  15. Resurfacing arthroplasty as an alternative to the posttraumatic sequelae of fractures of the external column of the humerus in the young adult.

    Science.gov (United States)

    Aroca-Peinado, M; Cecilia-López, D; Jiménez-Díaz, V

    Symptomatic posttraumatic arthritis of the elbow in young patients is a disorder for which there is currently no satisfactory solution. In this case report we show the evolution of a comminuted fracture of the capitellum with trochlear extension (McKee typeIV) treated initially with open reduction and internal fixation that eventually required a resurfacing hemiarthroplasty of the capitellum and reconstruction of the lateral ligament complex. After this surgical procedure, the patient had evident improvement of pain and of elbow range of motion, keeping the possibility of performing other rescue techniques open if they were to be necessary in the future. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Hip ontogenesis: how evolution, genes, and load history shape hip morphotype and cartilotype.

    Science.gov (United States)

    Hogervorst, Tom; Eilander, Wouter; Fikkers, Joost T; Meulenbelt, Ingrid

    2012-12-01

    Developmental hip disorders (DHDs), eg, developmental dysplasia of the hip, slipped capitis femoris epiphysis, and femoroacetabular impingement, can be considered morphology variants of the normal hip. The femoroacetabular morphology of DHD is believed to induce osteoarthritis (OA) through local cumulative mechanical overload acting on genetically controlled patterning systems and subsequent damage of joint structures. However, it is unclear why hip morphology differs between individuals with seemingly comparable load histories and why certain hips with DHD progress to symptomatic OA whereas others do not. We asked (1) which mechanical factors influence growth and development of the proximal femur; and (2) which genes or genetic mechanisms are associated with hip ontogenesis. We performed a systematic literature review of mechanical and genetic factors of hip ontogeny. We focused on three fields that in recent years have advanced our knowledge of adult hip morphology: imaging, evolution, and genetics. WHERE ARE WE NOW?: Mechanical factors can be understood in view of human evolutionary peculiarities and may summate to load histories conducive to DHD. Genetic factors most likely act through multiple genes, each with modest effect sizes. Single genes that explain a DHD are therefore unlikely to be found. Apparently, the interplay between genes and load history not only determines hip morphotype, but also joint cartilage robustness ("cartilotype") and resistance to symptomatic OA. WHERE DO WE NEED TO GO?: We need therapies that can improve both morphotype and cartilotype. HOW DO WE GET THERE?: Better phenotyping, improving classification systems of hip morphology, and comparative population studies can be done with existing methods. Quantifying load histories likely requires new tools, but proof of principle of modifying morphotype in treatment of DDH and of cartilotype with exercise is available.

  17. RAZVOJ OBLAČIL V HIP HOP KULTURI

    OpenAIRE

    Marić, Sanja

    2010-01-01

    V diplomskem delu smo raziskovali, kako so se hip hop oblačila razvijala skozi obdobja v hip hop kulturi. V teoretičnem deli smo ugotavljali ozadje in dejavnike, ki so vplivali na razvoj hip hop kulture, v empiričnem delu diplomske naloge pa smo izvedli anketni vprašalnik z glavnimi akterji hip hop kulture na slovenski hip hop sceni. Rezultati, ki smo jih dobili, kažejo da so imela oblačila velik vpliv na prepoznavnost in razvoj hip hop kulture po celem svetu. K temu so največ pripomogli ustv...

  18. The history of the anterior approach to the hip.

    Science.gov (United States)

    Rachbauer, Franz; Kain, Michael S H; Leunig, Michael

    2009-07-01

    The anterior approach is a safe, reliable, and feasible technique for total hip arthroplasty, permitting optimal soft tissue preservation. Since Hueter first described this interval, many surgeons have approached the hip anteriorly to perform a myriad of surgical procedures. The anterior approach allows optimal muscle preservation, and it is a truly internervous approach to the hip. An understanding of the evolution of the anterior approach to the hip will help the orthopedic community understand these advantages and why so many have used this approach in the treatment of hip pathology and for the implantation total hip arthroplasty.

  19. Neuromuscular hip biomechanics and pathology in the athlete.

    Science.gov (United States)

    Torry, Michael R; Schenker, Mara L; Martin, Hal D; Hogoboom, Doug; Philippon, Marc J

    2006-04-01

    Although hip arthroscopic techniques have been developed and evolved over the last 5 to 10 years to help active athletes, the mechanisms of athletic hip injuries across various sports are not well understood. The purpose of this article is to review the literature related to the osseous and ligamentous support as well as the neuromuscular control strategies associated with hip joint mechanics. The neuromuscular contributions to hip stability and mobility with respect to gait will be provided because this data represents the largest body of knowledge regarding hip function. Further, this article will present and describe probable mechanisms of injury in sporting activities most often associated with hip injury in the young athlete.

  20. Bilateral Hip Dislocation in Unrestrained Driver

    Directory of Open Access Journals (Sweden)

    Samer Assaf

    2017-09-01

    Full Text Available History of present illness: A 24-year-old male was brought in by paramedics status post motor vehicle collision (MVC into an electric pole and tree at high speed. The patient was an unrestrained driver who required extrication. The patient complained of left hip pain, left foot pain, and difficulty extending his bilateral lower extremities. He denied numbness or tingling to his lower extremities. The patient had normal vitals; his bilateral lower extremities were held in flexion at the hips, but otherwise had no obvious injuries. The patient’s pelvis was stable with palpable distal pulses and intact motor and sensory function of his distal lower extremities. Significant findings: The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula. Discussion: Bilateral hip dislocations are extremely rare, occurring in only 1% of all hip dislocations,2 and require immense force, typically occurring in MVCs (74%.3-7 Associated injuries include fracture of the acetabulum or femoral head, sciatic nerve damage, and obstruction of the blood supply to the femoral head.8 X-ray imaging and CT scans are used to assess the injury and to detect intra-articular fragments.3 Definitive treatment is achieved by closed reduction if possible; otherwise open reduction is utilized.9 Post-reduction therapy includes a non-weight-bearing period of time. Complications include avascular necrosis of the femoral head, osteonecrosis, and posttraumatic arthritis, the occurrence of which can be decreased by early reduction.4,10-12 This patient underwent bilateral

  1. Screening for congenital dislocation of the hip

    International Nuclear Information System (INIS)

    Fendel, H.

    1987-01-01

    Although the prevalence of (idiopathic) congenital dislocation of the hip (CDH) within the Member States of the European Community is not exactly known, it must be considered as a major problem of public health care and protection. By assessment of available data one can assume that between 1 and 2% of all newborns have dislocation or instability of one or both hips. There is a female predominance of 4:1 and some risk factors are known. The reasons of a higher prevalence in some areas are not yet well understood. Most of instable hips will spontaneously become stable within the first days or weeks of life. However, a considerable number of infants (less than 1%) will remain with instable hips which may dislocate. Dislocation either present at birth or as a result of persistent instability leads to subsequent hip deformation. This is a serious event for each affected individual, and is a heavy load on health care and social costs for the public. Treatment of CDH is easy and usually effective when started early, i.e. before the fourth month of life. The earlier treatment is started the easier, shorter, safer and less expensive it is and its impairment on child development and mother-child interaction can be held to a minimum. Screening for CDH is therefore the most important part of health protection in early infancy. However, this paper concludes that neither sonography nor X-ray examinations are appropriate for CDH screening

  2. [Clinical pathway for hip fracture patients].

    Science.gov (United States)

    Sáez López, Pilar; Sánchez Hernández, Natalia; Paniagua Tejo, Sonsoles; Valverde García, José Antonio; Montero Díaz, Margarita; Alonso García, Noelia; Freites Esteve, Alfonso

    2015-01-01

    Hip fracture in the elderly often occurs in patients with high co-morbidity. Effective management requires a comprehensive and multidisciplinary approach. To evaluate the effect of a quality improvement intervention in the detection and treatment of complications in elderly patients admitted for hip fracture. A comparative study was conducted between two groups of patients admitted for hip fracture prior to 2010, and after a quality improvement intervention in 2013. The intervention consisted of implementing improved multidisciplinary measures in accordance with recent scientific evidence. The degree of compliance of the implemented measures was quantified. Patients admitted due to hip fracture in 2010 (216 patients) and 2013 (196 patients) were similar in age, sex, Barthel Index, and a reduced Charlson Index, although there were more comorbidities in 2013. After implementation of the protocols, the detection of delirium, malnutrition, anemia, and electrolyte disturbances increased. A larger number of patients in 2013 were precribed intravenous iron (24% more) and osteoporosis treatment (61.3% more). The average stay was reduced by 45.3% and surgical delay by 29.4%, achieving better functional efficiency. The implementation of a clinical pathway in geriatric patients with hip fracture is useful to detect and treat complications at an early stage, and to reduce pre-operative and overall stay, all without a negative clinical or functional impact. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  3. Levofloxacin-induced tendinopathy of the hip.

    Science.gov (United States)

    Ganske, Corrine M; Horning, Kristin K

    2012-05-01

    To describe what we believe to be the first reported possible case of tendinopathy of the hip in a patient receiving levofloxacin. A 58-year-old male with recurrent otitis media was admitted for left lateral hip pain of 10 on a scale of 10. He had started a 5-day course of levofloxacin 750 mg/day 10 days before he began experiencing pain. He also took simvastatin 20 mg/day and walked 90 minutes each day. He was treated with oxycodone with acetaminophen and physical therapy. His pain had improved significantly at a 10-day recheck. Fluoroquinolone-induced tendinopathy has been well-reported in the literature, but most cases involve pefloxacin and affect the Achilles tendon. Only 11 cases of tendinopathy have been reported with levofloxacin based on a MEDLINE search (1966-December 2011). This is the first known case reported that involved tendinopathy of the hip believed to be caused by fluoroquinolones. The Naranjo probability scale revealed a possible adverse reaction of levofloxacin-induced tendinopathy of the hip. Contributing factors likely included the high dose of levofloxacin, concomitant use of a statin, and strenuous physical activity. Health care professionals should be aware of the possibility of tendinopathy of the hip in patients who receive fluoroquinolones. Thorough history for possible risk factors should be obtained. Patients on fluoroquinolones at risk for tendinopathy should be counseled to avoid strenuous physical activity.

  4. Hip and Groin Injuries in Baseball Players.

    Science.gov (United States)

    Mlynarek, Ryan A; Coleman, Struan H

    2018-03-01

    To discuss the clinical significance of the most common hip and groin injuries in baseball players, as well as an algorithmic approach to diagnosis and treatment of these injuries. (a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list. Injuries involving the hip and groin are relatively common in baseball players. Our knowledge of the mechanics of overhead throwing continues to evolve, as does our understanding of the contribution of power from the lower extremities and core. It is paramount that the team physician be able to accurately diagnose and treat injuries involving the hip/groin, as they may lead to significant disability and inability to return to elite levels of play. This review focuses on hip- and groin-related injuries in the baseball player, including femoroacetabular impingement, core muscle injury, and osteitis pubis.

  5. Development of post hip replacement comfort scale.

    Science.gov (United States)

    Saray Kilic, Hulya; Tastan, Sevinc

    2017-12-01

    To develop and psychometrically test the Post Hip Replacement Comfort Scale (PHRCS). Evaluation of the patient comfort after hip replacement surgery is highly important in order to increase the quality of patient care. The review of the relevant literature shows that a scale that specifically measures the patient comfort after hip replacement surgery is absent. Methodological design was used. This study included the development of the scale and tested the psychometric properties of the scale. 180 patients who had been hip replacement surgery recruited from three education and research hospitals' orthopedic and trauma departments from January 2014 to December 2015. The study was conducted in three phases. In phase 1, scale items were developed based on the literature review and other comfort scales. In phase 2, the trial was applied with data collection forms. Phase 3 was conducted to evaluate the reliability and validity of the finalized inventory using item analysis. The Cronbach's alpha coefficient value is 0.758. Test-retest results found positive and meaningful correlation between the scores of the scales, indicating the reliability of the scale. Scope, surface, criterion and construct validity analysis confirmed the validity of the scale. There were 26 items in the final scale. In our study, the average patient comfort score was 3.64±0.43 (from 1 to 5). The PHRCS is recommended for evaluating patients' comfort after hip replacement surgery and examining the effects of nursing interventions on patients' comfort. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. A cluster randomised controlled trial evaluating the effectiveness and cost-effectiveness of the daily mile on childhood obesity and wellbeing; the Birmingham daily mile protocol.

    Science.gov (United States)

    Breheny, Katie; Adab, Peymane; Passmore, Sandra; Martin, James; Lancashire, Emma; Hemming, Karla; Frew, Emma

    2018-01-11

    Childhood obesity prevention is a public health priority. Children spend a large proportion of their waking time in school; therefore this is an appropriate setting to implement obesity prevention initiatives. Anecdotal reports suggest that implementing The Daily Mile in schools has had positive effects on childhood obesity, academic attainment and wellbeing. This trial aims to measure the effectiveness of The Daily Mile for improving health and wellbeing. This protocol describes a cluster randomised controlled trial (RCT) in 40 primary schools located in Birmingham, UK. Eligible participants are children in years 3 (aged 7-8) and 5 (aged 9-10). The study compares The Daily Mile (intervention) to usual practice (control) in relation to health and wellbeing. The Daily Mile intervention involves an additional 15 min of running or walking integrated into the school day, throughout a 12 month study period. The primary clinical outcome is body mass index (BMI) z-scores at 12 months following introduction of the intervention. The cost per Quality Adjusted Life Year (QALY) is the primary outcome of the economic evaluation. Secondary outcomes include wellbeing, physical fitness and teacher reported academic attainment. This study is the first RCT investigating the clinical and cost-effectiveness of The Daily Mile. A range of outcomes will be measured to evaluate the broader wellbeing and academic benefits in addition to clinical outcomes typically measured in childhood obesity prevention trials. The intervention is simple and low-cost, therefore if the benefits are demonstrated it has enormous potential to influence future policy. ISRCTN: 12698269 . Date protocol registered 27th October 2016.

  7. Re-suspension of lead contaminated urban soil as a dominant source of atmospheric lead in Birmingham, Chicago, Detroit and Pittsburgh, USA

    Science.gov (United States)

    Laidlaw, Mark A. S.; Zahran, Sammy; Mielke, Howard W.; Taylor, Mark P.; Filippelli, Gabriel M.

    2012-03-01

    Soils in older areas of cities are highly contaminated by lead, due largely to past use of lead additives in gasoline, the use of lead in exterior paints, and industrial lead sources. Soils are not passive repositories and periodic re-suspension of fine lead contaminated soil dust particulates (or aerosols) may create seasonal variations of lead exposure for urban dwellers. Atmospheric soil and lead aerosol data from the Interagency Monitoring of Protected Visual Environments (IMPROVE) database were obtained for Pittsburgh (Pennsylvania), Detroit (Michigan), Chicago (Illinois), and Birmingham (Alabama), USA. In this study the temporal variations of atmospheric soil and lead aerosols in these four US cities were examined to determine whether re-suspended lead contaminated urban soil was the dominant source of atmospheric lead. Soil and lead-in-air concentrations were examined to ascertain whether lead aerosols follow seasonal patterns with highest concentrations during the summer and/or autumn. In addition, atmospheric soil and lead aerosol concentrations on weekends and Federal Government holidays were compared to weekdays to evaluate the possibility that automotive turbulence results in re-suspension of lead contaminated urban soil. The results show that the natural logs of atmospheric soil and lead aerosols were associated in Pittsburgh from April 2004 to July 2005 (R2 = 0.31, p contaminated roadside soils and dusts. In order to decrease urban lead aerosol concentrations, lead deposition and subsequent children's seasonal exposure, lead contaminated urban soils need remediation or isolation because the legacy of lead continues to pose unnecessary and preventable health risks to urban dwellers.

  8. The Federation of Student Islamic Societies programme to challenge mental health Stigma in Muslim communities in England: The FOSIS Birmingham study.

    Science.gov (United States)

    Hankir, Ahmed; Khalil, Sajjaad; Wadood, Qasim; Madarbukus, Daanyaal; Yunus, Habibah Arifah; Bibi, Saleena; Carrick, Frederick R; Zaman, Rashid

    2017-09-01

    1 in 4 people experience mental health problems at some point during their lives and Muslims are no exception. Exacerbating the morbidity and mortality associated with mental health problems in Muslims is Islamophobia. Stigma and shame are major barriers to accessing and using mental health services and many Muslims with mental health problems do not receive the treatment they need. The Federation of Student Islamic Societies (FOSIS) United Kingdom branch organized a mental health conference to challenge the stigma attached to psychological problems in Muslims and to encourage care seeking in this group. We conducted a single arm, pre-post comparison study on Muslims who attended the FOSIS mental health conference in Birmingham Medical School, England. Validated stigma scales measuring knowledge, attitudes and behavior were administered on participants before and immediately after exposure to the programme. Participants were also asked to respond to statements, the items of which were on a 5-point Likert scale, about the role that Islam plays in Muslim mental health, stigma as a barrier for Muslims with mental health problems to accessing and using mental health services and if they felt inspired to challenge stigma. 50/250 (20%) of participants completed the study. There were statistically significant improvements in the 'Reported and Intended Behavior' score (p=0.0036), the 'Inspired to Take Action' Score (p=0.0202) and the 'Incorporating Islamic Principles into Mental Health Treatment for Muslims is Beneficial' score (p=0.0187). The findings of our study suggest that a 'bespoke' Muslim mental health conference comprised of talks delivered by experts in Islam and mental health and a Muslim who has first-hand experience of psychological distress might be effective at reducing mental health stigma in the Muslim community. Our results should help to inform the design, development and delivery of future Muslim mental health conferences however more robust research in

  9. Evaluating the effects of sevelamer carbonate on cardiovascular structure and function in chronic renal impairment in Birmingham: the CRIB-PHOS randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Steeds Richard P

    2011-02-01

    Full Text Available Abstract Background Serum phosphate is an independent predictor of cardiovascular morbidity and mortality in patients with chronic kidney disease and the general population. There is accumulating evidence that phosphate promotes arterial stiffening through structural vascular alterations such as medial calcification, which are already apparent in the early stages of chronic kidney disease. Aim To determine the effects of phosphate binding with sevelamer carbonate on left ventricular mass and function together with arterial stiffness in patients with stage 3 chronic kidney disease. Methods/Design A single-centre, prospective, randomised, double-blind, placebo-controlled trial of 120 subjects with stage 3 chronic kidney disease recruited from University Hospitals Birmingham NHS Foundation Trust. Baseline investigations include transthoracic echocardiography and cardiac magnetic resonance imaging to assess ventricular mass, volumes and function, applanation tonometry to determine pulse wave velocity and pulse wave analysis as surrogate measures of arterial stiffness and dual energy x-ray absorptiometry scanning to determine bone density. During an open-label run in phase, subjects will receive 1600 mg sevelamer carbonate with meals for four weeks. They will then be randomised to either continue sevelamer carbonate or receive an identical placebo (60 subjects per arm for the remaining 36 weeks. Four-weekly monitoring of serum electrolytes and bone biochemistry will be performed. All baseline investigations will be repeated at the end of the treatment period. The primary endpoint of the study is a reduction in left ventricular mass after 40 weeks of treatment. Secondary endpoints are: i change in aortic compliance; ii change in arterial stiffness; iii change in arterial elastance; iv change in left ventricular systolic and diastolic elastance; v change in left ventricular function; and vi change in bone density. Trial Registration This trial is

  10. OA17 Compassionate communities: engaging with communities to support patients at end of life: a birmingham st. mary's hospice lived experience.

    Science.gov (United States)

    Murungu, Diana; Woolf, Tina Swani Sarah

    2015-04-01

    Researchers carrying out a rebranding exercise for us in 2006 found that people from Black Asian and other Minority Ethnic (BAME) communities did not respond to their survey. This appeared to support anecdotal evidence from staff suggesting that the number of BAME patients accessing our services did not reflect the real need. To increase access to Hospice Care services for people from BAME communities. From April to July 2007 we used qualitative methods to carry out an exploratory study, to identify barriers to hospice care for patients from BAME communities. Currently we use community development methods to raise awareness of hospice services among BAME communities in Birmingham and Sandwell; while offering training and cultural/spiritual broker services to clinicians increasing their understanding of patients and families from these communities. There was no information about Hospice care services among people from BAME communities. Many people from BAME communities belong to cultural or spiritual groups whose members support each other during times of celebration, illness, death and bereavement. They refer to this support as 'our way of life'. Death, dying, and cancer are taboo subjects. In 2009 we set up the Compassionate Communities Project (CCP) within our Reaching People Programme (RPP) to increase access to our services for people from BAME communities. CCP enables community groups and service providers to work together in end of life. Representatives from BAME communities help train clinicians on supporting people from their communities in end of life. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Cumulative hip contact stress predicts osteoarthritis in DDH.

    Science.gov (United States)

    Mavcic, Blaz; Iglic, Ales; Kralj-Iglic, Veronika; Brand, Richard A; Vengust, Rok

    2008-04-01

    Hip stresses are generally believed to influence whether a hip develops osteoarthritis (OA); similarly, various osteotomies have been proposed to reduce contact stresses and the risk of OA. We asked whether elevated hip contact stress predicted osteoarthritis in initially asymptomatic human hips. We identified 58 nonoperatively treated nonsubluxated hips with developmental dysplasia (DDH) without symptoms at skeletal maturity; the control group included 48 adult hips without hip disease. The minimum followup was 20 years (mean, 29 years; range, 20-41 years). Peak contact stress was computed with the HIPSTRESS method using anteroposterior pelvic radiographs at skeletal maturity. The cumulative contact stress was determined by multiplying the peak contact stress by age at followup. We compared WOMAC scores and radiographic indices of OA. Dysplastic hips had higher mean peak contact and higher mean cumulative contact stress than normal hips. Mean WOMAC scores and percentage of asymptomatic hips in the study group (mean age 51 years) were similar to those in the control group (mean age 68 years). After adjusting for gender and age, the cumulative contact stress, Wiberg center-edge angle, body mass index, but not the peak contact stress, independently predicted the final WOMAC score in dysplastic hips but not in normal hips. Cumulative contact stress predicted early hip OA better than the Wiberg center-edge angle. Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

  12. Results of hip arthroplasty using Paavilainen technique in patients with congenitally dislocated hip

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2014-01-01

    Full Text Available The purpose of the study was to analyze the medium- and long-term results of hip arthroplasty using Paavilainen technique in patients with the congenitally dislocated hip. Methods: From 2001 to 2012 180 operations were carried out were using the Paavilainen technique in 140 patients with high dislocation of the hip (Crowe IV. All patients were clinically evaluated using the Harris Hip Score (HHS, VAS and radiography. Statistical analysis was performed using the Pearson correlation coefficients, multiple regression analysis and classification trees analysis. Results: The average Harris score improved from preoperative 41.6 (40,3-43,5 to 79.3 (77,9-82,7 at final follow-up, and the difference was significant. Early complications were 9% (the most frequent were fractures of the proximal femur, later - 16.7% (pseudoarthrosis of the greater trochanter, 13.9%; disclocations-1,1%, aseptic loosening of the components - 1.7%, reoperation performed in 8.3% of cases. Such factors as age and limb length has statistically significant effect on functional outcomes. Established predictive model allows to get the best possible functional outcome in such patients with severe dysplasia. Conclusions: Total Hip arthroplasty using the Paavilainen technique is an effective method of surgical treatment in patients with the congenitally dislocated hip, but it is technically difficult operation with a high incidence of complications in comparison with standard primary total hip replacement.

  13. The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

    Directory of Open Access Journals (Sweden)

    Haviv Barak

    2010-07-01

    Full Text Available Abstract Objective To assess the incidence of total hip arthroplasty (THA in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA. Design Retrospective clinical series Methods Follow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years. The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis. Results Ninety (16% of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA. Conclusions In our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures.

  14. Utility of combined hip abduction angle for hip surveillance in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Akshay Divecha

    2011-01-01

    Full Text Available Background: Spontaneous hip lateralization complicates the management of non-ambulatory children with cerebral palsy (CP. It can be diagnosed early using radiographs, but it involves standardization of positioning and exposure to radiation. Hence, the aim of this study was to assess the utility of Combined hip abduction angle (CHAA in the clinical setting to identify those children with CP who were at greater risk to develop spontaneous progressive hip lateralization. Materials and Methods: One hundred and three children (206 hips with CP formed our study population. There were 48 boys and 55 girls aged 2-11 years (mean 5.03 years. 61 children were Gross Motor Function Classification System (GMFCS level 5, while 42 were GMFCS level 4. Clinical measurements of CHAA were statistically correlated with radiographic measurements of Reimer′s migration percentage (MP for bivariate associations using c2 and t tests. Results: CHAA is evaluated against MP which is considered as a reliable measure of hip subluxation. Thus, for CHAA, sensitivity was 74.07% and specificity was 67.35%. False-positive rate was 32.65% and false-negative rate was 25.93%. Conclusions: Our study shows that correlation exists between CHAA and MP, which has been proved to be useful for hip screening in CP children at risk of hip dislocation. CHAA is an easy, rapid, cost-effective clinical test which can be performed by paraclinical health practitioners (physiotherapists and orthopedic surgeons.

  15. Hip Pain: Dry Needling Versus Cortisone Injections.

    Science.gov (United States)

    2017-04-01

    Greater trochanteric pain syndrome (GTPS) is chronic, intermittent pain and tenderness on the outside of the hip. The medical community once thought that a swollen hip bursa was the source of such pain, which led to the use of corticosteroid injections to the bursa to help decrease swelling and pain. However, researchers now believe that injuries to the muscles and tendons around the hip are the actual cause of this pain, and that inflammation is often not involved. A study published in the April 2017 issue of JOSPT explores dry needling as an alternative to cortisone injections to reduce pain and improve function in patients with GTPS. J Orthop Sports Phys Ther 2017;47(4):240. doi:10.2519/jospt.2017.0504.

  16. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...... ). Results - 3,416 patients were included (2,064 females (60%)). AKI (according to KDIGO criteria) was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD of class 3-5, indicating moderately to severely...

  17. Fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik

    2012-01-01

    thromboembolic complications in particular (V); feasibility studies showing excellent outcomes following fast-track bilateral simultaneous total knee arthroplasty (VI) and non-septic revision knee arthroplasty (VII); how acute pain relief in total hip arthroplasty is not enhanced by the use of local infiltration......Fast-track hip and knee arthroplasty aims at giving the patients the best available treatment at all times, being a dynamic entity. Fast-track combines evidence-based, clinical features with organizational optimization including a revision of traditions resulting in a streamlined pathway from...... on clinical and organizational aspects of fast-track hip and knee arthroplasty (I–IX). A detailed description of the fast-track set-up and its components is provided. Major results include identification of patient characteristics to predict length of stay and satisfaction with different aspects...

  18. Osteoblastoma in the region of the hip

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Yang

    2013-02-01

    Full Text Available Osteoblastoma occurring in the region of the hip is very rare, and vague symptoms with uncharacteristic radiographic features often lead to misdiagnosis. Because of radiographic and histological similarities, it must be carefully distinguished from osteoid osteoma, aneurysmal bone cyst, giant cell tumor, and osteosarcoma. Computed tomography is the preferred imaging modality as it is able to detect the nidus and images will not exhibit the flare phenomenon caused by surrounding inflammation seen with magnetic resonance imaging. For hip joint lesions in weight-bearing areas, intralesional curettage may achieve satisfactory outcomes as compared with wide resection. We herein report two cases of osteoblastoma in the hip region in which diagnosis was delayed that were successfully treated with curettage and followed by high-speed burring.

  19. Osteoblastoma in the region of the hip.

    Science.gov (United States)

    Yang, Chen-Yuan; Chen, Cheng-Fong; Chen, Wei-Ming; Wu, Po-Kuei; Lee, Fang-Tsai; Chen, Paul Chih-Hsueh; Liu, Chien-Lin; Chen, Tain-Hsiung

    2013-02-01

    Osteoblastoma occurring in the region of the hip is very rare, and vague symptoms with uncharacteristic radiographic features often lead to misdiagnosis. Because of radiographic and histological similarities, it must be carefully distinguished from osteoid osteoma, aneurysmal bone cyst, giant cell tumor, and osteosarcoma. Computed tomography is the preferred imaging modality as it is able to detect the nidus and images will not exhibit the flare phenomenon caused by surrounding inflammation seen with magnetic resonance imaging. For hip joint lesions in weight-bearing areas, intralesional curettage may achieve satisfactory outcomes as compared with wide resection. We herein report two cases of osteoblastoma in the hip region in which diagnosis was delayed that were successfully treated with curettage and followed by high-speed burring. Copyright © 2012. Published by Elsevier B.V.

  20. Wear mechanisms in ceramic hip implants.

    Science.gov (United States)

    Slonaker, Matthew; Goswami, Tarun

    2004-01-01

    The wear in hip implants is one of the main causes for premature hip replacements. The wear affects the potential life of the prosthesis and subsequent removals of in vivo implants. Therefore, the objective of this article is to review various joints that show lower wear rates and consequently higher life. Ceramics are used in hip implants and have been found to produce lower wear rates. This article discusses the advantages and disadvantages of ceramics compared to other implant materials. Different types of ceramics that are being used are reviewed in terms of the wear characteristics, debris released, and their size together with other biological factors. In general, the wear rates in ceramics were lower than that of metal-on-metal and metal-on-polyethylene combinations.