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Sample records for birmingham hip resurfacing

  1. Clinical and Functional Outcomes of the Birmingham Hip Resurfacing System.

    Science.gov (United States)

    Pascual-Garrido, Cecilia; Morris, Brandon L; Dayton, Michael R

    2016-01-01

    This study reported the outcomes of patients treated with the Birmingham Hip Resurfacing System (Smith & Nephew, Memphis, Tennessee) to identify the prevalence of complications and failures. A retrospective review of 202 patients (206 hips) was performed. Outcomes were assessed clinically with Harris Hip Score at 6 and 12 months and then yearly. Subanalysis was performed, with the hips divided according to patient sex and size of the femoral component. Mean patient age was 51±8 years, and mean follow-up was 4±1.6 years. Of the patients, 163 were men (83%) and 35 were women (17%). Postoperative improvement was significant, with preoperative Harris Hip Score of 62.9±10.6 and postoperative Harris Hip Score of 98.6±6.7 (Phips (2.4%) underwent revision. At 3 years, mean survival was better for men than for women (99% vs 92%, respectively). Survival was lowest in patients with femoral component diameter of less than 46 mm. According to the authors' results, the Birmingham Hip Resurfacing System resulted in good clinical outcomes at 4 years. Survival and outcomes in women, particularly those with modest bone size, are inferior.

  2. Fixation of a Periprosthetic Intertrochanteric Hip Fracture below a Birmingham Hip Resurfacing

    Directory of Open Access Journals (Sweden)

    J. Macdonald

    2014-01-01

    Full Text Available This case report involves a 56-year-old female (Mrs X with a traumatic intertrochanteric hip fracture with subtrochanteric extension below a previous Birmingham hip resurfacing. Periprosthetic fractures following hip resurfacing are usually subcapital and treated with a revision or conservative management. We present an unusual surgical problem with an interesting solution stabilising the fracture using a proximal femoral locking compression plate (LCP. Eight months following surgery the patient is able to walk pain free and there is good fixation and stability.

  3. 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.

  4. Birmingham Hip Resurfacing: A Single Surgeon Series Reported at a Minimum of 10 Years Follow-Up.

    Science.gov (United States)

    Mehra, Akshay; Berryman, Fiona; Matharu, Gulraj S; Pynsent, Paul B; Isbister, Eric S

    2015-07-01

    We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris. Ten-year survival was 94.2% (95% confidence interval (CI) 88.8%-98.7%) for all revisions and 96.1% (95% CI 91.5%-99.8%) for revisions for aseptic loosening. Gender (P = 0.463) and head size (P = 0.114) did not affect revision risk. Mean post-operative Harris hip score was 84.0. Contrary to previous independent reports, good outcomes into the second decade were achieved with the BHR in both men and women. Longer term follow-up will confirm whether these promising outcomes in women continue.

  5. Return to sporting activity after Birmingham hip resurfacing arthroplasty: Mid term results

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    Nemandra Sandiford

    2015-01-01

    Full Text Available Background: Hip resurfacing arthroplasty (HRA is primarily indicated for young, active patients with disabling coxarthrosis who wish to remain active and return to sports after surgery. Relatively few prospective studies have assessed return to sporting activity and impact of gender and age on this. Materials and Methods: Seventy-nine consecutive patients treated with HRA were included. Patients were reviewed clinically and radiologically. Function was assessed using the modified University of California Los Angeles (UCLA activity score. The Oxford, Harris and WOMAC hip scores were calculated. Results: Average age at the time of surgery was 54.9 years (range 34.5–73.6 years. Average preoperative and postoperative UCLA scores were 4 and 7.6 respectively. Patients were involved in 2 (0–4 sporting activities preoperatively and 2 (0–5 postoperatively. Preoperative and postoperative Oxford Hip Scores, Harris Hip Score and WOMAC scores were 40, 46 and 51 and 16, 94 and 3 respectively (P < 0.0001. Patients returned to sports at an average of 3 months postoperatively. Conclusion: Patients were able to return to sports by 3 months and perform the same number of activities at preoperative intensity. Activity levels are maintained up to the medium term with few complications.

  6. Safety Issue of Hip Resurfacing

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    Timothy McTighe

    2015-10-01

    Full Text Available Hip Resurfacing (HR development of the 1970s was an attempt to address the failures of conventional cemented stems. Those early HR designs failed because problems with maintaining bone under the resurfaced femoral head, and loosening of the socket with substantial acetabular bone loss. However technology, knowledge and surgical techniques have evolved over the past 45 years. The more recent designs like the Birmingham Hip Resurfacing (BHR focused on metal to metal bearing surfaces. These devices are under attack and maybe they should be. However, lets not ignore the significant amount of information and potential improvements in both design technology and surgical techniques that have come about over the past few years.

  7. Hip Resurfacing. Case presentation.

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    Pedro Gonzalo González González

    2008-12-01

    Full Text Available Hip resurfacing in youngest patients is an excellent surgical technique for Avascular Necrosis compare with a traditional Total Hip Replacement. Report about a 21 years old female patient involved in a car accident in February 2004 with Fracture of the neck of femur treated with compression hip screw Richard’s type. Two years later the patient was diagnose with avascular necrosis of the contra lateral hip. Hip resurfacing Metal-Metal was carry out in the above mentioned patient.

  8. Hip resurfacing arthroplasty

    OpenAIRE

    2010-01-01

    Background and purpose Hip resurfacing arthroplasty is claimed to allow higher activity levels and to give better quality of life than total hip arthroplasty. In this literature review, we assessed the therapeutic value of hip resurfacing arthroplasty as measured by functional outcome. Methods An extensive literature search was performed using the PubMed, Embase, and Cochrane databases. Results 9 patient series, 1 case-control study, and 1 randomized controlled trial (RCT) were included. Clin...

  9. Hip Resurfacing Implants.

    Science.gov (United States)

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants.

  10. The effect of 'running-in' on the tribology and surface morphology of metal-on-metal Birmingham hip resurfacing device in simulator studies.

    Science.gov (United States)

    Vassiliou, K; Elfick, A P D; Scholes, S C; Unsworth, A

    2006-02-01

    It is well documented that hard bearing combinations show a running-in phenomenon in vitro and there is also some evidence of this from retrieval studies. In order to investigate this phenomenon, five Birmingham hip resurfacing devices were tested in a hip wear simulator. One of these (joint 1) was also tested in a friction simulator before, during, and after the wear test and surface analysis was conducted throughout portions of the testing. The wear showed the classical running in with the wear rate falling from 1.84 mm3 per 10(6) cycles for the first 10(6) cycles of testing to 0.24 mm3 per 10(6) cycles over the final 2 x 10(6) cycles of testing. The friction tests suggested boundary lubrication initially, but at 1 x 10(6) cycles a mixed lubrication regime was evident. By 2 x 10(6) cycles the classical Stribeck curve had formed, indicating a considerable contribution from the fluid film at higher viscosities. This continued to be evident at both 3 x 10(6) and 5 x 10(6) cycles. The surface study complements these findings.

  11. Hip resurfacing: a technology reborn

    OpenAIRE

    2006-01-01

    In recent years there has been a resurgence of interest in the concept of hip resurfacing. Much of this interest has stemmed from the work of McMinn in the West Midlands. Hip resurfacing is now emerging as a viable alternative to conventional hip replacement. In this article, we discuss the conceptual advantages offered by hip resurfacing and review the early clinical results and the ongoing clinical concerns regarding this technology.

  12. Revision of hip resurfacing arthroplasty.

    Science.gov (United States)

    Wera, Glenn D; Gillespie, Robert J; Petty, Carter; Petersilge, William J; Kraay, Matthew J; Goldberg, Victor M

    2010-08-01

    Metal-on-metal (MOM) hip resurfacing has become an increasingly popular treatment for young, active patients with degenerative disease of the hip, as bearing surfaces with better wear properties are now available. One proposed advantage of resurfacing is its ability to be successfully revised to total hip arthroplasty (THA). In addition, radiographic parameters that may predict failure in hip resurfacing have yet to be clearly defined. Seven MOM resurfacing arthroplasties were converted to conventional THAs because of aseptic failure. Using Harris Hip Scores (HHS) and Short Form 12 (SF-12) questionnaire scores, we compared the clinical outcomes of these patients with those of patients who underwent uncomplicated MOM hip resurfacing. In addition, all revisions were radiographically evaluated. Mean follow-up periods were 51 months (revision group) and 43 months (control group). There was no significant difference between the 2 groups' HHS or SF-12 scores. There was no dislocation or aseptic loosening after conversion of any resurfacing arthroplasty. Valgus neck-shaft angle (P hip resurfacing. Conversion of aseptic failure of hip resurfacing to conventional THA leads to clinical outcomes similar to those of patients who undergo uncomplicated hip resurfacing. The orientation of the femur and the components placed play a large role in implant survival in hip resurfacing. More work needs to be done to further elucidate these radiographic parameters.

  13. Biomimetic Composite-Metal Hip Resurfacing Implant

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    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.

  14. Results of hip resurfacing

    Science.gov (United States)

    Favetti, Fabio; Casella, Filippo; Papalia, Matteo; Panegrossi, Gabriele

    2011-01-01

    Background The renewed popularity of resurfacing hip arthroplasty in the last 10 years has generated a remarkable quantity of scientific contributions based on mid- and short-term follow-up. More than one paper has reported a consistent early revision rate as a consequence of biological or biomechanical failure. Two major complications are commonly described with resurfacing implants: avascular necrosis and femoral-neck fracture. A close relationship between these two events has been suggested, but not firmly demonstrated, whereas cementing technique seems to be better understood as potential cause of failure. Methods We performed an in vitro study in which four different resurfacing implants were evaluated with a simulated femoral head, two types of cement, (low and high viscosity) and two cementing techniques: direct (cement apposition directly on the femoral head) and indirect (cement poured into the femoral component). Results High-viscosity cement showed homogeneous distribution over the entire femoral head. Low-viscosity cement showed a massive polar concentration with insufficient, if not absent, distribution in the equatorial zone. Conclusion Polar cement concentration could be a risk factor for early implant failure due to two effects on the femoral head: biological (excessive local exothermic reaction could cause osteocyte necrosis) and biomechanical (which could lead to uneven load distribution on the femoral head). PMID:21234563

  15. 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.

  16. Radiology of the resurfaced hip

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, Luthfur [The London Hip Unit, London (United Kingdom); Hall-Craggs, Margaret [University College London Hospital, London (United Kingdom); Muirhead-Allwood, Sarah K. [The London Hip Unit, London (United Kingdom); The Royal National Orthopaedic Hospital, Middlesex (United Kingdom)

    2011-07-15

    Hip resurfacing arthroplasty is an increasingly common procedure for osteoarthritis. Conventional radiographs are used routinely for follow-up assessment, however they only provide limited information on the radiological outcome. Various complications have been reported in the scientific literature although not all are fully understood. In an effort to investigate problematic or failing hip resurfacings, various radiological methods have been utilized. These methods can be used to help make a diagnosis and guide management. This paper aims to review and illustrate the radiographic findings in the form of radiography, computerized tomography (CT), magnetic resonance imaging (MRI), and ultrasound of both normal and abnormal findings in hip resurfacing arthroplasty. However, imaging around a metal prosthesis with CT and MRI is particularly challenging and therefore the potential techniques used to overcome this are discussed. (orig.)

  17. Cost-utility of metal-on-metal hip resurfacing compared to conventional total hip replacement in young active patients with osteoarthritis

    NARCIS (Netherlands)

    Heintzbergen, S.; Kulin, N.A.; IJzerman, M.J.; Steuten, L.M.G.; Werle, J.; Khong, H.; Marshall, D.A.

    2013-01-01

    Background: Metal-on-metal hip resurfacing arthroplasty (MoM HRA) has emerged as an alternative to total hip arthroplasty (THA) for younger active patients with osteoarthritis (OA). Birmingham hip resurfacing is the most common MoM HRA in Alberta, and is therefore compared with conventional THA. Obj

  18. Retrieval analysis of 240 metal-on-metal hip components, comparing modular total hip replacement with hip resurfacing.

    Science.gov (United States)

    Matthies, A; Underwood, R; Cann, P; Ilo, K; Nawaz, Z; Skinner, J; Hart, A J

    2011-03-01

    This study compared component wear rates and pre-revision blood metal ions levels in two groups of failed metal-on-metal hip arthroplasties: hip resurfacing and modular total hip replacement (THR). There was no significant difference in the median rate of linear wear between the groups for both acetabular (p = 0.4633) and femoral (p = 0.0872) components. There was also no significant difference in the median linear wear rates when failed hip resurfacing and modular THR hips of the same type (ASR and Birmingham hip resurfacing (BHR)) were compared. Unlike other studies of well-functioning hips, there was no significant difference in pre-revision blood metal ion levels between hip resurfacing and modular THR. Edge loading was common in both groups, but more common in the resurfacing group (67%) than in the modular group (57%). However, this was not significant (p = 0.3479). We attribute this difference to retention of the neck in resurfacing of the hip, leading to impingement-type edge loading. This was supported by visual evidence of impingement on the femur. These findings show that failed metal-on-metal hip resurfacing and modular THRs have similar component wear rates and are both associated with raised pre-revision blood levels of metal ions.

  19. Hip resurfacing: a large, US single-surgeon series.

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    Brooks, P J

    2016-01-01

    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system.

  20. High Prevalence of Pseudotumors in Patients with a Birmingham Hip Resurfacing Prosthesis A Prospective Cohort Study of One Hundred and Twenty-nine Patients

    NARCIS (Netherlands)

    Bisschop, R.; Boomsma, M. F.; Van Raay, J. J. A. M.; Tiebosch, A. T. M. G.; Maas, M.; Gerritsma, C. L. E.

    2013-01-01

    Background: Recently, concern has emerged about pseudotumors (lesions that are neither malignant nor infective in the soft tissues surrounding total hip arthroplasty components) after hip arthroplasties with metal-on-metal bearings. Patients treated in our hospital for degenerative arthritis of the

  1. HIP RESURFACING - FIRST IMPRESSIONS AND NEW OPPORTUNITIES

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    G. V. Kuropatkin

    2010-01-01

    Full Text Available Midi-time follow-up results of hip resurfacing were retrospectively analyzed. 117 operations in 109 patients with average age 36,2 years were performed. From one to four years follow-up results showed good clinical and functional result with proximal hip bone stock preservation. In spite of technical difficulties of resurfacing, complication level was not more, than in standard total hip arthroplasty. This surgical procedure may be recommends for young, active patients.

  2. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

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    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.

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

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    Pailhé, Régis; Reina, Nicolas; Cavaignac, Etienne; Sharma, Akash; Lafontan, Valérie; Laffosse, Jean-Michel; Chiron, Philippe

    2013-01-01

    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.

  4. 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.

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

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    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.

  6. [Hip resurfacing in patients under 55 years of age

    NARCIS (Netherlands)

    Schmitz, M.W.J.L.; Veth, R.P.H.; Schreurs, B.W.

    2011-01-01

    Hip resurfacing arthroplasty was introduced as an alternative to the conventional total hip arthroplasty which had shown suboptimal results in younger patients. Application of the resurfacing technique in younger patients has increased over the last few years. To date, no randomized controlled trial

  7. 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...

  8. Five year results of the first US FDA-approved hip resurfacing device.

    Science.gov (United States)

    Su, Edwin P; Housman, Lawrence R; Masonis, John L; Noble, John W; Engh, C Anderson

    2014-08-01

    A prospective, multi-center postmarket approval study has been ongoing since May 2006 to assess safety and efficacy of the first US FDA approved hip resurfacing implant. 265 patients have been enrolled at five study sites. The average age of the patients is 51.3 years. There have been 7 revisions (2.4%) in the cohort to date. K-M survival curves for the cohort are 97.6% at 5 years. There is a trend toward a gender difference in implant survivorship, with 98.6% of men and 94.7% of women free from revision. Metal ion analysis revealed median cobalt and chromium levels of 1.5 ppb and 1.7 ppb at 1 year. In this prospective US study, the Birmingham Hip Resurfacing implant is demonstrating results comparable to those in the literature.

  9. A comparison of acetate and digital templating for hip resurfacing.

    Science.gov (United States)

    Bracey, Daniel N; Seyler, Thorsten M; Shields, John S; Leng, Xiaoyan; Jinnah, Riyaz H; Lang, Jason E

    2014-01-01

    This study sought to determine whether templating for metal-on-metal hip resurfacing is more accurate with digital or acetate methodology. The medical records of 102 consecutive patients who underwent hip resurfacing at our institution were retrospectively reviewed. Records lacking preoperative radiographs that included a magnification-establishing marker were excluded, leaving 78 records for study. Two investigators independently prepared acetate and digital templates of the preoperative radiographs, which had been calibrated to 120% magnification, to predict femoral and acetabular component size. Accuracy was measured by comparing the predicted component sizes to the surgically implanted component sizes. Digital templating was more accurate than acetate templating in predicting hip resurfacing component size when measuring accuracy of templates by the absolute error of predicted component sizes (femoral, P hip resurfacing procedures.

  10. Poor 10-year survivorship of hip resurfacing arthroplasty

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    Seppänen, Matti; Karvonen, Mikko; Virolainen, Petri; Remes, Ville; Pulkkinen, Pekka; Eskelinen, Antti; Liukas, Antti; Mäkelä, Keijo T

    2016-01-01

    Background and purpose In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods 5,068 HRAs performed during the period 2001–2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period. Results The 8-year survival, with any revision as an endpoint, was 93% (CI: 92–94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap, 92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant. Interpretation The 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal. PMID:27759474

  11. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    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

  12. Narrowing of the neck in resurfacing arthroplasty of the hip: a radiological study.

    Science.gov (United States)

    Hing, C B; Young, D A; Dalziel, R E; Bailey, M; Back, D L; Shimmin, A J

    2007-08-01

    Narrowing of the femoral neck after resurfacing arthroplasty of the hip has been described previously in both cemented and uncemented hip resurfacing. The natural history of narrowing of the femoral neck is unknown. We retrospectively measured the diameter of the femoral neck in a series of 163 Birmingham hip resurfacings in 163 patients up to a maximum of six years after operation to determine the extent and progression of narrowing. There were 105 men and 58 women with a mean age of 52 years (18 to 82). At a mean follow-up of five years, the mean Harris hip score was 94.8 (47 to 100) and the mean flexion of the hip 112.5 degrees (80 degrees to 160 degrees ). There was some narrowing of the femoral neck in 77% (125) of the patients reviewed, and in 27.6% (45) the narrowing exceeded 10% of the diameter of the neck. A multiple logistic regression analysis showed a significant association (chi-squared test (derived from logistic regression) p = 0.01) of narrowing with female gender and a valgus femoral neck/shaft angle. There was no significant association between the range of movement, position or size of the component or radiological lucent lines and narrowing of the neck (chi-squared test; p = 0.10 (flexion), p = 0.08 (size of femoral component), p = 0.09 (size of acetabular component), p = 0.71 (femoral component angulation), p = 0.99 (lucent lines)). There was no significant difference between the diameter of the neck at a mean of three years (2.5 to 3.5) and that at five years (4.5 to 5.5), indicating that any change in the diameter of the neck had stabilised by three years (sign rank test, p = 0.60). We conclude that narrowing of the femoral neck which is found with the Birmingham hip resurfacing arthroplasty is in most cases associated with no adverse clinical or radiological outcome up to a maximum of six years after the initial operation.

  13. Metal ion levels and revision rates in metal-on-metal hip resurfacing arthroplasty: a comparative study.

    Science.gov (United States)

    Robinson, Patrick G; Wilkinson, Andrew J; Meek, Robert M D

    2014-01-01

    Metal-on-metal (MoM) bearings in hip surgery are related to increased blood levels of metal ions. The nature of the relationship between ion levels and failure is still not fully understood. This study compares three cohorts of patients, 120 patients in each cohort, treated with a hip resurfacing arthroplasty, grouped by brand and diameter of femoral component on average four years postoperatively: Birmingham Hip Resurfacing ≥50 mm, Durom resurfacing ≥50 mm and Durom resurfacing resurfacing than the other two cohorts (P<0.05). The large BHR and large Durom HRA had revision rates of 3.3%. The small Durom HRA had a revision rate of 8.3%. Elevated blood ion levels can indicate a failing MoM bearing. The large BHR and large Durom HRA have similar revision rates yet the large Durom HRA had significantly lower metal ion levels. When similar ion levels were reported for BHR and small Durom the latter had significantly higher revision rates. This suggests ion levels do not absolutely predict the rate of HRA failure. Since MoM generation of metal ions is not the sole reason of failure, regular clinical and radiographic follow-up should also be in place for patients with these joints.

  14. How Do Metal Ion Levels Change over Time in Hip Resurfacing Patients? A Cohort Study

    Directory of Open Access Journals (Sweden)

    Lucia Savarino

    2014-01-01

    Full Text Available Metal-on-metal hip resurfacing (MOM-HR is offered as an alternative to traditional hip arthroplasty for young, active adults with advanced osteoarthritis. Nevertheless, concerns remain regarding wear and corrosion of the bearing surfaces and the resulting increase in metal ion levels. We evaluated three cohorts of patients with Birmingham hip resurfacing (BHR at an average follow-up of 2, 5, and 9 years. We asked whether there would be differences in ion levels between the cohorts and inside the gender. Nineteen patients were prospectively analyzed. The correlation with clinical-radiographic data was also performed. Chromium, cobalt, nickel, and molybdenum concentrations were measured by atomic absorption spectrophotometry. Chromium and cobalt levels demonstrated a tendency to decrease over time. Such tendency was present only in females. An inverse correlation between chromium, implant size, and Harris hip score was present at short term; it disappeared over time together with the decreased ion levels. The prospective analysis showed that, although metal ion levels remained fairly constant within each patient, there was a relatively large variation between subjects, so mean data in this scenario must be interpreted with caution. The chronic high exposure should be carefully considered during implant selection, particularly in young subjects, and a stricter monitoring is mandatory.

  15. Groin pain after metal-on-metal hip resurfacing prosthesis

    Directory of Open Access Journals (Sweden)

    Daniel Hernández-Vaquero

    2014-08-01

    Full Text Available Total hip replacement continues to be a widely successful operation, but persistent groin pain following a metal-on-metal hip resurfacing remains a problem for some patients. The concern regarding the safety and efficacy of metal-on-metal total hip replacements has been rising. We present the case of a 47-year-old man with groin pain after metal-on-metal hip resurfacing. We observed high metal ion levels detected in blood analytical studies and a pseudotumor in magnetic resonance imaging. Our patient was treated with a revision surgery. The progressive elevation of blood and urine metal levels in the presence of periarticular cysts and/or groin pain is a complication of metal-on-metal hip arthroplasty and needs revision surgery.

  16. Hip resurfacing in a district general hospital: 6-year clinical results using the ReCap hip resurfacing system

    Directory of Open Access Journals (Sweden)

    van der Weegen Walter

    2012-12-01

    Full Text Available Abstract Background The purpose of our study was to prospectively report the clinical results of 280 consecutive hips (240 patients who received a ReCap Hip Resurfacing System implant (Biomet Inc., Warsaw, USA in a single district general hospital. Literature reports a large variation in clinical results between different resurfacing designs and published results using this particular design are scarce. Methods Mean follow up was 3.3 years (1.0 to 6.3 and four patients were lost to follow-up. All patients were diagnosed with end-stage hip osteoarthritis, their mean age was 54 years and 76.4% of all patients were male. Results There were 16 revisions and four patients reported a Harris Hip Score Conclusions This independent series confirms that hip resurfacing is a demanding procedure, and that implant survival of the ReCap hip resurfacing system is on a critical level in our series. In non-revised patients, reported outcomes are generally excellent. Trial registration ClinicalTrials.gov Identifier: NCT00603395

  17. Current expert views on metal-on-metal hip resurfacing arthroplasty. Consensus of the 6th advanced Hip resurfacing course, Ghent, Belgium, May 2014.

    Science.gov (United States)

    Van Der Straeten, Catherine; De Smet, Koen A

    2016-01-01

    This paper reports the consensus of an international faculty of expert metal-on-metal (MoM) hip resurfacing surgeons, with a combined experience of over 40,000 cases, on the current status of hip resurfacing arthroplasty. Indications, design and metallurgy issues, release of metal ions and adverse soft tissue reactions to particles, management of problematic cases and revisions, as well as required experience and training are covered. The overall consensus is that MoM hip resurfacing should not be banned and should be viewed separately from MoM total hip arthroplasty (THA) with a large diameter head because of the different design and wear behaviour related to the taper/trunnion connection. The use of hip resurfacing has decreased worldwide but specialist centres continue to advocate hip resurfacing in young and active male patients. Regarding age the general recommendation is to avoid hip resurfacing in men older than 65 and in women older than 55, depending on the patient activity and bone quality. Female gender is considered a relative contraindication. Most surgeons would not implant a MoM hip in women who would still like a child. Regardless of gender, there is a consensus not to perform hip resurfacing in case of a femoral head size smaller than 46 mm and in patients with renal insufficiency or with a known metal allergy. Regarding follow-up of hip resurfacing and detection of adverse local tissue reactions, metal ion measurements, MRI and ultrasound are advocated depending on the local expertise. The consensus is that hip resurfacing should be limited to high volume hip surgeons, who are experienced in hip resurfacing or trained to perform hip resurfacing in a specialist centre.

  18. Metal on metal hip resurfacing versus uncemented custom total hip replacement - early results

    Directory of Open Access Journals (Sweden)

    Muirhead-Allwood Sarah K

    2010-02-01

    Full Text Available Abstract Introduction There is no current consensus on the most appropriate prosthesis for treating symptomatic osteoarthritis (OA of the hip in young, active patients. Modern metal on metal hip resurfacing arthroplasty (HR has gained popularity as it is theoretically more stable, bone conserving and easier to revise than total hip arthroplasty. Early results of metal on metal resurfacing have been encouraging. We have compared two well matched cohorts of patients with regard to function, pain relief and patient satisfaction. Methods This prospective study compares 2 cohorts of young, active patients treated with hip resurfacing (137 patients, 141 hips and custom uncemented (CADCAM stems (134 patients, 141 hips. All procedures were performed by a single surgeon. Outcome measures included Oxford, WOMAC and Harris hip scores as well as an activity score. Statistical analysis was performed using the unpaired student's t-test. Results One hundred and thirty four and 137 patients were included in the hip replacement and resurfacing groups respectively. The mean age of these patients was 54.6 years. The mean duration of follow up for the hip resurfacing group was 19.2 months compared to 13.4 months for the total hip replacement group. Pre operative oxford, Harris and WOMAC scores in the THA group were 41.1, 46.4 and 50.9 respectively while the post operative scores were 14.8, 95.8 and 5.0. In the HR group, pre- operative scores were 37.0, 54.1 and 45.9 respectively compared to 15.0, 96.8 and 6.1 post operatively. The degree of improvement was similar in both groups. Conclusion There was no significant clinical difference between the patients treated with hip resurfacing and total hip arthroplasty in the short term.

  19. Hip resurfacing arthroplasty: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    K Corten

    2011-03-01

    Full Text Available Hip resurfacing arthroplasty (HRA is a concept of hip replacement that allows treating young active patients with a femoral bone preserving procedure. The proposed advantages of resuming an active lifestyle with increased frequency and duration of sports activities have been shown to be realistic. The 30-year cost-effectiveness in young male patients has been shown to be higher in resurfacing compared to conventional total hip replacement (THA. However, prognosticators of an inferior outcome have also been identified. The most important patient related factors are secondary osteoarthritis as the indication for surgery such as post-childhood hip disorders or AVN, female gender, smaller component sizes and older age (>65 years for males and >55 years for females. In addition, surgical technique (approach and cementing technique and component design are also important determinant factors for the risk of failure. Moreover, concerns have surfaced with respect to high metal ion concentrations and metal ion hypersensitivities. In addition, the presumed ease of revising HRA has not reflected in improved or equal survivorship in comparison to a primary THA. This highlights the importance of identifying patient-, surgery-, and implant-related prognosticators for success or failure of HRA. Rather than vilifying the concept of hip resurfacing, detailed in depth analysis should be used to specify indications and improve implant design and surgical techniques.

  20. Metal-on-metal hip resurfacings. A radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Zhongbo [University of Oxford, Medical School, Oxford (United Kingdom); Pandit, Hemant; Taylor, Adrian; Gill, Harinderjit; Murray, David [University of Oxford, Nuffield Department of Orthopaedic Surgery, Oxford (United Kingdom); Ostlere, Simon [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom)

    2011-03-15

    It is important to be aware of the various complications related to resurfacing arthroplasty of the hip (RSA) and the spectrum of findings that may be encountered on imaging. The bone conserving metal-on-metal (MOM) hip resurfacing has become increasingly popular over the last ten years, especially in young and active patients. Initial reports have been encouraging, but long-term outcome is still unknown. Early post operative complications are rare and have been well documented in the literature. Medium and long term complications are less well understood. A rare but important problem seen at this stage is the appearance of a cystic or solid periarticular reactive mass, which occurs predominately in women and usually affects both hips when seen in patients with bilateral RSAs. The following imaging findings are illustrated and their significance discussed; Uncomplicated hip resurfacing arthroplasty, radiolucency around the femoral peg, femoral neck fracture, loosening and infection, suboptimal component position, femoral notching, dislocation, heterotopic ossification, femoral neck thinning and reactive masses. The radiologist should be aware of the normal radiographic appearances and the variety of complications that may occur following RSA and should recommend ultrasound or MRI in patients with an unexplained symptomatic hip and normal radiographs. (orig.)

  1. Femoral lengthening during hip resurfacing arthroplasty: a new surgical procedure.

    Science.gov (United States)

    Vasseur, L; Ayoub, B; Mesnil, P; Pasquier, G; Migaud, H; Girard, J

    2015-04-01

    Correction of leg length discrepancy during hip arthroplasty is a technical challenge. Although resurfacing proposed to young subjects presents a number of advantages (stability, bone stock, etc.), it does not correct leg length discrepancy. We propose an original femoral lengthening technique concomitant to resurfacing performed through the same approach, consisting in a Z-shaped subtrochanteric osteotomy. Resurfacing was performed first and the femoral and acetabular reaming material was used for autografting. The series comprised five cases followed for a mean 42.2 months (range, 33-64 months). The mean surgical time was 100 min (range, 76-124 min). Weightbearing was authorized in all cases at the 8th week. The mean lengthening was 32 mm (range, 25-40 mm). Healing was observed in all cases. This surgical technique, reserved for very young subjects who accept an 8-week postoperative period without weightbearing, can be proposed in cases with substantial preoperative leg length discrepancy.

  2. Histological, histomorphometric and microtomographic analyses of retrieval hip resurfacing arthroplasty failed at different times

    Directory of Open Access Journals (Sweden)

    Salamanna Francesca

    2013-01-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing arthroplasty (HR has been gaining popularity especially for young and active patients. Although different series report good mid-term results, the long-term outcome and failure mechanisms are still concerning. In this consecutive revision case series, 9 retrieved specimens of a failed Birmingham Hip Resurfacing (BHR were divided according to the time to fracture: 3 specimens failed at less than 6 months (Group 1, 3 failed between 6 months and 3 years (Group 2 and 3 failed later than 3 years (Group 3. The objective of the study was to examine by a specific quantitative histomorphometry and microtomography (micro-CT method the characteristics of bone quality and its microarchitecture in retrieved metal-on-metal HR. Methods A series of 948 BHR were performed between 2001 and 2009. Among these implants 10 failures occurred and nine of these underwent revision surgery and were examined by histomorphometry and micro-CT. Results Histomorphometry showed a significant increase in trabecular separation (Tb.Sp in Group 3 in comparison with Group 1 (113%, p  Conclusions This study showed that the morphometric parameters considered are crucial for a good understanding of mechanical properties of HR and may be of significant importance in the pathogenesis of HR failure particularly in the development of late fractures.

  3. Revision of Failed Hip Resurfacing and Large Metal-on-Metal Total Hip Arthroplasty Using Dual-Mobility Components.

    Science.gov (United States)

    Snir, Nimrod; Park, Brian K; Garofolo, Garret; Marwin, Scott E

    2015-06-01

    Revision of metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing is associated with high complication rates. The authors propose dual-mobility components as a surgical option and present short- to mid-term results of MoM hips revised with dual-mobility components. Eighteen consecutive hips that underwent revision of MoM THA or hip resurfacing using dual-mobility components were identified. At final follow-up (mean, 17.5 months), the visual analog scale, modified Harris Hip Score, and SF-12 scores had all improved (Phip resurfacing using a dual-mobility device is an effective strategy.

  4. Intramedullary fixation of a femoral shaft fracture with preservation of an existing hip resurfacing prosthesis.

    Science.gov (United States)

    Bilkhu, A; Sisodia, G; Chakrabarty, G; Muralikuttan, K P

    2015-04-01

    Femoral neck fractures have been reported as a cause for failure in patients with a hip resurfacing arthroplasty. However, the incidence and management of fractures of the femoral shaft with an ipsilateral hip resurfacing arthroplasty is relatively absent in current literature. Although, the gold standard for the fixation of a closed femoral shaft fracture is with the use of an intramedullary nail, this can be a challenge in the presence of a hip resurfacing arthroplasty. We describe the case of anterograde intramedullary nail fixation for a femoral shaft fracture in a patient with an ipsilateral hip resurfacing arthroplasty in situ.

  5. 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.

  6. Intertrochanteric Fracture After Hip Resurfacing Arthroplasty Managed with a Reconstruction Nail

    Directory of Open Access Journals (Sweden)

    Jason Chow

    2013-12-01

    Full Text Available Periprosthetic fractures after hip resurfacings are rare occurrences that can pose a challenge to orthopaedic surgeons. With hip resurfacings becoming more common, the prevalence of these fractures is likely to increase because these patients are usually younger and more active. We report a case of traumatic periprosthetic proximal femur fracture treated with a reconstruction intramedullary nail technique.

  7. Learning from the learning curve in total hip resurfacing: a radiographic analysis.

    NARCIS (Netherlands)

    Witjes, S.; Smolders, J.M.; Beaule, P.E.; Pasker, P.; Susante, J.L.C. van

    2009-01-01

    BACKGROUND: Operation of hip resurfacing prosthesis is a technically demanding procedure accompanied by a learning curve. To our knowledge no objective data on this learning curve are available in the literature. METHODS: For the first 40 resurfacing hip prostheses implanted by a single-surgeon radi

  8. Long-term outcome of a metal-on-polyethylene cementless hip resurfacing.

    Science.gov (United States)

    Tan, Timothy L; Ebramzadeh, Edward; Campbell, Patricia A; Al-Hamad, Mariam; Amstutz, Harlan C

    2014-04-01

    Due to the well-documented problems surrounding metal-on-metal bearings, the use of hip resurfacing has declined. Since the potential benefits of hip resurfacing remain desirable, it may be beneficial to investigate the long-term outcome of hip resurfacings using metal-on-polyethylene in the 1980's. We report the long-term survivorship and modes of failure of a cementless metal-on-polyethylene resurfacing (n = 178) with different porous ingrowth surfaces. While acetabular loosening was absent, a high incidence of femoral failures (femoral loosening = 18.1%, osteolytic neck fracture = 21%) occurred despite using the same ingrowth surface for both components. Ongoing developments using the lessons learned from these previous generation components and utilizing modern low wear materials, e.g., cross-linked polyethylene, may lead to improved implants for future hip resurfacings.

  9. Efficacy of hip resurfacing arthroplasty: 6 year results from an international multisurgeon prospective cohort study.

    Science.gov (United States)

    Aulakh, Tajeshwar S; Jayasekera, Narlaka; Singh, Rohit; Patel, Amit; Roulahamin, Nick; Kuiper, Jan H; Richardson, James B

    2015-06-01

    Metal-on-metal hip resurfacing is undertaken worldwide. This procedure helps preserve femoral bone stock and allows patients to return to high activity sports. Most outcome studies are individual surgeon case series from single centers where the results and outcomes are evaluated by the same surgeon. One method of increasing the external validity of a follow-up study is to have a multi-centre study design with independent assessment of the outcomes. We present an independent assessment of eleven year follow-up of hip resurfacing outcomes from an international hip resurfacing register. The purpose of this study was to assess: Implant survival at maximum follow-up for revision due to any reason, implant survival at maximum follow-up for revision due to major causes of failure, hip function following hip resurfacing and factors affecting hip function, effect of gender and age on hip function and implant survival, effect of femoral component size on hip function and implant survival. 4535 patients (5000 hips) entered into the registry during 1997-2002 were studied. In summary, at a maximum follow-up of 11 years hip resurfacing has a good implant survival of 96.2% and excellent post-operative function. This is excellent given the international and multisurgeon nature of this cohort where majority of the surgeons were in their learning curve.

  10. Results of hip resurfacing for developmental dysplasia of the hip of Crowe type Ⅰ and Ⅱ

    Institute of Scientific and Technical Information of China (English)

    XU Wei-dong; LI Jia; ZHOU Zhen-hua; WU Yue-song; LI Ming

    2008-01-01

    Background Recently, the new generation of metal-on-metal total hip resurfacing arthroplasty is well known for preserving the proximal femoral bone stock, minimizing the risk of postoperative dislocation using large femoral heads, and expecting low wear of metal-on-metal articulation for longer prosthesis survival. It also has the advantage in biomechanical loading in the proximal femur. The osteoarthritis secondary to developmental dysplasia of the hip (DDH) has been the most common reason for total hip arthroplasty. Most of the patients are young and active, who require improved range of motion of the hip besides relief of the pain, even expect to resume the ability to run and jump after the joint arthroplasty, thus to be allowed an active lifestyle. The objective of the current study was to evaluate the early outcome of resurfacing arthroplasty for the mild DDH cases (Crowe type Ⅰ and Ⅱ).Methods Between September 2005 and May 2007, twenty-one consecutive patients (twenty-six hips) with the diagnosis of osteoarthritis secondary to DDH underwent metal-on-metal resurfacing arthroplasty. The average age at the time of surgery was 46.5 years (range, 37-59 years). Six patients (28.6%) were male and fifteen (71.4%) were female. Clinical and radiographic results were observed. The follow-up was performed at 6 weeks, 3, 6, 9 months and then yearly.Results All patients were followed for a mean of 18 months (9-29 months). During the follow-up period no complications, such as dislocation of hip joints, infection or femoral neck fracture occurred. The clinical outcomes, as rated with the Harris hip score, improved significantly compared with the preoperative ratings. The mean postoperative Harris hip score was 90.7, compared to 35.5 preoperatively. The radiographic analysis showed that all prostheses were fixed with no radiolucencies. All of the patients who had equal limb lengths preoperatively had equal lengths postoperatively. Of the nine patients with preoperative

  11. 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....

  12. Evaluation of a patient specific femoral alignment guide for hip resurfacing.

    Science.gov (United States)

    Olsen, Michael; Naudie, Douglas D; Edwards, Max R; Sellan, Michael E; McCalden, Richard W; Schemitsch, Emil H

    2014-03-01

    A novel alternative to conventional instrumentation for femoral component insertion in hip resurfacing is a patient specific, computed tomography based femoral alignment guide. A benchside study using cadaveric femora was performed comparing a custom alignment guide to conventional instrumentation and computer navigation. A clinical series of twenty-five hip resurfacings utilizing a custom alignment guide was conducted by three surgeons experienced in hip resurfacing. Using cadaveric femora, the custom guide was comparable to conventional instrumentation with computer navigation proving superior to both. Clinical femoral component alignment accuracy was 3.7° and measured within ± 5° of plan in 20 of 24 cases. Patient specific femoral alignment guides provide a satisfactory level of accuracy and may be a better alternative to conventional instrumentation for initial femoral guidewire placement in hip resurfacing.

  13. 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.

  14. Clinical results of the conserve plus metal on metal hip resurfacing: an independent series.

    Science.gov (United States)

    Zylberberg, Alejandro D; Nishiwaki, Toru; Kim, Paul R; Beaulé, Paul E

    2015-01-01

    The purpose of the present study was to report the clinical and radiographic results of an independent series of the Conserve Plus hip resurfacing. Five hundred forty-eight consecutive hip resurfacings were performed using the Conserve Plus prosthesis in 458 patients (350 males) with a mean age of 48.3 years (range 19 to 66). No patients were lost to follow-up. At a mean follow-up of 6.6 years (3.9 to 11.9) thirty (5.4%) hips required conversion to a total hip arthroplasty (THA) (20 males, 10 females, mean age=48.3±7.3 years). Five-year survival with as revision endpoint was 94.5% (95% CI: 93.5% to 95.5%). This study confirms the good clinical results previously reported with the Conserve Plus hip resurfacing device.

  15. Hip resurfacing arthroplasty: A new method to assess and quantify learning phase.

    Science.gov (United States)

    Aulakh, T S; Jayasekera, N; Singh, R; Patel, A; Kuiper, J H; Richardson, J B

    2014-09-01

    Hip resurfacing had initially gained acceptance and popularity as it helps preserve femoral bone stock. In this study we tried to answer the following questions; 1. Whether there is a learning curve for hip resurfacing? 2. Is it present in surgeons from non-developer centres? 3. Is it present in surgeons from developer centres as well? The Oswestry outcome centre was setup to serve an independent international registry for collecting, analysing and reporting outcomes following hip resurfacing. Over a 10 year period, 4535 patients (5000 hips) were recruited from different countries and within the UK from different centres in this study by 139 surgeons from 37 different countries. Our study has shown that function can be used to assess the level of surgical competence. The results from this multilevel analysis have helped to answer the questions posed in the introduction. Hip resurfacing is a surgical procedure with a learning phase and this learning effect is more pronounced in non-developer surgeons as compared to developer surgeons. Hip scores can be used to assess proficiency and competence of surgeons undertaking hip resurfacing arthroplasty.

  16. Computerized range of motion analysis following dual mobility total hip arthroplasty, traditional total hip arthroplasty, and hip resurfacing.

    Science.gov (United States)

    Klingenstein, Gregory G; Yeager, Alyssa M; Lipman, Joseph D; Westrich, Geoffrey H

    2013-08-01

    Newer arthroplasty designs claim to provide superior range of motion (ROM) and greater stability than their predecessors. However, there is no way to compare ROM of implant systems in an equivalent anatomical environment in a clinical setting. This study used computer-aided design to compare ROM after hip resurfacing, 28 mm THA, 36 mm THA, and anatomic dual mobility (ADM) THA in 3D models of 5 cadaver pelvises. ROM to impingement was then tested in 10 different motions and a one-way ANOVA was used to compare results. The hip resurfacing resulted in restricted ROM compared to the other 3 models in all motions except adduction. The ADM, 36 mm, and 28 mm THA resulted in similar ROM. Dual mobility constructs provide comparable ROM in patients where large head THA is not appropriate.

  17. Periacetabular bone mineral density changes after resurfacing hip arthroplasty versus conventional total hip arthroplasty. A randomized controlled DEXA study

    NARCIS (Netherlands)

    Smolders, J.M.; Pakvis, D.F.M.; Hendrickx, B.W.; Verdonschot, N.J.; Susante, J.L.C. van

    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=

  18. 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, N.J.J.; Susante, van 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

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

    DEFF Research Database (Denmark)

    Nissen, Tina Koerner; 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...

  20. 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 ...

  1. A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up.

    Science.gov (United States)

    Haddad, F S; Konan, S; Tahmassebi, J

    2015-05-01

    The aim of this study was to evaluate the ten-year clinical and functional outcome of hip resurfacing and to compare it with that of cementless hip arthroplasty in patients under the age of 55 years. Between 1999 and 2002, 80 patients were enrolled into the study: 24 were randomised (11 to hip resurfacing, 13 to total hip arthroplasty), 18 refused hip resurfacing and chose cementless total hip arthroplasty with a 32 mm bearing, and 38 insisted on resurfacing. The mean follow-up for all patients was 12.1 years (10 to 14). Patients were assessed clinically and radiologically at one year, five years and ten years. Outcome measures included EuroQol EQ5D, Oxford, Harris hip, University of California Los Angeles and University College Hospital functional scores. No differences were seen between the two groups in the Oxford or Harris hip scores or in the quality of life scores. Despite a similar aspiration to activity pre-operatively, a higher proportion of patients with a hip resurfacing were running and involved in sport and heavy manual labour after ten years. We found significantly higher function scores in patients who had undergone hip resurfacing than in those with a cementless hip arthroplasty at ten years. This suggests a functional advantage for hip resurfacing. There were no other attendant problems.

  2. A comparison of leg length and femoral offset discrepancies in hip resurfacing, large head metal-on- metal and conventional total hip replacement: a case series

    Directory of Open Access Journals (Sweden)

    Herman Katie A

    2011-12-01

    Full Text Available Abstract Background A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement. Method Sixty patient's post-operative radiographs were reviewed; 20 patients had a hip resurfacing (HR, 20 patients had a Large Head Metal-on-metal (LHM hip replacement and 20 patients had a conventional small head Total Hip Replacement (THR. The leg length and femoral offset of the operated and unoperated hips were measured and compared. Results Hip resurfacing accurately restored hip biomechanics with no statistical difference in leg length (P = 0.07 or femoral offset (P = 0.95 between the operated and non-operative hips. Overall HR was superior for reducing femoral offset discrepancies where it had the smallest bilateral difference (-0.2%, P = 0.9. The traditional total hip replacement was least effective at restoring the hip anatomy. Conclusion The use of a larger-diameter femoral head in hip resurfacing does not fully account for the superior biomechanical restoration, as LHM did not restore femoral offset as accurately. We conclude that restoration of normal hip biomechanics is best achieved with hip resurfacing.

  3. Changes in bone mineral density of the acetabulum and proximal femur after total hip resurfacing arthroplasty.

    Science.gov (United States)

    Huang, Qiang; Shen, Bin; Yang, Jing; Zhou, Zong-ke; Kang, Peng-de; Pei, Fu-xing

    2013-12-01

    Our aim was to investigate the changes in bone mineral density (BMD) of acetabulum and proximal femur after total hip resurfacing arthroplasty. A comparative study was carried out on 51 hips in 48 patients. Group A consisted of 25 patients (26 hips) who had undergone total hip resurfacing and group B consisted of 23 patients (25 hips) who had had large-diameter metal-on-metal total hip arthroplasty (THA). BMDs around the acetabulum and proximal femur were measured using dual-energy x-ray absorptiometry (DEXA) at 2 weeks, 6 months, 1 year and annually thereafter during the 3 years after surgery. At final follow-up, the acetabular net mean BMD decreased by 11% in group A and 10% in group B with no differences between two groups (P = .35). For the femoral side, in Gruen zone 1, the mean BMD increased by 4% in group A, whereas it decreased by 11% in group B (P = .029). In Gruen zone 7, the mean BMD increased by 8% at the final follow-up in group A, whereas it decreased by 13% in group B (P = .02). In both groups the mean BMD increased by 3% in Gruen zones 3, 4, 5, and 6. Stress-related bone loss of the acetabulum was comparable for MOM THA and resurfacing devices, but proximal femoral bone density increased in the resurfacing group and decreased in the THA group.

  4. Differences in hip morphology between the sexes in patients undergoing hip resurfacing

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles

    2010-10-01

    Full Text Available Abstract There is limited morphological data on the sex differences between the commonly used pelvic parameters. This study analysed the CT scans of 100 consecutive Caucasian patients, 61 males and 39 females, undergoing hip resurfacing arthroplasty surgery for hip osteoarthritis in one institution. There were no sex differences in femoral torsion/anteversion, femoral neck angle and acetabular inclination. Males had a mean femoral torsion/anteversion of 8 degrees (range -5 to 26 degrees, a mean femoral neck angle of 129 degrees (range 119 to 138 degrees and a mean acetabular inclination of 55 degrees (range 40 to 86 degrees. Females had a mean femoral torsion/anteversion of 9 degrees (range -2 to 31 degrees, a mean femoral neck angle of 128 degrees (range 121 to 138 and a mean acetabular inclination of 57 degrees (range 44 to 80 degrees. Females had a significantly greater acetabular version of 23 degrees (range 10 to 53 compared with 18 degrees in males (range 7 to 46 degrees (p = 0.02 and males had a significantly greater femoral offset of 55 mm (range 42 to 68 mm compared with 48 mm (range 37 to 57 mm in females (p = 0.00. There were no significant differences between measurements taken from each patient's right and left hips. These findings may be useful for the future design and the implantation of hip arthroplasty components.

  5. Hip resurfacing arthroplasty: mid-term results in 486 cases and current indication in our institution.

    Science.gov (United States)

    Ribas, Manuel; Cardenas, Carlomagno; Astarita, Emanuele; Moya, Esther; Bellotti, Vittorio

    2014-10-02

    In the previous decade, metal-on-metal hip resurfacing has been considered an attractive option and theoretically advantageous over conventional total hip arthroplasty, especially in young active patients. Different authors have reported favourable mid-term clinical and functional results with acceptable survival rates. Proper indication and planning, as accurate technical execution have been advocated to be crucial elements for success.Concerns regarding serum metal ion levels and possible clinical implications have led in the last years to a decline in the use of metal-on-metal hip resurfacing and metal-on-metal bearings in general.The aim of this study is to present the results of our first 486 cases of hybrid hip resurfacing arthroplasties with a second generation cementing technique, and to describe our current restricted indication of this type of prosthesis, in the light of recent findings in the literature about the possible complications related to metallosis or improper patient selection. Global survivorship of our series was 97.9% at a mean follow-up of 7.2 years.In the second season of our experience the indication is restrictive. The candidate for a resurfacing hip replacement is a young and active male patient, with good bone quality, that has been made aware of the risks and benefits of this type of prosthesis.

  6. Effect of acetabular cup design on metal ion release in two designs of metal-on-metal hip resurfacing.

    Science.gov (United States)

    Cadossi, Matteo; Tedesco, Giuseppe; Savarino, Lucia; Baldini, Nicola; Mazzotti, Antonio; Greco, Michelina; Giannini, Sandro

    2014-10-01

    The purpose of this observational prospective cohort study was to evaluate the serum concentrations of cobalt (Co), chromium (Cr), and nickel (Ni) at a 2-year follow-up in patients operated on with a novel design of hip resurfacing: Romax resurfacing system (RRS). RRS is characterized by the presence of an acetabular notch which theoretically provides a wider range of motion and a reduced incidence of groin pain. The presence of radiolucencies and functional outcome, assessed using the Harris hip score (HHS) and the University of California Activity scale (UCLA), were secondary endpoints. Moreover, these results were compared with those obtained in our previous study from a similar cohort of patients implanted using the Birmingham Hip Resurfacing (BHR) system. At a 2-year follow-up, the serum levels of Co in patients operated on using the RRS were five times higher (p = 0.0002) than those found before surgery (Co, means: 1.04 and 0.20 ng/mL, respectively); similarly, Cr levels were 13 times higher (p < 0.0001) at a 2-year follow-up than before surgery (Cr, means: 1.69 and 0.13 ng/mL, respectively). Ni concentrations (0.42 and 0.78 ng/mL) were not significantly different (p = 0.16), even if they increased 86% after surgery. In the RRS patients, an inverse correlation was found between Co and Cr concentrations and length of follow-up (Co: r = -0.64, p = 0.0096; Cr: r= -0.45, p = 0.08). The serum levels of Co and Cr were not significantly different between RRS (Co: 1.04 ng/mL and Cr: 1.69 ng/mL) and BHR (Co: 1.39 ng/mL and Cr: 2.30 ng/mL) patients at 2 years (p = 0.95 and 0.26 for Co and Cr, respectively). Our results showed that RRS patients achieved an excellent clinical outcome with limited metal ion release.

  7. 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) c...... 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.......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...

  8. 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 analysi

  9. 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.

  10. 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.

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

    Science.gov (United States)

    Lord, James K; Langton, David J; Nargol, Antoni V F; Meek, R M Dominic; Joyce, Thomas J

    2015-10-15

    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.

  12. Contact mechanics and wear simulations of hip resurfacing devices using computational methods.

    Science.gov (United States)

    Ali, Murat; Mao, Ken

    2014-01-01

    The development of computational and numerical methods provides the option to study the contact mechanics and wear of hip resurfacing devices. The importance of these techniques is justified by the extensive amount of testing and experimental work required to verify and improve current orthopaedic implant devices. As the demands for device longevity is increasing, it is as important as ever to study techniques for providing much needed orthopaedic hip implant solutions. Through the use of advanced computer aided design and the finite element method, contact analysis of hip resurfacing devices was carried out by developing both three-dimensional and two-dimensional axisymmetric models whilst considering the effects of loading conditions and material properties on the contact stresses. Following on from this, the three-dimensional model was used in combination with a unique programme to develop wear simulations and obtain cumulative wear for both the acetabular cup and femoral head simultaneously.

  13. Highly cross-linked polyethylene in hip resurfacing arthroplasty: long-term follow-up.

    Science.gov (United States)

    Amstutz, Harlan C; Takamura, Karren M; Ebramzadeh, Edward; Le Duff, Michel J

    2015-01-01

    Highly cross-linked polyethylene (XLPE) has improved wear properties. This study reports the results of a small series of patients treated over 10 years ago with a metal-on-XLPE hip resurfacing.A total of 21 hips in 20 patients received a hip resurfacing with a cobalt-chromium metal femoral head and metal-backed acetabular cup lined with a XLPE insert and were retrospectively studied. Kaplan-Meier Survivorship was calculated.Five patients who had initial extreme cystic disease in the femoral head failed due to femoral loosening. Survivorship was 95.2% at 5 years and 81.0% at 10 years.We found that XLPE wear was not implicated in these failures, which were primarily attributed to poor bone quality of the femoral head, early bone preparation, cementing technique and excessive head reaming to near the neck diameter, necessitated for the implantation of a thick two-part socket.

  14. 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...

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

    DEFF Research Database (Denmark)

    Gustafson, Klas; Jakobsen, Stig Storgaard; 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...

  16. 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 hip

  17. Does commitment to rehabilitation influence clinical outcome of total hip resurfacing arthroplasty?

    Directory of Open Access Journals (Sweden)

    Zywiel Michael G

    2010-03-01

    Full Text Available Abstract Background The purpose of this study was to evaluate whether compliance and rehabilitative efforts were predictors of early clinical outcome of total hip resurfacing arthroplasty. Methods A cross-sectional survey was utilized to collect information from 147 resurfacing patients, who were operated on by a single surgeon, regarding their level of commitment to rehabilitation following surgery. Patients were followed for a mean of 52 months (range, 24 to 90 months. Clinical outcomes and functional capabilities were assessed utilizing the Harris hip objective rating system, the SF-12 Health Survey, and an eleven-point satisfaction score. A linear regression analysis was used to determine whether there was any correlation between the rehabilitation commitment scores and any of the outcome measures, and a multivariate regression model was used to control for potentially confounding factors. Results Overall, an increased level of commitment to rehabilitation was positively correlated with each of the following outcome measures: SF-12 Mental Component Score, SF-12 Physical Component Score, Harris Hip score, and satisfaction scores. These correlations remained statistically significant in the multivariate regression model. Conclusions Patients who were more committed to their therapy after hip resurfacing returned to higher levels of functionality and were more satisfied following their surgery.

  18. The imaging spectrum of peri-articular inflammatory masses following metal-on-metal hip resurfacing

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Christopher S.J.; Ostlere, Simon [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom); Harvie, Paul; Gibbons, Christopher L.M.H.; Whitwell, Duncan [Nuffield Orthopaedic Centre, Department of Orthopaedic Surgery, Oxford (United Kingdom); Athanasou, Nicholas A. [Nuffield Orthopaedic Centre, Department of Pathology, Oxford (United Kingdom)

    2008-08-15

    Resurfacing metal-on-metal hip arthroplasty is increasing in popularity, especially in younger patients. To date, studies indicate that the procedure is associated with a good outcome in the medium-term. Formation of a peri-articuar mass is a rarely reported complication. In this study we analyse the imaging findings in patients with resurfacing implants presenting to our institution with peri-articular masses identified on cross sectional imaging. All patients with documented peri-articular masses following resurfacing arthroplasty were included. The available imaging related to the masses was reviewed and the findings documented along with the patient's demographics. There were 10 patients (13 joints). All patients were female. Patients presented with periprosthetic anterior or posterolateral solid and cystic masses. The anterior masses involved psoas muscle and were predominately solid. The posterolateral masses were predominately cystic. In the three cases with bilateral arthroplasties, masses were detected in both hips. Histology in six cases showed features compatible with a type IV hypersensitivity reaction. The preponderance of females, the bilateral nature of the masses and the histological features suggest that peri-articular masses following resurfacing arthroplasty is due to the metal hypersensitivity. (orig.)

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

    Science.gov (United States)

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

    2013-12-01

    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 analysis and clinical examination to study 14 unrevised hips (mean patient age 52.7 years, 46 to 68, 5 female, 7 male) with a pseudotumour and 23 hips (mean patient age 52.8 years, 38 to 69, 7 female, 16 male) without a pseudotumour. The mean post-operative time to the first MARS-MRI scan was 4.3 years (2.2 to 8.3), and mean time between the first and second MARS-MRI scan was eight months (6 to 12). At the second MRI scan, the grade of severity of the pseudotumour had not changed in 35 hips. One new pseudotumour (Anderson C2 score, moderate) was observed, and one pseudotumour was downgraded from C2 (moderate) to C1 (mild). In general, the characteristics of the pseudotumours hardly changed. Repeated MARS-MRI scans within one year in patients with asymptomatic pseudotumours after MoM hip resurfacing showed little or no variation. In 23 patients without pseudotumour, one new asymptomatic pseudotumour was detected. This is the first longitudinal study on the natural history of pseudotumours using MARS-MRI scans in hip resurfacing, and mirrors recent results for 28 mm diameter MoM total hip replacement.

  20. Current status of modern fully porous coated metal-on-metal hip resurfacing arthroplasty.

    Science.gov (United States)

    Gross, Thomas P; Liu, Fei

    2014-01-01

    Between March 2007 and July 2010, 1000 consecutive fully porous coated hip resurfacing arthroplasties (HRA) were performed by a single surgeon in 871 patients. The average length of follow-up was 3 ± 1 years. Three cases (0.3%) in three patients showed adverse wear related failures. Another 17 (1.7%) failures were identified at the time of this study. Using any failure of any component as the endpoint, the survivorship rate was 98.8% at two years and 97.4% at five years. Excluding the failed cases, all components were radiographically stable; there was only one partial femoral radiolucency seen. The clinical and radiological outcomes of this fully porous coated hip resurfacing were comparable to, if not better than, those reported by others using hybrid fixation methods at five years post-operatively.

  1. 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.

  2. Impact of implant size on cement filling in hip resurfacing arthroplasty.

    Science.gov (United States)

    de Haan, Roel; Buls, Nico; Scheerlinck, Thierry

    2014-01-01

    Larger proportions of cement within femoral resurfacing implants might result in thermal bone necrosis. We postulate that smaller components are filled with proportionally more cement, causing an elevated failure rate. A total of 19 femoral heads were fitted with polymeric replicas of ReCap (Biomet) resurfacing components fixed with low-viscosity cement. Two specimens were used for each even size between 40 and 56 mm and one for size 58 mm. All specimens were imaged with computed tomography, and the cement thickness and bone density were analyzed. The average cement mantle thickness was 2.63 mm and was not correlated with the implant size. However, specimen with low bone density had thicker cement mantles regardless of size. The average filling index was 36.65% and was correlated to both implant size and bone density. Smaller implants and specimens with lower bone density contained proportionally more cement than larger implants. According to a linear regression model, bone density but not implant size influenced cement thickness. However, both implant size and bone density had a significant impact on the filling index. Large proportions of cement within the resurfacing head have the potential to generate thermal bone necrosis and implant failure. When considering hip resurfacing in patients with a small femoral head and/or osteoporotic bone, extra care should be taken to avoid thermal bone necrosis, and alternative cementing techniques or even cementless implants should be considered. This study should help delimiting the indications for hip resurfacing and to choose an optimal cementing technique taking implant size into account.

  3. Hip Resurfacing. Case presentation. Resuperficialización de Cadera. Presentación de caso.

    Directory of Open Access Journals (Sweden)

    Tamara Elizabeth Morales Perez

    Full Text Available Hip resurfacing in youngest patients is an excellent surgical technique for Avascular Necrosis compare with a traditional Total Hip Replacement. Report about a 21 years old female patient involved in a car accident in February 2004 with Fracture of the neck of femur treated with compression hip screw Richard’s type. Two years later the patient was diagnose with avascular necrosis of the contra lateral hip. Hip resurfacing Metal-Metal was carry out in the above mentioned patient.
    La resuperficialización de la cadera en pacientes jóvenes con necrosis avascular es una novedosa técnica quirúrgica que ofrece marcadas ventajas comparadas con las técnicas convencionales de Reemplazo Total de Cadera. Se trata una paciente del sexo femenino de 21 años de edad que sufrió en un accidente de transito en febrero de 2004 con una fractura del cuello femoral por lo que se intervino quirúrgicamente con el sistema intercompresivo de Richard’s. Dos años más tarde se le diagnosticó una necrosis avascular de la cadera contra lateral por lo que se le realizó una resuperficialización de cadera metal-metal.

  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. Influence of ingrowth regions on bone remodelling around a cementless hip resurfacing femoral implant.

    Science.gov (United States)

    Haider, Ifaz T; Speirs, Andrew D; Beaulé, Paul E; Frei, Hanspeter

    2015-01-01

    Hip resurfacing arthroplasty is an alternative to traditional hip replacement that can conserve proximal bone stock and has gained popularity but bone resorption may limit implant survival and remains a clinical concern. The goal of this study was to analyze bone remodelling patterns around an uncemented resurfacing implant and the influence of ingrowth regions on resorption. A computed tomography-derived finite element model of a proximal femur with a virtually implanted resurfacing component was simulated under peak walking loads. Bone ingrowth was simulated by six interface conditions: fully bonded; fully friction; bonded cap with friction stem; a small bonded region at the stem-cup intersection with the remaining surface friction; fully frictional, except for a bonded band along the distal end of the cap and superior half of the cap bonded with the rest frictional. Interface condition had a large influence on remodelling patterns. Bone resorption was minimized when no ingrowth occurred at the bone-implant interface. Bonding only the superior half of the cap increased bone resorption slightly but allowed for a large ingrowth region to improve secondary stability.

  6. Resurfacing hip replacement and cemented total hip replacement have equivalent outcome at one year in a disease matched population: a case-control study of patient reported outcome measures.

    Science.gov (United States)

    Ray, Robbie; Goudie, Ewan B; Jenkins, Paul; Gaston, Paul

    2013-01-01

    Resurfacing hip replacement has demonstrated good survival and outcomes for cohorts of younger male patients, but few controlled studies exist. In this study we compared patient reported outcome measures and satisfaction scores at one year following resurfacing hip replacement in 69 male patients with two control groups of equal numbers undergoing cemented total hip replacement: aged-matched patients and disease matched patients. At one year we found no difference in improvement in patient reported outcome measures between patients undergoing resurfacing hip replacement and disease matched patients, whereas patients undergoing resurfacing hip replacement had a statistically significant improvement in Oxford Hip Score compared to the age-matched controls (pResurfacing hip replacement and total 
hip replacement both confer increase in patient reported outcome scores and high patient satisfaction at one year. The results of this study will allow better counselling of patients and help inform 
treatment decisions.

  7. Sex differences in the morphological failure patterns following hip resurfacing arthroplasty

    Directory of Open Access Journals (Sweden)

    Rüther Wolfgang

    2011-10-01

    Full Text Available Abstract Background Metal-on-metal hybrid hip resurfacing arthroplasty (with a cementless acetabular component and a cemented femoral component is offered as an alternative to traditional total hip arthroplasty for the young and active adult with advanced osteoarthritis. Although it has been suggested that women are less appropriate candidates for metal-on-metal arthroplasty, the mechanisms of prosthesis failure has not been fully explained. While specific failure patterns, particularly osteonecrosis and delayed type hypersensitivity reactions have been suggested to be specifically linked to the sex of the patient, we wished to examine the potential influence of sex, clinical diagnosis, age of the patient and the size of the femoral component on morphological failure patterns in a large cohort of retrieved specimens following aseptic failure of hip resurfacing arthroplasty. Methods Femoral remnants retrieved from 173 hips with known patient's sex were morphologically analyzed for the cause of failure. The results were compared with the control group of the remaining 31 failures from patients of unknown sex. The odds ratios (OR and 95% confidence intervals (CI of the following morphologically defined variables were calculated using logistic regression analysis: periprosthetic fractures (n = 133, osteonecrosis (n = 151, the presence of excessive intraosseous lymphocyte infiltration (n = 11, and interface hyperosteoidosis (n = 30. Logistic regression analysis was performed both unadjusted and after adjustment for sex, age, the size of the femoral component, and preoperative clinical diagnosis. Results Femoral remnants from female patients had a smaller OR for fracture (adjusted OR: 0.29, 95% CI 0.11, 0.80, P for difference = 0.02 and for the presence of osteonecrosis (adjusted OR: 0.16, 95% CI 0.04, 0.63, P for difference = 0.01. However, women had a higher OR for both the presence of excessive intraosseous lymphocyte infiltration (adjusted OR: 10

  8. Accuracy of navigation in hip resurfacing with different surgeons and varying anatomy.

    Science.gov (United States)

    Schleicher, Iris; Haselbacher, Matthias; Mayr, Eckart; Kaiser, Peter M; Lenze, Florian W; Keiler, Alexander; Nogler, Michael

    2012-01-01

    The accuracy of a commercial imageless navigation system for hip resurfacing and its reproducibility among different surgeons and for varying femoral anatomy was tested by comparing conventional and navigated implantation of the femoral component on different sawbones in a hip simulator. The position of the component was measured on postoperative radiographs. Variance for varus/valgus alignment and anteversion was higher for conventional implantation. Among the three surgeons, operation time, chosen implant size and anteversion were significantly different for conventional implantation but not for the navigated method. Using navigation, no difference was found for normal and abnormal anatomy. Values obtained with the navigation system were consistent with those measured on radiographs. Navigation appeared to be accurate and helped to reduce outliers. This was true for the three different surgeons and in varying anatomical situations.

  9. 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

    OBJECTIVES: To evaluate the effect of resurfacing vs standard total hip replacement on post-surgery hip and knee muscle strength recovery in a prospective randomised controlled trial at the Department of Orthopaedics, University Hospital, Odense, Denmark. METHODS: Forty-three patients were......-29%) with the affected side being weakest (P ≤ 0.05) and hip flexors being most affected. Asymmetry was present in half of the muscle groups at 26 wks (P ≤ 0.05), and remained present for the hip flexors and hip adductors at 52 wks (P ≤ 0.05). CONCLUSIONS: R-THA patients showed an attenuated and delayed recovery...... 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...

  10. Results of Conserve Plus Hip Resurfacing: prospective clinical, radiographic and ion study.

    Science.gov (United States)

    Somers, Jan F A; Vanbiervliet, Jens; Lefevere, Filip

    2015-09-01

    We report the 3- to 5-year clinical, radiographic and serum ion level results of a prospective consecutive cohort of 42 hip resurfacing arthroplasties using the Conserve Plus implant in 39 male patients that were operated on by a single surgeon in a community hospital. Average age was 53 years (range 34-67) at surgery. There was one revision for a subcapital neck fracture. There were no surgery related complications. The survival of the implant was 95%. Clinical evaluation showed excellent results with a modified Charnley score of 17.6/18, Harris Hip Score of 96.2/100, WOMAC of 95.1/100, Oxford Score 15.3, and UCLA-Activity Score of 8/10. Radiographic analysis showed no implant at risk, no migration or signs of loosening, no neck narrowing and no osteolysis at final follow-up. Average cup inclination angle was 43.5° with 2 outliers (34° and 57°). Ion level study showed average cobalt in serum 1.04 µg/l (range 0-4) for the whole group, 0.7 µg/l (range 0-3) in patients with unilateral resurfacing and 2.0 µg/l (range 0-4) in patients with bilateral resurfacing. All patients had ion levels within the safe zone. This independent series of Conserve Plus HRA confirms good results at short- to mid-term with excellent wear characteristics. Results for avascular necrosis were equal to those for osteoarthritis.

  11. Are component positioning and prosthesis size associated with hip resurfacing failure?

    Directory of Open Access Journals (Sweden)

    Seyler Thorsten M

    2010-10-01

    Full Text Available Abstract Background Recent studies suggest that there is a learning curve for metal-on-metal hip resurfacing. The purpose of this study was to assess whether implant positioning changed with surgeon experience and whether positioning and component sizing were associated with implant longevity. Methods We evaluated the first 361 consecutive hip resurfacings performed by a single surgeon, which had a mean follow-up of 59 months (range, 28 to 87 months. Pre and post-operative radiographs were assessed to determine the inclination of the acetabular component, as well as the sagittal and coronal femoral stem-neck angles. Changes in the precision of component placement were determined by assessing changes in the standard deviation of each measurement using variance ratio and linear regression analysis. Additionally, the cup and stem-shaft angles as well as component sizes were compared between the 31 hips that failed over the follow-up period and the surviving components to assess for any differences that might have been associated with an increased risk for failure. Results Surgeon experience was correlated with improved precision of the antero-posterior and lateral positioning of the femoral component. However, femoral and acetabular radiographic implant positioning angles were not different between the surviving hips and failures. The failures had smaller mean femoral component diameters as compared to the non-failure group (44 versus 47 millimeters. Conclusions These results suggest that there may be differences in implant positioning in early versus late learning curve procedures, but that in the absence of recognized risk factors such as intra-operative notching of the femoral neck and cup inclination in excess of 50 degrees, component positioning does not appear to be associated with failure. Nevertheless, surgeons should exercise caution in operating patients with small femoral necks, especially when they are early in the learning curve.

  12. Hip Resurfacing. An Experience in Livingstone Hospital, Port Elizabeth, South Africa. From January 2004 to January 2006.

    Directory of Open Access Journals (Sweden)

    Pedro Gonzalo González González

    2008-12-01

    Full Text Available Background. Hip resurfacing in youngest patients with osteoarthritis is a very outstanding surgical technique which offer excellent results compare with a traditional Total Hip Replacement. Objective. To describe the evolution of the patients with osteoarthritis of the hip treated with the surgical technique of resurfacing in Livingstone Hospital. Port Elizabeth. South Africa. Method. A descriptive-retrospective study in the orthopedic department at Livingstone Hospital from January 2004 to January 2006. The variables used were the following: age, sex, affected hip, surgical approach and survivorship of the prosthesis at 12 moths-24 months after surgery. Results. Out of 30 patients operated 22 were males 73,3% the age group more affected was 46-55, 53,3%, the most common cause affecting the hip was the primary osteoarthritis in 17 patients 56,7% and the survivorship of the prosthesis 12 moths after surgery was 100%. Conclusions. Primary osteoarthritis of the hip is a health problem in male youngest patients and the surgical technique hip resurfacing is a very good choice.

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

    Directory of Open Access Journals (Sweden)

    Griffin Damian R

    2010-01-01

    Full Text Available Abstract Background 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. Methods/design 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. Trial registration Current Controlled Trials ISRCTN33354155 UKCLRN portfolio ID 4093

  14. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement: two-year results from a randomised study.

    Science.gov (United States)

    Penny, J O; Brixen, K; Varmarken, J E; Ovesen, O; Overgaard, S

    2012-08-01

    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 two groups to receive either a resurfacing or a THR and were followed for two years. One patient's resurfacing subsequently failed, leaving 19 patients in each group. Resurfaced replacements maintained proximal femoral BMD and, compared with THR, had an increased bone mineral density in Gruen zones 2, 3, 6, and particularly zone 7, with a gain of 7.5% (95% confidence interval (CI) 2.6 to 12.5) compared with a loss of 14.6% (95% CI 7.6 to 21.6). Resurfacing replacements maintained the BMD of the medial femoral neck and increased that in the lateral zones between 12.8% (95% CI 4.3 to 21.4) and 25.9% (95% CI 7.1 to 44.6). On the acetabular side, BMD was similar in every zone at each point in time. The mean BMD of all acetabular regions in the resurfaced group was reduced to 96.2% (95% CI 93.7 to 98.6) and for the total hip replacement group to 97.6% (95% CI 93.7 to 101.5) (p = 0.4863). A mean total loss of 3.7% (95% CI 1.0 to 6.5) and 4.9% (95% CI 0.8 to 9.0) of BMD was found above the acetabular component in W1 and 10.2% (95% CI 0.9 to 19.4) and 9.1% (95% CI 3.8 to 14.4) medial to the implant in W2 for resurfaced replacements and THRs respectively. Resurfacing resulted in a mean loss of BMD of 6.7% (95% CI 0.7 to 12.7) in W3 but the BMD inferior to the acetabular component was maintained in both groups. These results suggest that the ability of a resurfacing hip replacement to preserve BMD only applies to the femoral side.

  15. The influence of computer navigation on trainee learning in hip resurfacing arthroplasty.

    Science.gov (United States)

    Saithna, Adnan; Dekker, Andrew Peter

    2009-01-01

    Computer navigation in arthroplasty surgery is a form of concurrent augmented feedback. Motor learning theory suggests such feedback may be detrimental to learning as a result of the learner either developing a dependence on the additional feedback or being distracted from using intrinsic feedback. To determine whether computer navigation influences the learning curve of novices performing hip resurfacing arthroplasty, a systematic review and critical appraisal of the current English-language literature on the topic was conducted. There is some evidence that use of navigation by trainees facilitates more accurate placement of arthroplasty components as compared to conventional instrumentation. However, there is no evidence that training with computer navigation impairs performance in retention or transfer tests. Thus, although the published literature has significant limitations, there is no evidence that supports concerns regarding the impact of computer navigation on the learning curve of arthroplasty trainees.

  16. Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty.

    Science.gov (United States)

    Parry, Michael C; Povey, James; Blom, Ashley W; Whitehouse, Michael R

    2015-10-01

    Controversy exists regarding the amount of acetabular bone resection, biomechanics and function of patients receiving either total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA). A cohort of patients undergoing 36 mm ceramic-on-ceramic THA (89) or metal-on-metal HRA (86) were compared. No difference was observed when the ratio of native femoral head size was compared to the implanted acetabular component size (1.15 ± 0.1 HRA c.f. 1.13 ± 0.1 THA). No difference was observed in acetabular offset, vertical centre of rotation or function (OHS mean 47 in both groups) but leg length discrepancy (1.8 mm c.f. 5.5 mm) and femoral offset did differ (0.6 mm c.f. 4.1 mm). This demonstrates that 36 mm ceramic-on-ceramic THA is not associated with more bone resection than HRA and achieves equivalent function whilst avoiding the problems of metal-on-metal bearings.

  17. 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.

  18. Center of Mass Compensation during Gait in Hip Arthroplasty Patients: Comparison between Large Diameter Head Total Hip Arthroplasty and Hip Resurfacing

    Directory of Open Access Journals (Sweden)

    Vicky Bouffard

    2011-01-01

    Full Text Available Objective. To compare center of mass (COM compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA and hip resurfacing (HR. Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC and the COM. The ratio (RHPJC-COM and the variability (CVHPJC-COM were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and RHPJC-COM is correlated with the muscle strength ratios (FRABD at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher RHPJC-COM than healthy controls at push-off, and CVHPJC-COM is significantly correlated with FRFLEX. Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls.

  19. 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

      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......, 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...

  20. 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...

  1. Elegibilidade da cirurgia do tipo resurfacing na artroplastia do quadril: uma avaliação de 592 quadris Eligibility for the hip-resurfacing arthroplasty procedure: an evaluation on 592 hips

    Directory of Open Access Journals (Sweden)

    Roberto Dantas Queiroz

    2012-01-01

    Full Text Available OBJETIVO: Verificar a porcentagem de pacientes ideais elegíveis à cirurgia do tipo resurfacing do quadril em um serviço referência de artroplastias do quadril. MÉTODOS: Analisamos, dentre todos os casos de artroplastia do quadril realizadas no Hospital do Servidor Público Estadual de São Paulo (HSPE entre janeiro de 2009 e dezembro de 2010, um total de 592 artroplastias, as quais se enquadrariam nos critérios de indicação ideal para artroplastia de resurfacing segundo avaliação clínica e radiológica preconizada com os critérios estabelecidos pela Food and Drug Administration (FDA e por Seyler et al. RESULTADOS: Considerando o universo total das artroplastias de substituição do quadril, foram elegíveis 5,74% dos pacientes. Nos pacientes submetidos à artroplastia primária, encontrou-se 8,23% em condições ideais a este procedimento. CONCLUSÃO: Demonstra-se o papel ainda restrito desta modalidade cirúrgica entre as cirurgias do quadril.OBJECTIVE: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. METHODS: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA and by Seyler et al. RESULTS: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. CONCLUSION: The study demonstrated that this type of surgery still has a limited role among hip surgery methods.

  2. The effectiveness of metal on metal hip resurfacing: a systematic review of the available evidence published before 2002

    Directory of Open Access Journals (Sweden)

    McCormack Kirsty

    2004-12-01

    Full Text Available Abstract Background Conventional total hip replacement (THR may be felt to carry too high a risk of failure over a patient's lifetime, especially in young people. There is increasing interest in metal on metal hip resurfacing arthroplasty (MoM as this offers a bone-conserving option for treating those patients who are not considered eligible for THR. We aim to evaluate the effectiveness of MoM for treatment of hip disease, and compare it with alternative treatments for hip disease offered within the UK. Methods A systematic review was carried out to identify the relevant literature on MoM published before 2002. As watchful waiting and total hip replacement are alternative methods commonly used to alleviate the symptoms of degenerative joint disease of the hip, we compared MoM with these. Results The data on the effectiveness of MoM are scarce, as it is a relatively new technique and at present only short-term results are available. Conclusion It is not possible to make any firm conclusions about the effectiveness of MoM based on these early results. While the short-term results are promising, it is unclear if such results would be replicated in more rigorous studies, and what the long-term performance might be. Further research is needed which ideally should involve long-term randomised comparisons of MoM with alternative approaches to the clinical management of hip disease.

  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. 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.)

  5. Influence of different DXA acquisition modes on monitoring the changes in bone mineral density after hip resurfacing arthroplasty.

    Science.gov (United States)

    Hakulinen, Mikko A; Borg, Håkan; Häkkinen, Arja; Parviainen, Tapani; Kiviranta, Ilkka; Jurvelin, Jukka S

    2012-01-01

    Dual-energy X-ray absorptiometry (DXA) is a technique enabling the measurement of bone mineral density (BMD) around prostheses after hip resurfacing arthroplasty (HRA). In this study, we evaluated the consistency of different DXA acquisition modes with 33 patients who had undergone HRA. Patients were scanned with DXA immediately after surgery and at 3-, 6-, and 12-mo time points. All the patients were scanned with dual femur and orthopedic hip acquisition modes and analyzed using 10-region ROI model. With both acquisition modes, a statistically significant decrease (p<0.05, Wilcoxon's test) in BMD at 3mo was revealed in 3 ROIs, located to upper and lateral upper femur. Both acquisition modes detected similarly (p<0.01) preservation of the femoral bone stock within 12mo in all but 1 ROI. The applied acquisition protocols involved the use of different footplates for hip fixation. Because the differences between acquisition modes ranged between +1.6% and -7.1% and the reproducibility of BMD values can vary by as much as 28% due to hip rotation, it is proposed that both dual femur and orthopedic hip acquisition modes can be used to monitor the changes in BMD after HRA. However, the same hip rotation is recommended for all DXA measurements.

  6. Metal ion levels and functional results following resurfacing hip arthroplasty versus conventional small-diameter metal-on-metal total hip arthroplasty; a 3 to 5year follow-up of a randomized controlled trial

    NARCIS (Netherlands)

    Bisseling, P.; Smolders, J.M.; Hol, A.; Susante, J.L.C. van

    2015-01-01

    We present an update of a randomized controlled trial on 71 patients (<65 years) who received either a resurfacing hip arthroplasty (RHA) (n=38) or cementless 28-mm metal-on-metal (MoM) total hip arthroplasty (THA) (n=33). Metal ion levels and functional outcome scores were analyzed with a mean f

  7. Combined Vascular and Orthopaedic Approach for a Pseudotumor Causing Deep Vein Thrombosis after Metal-on-Metal Hip Resurfacing Arthroplasty

    Directory of Open Access Journals (Sweden)

    Hossam Abdel-Hamid

    2015-01-01

    Full Text Available Introduction. Metal-on-metal (MoM hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to cause deep venous thrombosis (DVT. Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal\thip resurfacing 6 years ago presented with left groin pain associated with unilateral lower limb edema and swelling. By duplex and MRI studies, our patient had an extensive soft tissue necrosis associated with a large pelvic mass causing extensive DVT of the lower limb secondary to mechanical compression of the left iliac vein. Results. Our case was initially treated for DVT followed by dual surgical approach. The pseudotumor was excised through a separate iliofemoral approach and revision of the hip implant was undertaken through a posterior approach in the same setting. An inferior vena cava (IVC filter was inserted to minimise the perioperative risks of handling the iliac veins. Conclusion. A combined approach with vascular surgeons is required. Combined resection of the pseudotumor and revision of the metal bearing surfaces is essential, in order to achieve a good surgical outcome in this rare complication.

  8. A safe zone for acetabular component position in metal-on-metal hip resurfacing arthroplasty: winner of the 2012 HAP PAUL award.

    Science.gov (United States)

    Liu, Fei; Gross, Thomas P

    2013-08-01

    A safe zone for acetabular component positioning in hip resurfacing (RAIL: Relative Acetabular Inclination Limit) was calculated based on implant size and acetabular inclination angle (AIA). For AIA below the RAIL, there were no adverse wear failures or dislocations, and only 1% of cases with ion levels above 10 μg/L. Other than high inclination angle and small bearing size, female gender was the only other factor that correlated with high ion levels in the multivariate analysis. Seven hundred sixty-one hip resurfacing cases are included in this study. The UCLA activity score, femoral shaft angle, body mass index, weight, American Society of Anesthesiologists score, combined range of motion, diagnosis, age, gender, implant brand, AIA, bearing size, and duration of implantation were analyzed to determine the potential risk factors for elevated metal ion levels. These findings apply to sub hemispheric metal-on-metal bearings with similar coverage arcs as the Biomet and Corin hip resurfacing brands. Additional problems may occur when these bearings are connected with trunions on stems for total hip arthroplasty.

  9. 金属对金属髋关节表面置换术的研究进展%Progress of metal-on-metal hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    马立峰; 郭艾

    2014-01-01

    Metal-on-metal hip resurfacing is a viable alternative for younger patients because it is a bone conserving procedure which can easily be converted to a total hip arthroplasty if necessary,and the results were satisfactory for short-term follow-up. In the same time,the operation will bring about some problems such as femoral neck fracture,femoral head collapse and release of metal ion into the bloodstream. So it is important for the surgeons to select the ideal patients who are underwent hip resurfacing arthroplasty in order to avoid the complications of hip resurfacing arthroplasty. Here is to make a review of the research progress of metal-on-metal hip resurfacing arthroplasty.%对于年轻髋关节疾病的患者,金属对金属髋关节表面置换术是一个不错的治疗方法,因为它能够很好地保留股骨的骨量,以及根据病情需要能够转而进行全髋关节置换术,并且在短期随访中获得良好的效果。但是该手术也会产生一些问题比如:股骨颈骨折、股骨头塌陷以及金属离子释放入循环系统。因此,对于骨科医师,正确地选择适合接受髋关节表面置换术的患者十分重要,以避免该手术并发症的发生。本文就金属对金属髋关节表面置换术的研究进展进行综述。

  10. Revision of hip resurfacing arthroplasty with a bone-conserving short-stem implant: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Schmidutz Florian

    2012-08-01

    Full Text Available Abstract Introduction Suitable treatment of early failure of total hip replacement is critical in younger patients, as bone stock is lost and the functional outcome is impaired. Case presentation We report the case of a 56-year-old Caucasian woman with early failure of hip resurfacing arthroplasty. While revision is usually performed with a conventional hip implant, this case report describes for the first time a revision procedure with a bone-conserving short-stem hip implant. Conclusions Our approach allows further conservation of femoral bone stock and provides a long-term solution to the patient, which maintains the possibility of using a conventional hip implant should a second revision become necessary.

  11. 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.

  12. Metal ion levels in large-diameter total hip and resurfacing hip arthroplasty-Preliminary results of a prospective five year study after two years of follow-up

    Directory of Open Access Journals (Sweden)

    Maurer-Ertl W

    2012-04-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. Methods The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively. Results The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p  Discussion In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.

  13. Changes in bone mineral density and femoral neck narrowing in the proximal femur three to five years after hip resurfacing versus conventional total hip arthroplasty.

    Science.gov (United States)

    Gerhardt, Davey M J M; Smolders, José M H; Rijnders, Ton A J M; Hol, Annemiek; van Susante, Job L C

    2015-02-01

    We studied whether bone mineral density (BMD) is preserved without significant femoral neck narrowing (FNN) after hip resurfacing (RHA) (n=42) versus small diameter metal-on-metal total hip arthroplasty (MoM THA) (n=40). In this three to five year randomized trial BMD was measured in the calcar with dual energy absorptiometry (DXA) preoperatively, at three and six months, one, two, three and five years postoperatively. Four additional BMD regions of interest (ROIs) and femoral neck narrowing (FNN) were measured after RHA. BMD in the calcar increased to 107% (P<0.001) at one year and remained stable. Additional ROIs in the femoral neck and trochanter-area BMD changes fluctuated between 99.9% and 104.1%. FNN was minimal with a mean of 1.3% at three years. After THA BMD decreased in the calcar to 80% at one year (P<0.001) and stabilized. This bone stock preserving nature of RHA must be weighed against potential disadvantages caused by specific metal-on-metal bearing problems.

  14. 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.)

  15. Impact of Total Hip Resurfacing Arthroplasty on Health-Related Quality of Life Measures: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Koutras, Christos; Antoniou, Stavros A; Talias, Michael A; Heep, Hansjoerg

    2015-11-01

    The aim of this study was to investigate the effect of total hip resurfacing arthroplasty (RA) on general health-related quality of life (HRQOL) and disease/hip-specific measures. Original studies published after 2000, enrolling at least ten skeletally mature patients with a minimum follow-up of 6 months were considered. The standardized mean difference (SMD) was obtained with a random effects model. The cumulative patient population encompassed 1898 patients (2123 RA). Mean follow-up duration was 4 years. The physical component score (PHip Score (PHip Score (P<0.001) and UCLA (P<0.00001) were markedly improved and patient satisfaction was favorable.

  16. 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.

  17. 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

    and hip muscle strength were positively associated with gait speed, step length and cadence during maximal walking (R2= 0.13-0.37, P ...-dimensional gait data were collected at self-selected normal and maximal walking speed. Primary outcome was gait speed while secondary outcomes comprised selected temporospatial and kinematic parameters obtained during horizontal walking. Explorative outcome was the relationship between isolated mechanical hip...... and knee muscle performance and horizontal gait function in younger THA patients 56 ± 6 years (range 44-64). Data was collected pre-operatively, 2 and 6 months post-operatively Results: There was no effect of treatment on horizontal self-selected normal speed, however an effect of treatment was observed...

  18. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study

    NARCIS (Netherlands)

    Bisseling, P.; Wit, B.W. de; Hol, A.M.; Gorp, M.J. van; Kampen, A. van; Susante, J.L. van

    2015-01-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patien

  19. Design of Individual and Digital Hip Resurfacing%全髋关节表面置换术个体化数字手术设计

    Institute of Scientific and Technical Information of China (English)

    刘登均; 李争艳; 李鉴轶; 李奇; 林荔军

    2011-01-01

    Objective: Through the exploration of virtual reality technology to Design of ndividual and digital hip resurfacing Methods: Estabishment Pelvic 3D model through the mimics Software, through the exploration of Reverse Engineering Forward design technique to reconstruct hip surface replacement prosthesis To achieve hip resurfacing in the simulation platform. Results: The diseased tissue of Pelvic can be positioned and volume can be calculated by Mimics Software,estabishment model of prosthesis matched entity, simulation surgery was clear and intuitive Conclusion: Digital hip resurfacing provided technical support for the preoperative assessment, implant placement, follow-up of the finite element analysis%目的:探索通过虚拟现实技术设计数字化全髋关节表面置换仿真手术.方法:基于Mimics软件三维重建骨盆模型、逆向工程/正向设计技术还原假体模型,在虚拟仿真平台上实现全髋关节表面置换手术.结果:Mimics软件能够对病变部位骨质进行客观评估,逆向工程/正向设计技术可真实再现髋臼假体和股骨假体的结构,虚拟仿真手术清晰,直观.结论:数字化全髋关节表面置换术为术前评估、假体放置、后续的有限元分析提供了技术支持.

  20. Clinical application and efficacy of hip resurfacing arthroplasty%髋关节表面置换术的临床应用及疗效

    Institute of Scientific and Technical Information of China (English)

    郭盛杰; 周一新; 周乙雄; 李玉军; 殷建华

    2012-01-01

    [Objective]To investigate the clinical application and efficacy of hip resurfacing arthroplasty by following-up and analyzing of the hip resurfacing cases. [Method]Thirty-two patients with 32 hips were treated with metal on metal hip resurfacing arthroplasty from Jan, 2004 to Jan. 2009. The study group consisted of twelve men and twenty women with the average age of 44. 8 years(range, 19 -65 years)and the average BMI of 25. 2(range, 18. 7 -33. 1). Thirteen patients were diagnozed as avascular necrosis of femoral head and nineteen patients were diagnozed as osteoarthritis secondary to developmental dysplasia of the hip. The hip resurfacing prosthesis system with cementless acetabular side and stemmed cement femoral side was used in operation. The mean follow-up were 56 months (range, 37 -75 months). [Result] One male patient with osteoarthritis was performed with total hip arthroplasty because of fracture of femoral neck at 1 month post-operation, and the other cases had no loosening or revision of the prosthesis till the terminal point of follow-up. Harris score was improved significantly and the function of hip recovered well. [ Conclusion] Metal on metal hip resurfacing arthroplasty has good clinical efficacy,and that is based on strict selection of patients and standardized operative technique.%[目的]通过对髋关节表面置换术病例的随访及分析,探讨该术式的临床应用及疗效.[方法]自2004年1月~2009年1月之间32例患者32髋施行了金属对金属的髋关节表面置换手术,其中男12例,女20例,平均年龄44.8岁(19~ 65岁),平均体重指数(BMI) 25.2 (18.7~33.1),术前诊断为股骨头缺血性坏死13例,髋臼发育不良继发骨关节炎19例.手术所采用的表面置换系统的髋臼侧均为生物型固定,股骨侧均为骨水泥型固定且带有导向柄.术后平均随访56个月(37~75个月).[结果]1例髋臼发育不良继发骨关节炎男性患者因术后1个月出现股骨颈骨折而改行全

  1. 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.)

  2. Influence of the clearance on in-vitro tribology of large diameter metal-on-metal articulations pertaining to resurfacing hip implants.

    Science.gov (United States)

    Rieker, Claude B; Schön, Rolf; Konrad, Reto; Liebentritt, Gernot; Gnepf, Patric; Shen, Ming; Roberts, Paul; Grigoris, Peter

    2005-04-01

    Large-diameter metal-on-metal articulations may provide an opportunity for wear reduction in total hip implants because earlier studies have shown that the formation of a fluid film that completely separates the bearing surfaces is theoretically possible. In such a lubrication mode and under ideal conditions, there is theoretically no amount of wear. Studies have suggested that the two primary parameters controlling the lubrication mode are the diameter and the clearance of the articulation. The goal of the present study was to experimentally investigate the influence of these two parameters on the wear behavior of large-diameter metal-on-metal articulations pertaining to resurfacing hip implants. The results of this in vitro investigation showed that longer running-in periods and higher amounts of running-in wear were associated with larger clearances.

  3. Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index

    Directory of Open Access Journals (Sweden)

    Gross Thomas P

    2012-01-01

    Full Text Available Abstract Background The importance of appropriately selecting patients based on factors such as bone mineral density, body mass index, age, gender, and femoral component size has been demonstrated in many studies as an aid in decreasing the rate of revisions and improving the outcomes for patients after hip resurfacing arthroplasty (HRA; however, there are few published studies quantitatively specifying the potential risk factors that affect early femoral component failures. Therefore, the purpose of this study was to investigate the specific causes of early femoral component failures in hip resurfacing separately and more carefully in order to develop strategies to prevent these failures, rather than excluding groups of patients from this surgical procedure. Methods This retrospective study included 373 metal-on-metal HRAs performed by a single surgeon using the vascular sparing posterior minimally invasive surgical approach. The average length of follow-up was 30 ± 6 months. In order to understand the causes of early femoral failure rate, a multivariable logistic regression model was generated in order to analyze the effects of bone mineral density (T-score, gender, diagnosis, body mass index, femoral implant fixation type, age, and femoral component size. Results The average post-operative Harris hip score was 92 ± 11 points and the average post-operative UCLA score was 7 ± 2 points. There were three revisions due to femoral neck fracture and two for femoral component loosening. These occurred in two female and three male patients. In the multi-variable regression model, only T-score and body mass index showed significant effects on the failure rate of femoral components. Patients with a lower T-score and a higher body mass index had a significantly increased risk of early femoral component failure. Conclusion We recommend that dual energy x-ray absorptiometry scan T-score tests should be routinely performed on all hip resurfacing patients

  4. Effect of cementing technique and cement type on thermal necrosis in hip resurfacing arthroplasty - a numerical study

    NARCIS (Netherlands)

    Janssen, D.; Srinivasan, P.; Scheerlinck, T.; Verdonschot, N.J.J.

    2012-01-01

    Femoral fractures within resurfacing implants have been associated with bone necrosis, possibly resulting from heat generated by cement polymerization. The amount of heat generated depends on cement mantle volume and type of cement. Using finite element analysis, the effect of cement type and volume

  5. Metal ion levels and functional results following resurfacing hip arthroplasty versus conventional small-diameter metal-on-metal total hip arthroplasty; a 3 to 5year follow-up of a randomized controlled trial.

    Science.gov (United States)

    Bisseling, Pepijn; Smolders, José M H; Hol, Annemiek; van Susante, Job L C

    2015-01-01

    We present an update of a randomized controlled trial on 71 patients (resurfacing hip arthroplasty (RHA) (n=38) or cementless 28-mm metal-on-metal (MoM) total hip arthroplasty (THA) (n=33). Metal ion levels and functional outcome scores were analyzed with a mean follow-up of 58 months (SD 8.1). No clear shifts in relatively good outcome was encountered between RHA and THA. Metal ion levels appear to equalize between groups after 3 years. Median cobalt and chromium remained below 1.3 μg/L throughout follow-up in both groups. Six revisions were performed, of which three for pseudotumor formation (one THA, two RHA). In conclusion there were no clinical differences between the two groups and metal ion levels were lower than other series remained low, however, pseudotumor formation was not eliminated.

  6. The clinical progress of hip resurfacing arthroplasty%髋关节表面置换术的临床进展

    Institute of Scientific and Technical Information of China (English)

    王玉聪; 付有伟

    2011-01-01

    @@ 髋关节疾病严重影响着患者的生活质量,尤其对于年轻、活动量大、预期寿命长、功能要求高的患者,由于传统的全髋关节置换术(total hip arthroplasty,THA)截除了正常的股骨颈而改变了生物力学关系,加上假体磨损相关并发症、股骨颈骨折等问题,使得THA术后可能需行多次翻修手术.相比THA,髋关节表面置换术(hip resurfacing arthroplasty,HRA)保留了较多的骨质,维持了关节正常的生物力学和应力转移性能,增强了关节的稳定性,也使以后的翻修手术更简单易行,目前普遍认为对于活动量大的年轻患者,HRA可作为一种暂时性替代治疗方法.笔者就HRA的相关临床研究进行综述.

  7. A randomised controlled trial of cemented and cementless femoral components for metal-on-metal hip resurfacing: a bone mineral density study.

    Science.gov (United States)

    Tice, A; Kim, P; Dinh, L; Ryu, J J; Beaulé, P E

    2015-12-01

    The primary purpose of this study of metal-on-metal (MoM) hip resurfacing was to compare the effect of using a cementless or cemented femoral component on the subsequent bone mineral density (BMD) of the femoral neck. This was a single-centre, prospective, double-blinded control trial which randomised 120 patients (105 men and 15 women) with a mean age of 49.4 years (21 to 68) to receive either a cemented or cementless femoral component. Follow-up was to two years. Outcome measures included total and six-point region-of-interest BMD of the femoral neck, radiological measurements of acetabular inclination, neck-shaft and stem-shaft angles, and functional outcome scores including the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index and the University of California at Los Angeles activity scale. In total, 17 patients were lost to follow-up leaving 103 patients at two years. There were no revisions in the cementless group and three revisions (5%) in the cemented group (two because of hip pain and one for pseudotumour). The total BMD was significantly higher in the cementless group at six months (p < 0.001) and one year (p = 0.01) than in the cemented group, although there was a loss of statistical significance in the difference at two years (p = 0.155). All patient outcomes improved significantly: there were no significant differences between the two groups. The results show better preservation of femoral neck BMD with a cementless femoral component after two years of follow-up. Further investigation is needed to establish whether this translates into improved survivorship.

  8. Preliminary results of implantation in animal model and osteoblast culture evaluation of prototypes of biomimetic multispiked connecting scaffold for noncemented stemless resurfacing hip arthroplasty endoprostheses.

    Science.gov (United States)

    Uklejewski, Ryszard; Rogala, Piotr; Winiecki, Mariusz; Kędzia, Andrzej; Ruszkowski, Piotr

    2013-01-01

    We present the new fixation method for RHA (resurfacing hip arthroplasty) endoprostheses by means of the biomimetic multispiked connecting scaffold (MSC-Scaffold). Such connecting scaffold can generate new type of RHA endoprostheses, that is stemless and fixed entirely without cement. The preprototypes of this MSC-Scaffold were manufactured with modern additive laser additive technology (SLM). The pilot surgical implantations in animal model (two laboratory swine) of MSC-Scaffold preprototypes have showed after two months neither implant loosening, migration, and nor other early complications. From the results of performed histopathological evaluation of the periscaffold spikes bone tissue and 10-day culture of human osteoblasts (NHOst) we can conclude that (1) the scaffolding effect was obtained and (2) to improve the osseointegration of the scaffold spikes, their material surface should be physicochemically modified (e.g., with hydroxyapatite). Some histopathological findings in the periscaffold domain near the MSC-Scaffold spikes bases (fibrous connective tissue and metallic particles near the MSC-Scaffold spikes bases edges) prompt considering the necessity to optimize the design of the MSC-Scaffold in the regions of its interspike space near the spikes bases edges, to provide more room for new bone formation in this region and for indispensable post-processing (glass pearl blasting) after the SLM manufacturing.

  9. 髋关节表面置换术治疗先天性髋关节发育不良%Hip resurfacing arthroplasty for secondary osteoarthrltis after developmental dysplasia of hip

    Institute of Scientific and Technical Information of China (English)

    王琦; 张先龙; 蒋垚; 陈云苏; 沈灏; 邵俊杰

    2008-01-01

    Objective To study the clinical results of metal on metal hip resurfacing arthroplasty for developmental dysplasia patients.Methods From March 2005 to December 2006, 34 eases of developmental dysplasia patients ( Crowe Ⅰ , Crowe Ⅱ ) were attempted to have metal on metal hip resurfacing arthroplasty.There were 29 females (32 hips), 5 males (5 hips).The average age was 45 (26-57 ) years old.Radiographic and clinical evaluations were taken at 6 weeks, 3 months, 1 year and then once a year postoperatively.The average Harris score was 35 (25-44).Hip flexion was 101°, abduction 24°,adduction 15°.Results Three patients were turned to total hip arthroplasty during operations.Thirty-one patients (34 hips) received hip resurfacing surgery. These 31 patients were followed for average 21.4 months (12-33 months).The average Harris score was 94 (82-100) at the latest follow-up, and there was statistical difference compared with the preoperative score ( P < 0.01 ).Hip flexion increased to 133°,abduction to 48°, adduction to 26°.No radiolueency line was found at both acetabular and femoral sides in all the patients.The average abduction angle of acetabular cup was 43°(40°-53°) , and the average stern shaft angle was 139°(130°-145°).Conclusions The short term result is excellent.While the mid to long term results for hip resurfscing arthroplasty in developmental dysplasia patients are still looking forward, and the rneticulous surgical technique and strict patient selection are the key of the good results.%目的 探讨髋关节表面置换术治疗先天性髋关节发育不良的临床疗效.方法 2005年3月至2006年12月对34例(37髋)先天性髋关节发育不良患者行髋关节表面置换术,其中Crowe Ⅰ型28例(31髋)、Crowe Ⅱ型6例(6髋).其中女性29例(32髋),男性5例(5髋),患者平均年龄45岁(26~57岁).患者在术后6周、3个月、1年,及此后每年1次进行随访,接受放射学及临床

  10. 髋关节表面置换术治疗Crowe Ⅰ、Ⅱ型髋关节发育不良%Hip resurfacing arthroplasty for patients with Crowe Ⅰ and Crowe Ⅱ developmental dysplasia of the hip

    Institute of Scientific and Technical Information of China (English)

    王琦; 张先龙; 蒋垚; 陈云苏; 沈灏; 邵俊杰

    2014-01-01

    Objective To research the clinical results of hip resurfacing arthroplasty (HRA) for patients with Crowe type Ⅰ or Ⅱ developmental dysplasia of the hip(DDH).Methods From March 2005 to December 2006,a total of 80 Crowe type Ⅰ or Ⅱ dysplasia hip patients were randomly assigned for HRA or total hip replacement (THR).Three patients planed for HRA were converted to THR,three HRA patients and two THR patients were lost follow-up.This left a total of 34 patients (37 hips) who underwent HRA and 38 (39 hips) who underwent THR.Radiographic and clinical evaluations were taken 6 weeks,3months,1 year and then they were followed up annually.Results The mean follow-up period was 59.4 months (52 to 70) in the HRA group and 60.6 months (50 to 72) in the THR group.There was no failure of the prosthesis in either group.There was no difference in the mean post-operative Harris hip scores between the groups (P =0.073),while hip flexion was significandy better after HRA (P < 0.01).There was no difference in the mean abduction angle of the acetabular component between the two groups (P =O.982) and the mean size of the acetabular component in the HRA group was significantly larger than that in the THR group (49.5 mm vs 46.1 mm,P =0.001).Conclusions The clinical result after HRA was similar to that after THR,but flexion of the hip was better after HRA.More acetabular bone will be sacrificed in HRA in compensation for a bigger femoral head.%目的 研究Crowe Ⅰ型和Ⅱ型髋关节发育不良(DDH)患者行髋关节表面置换术(HRA)的临床结果.方法 前瞻性将2005年3月-2006年12月80例Crowe Ⅰ型和Ⅱ型DDH患者随机分入HRA组和全髋关节置换术(THR)组.HRA组中3例改行THR、3例失随访,THR组中2例失随访,故34例37髋接受HRA,38例39髋接受THR.在术后6周、3个月、1年,以后每年1次进行随访,接受放射学及临床评价.结果 HRA组和THR组分别平均随访59.4个月(52~ 70个月)及60.6个月(50~72个月),2

  11. 全髋关节置换与髋关节表面置换治疗髋臼骨折后骨关节炎的疗效研究%Study on the Curative Effect of Total Hip Replacement and Hip Resurfacing for Osteoarthritis after Acetabular Fracture

    Institute of Scientific and Technical Information of China (English)

    张勇

    2012-01-01

    Objective To compare clinical curative effect of total hip replacement and hip resurfacing for osteoarthritis after acetabular fracture. Methods 61 patients( 61 hips ) with osteoarthritis after acetabular fractures from Heze Municipal Hospital during January 2008 to May 2010 were randomly divided into total hip replacement group( 31 cases )and hip resurfacing group( 30 cases ),hip function were evaluated after the operation. Results Follow-up time was 9 months to 5. 5 years, hip activities of all patients have improved markedly, pain symptoms disappeared or improved obviously, no complications of neurovascular injury, prosthesis loosening, joint dislocation, lower extremity deep vein thrombosis, and femoral neck fracture occurred. In total hip replacement group 3 hips were with X-ray bright area,l hip was with a focal bone dissolving. Hip resurfacing group hip flexion activities degree was greater than total hip replacement group, the difference was statistically significant P <0. 05 ). Conclusion Hip resurfacing can be chosen for younger patients or elder patients with higher requirement for activity to treat osteoarthritis after acetabular fractures, which may improve postoperative joint function significantly, and realize better degrees of hip flexion and extension activities.%目的 比较全髋关节置换和髋关节表面置换对髋臼骨折后骨关节炎的临床疗效.方法 将菏泽市立医院2008年1月至2010年5月收治的髋臼骨折后创伤性关节炎患者61例(61髋)随机分为全髋关节置换组(31例)和髋关节表面置换组(30例),术后评定髋关节功能.结果 随访时间为9个月至5.5年,所有患者髋关节活动显著改善,疼痛症状消失或明显好转,无神经血管损伤、假体松动、关节脱位、下肢深静脉血栓形成、股骨颈骨折等并发症发生.全髋关节置换组3髋有X线片透亮区,1髋有局灶性骨溶解.髋关节表面置换组术后髋关节屈伸活动度大于全髋关节置换

  12. 髋关节表面置换术后股骨近端的冲击特性数值模拟研究%Numerical modeling of impact character in proximal femur after hip resurfacing

    Institute of Scientific and Technical Information of China (English)

    韦葛堇; 杨华; 林荔军; 林舟丹; 李奇

    2012-01-01

    Objective To analyze the stress distribution at the femoral neck during human gait cycle under impact force following the hip resurfacing arthroplasty.Methods A three-dimensional finite element model of hip resurfacing arthroplasty (DuromTM hip prosthesis) was reconstructed using software Mimics and Abaqus on the basis of the dataset of patients undergoing hip resurfacing arthroplasty.The distal femur was fixed to simulate the impact of a static force of 500 N on the hip prosthesis at a standing position and an impulsive force of 500 N was also simulated on the hip prosthesis.Different effects of impact forces on the femur were compared and the mechanics of the femur under impact force was characterized.Results The peak stress under a 500 N static force was greater than that under a same impulsive force (5.21 MPa versus 1.89 MPa).The stress range under the impulsive force was similar to that under a static force,distributing around the femoral neck.The stress at the junction of the femoral head and neck decreased by 21% to 76% compared with other regions,indicating obvious stress shields at this region.The peak stress was present in the lower femoral neck.Conclusion After hip resurfacing arthroplasty a high stress may distribute in the lower femoral neck under an impulsive force,with obvious stress shielding at the femoral head-neck junction.%目的 探讨髋关节表面置换术后股骨近端在人体步态运动过程中受冲击载荷作用时的应力分布.方法 选择4名行金属对金属髋关节表面置换(均应用DuromTM髋关节表面置换系统假体)术后志愿者,利用64排螺旋CT对志愿者髋臼、股骨近端及假体进行扫描,采用Mimics、Abaqus软件重建金属对金属髋关节表面置换术后有限元模型,模拟股骨在膝关节完全固定(人体站立相)下的静力影响,同时采用冲击载荷对髋关节进行试验,比较冲击载荷对股骨的不同作用效果,以及股骨在冲击载荷

  13. 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.

  14. 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. 

  15. 金属对金属髋关节表面置换术并发症的研究%Complications after Metal-on-Metal Hip Resurfacing Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    刘二涛

    2012-01-01

    Metal-on-metal hip resurfacing arthroplasty has undergone a recent resurgence as an alternative treatment option for young and active patients,since it preserves bone stock for subsequent revision procedures and restores anatomic hip mechanics. At the same time, some complications such as femoral neck fracture,prosthesis loosening,especially the high levels of cobalt-chromium metal ions in blood and urine from the elevated levels of metal ions could have a negative impact on the body. Here is to make a review on the complications commonly associated with metal-on-metal hip resurfacing arthroplasty and the influence on the body.%金属髋关节表面置换术通过保留股骨近端骨量从而恢复髋关节正常的生物力学特性及关节的稳定性,为年轻及活动量大的患者提供了一个良好的治疗方案.与此同时,这一手术方案存在其特有的并发症,如股骨颈骨折、假体松动,特别是假体置换术后产生大量的金属离子使机体内血液尿液中金属离子水平升高,从而可能对机体产生不利影响.现就金属对金属全髋假体置换术后出现的特有并发症及其对机体的影响进行综述.

  16. Hip Resurfacing. An Experience in Livingstone Hospital, Port Elizabeth, South Africa. From January 2004 to January 2006. Resuperficialización de cadera. Experiencia en el Hospital Livingstone. Port Elizabeth. Sudáfrica.

    Directory of Open Access Journals (Sweden)

    Tamara Elizabeth Morales Perez

    Full Text Available Background. Hip resurfacing in youngest patients with osteoarthritis is a very outstanding surgical technique which offer excellent results compare with a traditional Total Hip Replacement. Objective. To describe the evolution of the patients with osteoarthritis of the hip treated with the surgical technique of resurfacing in Livingstone Hospital. Port Elizabeth. South Africa. Method. A descriptive-retrospective study in the orthopedic department at Livingstone Hospital from January 2004 to January 2006. The variables used were the following: age, sex, affected hip, surgical approach and survivorship of the prosthesis at 12 moths-24 months after surgery. Results. Out of 30 patients operated 22 were males 73,3% the age group more affected was 46-55, 53,3%, the most common cause affecting the hip was the primary osteoarthritis in 17 patients 56,7% and the survivorship of the prosthesis 12 moths after surgery was 100%. Conclusions. Primary osteoarthritis of the hip is a health problem in male youngest patients and the surgical technique hip resurfacing is a very good choice.
    Fundamento: La resuperficialización de la cadera en pacientes jóvenes con osteoartrosis es sin dudas una novedosa técnica quirúrgica que ofrece marcadas ventajas comparadas con las técnicas convencionales de Reemplazo Total de Cadera (RTC. Objetivo: Mostrar la evolución de los pacientes portadores de osteoartrosis de cadera, tratados con la técnica de resuperficialización, en el Hospital Livingstone de Port Elizabeth. Sudáfrica. Método: Se realizó una investigación observacional fundamental, descriptiva, retrospectiva, en el servicio de ortopedia del Hospital Livingstone de Port Elizabeth desde Enero 2004 a Enero 2006, se consideraron las variables: Edad, Sexo, Cadera afectada, Abordaje quirúrgico, Tiempo de supervivencia de

  17. 金属对金属全髋关节表面置换术研究进展%The research advances on metal on metal hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    何志勇; 吴海山

    2009-01-01

    金属对金属全髋关节表面置换术(metal on metal hip resurfacing arthroplasty,MOM—HRA)从1948年Smith—Petersen首先推出的髋关节表面术演变至今,经过了50多年的变革和发展。在上世纪70年代,由于当时材料抗磨损性能差、磨屑颗粒诱导的骨溶解以及高松动率,使得第1代髋关节表面置换假体被放弃了,但在当时仍被认为是治疗年轻而活跃患者的首选方法。

  18. 计算机导航系统辅助下全髋关节表面置换的初步经验%The application of computer-assisted navigation in the placement of component in total hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    廉永云; 裴福兴; 沈彬; 杨静; 周宗科; 程惊秋; Myung-chul Yoo

    2008-01-01

    Objective To primarily evaluate the operative methods of total hip resurfacing arthroplasty and the accuracy of prosthesis implantation assisted by computer-assisted navigation system.Methods Forty patients scheduled for total hip resurfacing arthroplasty were randomly assigned to undergo either conventional implantation of Birmingham resurfacing prosthesis(control group)or computer-assisted implantation of such a prosthesis (computer-assisted group).The operative time,the operative blood loss and the Harris hip score (HHS)were compared between the control group and the computer-assisted group.The deviation between the ideal abduction angles and the actual angles of the implanted acetabular cup was calculated,as well as that deviation of the cup anteversion angles.The deviation between the neck shaft angle (NSA) and actual implanted short stem shaft angle (SSA)and that between the anteversion angle of femoral neck and the anteversion angle of actual implanted short stem were measured.These deviations were also compared between the control group and the computer-assisted group respectively.Results The operative time of the computer-assisted procedures was longer than that of the conventional procedures (P<0.01).The operative blood loss in computer-assisted operations was 109.4ml(P<0.05)more than that in conventional ones.No significant difference was detected with respect to the improvement of Harris hip score in a mean of 14.5 months follow-up.The deviation of the cup abduction angle and anteversion angle was significantly lesser in computer-assisted group than in control group (P<0.05).The deviation of the femoral stem-shaft angle and anteversion angle were significantly lesser in computer-assisted group than in control group (P<0.05).Conclusion This study has shown the accuracy of prosthesis positioning using a computer-assisted navigation in a prospective randomized controlled protocol.%目的 初步评估计算机辅助下行全髋关节表面置换的

  19. 金属对金属全髋关节表面置换术的近期疗效%Preliminary results after metal-on-metal hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    何志勇; 狄正林; 曾智敏; 陶崑; 凌晶; 章军辉; 冯建翔

    2012-01-01

    Objective To introduce the technique of metal-on-metal hip resurfacing arthroplasty,evaluate its preliminary clinical results and review the factors which affect the results.Methods From January 2006 to October 2010,104 patients (116 hips) with osteonecrosis of the femoral head,hip osteoarthritis,hip dyplasia,or ankylosing spondylitis were treated with the total hip resurfacing arthroplasty.Among them,59 patients (66 hips) were male,and 45 patients (50 hips) were female,with an average age of 39.7 years (range,16-67 years).Standard operation technique was performed for all patients with Conserve Plus prosthesis.Each patient was followed up at 1 month,3 months,6 months,1 year postoperatively.Results Three patients (4 hips) were lost,so 101 patients (112 hips) were followed up for an average period of 33 months (range,9-66 months).The average Harris hip score was improved significantly from 37.6±6.3 preoperatively to 91.3±5.3 at final follow-up; 104 hips were excellent,7 hips were good,1 hip was poor,and the excellent and good rate was 99.1%.At final follow-up,the average abduction angle of the acetabutar cup was 42.7°(range,36°-55°); the average femoral prothesis stem-shaft angle was 138.5° (range,132°-146°).Two patients presented with heterotopic ossification (Brook Ⅲ and Brook Ⅱ ).One patient presented with prothesis dislocation,which healed after being treated with manual reduction.There was no femoral neck fracture,infection,or prosthesis loosening.Conclusion With strict patient selection criteria and optimized technique,the short-term results of metal-on-metal hip resurfacing arthroplasty are satisfactory.%目的 分析金属对金属全髋关节表面置换术的近期疗效,探讨其适应证选择和技术要点.方法 2006年1月至2010年10月因股骨头坏死、髋关节骨关节炎、髋关节发育不良、强直性脊柱炎接受全髋关节表面置换术104例(116髋),其中男59例(66髋),女45例(50髋);年龄16~67岁,平均39.7

  20. 全髋表面置换术治疗股骨头坏死短期随访研究%Short-term result of hip resurfacing arthroplasty in the treatment of patients with femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    何志勇; 狄正林; 陶崑; 章军辉; 冯建翔; 吴海山

    2011-01-01

    Objective:To study short-term results of hip resurfacing arthroplasty (HRA) in the treatment of patients with avascular necrosis of femoral head (ANFH) ,and to explore indication and strategy in this surgery. Methods: From December 2006 to December 2009,37 patients (43 hips) with avascular necrosis of femoral head were treated with total hip resurfacing arthroplasty. Among the patients,25 patients were male and 12 patients were female,with an average age of 44.5 years (ranged,21 to 67 years). According to ARCO classification,3 hips were 3A stage,6 hips were 3B stage,16 hips were 3C stage and 18 hips were 4 stage. X-ray evaluation of the patients were conducted. The clinical results were evaluated by the Harris hip score system including pain,range of motion, correction of deformity and total function. Results: Thirty-four patients (40 hips) were followed up with an average period of 32.4 months (ranged, 16 to 53 months), and 3 patients were lost. Thirty-seven hips got complete relief of joint pain and 3 patients feel aching pain after walking. There was 1 heterotopic ossification, no femoral neck fracture,no dislocation,no infection and no revision in all patients. From pre-operation to present,the average Harris hip score improved significantly from (51.5±1.7) to (94.3±1.4). Thirty-seven hips got an excellent result,3 hips good and no poor. Conclusion:The total hip resurfacing arthroplasty is an effective solution for the problems of the younger and active patients with ANFH, and the short-term results are satisfying.%目的:研究全髋表面置换术治疗股骨头坏死的短期疗效,探讨表面置换术治疗股骨头坏死技术要求和手术指征.方法:对2006年12月至2009年12月37例(43髋)行全髋表面置换术的股骨头缺血坏死患者进行随访,男25例,女12例;年龄21~67岁,平均44.5岁.按照ARCO进行分期:3A期3髋,3B期6髋,3C期16髋,4期18髋.根据Harris评分系统对手术前后关节疼痛、活动度、畸形矫正

  1. A Meta analysis on total hip resurfacing for osteonecrosis of the femoral head%全髋关节表面置换术治疗股骨头坏死的Meta分析

    Institute of Scientific and Technical Information of China (English)

    李军; 王健; 李阳; 史占军

    2012-01-01

    Objective To systematically review the efficacy and safety of total hip resurfacing in the treatment for osteonecrosis of the femoral head.Methods The literatures about total hip resurfacing in the treatment for osteonecrosis of the femoral head were searched at home and abroad from Jan 1990 to Dec 2011.According to established inclusion and exclusion criteria,literatures met evaluation criteria were selected,and the data were analyzed with Meta analysis.Results 10 trials involving 317 patients were included in this study.The results showed:weight average age was 41.98 years old ( 16 -77 years),and weight average follow-up time was 36.69 months (6 - 140 month).Postoperative Harris hip score (92)was significantly higher than preoperative score (44).The main complications included prosthesis aseptic loosening ( 1.06% ),ectopic ossification ( 0.80% ),pain ( 0.80% ) and femoral neck fracture ( 0.27% ),and eventual revision rate was 0.80%.Conclusions Total hip resurfacing for the treatment of osteonecrosis of the femoral head is safe and effective,but still needs to be paid attention to its complications.%目的 通过综合分析已发表文献,探讨全髋关节表面置换术治疗股骨头坏死的效果及安全性.方法 通过系统检索从1990年1月到2011年12月全髋关节表面置换术治疗股骨头坏死的相关文献,按照排除标准筛选后,提取需要的数据,通过循证医学Meta分析方法,加权汇总分析.结果 共检出192篇相关文献检出,经过三个阶段的筛选,共有10篇被纳入分析,共有317例患者,376例髋关节,男性患者191例,女性126例,平均加权年龄为41.98岁(16 ~77岁),加权平均随访时间36.69个月(6~140个月).术后的髋关节Harris评分(92分)较术前(44分)的差异有统计学意义(t=18.07,P<0.01).主要并发症包括假体无菌性松动(1.06%)、异位骨化(0.80%)、疼痛(0.80%)和股骨颈骨折(0.27%),最终翻修率为0.80%.结论 全髋关节表面置

  2. 金属对金属全髋关节表面置换术早中期临床报告%Short and medium term clinical follow-up of metalon-metal hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    樊立宏; 王坤正; 党晓谦; 王春生

    2011-01-01

    Objective To evaluate the Short and medium term outcome of patients receiving metal-on-mental hip resurfacing arthroplasty and analyze the factors affecting the results. Methods 54 patients received metal-on-metal hip resurfacing arthroplasty were followed up for 16 to 45 (average 32 ) months. Preoperative and postoperative pelvis plain radiographs were taken, Hip joint function was accessed before and after operation according to Harris, UCLA and VAS score. Results Harris and UCLA Score revealed an improvement from an average score of 38. 3 and 3.6 preoperatively to 95.4 and 7. 9 after the surgery respectively; VAS Score decreased from an average score of 8. 8 to 1.8 after the surgery. No obvious complications such as prosthesis loosening, dislocation, femoral neck fracture and and bone absorption were found. Conclusion Metal-on-Metal hip resurfacing arthroplasty is effective at pain relief and joint function improvement and the Short and medium term outcome is encouraging.%目的 探讨金属对金属全髋关节表面置换术治疗髋关节疾病的早中期临床效果,分析影响疗效的相关因素.方法 回顾性分析我科全髋关节表面置换术患者54例60髋,男28例32髋,女26例28髋,年龄22~62岁,平均(42.3±12.5)岁.术后患者均进行定期临床与影像学随访16~45个月,平均随访32个月.采用Harris,UCLA,VAS评分对患者术前术后的髋关节功能进行评估.结果 Harris评分由术前38.3分增加到术后95.4分;UCLA评分由术前3.6分增加到术后7.9分;VAS评分由术前8.8分降低到术后1.8分.患者假体位置良好,无假体松动、关节脱位、股骨颈骨折及明显骨溶解等并发症.结论 全髋关节表面置换术能有效改善髋关节疾病患者的关节功能、减轻疼痛,早中期随访结果满意.

  3. The short-term effects and complications of resurfacing arthroplasty of the hip%髋关节表面置换术的近期疗效及其并发症分析

    Institute of Scientific and Technical Information of China (English)

    姜文学; 尤佳; 李轶津; 范猛; 周海昱

    2009-01-01

    Objective To evaluate the short-term effects and complications of resuffacing arthro-plasty of the hip (RSAH). Methods Twenty-six cases (32 hips) treated with RSAH were analyzed retro-spectively. There were 14 males and 12 females, with a mean age of 46.8 years (range, 30-62 years). Nine cases (11 hips) were diagnosed as developmental dysplasia of the hip, 7 cases (9 hips) as osteonecrosis of the femoral head, 3 cases (4 hips) as ankylosing spondylitis, 5 cases (6 hips) as rheumatoid arthritis, 1 case (1 hip) as osteoarthritis, 1 case (1 hip) as pigmented villonodular synovitis. All cases were checked by MR or CT scan for observing the structure of the acetabulum and femoral head, osteolysis, osteosclerosis as well as the location of necrosis. The X-ray film was performed before operation and after operation (1 month, 3 months and every 6 months) to check the prosthesis loosening, migration and heterotopic ossification. Harris hip score system was used to evaluate the clinical results. Results All cases were followed up 8 months to 4.3 years (average, 2.1 years). The follow-ups showed that Harris scale increased from (44.5±7.1) points pre-operatively to (94.3±5.2) points postoperatively, with 28 hips (87.5%) excellent, 4 hips (12.5%) good. Com-plications consisted of 1 hip femoral nerve injury, 2 cases (3 hips) heterotopic ossification, 2 hips Trendelen-burg gait, 2 hips snapping hip, 1 case deep venous thromboembolism in the lower extremities, 1 hip femoral neck narrowing. There were not femoral neck fracture, infection, dislocation, and prosthesis loosening during our follow-up. Conclusion The RSAH has a satisfactory short-term effect. Mastering the indications and accurate procedure of the operation may help to avoid the complications.%目的 探讨髋关节表面置换术(resurfacing arthroplasty of the hip,RSAH)的近期疗效及并发症.方法 回顾性分析行RSAH的患者26例(32髋),男14例,女12例;年龄30~62岁,平均46.8岁.术

  4. 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.

  5. 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.

  6. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study.

    Science.gov (United States)

    Bisseling, P; de Wit, B W K; Hol, A M; van Gorp, M J; van Kampen, A; van Susante, J L C

    2015-09-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patients with a 32 mm ceramic-on-polyethylene (CoP) THA (n = 33, 18 males; median age 63 years, 38 to 71) were cross-sectionally screened with metal artefact reducing sequence-MRI (MARS-MRI) for pseudotumour formation at a median of 55 months (23 to 72) post-operatively. MRIs were scored by consensus according to three different classification systems for pseudotumour formation. Clinical scores were available for all patients and metal ion levels for MoM bearing patients. Periprosthetic lesions with a median volume of 16 mL (1.5 to 35.9) were diagnosed in six patients in the RHA group (17%), one in the MoM THA group (4%) and six in the CoP group (18%). The classification systems revealed no clear differences between the groups. Solid lesions (n = 3) were exclusively encountered in the RHA group. Two patients in the RHA group and one in the MoM THA group underwent a revision for pseudotumour formation. There was no statistically significant relationship between clinical scoring, metal ion levels and periprosthetic lesions in any of the groups. Periprosthetic fluid collections are seen on MARS-MRI after conventional CoP THA and RHA and may reflect a soft-tissue collection or effusion. Currently available MRI classification systems seem to score these collections as pseudotumours, causing an-overestimatation of the incidence of pseudotumours.

  7. 髋关节表面置换术治疗髋关节发育不良的临床疗效%Resurfacing arthroplasty for hip dysplasia:evaluation of treatment outcome

    Institute of Scientific and Technical Information of China (English)

    毛远青; 徐嘉炜; 张经纬; 徐辰; 于德刚; 李慧武; 王林; 朱振安

    2014-01-01

    目的:分析髋关节表面置换术治疗髋关节发育不良(developmental dysplasia of the hip,DDH)的临床疗效,探讨以稍大外展角度放置髋臼杯增加股骨头假体直径的可能性。方法2006年10月至2009年9月采用髋关节表面置换术治疗DDH患者32例34髋,男8例9髋,女24例25髋;年龄22~59岁,平均(44.6±11.85)岁。同一时期同一术者采用全髋关节置换术治疗DDH患者32例35例,男8例8髋,女25例27髋;年龄24~56岁,平均(43.7±10.4)岁。采用Harris髋关节评分评价髋关节功能,根据X线片评估关节稳定性及髋臼杯外展角。结果髋关节表面置换组平均随访6.2年,Harris髋关节评分由术前平均(54.9±13.2)分提高至末次随访平均(97.3±6.2)分,其中髋关节屈曲角度平均127°±6.9°;全髋关节置换组平均随访5.9年,Harris髋关节评分由术前平均(51.6±19.7)分提高至末次随访平均(95.6±7.9)分,其中髋关节屈曲角度117°±4.2°。两组髋关节屈曲角度的差异有统计学意义(P<0.05)。髋关节表面置换组骨盆正位X线片髋臼杯外展角平均51.6°±5.33°,全髋关节置换组平均43.9°±4.90°,两组差异有统计学意义(P<0.05)。髋关节表面置换组股骨头假体直径平均(46.5±1.5)mm。随访期间两组均无松动、骨折、炎性假瘤及假体相关感染等并发症发生。结论相对于全髋关节置换,表面置换术治疗DDH能获得更好的髋关节功能和更大的活动范围。采用加大外展角放置臼杯的方法,可以允许使用更大的髋臼杯和股骨头假体,可能有利于假体的长期稳定性。%Objective To assess the functional restoration in patients with developmental dysplasia of the hip (DDH) who underwent hip resurfacing arthroplasty and to determine whether greater abduction angle of the acetabular component is relat⁃ed to larger diameter of femoral head component. Methods

  8. Total hip resurface replacement for development dysplasia of hip in adults:technique for setting the prosthesis and its clinical outcome%全髋关节表面置换术治疗成人髋关节发育不良中假体的安放技术和临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    朱振安; 严孟宁; 唐坚; 戴尅戎

    2008-01-01

    Objective To analyze the techniques of setting prosthesis and clinical outcome of hip resurface replacement in adults developmental dysplasia of hip.Methods From Jan, 2005 to Sep, 2007, a consecutive series of 45 total hip resurface replacement were performed for developmental dyaplasia of hip in 42 patients, including 3 patients with bilateral involved.There were 39 female and 3 male.The mean age was 46.3 years.According to the Crowe classification, there were 18 hips in 17 patients with type Ⅰ, 19 hips in 17 patients with type Ⅱ, 6 hips with type Ⅲ and 2 hips with type Ⅳ.All the patients received the three dimension reconstruction CT to measure the anteversion of acetabulum and femoral neck and the femoral neck-shaft angle.The operation was done with the modified Gibson posterolateral approach.For those patients with femoral neck-shaft angle less than 135°, the femoral head prostheses were implanted with 5° valgus;for those with femoral neck-shaft angle more than 135°, the prostheses were implanted with no change.The anteversion of femoral neck and acetabulum and the abduction of acetabulum were adjusted to a little smaller than those of origin because most of these patients had increased anteversion of femoral neck.Each patient was evaluated clinically and by radiographs before the operation and during the follow-up period, according to the Harris hip scores (HHS).The average femoral neck-shaft angle increased from preoperative 134.1° to postoperative 138.2°, in which whose angle less than 135° increased from preoperative 131.7° to postoperative 137°, and those with angle more than 135° increased from preoperative 140.9° to postoperative 141.5°.The average preoperative anteversion of femoral neck was 34.5°.All of the acetabular prostheses were implanted in the true acetabula and with average abduction angle of 42°.The limb discrepancy decreased from preoperative 2.1 cm to postoperative 0.5 cm.The average follow-up period was 14.6 months

  9. Therapeutic efficacy comparison of hip resurfacing and total hip replacement in the treatment of avascular necrosis%髋关节表面置换与全髋关节置换治疗股骨头缺血性坏死的疗效比较

    Institute of Scientific and Technical Information of China (English)

    戚广秀; 王立民; 孙云明

    2012-01-01

    目的 探讨髋关节表面置换与全髋关节置换治疗股骨头缺血性坏死的疗效对比情况,为合理选择手术方法提供参考.方法 将60例股骨头缺血性坏死患者根据不同的手术方法分为治疗组与对照组,每组各30例.治疗组采用髋关节表面置换治疗,对照组采用全髋关节置换治疗.结果 两组的平均手术时间、术中和术后的总输血量比较,差异无统计学意义(P>0.05).对照组术后切口大出血的机率高于治疗组(P<0.05).两组人工全髋关节疗效评分(Harris评分)治疗前比较,差异无统计学意义(P>0.05);治疗后,治疗组有明显提高(P<0.05).结论 相对于全髋关节置换,髋关节表面置换治疗股骨头缺血性坏死能在不增加创伤的基础上,减少术后切口大出血,同时提高随访Harris评分,值得推广应用.%Objective To discuss the therapeutic efficacy comparison hip resurfacing and total hip replacement in the treatment of avascular necrosis. Methods 60 patients with avascular necrosis were divided into the treatment group and the control group according the different surgical methods, each group had 30 cases. The treatment group were treated with hip resurfacing replacement, and the control group were treated with total hip replacement. Results The operation time, the in-traoperative and postoperative total amount of blood transfusion between the two groups had no significant statistical difference (P > 0.05). The probability of postoperative wound bleeding of the control group were more than the treatment group (P < 0.05), there was no significant difference of Harris score before treatment between the two groups, but the treatment group were improved significantly of Harris score after treatment (P < 0.05). Conclusion Compared with total hip replacement, total hip replacement in the treatment of avascular necrosis can not increase trauma, reduce the probability of postoperative wound bleeding and increase the

  10. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T., E-mail: millertt@hss.edu [Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 (United States)

    2012-12-15

    The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

  11. 全髋关节表面置换术治疗髋关节发育不良的现状%Current of total hip resurfacing arthroplasty for the treatment of developmental dysplasia of hip

    Institute of Scientific and Technical Information of China (English)

    王健

    2010-01-01

    @@ 成人的髋关节发育不良(developmental dysplasia of hip,DDH)是因髋臼先天性发育缺陷或者是在髋臼早期发育过程中由于外因(如化脓性感染、结核性感染、外伤骨折)而引起的患者成年后髋臼形态异常.

  12. Birmingham probes the Big Bang

    CERN Multimedia

    2007-01-01

    "The world's largest particle accelerator in Geneva is gearing up to begin work again. BBC Midlands Today science correspondent David Gregory went to see how scientists from the University of Birmingham are at the heart of trying to understand what makes our universe tick." (1 page)

  13. A Trojan Horse in Birmingham

    Science.gov (United States)

    Yarker, Patrick

    2014-01-01

    "Trojan Horse" has become journalistic shorthand for an apparent attempt by a small group in East Birmingham to secure control of local non-faith schools and impose policies and practices in keeping with the very conservative (Salafist and Wahhabi) version of Islam which they hold. In this article, Pat Yarker gives an account of two…

  14. Application of visible simulation surgery in the hip resurfacing%可视化虚拟手术在全髋关节表面置换中的应用

    Institute of Scientific and Technical Information of China (English)

    刘登均; 李奇; 李鉴轶; 林荔军; 张飞; 韦葛堇

    2010-01-01

    目的 通过探索虚拟现实技术来寻找一种实行全髋关节表面置换可视化虚拟手术的方法,发掘可视化虚拟手术对金属对金属全髋表面置换(metal on metal hip resurfacing arthroplasty,MOM-HRA)的临床指导作用.方法 根据Zimmer公司提供Durom全髋表面置换假体,通过激光扫面在Geomegic软件中建立假体库,采集髋关节64排螺旋CT的原始扫描数据,并在mimics进行三维重建,重建的3 d模型进行分割,并在3 ds max软件系统上进行虚拟手术,明确假体选择的大小及假体放置的最佳位置.结果 采用激光扫描及Geomegic软件能建立与实体匹配的假体库, mimics医学图像处理软件对髋关节CT扫描的Dicom格式数据进行三维重建图像,结构清晰,可真实再现髋臼和股骨近端的结构.利用3 ds max软件系统可以有助于术前进行模拟全髋关节表面置换的可视化仿真手术.结论 可利用计算机虚拟现实技术制定出最佳的手术方案,对全髋关节表面置换的术前病变结构区域评估、术中股骨颈中心定位、优化假体放置及临床教学等方面都有很大的应用价值.

  15. CO2 laser resurfacing.

    Science.gov (United States)

    Fitzpatrick, R E

    2001-07-01

    The CO2 Laser offers a variety of unique features in resurfacing facial photodamage and acne scarring. These include hemostasis, efficient removal of the epidermis in a single pass, thermally induced tissue tightening, and safe, predictable tissue interaction. Knowledge of these mechanisms will result in the capability of using the CO2 laser effectively and safely whether the goal is superficial or deep treatment.

  16. Biomechanical reconstruction of the hip in total hip resurfacing arthroplasty versus conventional total hip arthroplasty%全髋表面置换术和传统全髋置换术术后生物力学结构恢复的比较研究

    Institute of Scientific and Technical Information of China (English)

    何志勇; 狄正林; 陶崑; 曾志敏; 章军辉; 吴海山

    2011-01-01

    Objective To study the effect of total hip resurfacing arthroplasty ( HRA ) in restoring of the biomechanical nature versus conventional total hip arthroplasty ( THA ).Methods In a randomised study involving 40 patients in unilateral avascular necrosis of femoral head undergoing unilateral primary hip replacement.The contralateral hip was used as a control.20 patients underwent HRA, the other 20 patients underwent THA.Postoperative femoral offset, leg length discrepancy and acetabular offset were measured by postoperative AP view X-ray.Results Post-operatively, the femoral offset was significantly increased with THA ( 3.1 ± 1.9 ) mm and decreased with HRA ( - 1.8 ±1.4 ) mm( P < 0.05 ).In the THA group, the leg was lengthened by a mean of ( 3.5 ±2.6 ) mm, whereas it was shortened hy a mean of ( - 2.1 ± 1.1 ) mm in the HRA group( P < 0.05 ), comparing with the contralateral side.On the pelvic side, the acetabular cup offset was increased with THA( 1.6 ± 1.8 )mm and decreased with HRA( - 2.3 ±2.1 )mm( P < 0.05 ).Conclusions Restoration of the normal proximal femoral anatomy is more precise with HRA.The enhanced stability afforded by the use of a large-diameter femoral head avoids over-lengthening of the limb or increasing offset to improve soft-tissue tension as occurs sometimes in THA.%目的 比较全髋表面置换术(HRA)和传统全髋置换术(THA)后的下肢长度、股骨偏心距和髋臼偏心距等恢复的情况,确定HRA是否更有利于恢复髋关节的生物力学结构.方法 选择单侧施行HRA或THA的股骨头坏死患者各20例(对侧髋关节均健康).术前、术后摄等比例X线正位片,测量患者双髋的下肢长度、股骨偏心距和髋臼偏心距指标,与对侧髋比较患髋术后的改变.将HRA和THA术后改变的结果进行比较.结果 HRA组各项生物力学参数差值恢复明显比THA组更接近正常.术后HRA组和THA组患侧和健侧比较下肢长度差分别为(-2.1±1.1) mm和(3.5±2.6)mm(P<0

  17. Total blood loss in total hip resurfacing arthroplasty and conventional total hip arthroplasty: a comparative study%全髋关节表面置换术与传统全髋关节置换术围手术期总失血量的比较研究

    Institute of Scientific and Technical Information of China (English)

    何志勇; 狄正林; 章军辉; 曾志敏; 陶崑; 凌晶

    2012-01-01

    Objective To evaluate the blood loss in total hip resurfacing arthroplasty (HRA) comparing with conventional total hip arthroplasty (THA). Methods From January, 2009 to December, 2009, 34 patients were performed total hip resurfacing arthroplasty(HRA group) and 33 patients were performed convetional total hip arthroplasty (THA group). All the operations were conducted by the same surgeon. HRA group involved 20 males and 14 females with an average age of 48. 7 years (range, 21 - 65 years). THA group involved 16 males and 17 females with an average age of 57.4 years (range, 39 -65 years). All arthroplasties were primary and unilateral. Total perioperative blood loss included perioperative visible blood loss and hidden blood loss. Using Gross formula, the total blood loss was calculated according to height, weight and pre-and postoperation hematocrit (HCT) , while the hidden hemorrhage volume was calculated by subtracting the visible blood loss from total loss. Total perioperative blood loss, visible blood loss, hidden blood loss, length of incision, duration of operation and length of hospital-stay were measured and compared. Results In HRA group, there were less total estimated blood loss [ average (1048. 0 ± 134. 2) ml of HRA group versus (1466. 0 ± 167. 4) ml of THA group; P < 0. 01 ] , less intraoperative blood loss [ average (542. 0 ± 68. 9) ml of HRA group versus (625. 0 ± 86. 3) ml of THA group; P<0. 01] and much less hidden blood loss [average (240.0±43.4) ml of of HRA group versus (462. 0 ±71.5) ml of of THA group; P <0. 05]. There was shorter duration of hospital stay in HRA group (4. 6 ±0. 9) days of HRA group versus (6. 1 ± 0. 9) days of THA group, P < 0. 05) , and longer operation time in HRA group [(114 ±13.9) min versus (87 ± 18.5) min]. Conclusions Total hip resurfacing arthroplasty gave rise to a positive final impression with regard to really less bleeding and less injury.%目的 比较全髋表面置换术(HRA) 和传统全髋置换

  18. Treatment of osteoarthritis secondary to developmental dysplasia of the hip by total hip resurfacing arthroplasty%全髋关节表面置换术治疗髋关节发育不良继发骨关节炎的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    沈彬; 黄强; 杨静; 周宗科; 康鹏德; 裴福兴

    2010-01-01

    Objective To investigate the clinical effect of total hip resurfacing arthroplasty (THRA) for treatment of osteoarthritis secondary to the developmental dysplasia of the hip (DDH). Methods From March 2005 to June 2006, 26 THRA were performed in 25 patients to treat osteoarthritis secondary to DDH. According to the Hartofilakidis classification, 22 hips were classified as dysplasia; 4 as low dislocation. Clin-ical outcomes were evaluated according to Harris score. Central-edge angle, abduction angle, stem-shaft an-gle, hip center, ratio of offset, cover rate of cup were measured radiologically. Bone mineral density was measured before and after THRA. Results The mean follow-up time of the 25 patients was 3.5 years. Using loosening or revision as the end point, the survival rate was 100%. The mean Harris hip score had improved from (46.1±6.57) points preoperative to (92.1±2.59) points at the final follow-up. Radiological measurement showed that the position of cup restored more anatomically after operation. At the sixth month after operation, the BMD ratio reduction occurred in ROI1-ROI 6, which then increased during 6 to 36 months. The BMD ratios of ROI7, ROIL, ROIM had returned to baseline value at the sixth month postoperatively and surpassed the reference by 36 months. Conclusion The clinical results of THRA for treatment of osteoarthritis sec-ondary to DDH are encouraging. The bone stock of proxiaml femur can be reserved and restored effectively.%目的 探讨全髋关节表面置换术(total hip resurfacing arthroplasty,THRA)治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)继发骨关节炎的早期疗效.方法 2005年3月至2006年6月,采用THRA治疗25位(26髋)DDH患者,女18例,男7例;年龄30~59岁,平均48岁.根据Hartofilakidis分型,半脱位22髋,低位脱位4髋.临床随访主要采用Harris评分,影像学测量指标包括CE角、Sharp角/臼杯外展角、股骨颈干角/柄干角、髋关节旋转中心、偏心

  19. A Biometrological Procedure Preceeding the Resurfacing

    Directory of Open Access Journals (Sweden)

    Ryniewicz Anna M.

    2016-03-01

    Full Text Available This paper presents a preoperative hip reconstruction method with diagnosed osteoarthritis using Durom Hip Resurfacing System (DHRS. The method is based on selection and application of the resurfacing to the pelvis reconstructed on the basis of computed tomography. Quality and geometrical parameters of distinguished tissues have a fundamental significance for locating and positioning the acetabular and femoral components. The application precedes the measurements of anatomical structures on a complex numerical model. The developed procedure enables functional selection of endo-prosthesis and its positioning in such a way that it secures geometric parameters within the bone bed and the depth , inclination angles and ante-version of the acetabular component, the neck-shaft angle and ante-torsion angle of the neck of the femoral bone, and reconstruction of the biomechanical axis of the limb and the physiological point of rotation in the implanted joint. Proper biomechanics of the bone-joint complex of the lower limb is determined by correlation of anatomical-geometrical parameters of the acetabular component and parameters of the femoral bone.

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

    Science.gov (United States)

    Howard, Jason J

    2016-01-01

    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 general, particularly for those who have a significant potential for harm. In this regard, a series of recommendations have been developed to contribute to the evolution of the medical device regulatory process

  1. Bridging the Legacy of Activism across Generations: Life Stories of African American Educators in Post-Civil Rights Birmingham

    Science.gov (United States)

    Loder-Jackson, Tondra L.

    2011-01-01

    This qualitative study takes account of the salience of activism in informing the worldviews and professional practices of a multigenerational sample of 42 African American educators in Birmingham, Alabama. Framed by life course, Black feminist thought, and hip-hop educational research perspectives, the study highlights how the participants…

  2. 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.

  3. Midterm Results of Total Hip Resurfacing Arthroplasty for Treatment of Developmental Dysplasia of the Hip%全髋关节表面置换术治疗成人髋关节发育不良25例中期随访

    Institute of Scientific and Technical Information of China (English)

    沈彬; 黄强; 杨静; 周宗科; 康鹏德; 裴福兴

    2009-01-01

    目的 探讨全髋关节表面置换术(total hip resurfacing arthroplasty,TUNA)治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)继发骨关节炎的中期疗效.方法 2005年3月至2006年6月,采用THRA治疗DDH患者25例,女18例,男7例;30~59岁,平均48岁;双髋1例,共26髋.根据Hartofilakidis分型,半脱位22髋,低位脱位4髋.采用Conservc-plus金属对金属全髋关节表面置换假体,髋臼假体为非骨水泥固定,股骨头假体采用低黏骨水泥固定.临床随访采用Harris评分,测量髋臼外展角、垂直距离、水平距离、股骨柄干角、髋臼假体覆盖率;记录髋臼和股骨假体周围透亮线及骨溶解;以各种原因所致翻修或影像学松动为随访终点.结果 所有患者均随访3年以上,平均随访3.5年.截至随访终点无翻修或影像学松动.患者的Harris评分由术前平均46分提高至术后平均92.1分,26髋均为优.术后轻度跛行2例,所有患者均无迟发感染、术后股骨颈骨折、术后残余股骨头坏死、术后假体松动、脱位、术后异位骨化.髋关节活动度:屈曲由97.5°增加至127.5°,外展由19.3°增加至40°,外旋由23.2°增加至42.5°,内旋由4.2°增加至28.5°.X线片显示:关节假体位置正常,髋臼假体平均外展角为41.6°,髋关节旋转中心位置平均下移6.2 mm、内移15 mm,股骨柄干角平均146.4°.宿主骨对臼杯的平均覆盖率为94.4%,1例宿主骨与臼杯界面在2区出现透亮线,宿主骨与股骨假体柄界面无一例出现透亮线.结论 THRA治疗成人半脱位型及低位脱位型DDH继发骨关节炎具有良好的中期疗效,熟练的手术技术和正确的适应证选择是降低中远期并发症的关键.

  4. Medulloblastoma in children: Birmingham experience

    Directory of Open Access Journals (Sweden)

    Anil Sivasankaran

    2006-01-01

    Full Text Available A retrospective review of 41 children diagnosed with medulloblastoma in Birmingham (United Kingdom between 1992-2002 presented. The age of the patients ranged from 2 weeks to 14.1 years (mean 5.89 years and the mean follow-up was 3.8 years. Children less than 3 years of age fared worse than those over 3 years. The 5-year survival with total and subtotal tumor excision was 61.3 and 40% respectively. Those children who received radiotherapy following surgery had an improved survival of 68% at 5 years as compared to 18% in those who did not receive irradiation. With regards to chemotherapy, the 5-year survival rates were 57% in those who received it and 52% in those who did not. The overall survival was 62% at 5 years for those patients who had postoperative combined radiotherapy and chemotherapy and only 48% for the rest, who received no adjuvant therapy. Age of the patient has a definite influence on overall survival. We found significant statistical difference in survival between patients with total tumor resection and those with subtotal resection. The 5-year survival rate was not directly affected by tumor location, hydrocephalus or ventriculo-peritoneal shunting. Postoperative irradiation and chemotherapy are clearly associated with improved survival.

  5. Non-operation related risk factors for femoral neck narrowing after resurfacing arthroplasty of the hip%全髋表面置换术后发生股骨颈狭窄非手术相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋志勇; 茹江英; 胡玉华; 仓海斌; 胡传亮

    2013-01-01

    [目的]探讨全髋表面置换术(resurfacing arthroplasty of the hip,RSAH)术后发生股骨颈狭窄的非手术相关危险因素.[方法]回顾性分析行全髋表面置换术的患者53例(61髋),男31例,女22例;年龄26 ~ 54岁,平均45.3岁;体重指数(RMI)为20.4~37.8,平均为27.4.按病因学分类:股骨头坏死22例(26髋),先天性髋关节发育不良13例(15髋),骨性关节炎10例(12髋)和创伤性关节炎8例(8髋).观察术后股骨颈狭窄发生情况并分组,股骨颈狭窄率≥5%纳入研究组,<5%列入对照组.对可能导致股骨颈狭窄的17个变量进行单因素分析,对差异有统计学意义的变量进行多因素非条件logistic回归分析.[结果]将37例(43髋)狭窄率>0%且<5%和未狭窄的病例纳入对照组;将16例(18髋)狭窄率≥5%的病例,纳入研究组.在研究组中,2例在术后1年于股骨头杯柄周围1、3区出现透光线;1例于术后2年出现假体松动、移位.单因素分析显示,体重指数、患髋疾病、颈干角、头颈比、股骨头囊肿大小及股骨假体柄固定方式6个变量差异有统计学意义(P值均<0.05);多因素分析显示,患髋疾病、颈干角、头颈比为独立危险因素(P值均<0.05).[结论]髋关节原发病的诊断、头颈比、颈干角是全髋表面置换术术后股骨颈狭窄发生的非手术独立危险因素.%[Objective] To analyze the non-operation related risk factors for femoral neck narrowing after resurfacing arthroplasty of the hip (RSAH).[Methods] Fifty-three cases (61 hips) treated with RSAH were retrospectively analyzed.The study included 31 men and 22 women with a mean age of 45.3 years (range,26 ~ 54 years) and body mass index of 27.4 kg/m2 (range,20.4 ~ 37.8 kg/m2).Twenty-two cases (26 hips) were diagnosed as osteonecrosis of the femoral head,13 (15 hips) as developmental dysplasia of the hip,10 (12 hips) as osteoarthritis,and 8 (8 hips) as traumatic arthritis.Post-operative femoral

  6. 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…

  7. [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 prosthes

  8. Analysis of the installation of acetabulum of total hip resurfacing arthroplasty in surgery of developmental ysplasia of hip%髋关节骨性关节炎及髋臼发育不良对髋关节表面置换术中髋臼安装角度的影响

    Institute of Scientific and Technical Information of China (English)

    赵赞栋; 王健; 肖军; 兰天; 李郅涵; 卢坤; 周亚鹏; 史占军

    2011-01-01

    [ Objective] To observe the early clinical result and the location and angle of acetabulum of the total hip resurfacing arthroplasty (THRA) in surgery of osteoarthritis of hip and developmental dysplasia of hip (DDH) . [ Method ] A retrospective study was carried out in twenty patients (twenty - three hips) dealt with THRA from 2006 to 2009, including ten cases of osteoarthritis and thirteen cases of DDH. All patients were implanted with metal - on - metal prostheses of large diameter. Femoral head was fixed with cement and the acetabular cup was biologically fixed. [ Result] Totally twenty - three cases received the follow -up ,with an average 24 months(6 -36months)after discharge. There was no significantly statistical difference between the two groups in the Harris score. However, there were numerous disparities between the two groups in the anatomy parameter of acetabular prosthesis. In group of osteoarthritis, the average acetabular cup abduction angle was 43.9° ± 19.9° (25.6° ~ 56.0° ) and the average acetabular fraction of coverage was 95. 8%. In group of DDH,the average acetabular cup abduction angle was 46.8° ± 12.9° (22.4° -69.3°) and the average acetabular fraction of coverage was 84.3%. No complications such as dislocation or fracture were found. [ Conclusion]There is no statistical difference in the early clinical result of THRA between osteoarthritis and DDH. Meanwhile, because of the mismatching of the acetabular cup components due to malformation of acetabulum in DDH, it is more difficult to install the acetabulum prosthesis in a good angle and location.%[目的]研究全髋关节表面置换术中,单纯骨性关节炎及髋关节发育不良对髋臼安装角度的影响及两组病例疗效比较.[方法]自2006~2009年,本科共实施全髋表面关节置换术20例23髋,病因包括单纯骨性关节炎10髋及髋关节发育不良13髋.手术假体均采用金属对金属大直径表面置换假体,股骨侧骨水泥固定,髋臼

  9. Gait analysis of patients with resurfacing hip arthroplasty compared with metal-on-metal bigfemoral-head total hip arthroplasty%全髋表面置换与金属对金属大直径股骨头全髋置换术后的步态分析比较

    Institute of Scientific and Technical Information of China (English)

    陈云苏; 赵松; 曹乐; 张先龙

    2010-01-01

    目的 比较全髋关节表面置换术与金属对金属大直径股骨头全髋关节置换术患者术后1年的步态有无差异.方法 选择2006年6月至2009年3月期间行全髋关节表面置换术与金属对金属大直径股骨头全髋关节置换术的连续病例各30例,利用Vicon步态分析仪测得两组患者术后平均1年左右的步态参数和步态周期中的髋、膝关节活动度,计算自身患侧/健侧比值进行比较分析.结果 两组患者术后平均1年左右步频、单腿支撑时间等比值和美国特种外科医院评分及加州大学洛杉矶分校评分比较差异无统计学意义,但全髋关节表面置换组患者步态周期中的髋屈伸度、收展度、旋转度及膝关节屈伸度患/健比分别为1.0323、0.9747、1.0558、1.0027,明显高于大直径股骨头全髋关节置换组(患/健比分别为0.8615、0.7824、0.8162、0.9472),P值分别为0.007、0.005、0.006、0.037.结论 (1)全髋关节表面置换术与金属对金属大直径股骨头全髋关节置换术患者术后1年的步态参数接近正常;(2)全髋关节表面置换术后患者行走时的关节活动度优于金属对金属大直径股骨头全髋关节置换术患者;(3)采用全髋关节表面置换除了能够保留骨量,还能最大程度恢复患者的关节功能.%Objective To compare gait patterns in patients with metal-on-metal resurfacing hip arthroplasty(RHA)and big-femoral-head total hip arthroplasty(BHA)at one year postoperatively.Methods From June 2006 to March 2009,two groups of 30 RHA and BHA patients participated in the study.Gait parameters,knee and hip joint range of motions(ROMs)in gait cycles were measured at one year postoperatively by Vicon gait analysis system,and the values were used to calculate affected/unaffected ratios of patients themselves.Results No significant difference were found in affected/unaffected ratios of cadence,single limb support time,foot off,peak value of vertical ground

  10. 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.

  11. Reflection on Letter from Birmingham Jail

    Institute of Scientific and Technical Information of China (English)

    张远艳; 罗瑞

    2015-01-01

    "Letter from Birmingham Jail" is written by Martin Luther King,Jr.,who is a famous American civil rights leader.This essay attempts to analyze three major arguments in this letter to arouse people’s consciousness to cherish and protect our freedom.

  12. Reflection on Letter from Birmingham Jail

    Institute of Scientific and Technical Information of China (English)

    张远艳; 罗瑞

    2015-01-01

    “Letter from Birmingham Jail” is written by Martin Luther King,Jr.,who is a famous American civil rights leader.This essay attempts to analyze three major arguments in this letter to arouse people’s consciousness to cherish and protect our freedom.

  13. 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.

  14. 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

  15. 表面置换治疗中青年强直性脊柱炎伴髋关节炎初步经验%Preliminary experience of hip resurfacing arthroplasty for coxarthria with ankylosing spondylitis in young and middle-aged adults

    Institute of Scientific and Technical Information of China (English)

    陈杰; 夏军; 魏亦兵; 陈飞雁; 黄钢勇; 石晶晟

    2011-01-01

    目的 总结髋关节表面置换术(HRA)治疗中青年强直性脊柱炎(AS)伴髋关节炎的初步经验.方法 2008年4月至2009年12月期间采用HRA治疗AS伴髋关节炎患者共9例(11髋),术前常规行X线、双髋CT等检查,并模板测量髋臼侧假体和股骨头侧假体大小(按15%放大率).记录手术时间、术中出血量,评价术后X线片、术前及术后髋关节活动度、Harris评分.结果 手术时间平均96 min(80~110 min),术中出血量平均300 ml(200~370 ml).患者术后住院期间均无伤口感染、神经血管损伤、假体脱位和下肢深静脉血栓形成等并发症发生.9例患者均成功随访,随访时间为6~21.5个月,平均随访12.3个月,Harris评分由术前平均33.8±4.2改善为术后末次随访时平均82.3±2.4(P<0.05).术后摄片显示假体在位,无脱位、异位骨化等并发症.结论 HRA治疗中青年AS伴髋关节炎可以保留更多骨量,明显增加髋关节活动度,提高生活质量.%Objective To investigate the preliminary experience of the hip resurfacing arthroplasty (HRA) for coxarthria with ankylosing spondylitis in young and middle-aged adults. Methods From April 2008 to December 2009, 9 patients (11 hips)suffering from ankylosing spondylitis with coxarthria underwent HRA. The preoperative X-ray and CT scan of the patients were taken, and the prosthesis measured (15% multiplying power). The operation time, blood loss, Harris score, range of motion of the hip joint were noted. And preoperative and postoperative X-ray in all patients were compared to evaluate the clinical effects.Results The mean operation time was 96 min (80 min to 110 min) and the mean blood loss was 300 ml (200 ml to 370 ml). No wound infection, nerve or vascular injury, joint dislocation or DVT occured during the hospital stay. The follow-up of all patients were among 6 months to 21.5 months (mean 12. 3 months). Harris score increased from 33. 8 ± 4. 2 preoperatively to 82. 3:± 2. 4

  16. Early clinical effects and complications of metal-on-metal hip resurfacing arthroplasty%金属对金属髋关节表面置换术的早期临床疗效及其并发症

    Institute of Scientific and Technical Information of China (English)

    陈伟义; 李奇; 林荔军

    2009-01-01

    髋关节表面置换术从20世纪50年代开始已经运用于临床,但由于早期的技术不成熟、股骨颈骨折发生率高、关节假体易磨损、假体早期松动率高等缺点,髋关节表面置换术到80年代几近消失。而全髋关节置换术(total hip arthroplasty,THA)在老年髋关节疾病患者中取得了良好的临床效果,但对年轻患者和对活动要求高的患者却不能提供理想的长久的临床疗效。从20世纪90年代中期以来,

  17. A finite element analysis of stress distribution on proximal femur after vulgus implantation in hip resurfacing arthroplasty%髋表面置换股骨侧假体外翻位植入后股骨近端应力变化的有限元分析

    Institute of Scientific and Technical Information of China (English)

    徐南伟; 孙荣彬; 王禹基; 侯丽丽; 赵峰

    2009-01-01

    Objective To determine an ideal angle for prosthesis implantation after analyzing the stress distribution on the proximal femur after valgus implantation of hip resurfacing arthroplasty.Methods A three-dimensional finite element model of intact femur was developed for implantation of the Wright hip resudaeing prosthesis at valgus degrees of 0°,5°,10°,and 15°.After articular resultant forces and related muscles' forces were loaded,changes in stresses on the proximal femur before and after implantation were analyzed.Results A slightly valgus orientation reduced the stress on the superior neck around the head-neck junction (sections 2 & 8).In the implantation at valgus degrees of 5°,the stress shielding in the proximal sections (sections 1 & 7) was the minimum,and the stress distribution in sections 4 and 10 were close to that in the case of an intact femur.Conclusion A valgus 5° implantation in hip resudacing arthroplasty may result in a stress distribution on the proximal femur similar to the normal value and thus may decrease the risks of femoral neck fracture and aseptic loosening of the femoral component.%目的 探讨髋表面置换股骨侧假体外翻位植入后股骨近端的应力变化,并寻求最佳外翻植入角度.方法 建立正常股骨近端髋表面置换股骨侧假体(Wright假体)三维模型,其中股骨假体按解剖颈干角(本文选用股骨模型的生理解剖颈干角为135°)、外翻5°、10°、15°植入,加载关节合力及相关肌肉的肌力负荷,分析假体植入前后股骨近端的应力分布变化,并对股骨近端假体周围区域骨质应力分布进行分区量化研究.结果 股骨假体轻度外翻植入降低了股骨头颈交界处上方(2、8区)的应力,5°外翻植入股骨头上方假体杯下缘(1、7区)应力遮挡最小,股骨颈下方(4、10区)应力分布更接近正常股骨.结论 外翻5°植入假体股骨近端应力更接近正常股骨,降低了股骨颈骨折和假体松动的危险.

  18. 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...

  19. 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.

  20. 人工髋关节表面置换术治疗股骨头坏死疗效观察%OBSERVATION OF EFFECTIVENESS OF HIP RESURFACING ARTHROPLASTY IN TREATMENT OF OSTEONECROSIS OF FEMORAL HEAD IN YOUNG AND MIDDLE-AGED PATIENTS

    Institute of Scientific and Technical Information of China (English)

    俞银贤; 易诚青; 马金忠; 王秋根

    2016-01-01

    目的 探讨人工髋关节表面置换术(hip resurfacing arthroplasty,HRA)治疗年龄<60岁中青年股骨头坏死患者的临床疗效.方法 2008年1月-2009年4月采用HRA治疗股骨头坏死患者34例,其中男19例,女15例;左髋16例,右髋18例;年龄33 ~ 59岁,平均54岁.病因:酒精性9例,激素性8例,创伤性7例,不明原因10例.病程2~11年,平均5年.股骨头坏死改良Ficat分期为Ⅲ期26例,Ⅳ期8例.采用Harris髋关节评分系统(Harris hip score,HHS)和改良加州大学洛杉矶分校(UCLA)活动评分评估患者临床效果;术后摄X线片评估假体位置及是否发生松动,并测量臼杯外展角、颈干角和股骨假体-股骨外侧皮质长度比判断术后有无股骨头假体塌陷.结果 术后患者切口均Ⅰ期愈合,无切口感染、下肢深静脉血栓形成等术后早期并发症发生.32例患者获随访,随访时间70 ~ 84个月,平均78个月.随访期间均无假体松动、感染、股骨颈骨折、脱位及炎性假瘤等并发症发生.末次随访时患者HHS评分和改良UCLA活动评分分别为(95.22±1.47)、(7.70±1.13)分,均显著优于术前的(50.10±2.27)、(3.90±0.90)分,比较差异均有统计学意义(t=1.510,P=0.008;t=0.830,P=0.003).术后3d与末次随访时比较患者臼杯外展角、颈干角及股骨假体-股骨外侧皮质长度比,差异均无统计学意义(P>0.05).结论 严格掌握手术指征,HRA可作为治疗中青年FicatⅢ期或Ⅳ期股骨头坏死患者的有效方法.

  1. 髋关节表面置换术假体柄固定方式对股骨近端骨密度及应力影响%Effect of stem fixing methods on stress and bone mineral density in the proximal femur following hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    屈瑾; 雷新玮; 展影; 张晨; 姜文学; 祁吉

    2014-01-01

    Objective To construct different 3-D finite element resurfacing arthroplasty of hip models and to explore the biomechanics influences of cement mantle varying in thickness on stress distribution and stressshielding in the proximal femur following hip resurfacing arthroplasty (RSAH),and evaluate the changes of bone mineral density in femur after RSAH,in order to find the adaptive methods to stem fixing.Methods A comparative study was carrie out in patients who underwent RSAH.The bone mineral Density of the proximal femur was measured through dual energy X-ray absorptiomenty of the four zone at post-operation and unoperation 6 months.Changes of bone mineral density ratio in proximal femur between post-operation and unoperation were compared and analyzed.the finite element models of RSAH with different thickness of cement mantle and normal femur were developed and stress analysis was performed under the load of body weight.Results The mean ration of bone mineral density of proximal femur in zone1,2,3 increased which was no significantly different from other areas (P > 0.05),the mean ration of bone mineral density of proximal femur in zone 4 and 5 increased which was significantly different from other areas (P < 0.05).Comparing with the 0 mm cement mantle model,the ratio of stress shielding of the cancellous bone around the stem in 1 mm cement mantle model has slightly increased,but also was less than 17%.The ratio of stress shielding was increased obviously in the 2 and 3 mm cement mantle mode and more than 17% in 1,2 and 5 zone.Conclusion The cement around stem not thicker than 1 mm produced slightly effect to the stress decreasing and did not result in marked stress shielding in the proximal femur following RSAH,and the bone stock of proximal femur can be well perserves and recovered.%目的 应用有限元分析方法研究髋关节表面置换术(RSAH)股骨侧假体柄周围骨水泥厚度与股骨近端应力分布间关系,比较术后手术侧与健

  2. 髋关节表面置换术中股骨头缺损区骨水泥填充和空置两种处理方法的生物力学比较%Biomechanical comparison of bone-cement filling and cement vacancy treatments for femoral head defect in hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    何志勇; 李明; 陶崑; 方超华; 章军辉; 狄正林

    2014-01-01

    Objective To investigate the reliable treatment methods for the femoral head defect during the hip resurfacing arthroplasty,by comparing the biomechanical effects between bone cement filling and cement vacancy using three-dimensional (3-D) finite element analysis.Methods The 3-D finite element model of the normal femur was constructed based on the CT scanning.Four defect models were established by the computer assissted design technology.The defect diameter was 50%of the femoral head diameter in two models, and it was 80%of the femoral head diameter in the other two models.The femoral head defects were dealt with cement filling or vacancy.The models were loaded with the simulated standing stress, and the biomechanical indices of the femoral head and neck were compared and analyzed, including the stress peak and the equivalent strain.Results The stress concentration in the femoral head: in the model of 50%diameter defect, the stress concentration was not significant in the cement filling group, but it was significant in areaⅠof the femoral head in the vacancy group;in the model of 80%diameter defect filled with cement, the stress concentration exceeded 100% in area Ⅰ of the femoral head, while in the vacancy group, it exceeded 1000%in areaⅠ;the maximum stress concentration in areaⅡwas as high as 766.89%.The stress concentration in the femoral neck:in the model of 50% diameter defect, the stress concentration in the femoral neck was between -50% and 50% in both groups;in the model of 80%diameter defect, it was between -50% and 50% in the cement filling group, while it was extremely increased in the vacancy group.The equivalent strain in the femoral head:in the model of 50% diameter defect, the equivalent strain did not chang significantly in the cement filling group, while it increased significantly in the proximal part of the head in the vacancy group;in the model of 80%diameter defect, it increased significantly in the vacancy group.The equivalent strain in

  3. Birmingham-Britain’s Second Largest City

    Institute of Scientific and Technical Information of China (English)

    汪伦

    2009-01-01

    Surrounded by several motorways, separated by canals and with many modem shopping centres, Birmingham seems like a huge maze (迷宫). (1) Best to.set your bearings on the great Council House 19th-century buildings which is located in the heart of town. This area consists of Victoria and Chamberlain Squares, which are the most attractive architecture in the city. To the west are Centenary Square, the International Convention Centre and Symphony Hall, as well as the popular bars and cafes. To the northwest is the colourful Jewellery Quarter. In the southeast of the area are the Pallasades and Pavilions shopping centres and the City Plaza.

  4. Laser Resurfacing: Full Field and Fractional.

    Science.gov (United States)

    Pozner, Jason N; DiBernardo, Barry E

    2016-07-01

    Laser resurfacing is a very popular procedure worldwide. Full field and fractional lasers are used in many aesthetic practices. There have been significant advances in laser resurfacing in the past few years, which make patient treatments more efficacious and with less downtime. Erbium and carbon dioxide and ablative, nonablative, and hybrid fractional lasers are all extremely effective and popular tools that have a place in plastic surgery and dermatology offices.

  5. 75 FR 10692 - Television Broadcasting Services; Birmingham, AL

    Science.gov (United States)

    2010-03-09

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Birmingham, AL AGENCY: Federal Communications... CFR Part 73 Television, Television broadcasting. 0 For the reasons discussed in the preamble,...

  6. 75 FR 3695 - Television Broadcasting Services; Birmingham, AL

    Science.gov (United States)

    2010-01-22

    ... From the Federal Register Online via the Government Publishing Office ] FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Birmingham, AL AGENCY: Federal Communications... 73 Television, Television broadcasting. For the reasons discussed in the preamble, the...

  7. 78 FR 75306 - Television Broadcasting Services; Birmingham, Alabama

    Science.gov (United States)

    2013-12-11

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Birmingham, Alabama AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: The Commission has before it a petition for...

  8. A Birmingham psychogeography: continuity and closure (Volume 2)

    OpenAIRE

    2015-01-01

    There has been some sociological interest in MG Rover’s decline and widespread deindustrialisation in Birmingham. However, little research has considered the proximity of Rover’s closure in 2005 to another seminal event for the city – the opening of the Bullring shopping centre in 2003. These events appear indicative of Daniel Bell’s conception of ‘postindustrialism’. This thesis uses the tradition of ‘psychogeography’ to critique postindustrialism in Birmingham, examining the city’s co...

  9. 缺血性股骨头坏死塌陷程度与金属对金属全髋表面置换术疗效的关系%Relationship between the collapse level of avascular necrosis of femoral fead and clinical results of metal-on-metal hip resurfacing

    Institute of Scientific and Technical Information of China (English)

    茹江英; 刘璠; 胡玉华; 王长峰; 胡传亮

    2008-01-01

    [目的]探讨缺血性股骨头坏死(avascular necrosis of femoral head, ANFH)塌陷程度与金属对金属全髋表面置换术(metal-on-metal hip resurfacing, MOMHR)疗效的关系,为术前合理选择缺血性股骨头坏死患者提供依据.[方法]从2003年11月~2006年9月,先后对27例(36髋)缺血性股骨头坏死患者行混合型金属对金属全髋表面置换术(conserve plus, wright),平均年龄43岁(28~54岁),平均体重指数(RMI)27.3(20.5~44.8).按国际骨循环研究会(association for research circulation osseous, ARCO)的建议分类法,将手术病例分为ⅢA、ⅢB、ⅢC、Ⅳ期四组,并分别进行术前、后的Harris评分,术后疼痛情况,术前后膝关节屈曲度及双下肢长度差异的测量及X线分析.[结果]平均随访29.6个月(16~50个月).最后一次随访时,36髋中3髋发生轻微疼痛,1髋严重疼痛.X线结果显示2例髋臼假体周围1、2区可见透光区;1例股骨假体松动而行全髋置换(THR)翻修术;1例股骨假体内翻成角10°,但未见假体松动迹象,全组无股骨颈骨折、股骨颈狭窄及假体断裂等并发症发生.术后ⅢA+ⅢB期组在Harris评分、疼痛发生及双下肢长度差异方面的恢复程度均显著高于ⅡC+Ⅳ期组(P<0.05),而在屈曲度改善方面ⅢA+ⅢB期组却显著低于ⅢC+Ⅳ期组(P<0.05).[结论]对于ARCOⅢ、Ⅳ期缺血性股骨头坏死患者,塌陷程度≤4 mm且未累及髋臼病变的病例应用金属对金属全髋表面置换,术后的早期疗效较为满意.

  10. Serum metal ion levels in patients after undergoing resurfacing arthroplasty of the hip: a 5-year follow-up study%髋关节表面置换术后5年血清金属离子水平的变化

    Institute of Scientific and Technical Information of China (English)

    万彦林; 姜文学

    2014-01-01

    [目的]探讨髋关节表面置换术(resurfacing arthroplasty of the hip,RSAH)后5年血清钴(Co)、铬(Cr)、钼(Mo)离子水平的变化.[方法]自2006年9月~2013年3月本院行RSAH 40例52髋,男20例,女20例;平均年龄49岁,单侧28例,双侧12例.采用Conserve Plus假体29髋,ASR 5髋,BHR或BMHR 18髋.术前留取7例患者血清样本作为对照组.使用电感耦合等离子体质谱仪检测术前和术后3、6个月,1、2、4、5年血清样本中Co、Cr、Mo离子的水平.[结果]随访26.1个月(3个月~7.6年),Co、Cr、Mo离子术前平均水平分别为0.69、0.75、0.83 ng/ml,术后三种离子水平均较术前升高,差异有统计学意义(P<0.05).Co、Cr、Mo离子术后即开始升高,并分别于术后6个月、1年和3个月达到峰值,为术前的2.9倍、1.5倍和10.7倍.此后Co、Cr离子水平均降低,Mo离子水平处于波动状态,但术后5年Co、Cr、Mo离子水平均再次升高,分别为术前1.5倍,1.6倍和10.0倍.对于Co、Cr离子,使用BHR或BMHR假体离子水平明显低于使用Conserve Plus和ASR假体(P<0.05),女性Cr离子水平要高于男性(P<0.05),Co、Mo离子在性别上没有差异(P>0.05).行单侧或双侧置换金属离子水平没有显著差异(P>0.05).[结论]近期随访未出现金属离子引起的不良反应,但仍需长期随访了解金属离子水平的变化以及女性患者、不同假体对金属离子水平的影响.

  11. Hip Ultrasound

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Hip Ultrasound Hip ultrasound uses sound waves to produce pictures ... of Ultrasound Imaging of the Hip? What is Ultrasound Imaging of the Hip? Ultrasound images of the ...

  12. 性别对金属对金属全髋表面置换术后血清钴铬钼离子水平的影响%Gender difference in metal ion levels following metal-on-metal resurfacing hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    王伟; 刘璠; 刘华; 陶然; 杨洪伟; 刘雅克

    2015-01-01

    目的 探讨性别对金属对金属全髋表面置换术(RHA)后血清钴、铬、钼离子水平的影响. 方法 收集2008年11月至2013年3月因交通伤导致的24例单侧股骨头骨折患者,根据性别不同分为两组:男性组12例,平均年龄为(54.7±5.9)岁,股骨头骨折分型:31-C1型5例,31-C2型7例;女性组12例,平均年龄为(53.9±5.8)岁,股骨头骨折分型:31-C1型6例,31-C2型6例.所有患者均行金属对金属RHA治疗.分别于术前、术后3个月、6个月、9个月及12个月应用电化学微量元素测定法测量患者血清中钴、铬、钼离子的浓度,并比较两组患者的差异. 结果 男性组和女性组患者术后血清钴、铬离子浓度明显升高,术后6个月达到高峰,此后开始下降.男性组患者术后3、6、9及12个月时血清钴离子浓度平均分别为(1.37±0.50)、(2.51 ±0.78)、(1.99±0.46)、(1.26±0.60)μg/L,铬离子浓度平均分别为(0.98 ±0.18)、(1.39±0.44)、(1.12±0.21)、(0.74±0.15) μg/L.女性组患者术后血清钴离子浓度平均分别为(1.23±0.59)、(2.17 ±0.82)、(1.79 ±0.43)、(1.23±0.11)μg/L,铬离子浓度平均分别为(0.90 ±0.20)、(1.19±0.31)、(1.03±0.20)、(0.74±0.17)μg/L.两组患者术后3、6、9及12个月血清钼离子浓度无明显变化.除了术后9个月男性组患者铬离子浓度显著高于女性组患者(P<0.05)外,其他时间点两组患者钴、铬、钼离子浓度比较差异均无统计学意义(P>0.05). 结论 除术后9个月男性患者铬离子浓度显著高于女性患者外,其他时间点男性与女性患者钴、铬、钼离子浓度差异不明显.%Objective To study the effect of gender on the serum ion levels of Co,Cr and Mo in the patients who have undergone metal-on-metal resurfacing hip arthroplasty.Methods Enrolled in the present study were 24 patients with fracture of uni-lateral femoral head who were injured from November 2008 to March 2013 in traffic accidents.There were 12 men,with an

  13. 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.

  14. Erbium laser resurfacing for actinic cheilitis.

    Science.gov (United States)

    Cohen, Joel L

    2013-11-01

    Actinic cheilitis is a precancerous condition characterized by grayish-whitish area(s) of discoloration on the mucosal lip, often blunting the demarcation between mucosa and cutaneous lip. Actinic cheilitis is considered to be an early part of the spectrum of squamous cell carcinoma. Squamous cell carcinoma specifically of the lip has a high rate of recurrence and metastasis through the oral cavity leading to a poor overall survival. Risk factors for the development of actinic cheilitis include chronic solar irradiation, increasing age, male gender, light skin complexion, immunosuppression, and possibly tobacco and alcohol consumption. Treatment options include topical pharmacotherapy (eg, fluorouracil, imiquimod) or procedural interventions (eg, cryotherapy, electrosurgery, surgical vermillionectomy, laser resurfacing), each with their known advantages and disadvantages. There is little consensus as to which treatment options offer the most clinical utility given the paucity of comparative clinical data. In my practice, laser resurfacing has become an important tool for the treatment of actinic cheilitis owing to its ease of use and overall safety, tolerability, and cosmetic acceptability. Herein the use of erbium laser resurfacing is described for three actinic cheilitis presentations for which I find it particularly useful: clinically prominent actinic cheilitis, biopsy-proven actinic cheilitis, and treatment of the entire lip following complete tumor excision of squamous cell carcinoma. All patients were treated with a 2940-nm erbium laser (Sciton Profile Contour Tunable Resurfacing Laser [TRL], Sciton, Inc., Palo Alto, CA).

  15. 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.

  16. 髋关节表面置换术假体柄的不同安放角度与其术后骨折风险相关性的有限元分析%Finite element analysis of the relationship between the fracture possibility and different implant angle of hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    展影; 雷新玮; 屈瑾; 祁吉

    2011-01-01

    目的 应用有限元分析方法,分析不同股骨假体柄安放角度对髋关节表面置换术后股骨头颈部拉/压应力分布的影响,预测骨折发生的可能性,为临床髋关节表面置换选取最适股骨假体柄安放角度提供生物力学依据.方法 采用16层螺旋CT采集正常成人髋关节数据,建立安放角度为120°、125°、130°、135°、140°、145°的髋关节表面置换术后三维有限元分析模型,对所有模型施加关节及肌肉载荷,观察不同模型间股骨头颈结构中的中性层位置、拉/压应力区范围,并统计超过屈服应力的节点比例.结果 髋关节表面置换术后,随股骨假体柄安放角度增加,中性层的位置发生变化,拉应力区范围逐渐减少.当股骨金属假体柄安放角为135°~145°时,这种变化趋势不明显,并且股骨金属假体下松质骨及股骨颈皮质骨没有超过屈服应力的节点存在,股骨颈松质骨内超过屈服应力的节点比例数均未超过0.3%;随着假体柄安放角度的减小,股骨头颈部皮质骨、松质骨均存在超过屈服应力的节点,且该节点比例明显增加.结论 骨质正常时进行髋关节表面置换术,股骨假体柄安放角度在135°~145°间可降低骨折的危险性,140°为其最适安放角度.%Objective To explore the biomechanics influences of the angle of femoral prosthesis implantaion by constructing and analyzing different 3-D finite element (FE) Resurfacing Arthroplasty of Hip (RSAH) models. Methods Six different implant angles of RSAH 3-D FE models were constructed based on the human data that had been collected with 16-slice spiral CT. The angle was 120°, 125°, 130°, 135°, 140°, and 145°, respectively. Joint loading and related musle strengh were applied. The regular pattern of the tensile/compressive stress distribution was analized and the ratios of nodes that tensile or compressive stress value exceeding the yield stress value on different models

  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. Highlights of the EANM Congress 2011: Birmingham, UK.

    NARCIS (Netherlands)

    Geus-Oei, L.F. de; Zerizer, I.; Uebleis, C.; Al-Nahhas, A.

    2012-01-01

    The EANM Congress 2011 took place in Birmingham between the 15th and 19th October 2011 under the presidency of Professor Werner Langsteger. The attendance was reassuringly high, in line with other EANM congresses, despite the current 'Eurozone Crisis'. Participants from 87 countries came along, met

  20. Gross and Histomorphological Studies of Femoral Head Resurfacing in Dog

    Directory of Open Access Journals (Sweden)

    D. Sharifi

    2006-01-01

    Full Text Available The foetal skull bone as a biological graft was investigated. This study was conducted on Fifteen adult mixed - breed normal dogs 12 to 24 months with weighing 21.4=3.6 Kg .Dogs were randomly divided into 3 groups of 5 animals each. The foetal skull bone of 45 days old was collected from one pregnant bitch via cesarean method. The right femoral head cartilage was removed completely in all dogs of 3 groups.. Group I acted as control one, whereas in II group, resurfacing was done by using foetal skull bone which was fixed by using 0.8 mm cerclage wire in criss-cross fashion, but in III group, it was done similar to II group and the hip joint additionally was fixed by using 2 mm steinmenn pin.The clinical observations was made accordingly for 60 days in all groups. The gross changes of femoral head in group I & II were quite smooth and slippy, but in III group were uneven and rough due to secondary changes and ankylosis, but on micropscopic interpertation there was a remarkable compatibility of the graft with femoral head.The reconstruction of articular cartilage was faster in group II and even group III animals than group I animals. There was single row of chondrocyte in scatter area of samples in group . The complete and uniform hyaline cartilage in group II and fibro - cartilage and mixture of connective tissues in group III animals were observed. The results indicated that the foetal skull bone due to its pleuripotent calvarium easily can orient itself into the chondrocytes and cartilagenous tissues in articular surface of the hip joint, if there is suitable enviroment before complete ossification,so that normal joint motion could expect.

  1. The use of the Gait Deviation Index for the evaluation of participants following total hip arthroplasty

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......, there was no additional effect of resurfacing hip arthroplasty on GDI scores compared with conventional hip arthroplasty. Participants with the most pathological preoperative gait pattern improved the most. The GDI increased, which indicates an overall improvement in gait pathology after surgery. TRIAL REGISTRATION: NCT......INTRODUCTION: In this paper, the Gait Deviation Index (GDI) was used as a convenient method to evaluate pre-to-postoperative gait pattern changes after total hip arthroplasty and identify factors which might be predictive of outcome. DESIGN: Three-dimensional gait data from a randomized clinical...

  2. Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Amarjit Singh Sidhu; Arun Pal Singh

    2010-01-01

    Bilateral hip dislocation rarely occurs.In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic acci-dent is reported.Both hips were emergently reduced under general anaesthesia.Acetabular reconstruction was done bilaterally due to the unstable hips.The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty.The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was aug-mented by tendon transfer.Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time.To the best of our knowledge, this kind of injury has not been reported in the English .language literature.

  3. Revision rates after primary hip and knee replacement in England between 2003 and 2006.

    Directory of Open Access Journals (Sweden)

    Nokuthaba Sibanda

    2008-09-01

    Full Text Available BACKGROUND: Hip and knee replacement are some of the most frequently performed surgical procedures in the world. Resurfacing of the hip and unicondylar knee replacement are increasingly being used. There is relatively little evidence on their performance. To study performance of joint replacement in England, we investigated revision rates in the first 3 y after hip or knee replacement according to prosthesis type. METHODS AND FINDINGS: We linked records of the National Joint Registry for England and Wales and the Hospital Episode Statistics for patients with a primary hip or knee replacement in the National Health Service in England between April 2003 and September 2006. Hospital Episode Statistics records of succeeding admissions were used to identify revisions for any reason. 76,576 patients with a primary hip replacement and 80,697 with a primary knee replacement were included (51% of all primary hip and knee replacements done in the English National Health Service. In hip patients, 3-y revision rates were 0.9% (95% confidence interval [CI] 0.8%-1.1% with cemented, 2.0% (1.7%-2.3% with cementless, 1.5% (1.1%-2.0% CI with "hybrid" prostheses, and 2.6% (2.1%-3.1% with hip resurfacing (p < 0.0001. Revision rates after hip resurfacing were increased especially in women. In knee patients, 3-y revision rates were 1.4% (1.2%-1.5% CI with cemented, 1.5% (1.1%-2.1% CI with cementless, and 2.8% (1.8%-4.5% CI with unicondylar prostheses (p < 0.0001. Revision rates after knee replacement strongly decreased with age. INTERPRETATION: Overall, about one in 75 patients needed a revision of their prosthesis within 3 y. On the basis of our data, consideration should be given to using hip resurfacing only in male patients and unicondylar knee replacement only in elderly patients.

  4. Separate Tables: Segregation, Gentrification, and the Commons in Birmingham, Alabama's Alternative Food and Agriculture Movement

    OpenAIRE

    Henson, Zachary Floyd

    2013-01-01

    Birmingham, Alabama has a long history of racial conflict and segregation. This dissertation investigates that how that history has shaped space in the region and the consequences of that spatial production on the current alternative food and agriculture movement. Specifically, I analyze three processes that produce Birmingham's racialized space - capital accumulation, racialization, and commoning. I first look at how Birmingham's segregated space shapes the initiatives of the alternative ...

  5. Inflammatory pseudotumor of the hip: a complication of arthroplasty to be recognized by the radiologist

    Directory of Open Access Journals (Sweden)

    Raquel de Melo Santos Vilas Boas

    2015-10-01

    Full Text Available AbstractSoft tissue complications following hip arthroplasty may occur either in cases of total hip arthroplasty or in hip resurfacing, a technique that has become popular in cases involving young patients. Both orthopedic and radiological literatures are now calling attention to these symptomatic periprosthetic soft tissue masses called inflammatory pseudotumors or aseptic lymphocytic vasculites-associated lesions. Pseudotumors are associated with pain, instability, neuropathy, and premature loosening of prosthetic components, frequently requiring early and difficult reoperation. Magnetic resonance imaging plays a relevant role in the evaluation of soft tissue changes in the painful hip after arthroplasty, ranging from early periprosthetic fluid collections to necrosis and more extensive tissue damage.

  6. Metal-on-metal hip arthroplasty : local tissue reactions and clinical outcome

    NARCIS (Netherlands)

    Weegen, Walter van der

    2014-01-01

    Hip replacements using a metal-on-metal (MoM) bearing surface were reintroduced with the promise of low wear rates and easy revision in case of the resurfacing design. Although initially mid-term results were promising, local adverse soft tissure reactions to metal debris were detected around the ye

  7. 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;

    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......, there was no additional effect of resurfacing hip arthroplasty on gait quality compared with conventional hip arthroplasty. Participants with the most pathological preoperative gait pattern improved the most. The GDI increased, which indicates an overall improvement in gait quality after surgery.......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...

  8. Can Gait Deviation Index be used effectively for the evaluation of gait pathology in total hip arthroplasty?

    DEFF Research Database (Denmark)

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

    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......, there was no additional effect of resurfacing hip arthroplasty on GDI scores compared with conventional hip arthroplasty. Participants with the most pathological preoperative gait pattern improved the most. The GDI increased, which indicates an overall improvement in gait pathology after surgery. Trial registration: NCT......Introduction: In this paper, the Gait Deviation Index (GDI) was used as a convenient method to evaluate pre-to-postoperative gait pattern changes after total hip arthroplasty and identify factors which might be predictive of outcome. Design: Three-dimensional gait data from a randomized clinical...

  9. Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?—A Registry Based Study

    Science.gov (United States)

    Pulikottil-Jacob, Ruth; Connock, Martin; Kandala, Ngianga-Bakwin; Mistry, Hema; Grove, Amy; Freeman, Karoline; Costa, Matthew; Sutcliffe, Paul; Clarke, Aileen

    2016-01-01

    Background Total hip replacement for end stage arthritis of the hip is currently the most common elective surgical procedure. In 2007 about 7.5% of UK implants were metal-on-metal joint resurfacing (MoM RS) procedures. Due to poor revision performance and concerns about metal debris, the use of RS had declined by 2012 to about a 1% share of UK hip procedures. This study estimated the lifetime cost-effectiveness of metal-on-metal resurfacing (RS) procedures versus commonly employed total hip replacement (THR) methods. Methodology/Principal Findings We performed a cost-utility analysis using a well-established multi-state semi-Markov model from an NHS and personal and social services perspective. We used individual patient data (IPD) from the National Joint Registry (NJR) for England and Wales on RS and THR surgery for osteoarthritis recorded from April 2003 to December 2012. We used flexible parametric modelling of NJR RS data to guide identification of patient subgroups and RS devices which delivered revision rates within the NICE 5% revision rate benchmark at 10 years. RS procedures overall have an estimated revision rate of 13% at 10 years, compared to hip replacement, or by patients concerned about the likelihood of revision, regardless of patient age or gender. PMID:27802289

  10. 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...

  11. The Rule of Law and Civil Disobedience: The Case behind King's Letter from a Birmingham Jail

    Science.gov (United States)

    Kaplan, Howard

    2013-01-01

    Fifty years ago, the Reverend Dr. Martin Luther King Jr. wrote his "Letter from a Birmingham Jail." In exploring the story of the events behind the essay, and the Supreme Court case that resulted, "Walker v. Birmingham", 399 U.S. 307 (1967), educators will find a pedagogically powerful lens through which to review the seminal…

  12. Hip Fracture

    Science.gov (United States)

    ... Medicine. 2014;161:189. Lewiecki EM. Prevention of osteoporosis. http://www.uptodate.com/home. Accessed Dec. 31, 2014. Hip fractures among older adults. Centers for Disease Control and Prevention. http://www. ...

  13. Rose Hip

    Science.gov (United States)

    ... dropsy or edema), gout, back and leg pain (sciatica), diabetes, high cholesterol, weight loss, high blood pressure, ... Painful menstruation. Some evidence suggests that applying an aromatherapy formula containing lavender, clary sage, and rose hip ...

  14. 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.

  15. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... 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...

  16. The Permanent Exclusion of Asian Pupils in Secondary Schools in Central Birmingham.

    Science.gov (United States)

    Mehra, Harish

    1998-01-01

    Examined the permanent exclusion of Asian students from secondary schools in Birmingham (England). City school records show that exclusion of Asian male students, particularly of Muslims, is on the increase. Patterns of racial discrimination and racism were apparent. (SLD)

  17. 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...

  18. Granular convection and its application to asteroidal resurfacing timescale

    Science.gov (United States)

    Yamada, Tomoya; Ando, Kosuke; Morota, Tomokatsu; Katsuragi, Hiroaki

    2016-04-01

    A model for the asteroid resurfacing resulting from regolith convection is built to estimate its timescale. The regolith convection by impact-induced global seismic shaking could be a possible reason for regolith migration and resultant segregated terrain which were found on the asteroids Itokawa [1]. Some recent studies [2, 3] experimentally investigated the convective velocity of the vibrated granular bed to discuss the feasibility of regolith convection under the microgravity condition such as small asteroids. These studies found that the granular convective velocity is almost proportional to the gravitational acceleration [2, 3]. Namely, the granular (regolith) convective velocity would be very low under the microgravity condition. Therefore, the timescale of resurfacing by regolith convection would become very long. In order to examine the feasibility of the resurfacing by regolith convection on asteroids, its timescale have to be compared with the surface age or the lifetime of asteroids. In this study, we aim at developing a model of asteroid resurfacing process induced by regolith convection. The model allows us to estimate the resurfacing timescale for various-sized asteroids covered with regolith. In the model, regolith convection is driven by the impact-induced global seismic shaking. The model consists of three phases, (i) Impact phase: An impactor intermittently collides with a target asteroid [4], (ii) Vibration phase: The collision results in a global seismic shaking [5], (iii) Convection phase: The global seismic shaking induces the regolith convection on the asteroid [3]. For the feasibility assessment of the resurfacing process driven by regolith convection, we estimate the regolith-convection-based resurfacing timescale T as a function of the size of a target asteroid Da. According to the estimated result, the resurfacing time scale is 40 Myr for the Itokawa-sized asteroid, and this value is shorter than the mean collisional lifetime of Itokawa

  19. 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

  20. Detection of incorrect manufacturer labelling of hip components.

    Science.gov (United States)

    Durand-Hill, Matthieu; Henckel, Johann; Burwell, Matthew; Skinner, John; Hart, Alister

    2017-01-01

    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.

  1. 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.)

  2. Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures.

    Science.gov (United States)

    Krakowski, Andrew C; Goldenberg, Alina; Eichenfield, Lawrence F; Murray, Jill-Peck; Shumaker, Peter R

    2014-12-01

    Conventional management of debilitating pediatric scar contractures, including hand therapy and surgery, may often be beset by delayed treatment, suboptimal results, and additional surgical morbidity. Ablative fractional laser resurfacing is an emerging adjunctive procedural option for scar contractures because of its promising efficacy and safety profile. However, its use to improve function has not been studied in the pediatric population. Herein we report 2 pediatric patients with recalcitrant scar contractures, causing persistent functional deficits, treated with an ablative fractional laser protocol. Both patients experienced rapid and cumulative subjective and objective improvements in range of motion and function as measured by an independent occupational therapist without reported complications. We highlight ablative fractional laser resurfacing as a novel and promising tool in the management of function-limiting scar contractures in children and propose that the technique be incorporated into existing scar treatment paradigms, guided by future research.

  3. 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

  4. Virtual Visit to the ATLAS Control Room by The University of Birmingham

    CERN Multimedia

    2014-01-01

    The particle physics research group in the School of Physics and Astronomy at the University of Birmingham is holding a Masterclass to highlight the exciting results from the LHC at CERN. The particle physics group is involved strongly in the ATLAS and LHCb experiments at the LHC.

  5. The Sociopolitical Context of Education in Post-Civil Rights Birmingham

    Science.gov (United States)

    Loder-Jackson, Tondra L.

    2015-01-01

    Drawing on scholarship from the politics and history of education, narrative and archival data, and the author's emic perspectives, this article examines social and political transformations in the Birmingham City Schools (BCS) and some of the surrounding metropolitan school districts during the pre- and post-classical phases of the American civil…

  6. The "Other" Beauty of Martin Luther King, Jr.'s "Letter from Birmingham Jail."

    Science.gov (United States)

    Klein, Mia

    1981-01-01

    Submits that Martin Luther King's persuasiveness in his writings may be attributed not only to his structure, logic, and ethos, but even more to his creative, eloquent, and commanding use of the English language. Supports this argument with examples from King's "Letter from Birmingham Jail." (RL)

  7. The Consequences of the Trojan Horse Affair and a Possible Way Forward for Birmingham

    Science.gov (United States)

    Barton, Sarah; Hatcher, Richard

    2014-01-01

    The UK government seized the opportunity of the Trojan Horse affair to launch a damaging Islamophobic attack, eagerly relayed by a racist press, on the Muslim community in Birmingham and beyond, abusing Ofsted and the Prevent strategy as blatant instruments of ideologically-driven policy. The various reports found no evidence of radicalisation or…

  8. The Rhetorical Construction of Time in Martin Luther King, Jr.'s "Letter from Birmingham Jail."

    Science.gov (United States)

    Lee, Ronald E.

    1991-01-01

    Explores the rhetorical use of time in Martin Luther King, Jr.'s "Letter from Birmingham Jail." Offers an explanation of the ideological heritage that temporarily unifies the discourse. Describes the letter's recent, historical, and spiritual time frames, accounts for the ideological purpose each serves, and explains on what ground they…

  9. Bilateral hip arthroplasty: is 1-week staging the optimum strategy?

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles A

    2010-11-01

    Full Text Available Abstract Seventy-nine patients underwent bilateral hip arthroplasty staged either at 1 week (Group 1 or after greater intervals (as suggested by the patients, mean 44 weeks, range 16-88 weeks (Group 2, over a five year period at one Institution. Sixty-eight patients (29 bilateral hip resurfacings and 39 total hip replacements completed questionnaires regarding their post-operative recovery, complications and overall satisfaction with the staging of their surgery. There was no significant age or ASA grade difference between the patient groups. Complication rates in the two groups were similar and overall satisfaction rates were 84% in Group 1 (n = 32 and 89% in Group 2 (n = 36. Cumulative hospital lengths of stay were significantly longer in Group 1 patients (11.9 days vs 9.1 days(p The mean time to return to part-time work was 16.4 weeks for Group 1, and a cumulative 17.2 weeks (8.8 and 8.4 weeks for Group 2. The time to return to full-time work was significantly shorter for Group 1 patients (21.0 weeks, compared with a cumulative 29.7 weeks for Group 2(p Hip resurfacing patients in Group 2 had significantly shorter durations of postoperative pain and were able to return to part-time and full time work sooner than total hip arthroplasty patients. There was a general trend towards a faster recovery and resumption of normal activities following the second operation in Group 2 patients, compared with the first operation. Bilateral hip arthroplasty staged at a 1-week interval resulted in an earlier resolution of hip pain, and an earlier return to full-time work (particularly following total hip replacement surgery, with high levels of patient satisfaction and no increased risk in complications; however the hospital length of stay was significantly longer. The decision for the timing of staged bilateral surgery should be made in conjunction with the patient, making adjustments to accommodate their occupational needs and functional demands.

  10. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 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...

  11. Timescale of asteroid resurfacing by regolith convection resulting from the impact-induced global seismic shaking

    CERN Document Server

    Yamada, Tomoya M; Morota, Tomokatsu; Katsuragi, Hiroaki

    2015-01-01

    A model for the asteroid resurfacing by regolith convection is built to estimate its timescale. In the model, regolith convection is driven by the impact-induced global seismic shaking. The model consists of three steps: (i) intermittent impact of meteors, (ii) impact-induced global vibration (seismic shaking), and (iii) vibration-induced regolith convection. In order to assess the feasibility of the resurfacing process driven by the regolith convection, we estimate the resurfacing timescale as a function of the size of a target asteroid. According to the estimated result, the regolith-convection-based resurfacing timescale is sufficiently shorter than the mean collisional lifetime for the main belt asteroids. This means that the regolith convection is a possible mechanism for the asteroid resurfacing process. However, the timescale depends on various uncertain parameters such as seismic efficiency and convective roll size. To clarify the parameter dependences, we develop an approximated scaling form for the ...

  12. Can Gait Deviation Index be used effectively for the evaluation of gait pathology in total hip arthroplasty An explorative randomized trial

    DEFF Research Database (Denmark)

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

    2014-01-01

    while walking at self-selected speed. Upon completion of the pre-operative assessment, the patients were randomly assigned to either resurfacing hip arthroplasty (RHA) or conventional total hip arthroplasty(THA). All patients were allowed early postoperative weight-bearing, and had rehabilitation...... changes in patients with hip OA following two types of THA. Methods: A total of 38 patients (11 females and 27 males, age 56 5.6, BMI 27.8 3.6) with unilateral end-stage primary hip osteoarthritis were evaluated pre-operatively, two- and six-months after total hip arthroplasty, using 3D gait analysis...... Deviation Index (GDI), used to evaluate treatment in children with cerebral palsy, has been proposed as such a measure. The experience with GDI in osteoarthritis (OA) patients following total hip arthroplasty (THA) is unknown. The aim of our study was to use the GDI to evaluate post-operative gait quality...

  13. PATELLA AND PATELLOFEMORAL RESURFACING (37 CASES REPORT)

    Institute of Scientific and Technical Information of China (English)

    沈建雄; 叶启彬; 李士英; 邱贵兴

    1994-01-01

    Chondromalacia and patellofemoral osteoarthritis are common diseases that cause pain and disablement of the knee.Conservative therapy is not always effective.Since 1983 we have used isolated polyethylene patellar prosthesis for patella resurfacing of 19 patients with patellofemoral osteoarthritis.After an average of 44.9 months follow-up ,we found the treatment was not as satisfactory as earlier trials.The main reason is the wide erosion of femoral condyle caused by the polyethylene patella.To overcome this shortness,we designed a new type of patellofemoral prosthesis which is named Y-L-Q.From January,1991 to November,1993,we used this prosthesis to treat 16 knees of 13 patients with patellofemoral osteoarthritis.Most of those patients improved both symptomatically and functionally.The good to excellent results rate was 87.5%(14/16 kness) at the time of an average 16 months follow-up.The early results of our experience with patellofemoral resurfacing are encouraging,and extended follow-ups are in progress.

  14. Scaling of granular convective velocity and timescale of asteroidal resurfacing

    Science.gov (United States)

    Yamada, Tomoya; Ando, Kousuke; Morota, Tomokatsu; Katsuragi, Hiroaki

    Granular convection is one of the well-known phenomena observed in a vertically vibrated granular bed. Recently, the possbile relation between granular convection and asteroidal surface processes has been discussed. The granular convection on the surface of small asteroids might be induced by seismic vibration resulting from meteorite impacts. To quantitatively evaluate the timescale of asteroidal resurfacing by granular convection, the granular convective velocity under various conditions must be revealed. As a first step to approach this problem, we experimentally study the velocity scaling of granular convection using a vertically vibrated glass-beads layer. By systematic experiments, a scaling form of granular convective velocity has been obtained. The obtained scaling form implies that the granular convective velocity can be written by a power-law product of two characteristic velocity components: vibrational and gravitational velocities. In addition, the system size dependence is also scaled. According to the scaling form, the granular convective velocity is almost proportional to gravitatinal acceleration. Using this scaling form, we have estimated the resurfacing timescale on small asteroid surface.

  15. First results from the BOXING (Birmingham-OCIW XMM and IMACS Nearby Groups) project.

    Science.gov (United States)

    Miles, T. A.; Raychaudhury, S.; Mulchaey, J. S.

    2004-12-01

    We present the first results from the BOXING (Birmingham-OCIW XMM and IMACS Nearby Groups) project, a collaboration between the Observatories of the Carnegie Institute of Washington (OCIW) and the University of Birmingham U.K. to study a sample of 25 galaxy groups (z ˜ 0.06) by means of optical photometry and spectroscopy (du Pont 2.5m; IMACS/Magellan) combined with x-ray observations (XMM). The combination of x-ray with optical data allows us to study the nature of the relationship between the properties of the groups and the galaxies that they contain. In this preliminary study, we present optical luminosity functions, which shows bimodal behavior in the poorer systems, interpreted as result of rapid merging. We also examine the dependence of galaxy morphology on local environment. Once spectroscopic observations are completed, we will be able to study velocity dispersions, star formation and nuclear activity in individual galaxies.

  16. Virtual Visit to the ATLAS Control Room by the University of Birmingham

    CERN Multimedia

    2013-01-01

    The particle physics research group in the School of Physics and Astronomy at the University of Birmingham is holding a Masterclass to highlight the exciting results from the Large Hadron Collider (LHC) at CERN: the existence of a new particle which may be the long sought Higgs boson. The particle physics group is involved strongly in the ATLAS, ATLAS and LHCb experiments at the LHC.

  17. 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.

  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. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  20. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip A A A What's in this ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  1. 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

  2. Hip Injuries and Disorders

    Science.gov (United States)

    ... problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily. Both of these are common in older people. Treatment for hip disorders may include rest, medicines, physical therapy, or surgery, including hip replacement.

  3. 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...

  4. 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.

  5. HIP-HOP教室

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    从现在开始我们要为了Hip-hop而奋斗,使身边的人改变对Hip-hop文化的看法,让他们知道什么是真正的Hip-hop,更要让大家学会怎样用肢体去表达,Yo,在这里,永远不会出现半吊子的Hip-hop,因为我们都是来真的,Yo,来真的,因为我要将Hip-hop发扬到底,Yeah!

  6. Long-term Results of Primary Total Knee Arthroplasty with and without Patellar Resurfacing

    Directory of Open Access Journals (Sweden)

    Park,Se-Jin

    2010-10-01

    Full Text Available Among patients that underwent total knee arthroplasty from June, 1990 to January, 1999, 61 cases (44 patients that could be followed for more than 10 years were included in this study. The patients were divided into a patellar retention group and a patellar resurfacing group, and were compared with regard to their clinical and radiological outcomes. In patients undergoing primary TKA, a selective patellar resurfacing protocol was used. The indications for patellar retention were a small patella, nearly normal articular cartilage, minimal preoperative patellofemoral pain, poor patellar bone quality, and young patient age. When patellar retention was performed, osteophytes of the patella were removed and marginal electrocauterization was carried out. There were 25 cases (20 patients in the patellar retention group and 36 cases (29 patients in the patellar resurfacing group. The mean follow-up period was 140.7 months in the patellar retention group and 149.0 months in the patellar resurfacing group. The selective patellar resurfacing with total knee arthroplasty had a favorable outcome;there were a significant difference noted between the 2 groups in the functional scores, which showed better outcomes in the patellar resurfacing group than in the patellar retention group.

  7. Lessons learnt from metal-on-metal hip arthroplasties will lead to safer innovation for all medical devices.

    Science.gov (United States)

    Hart, Alister J; Sabah, Shiraz A; Henckel, Johann; Lloyd, Gwynneth; Skinner, John A

    2015-01-01

    Metal-on-metal bearings were re-popularised in the late 1990s with the introduction of modern hip resurfacing. Large diameter (LD) metal-on-metal (MoM) hips became more prevalent and have been the least successful group of hip implants ever used. They were rapidly adopted from 2004 until the British Hip Society stopped their use in 2012. Well functioning MoM hip results (including the BHR and Metasul) are hidden in the mire of poor results from the group of all MoM bearings.We have reviewed what happened and we make 3 observations. Firstly, collaboration between surgeons and then between surgeons and other disciplines, first identified and then solved the clinical management problems. Secondly, the problems with MoM hips occurred because hip simulation was inadequate at predicting performance in patients. They gave no indications of the biological effects of wear in the human environment. Lastly, retrieval of failed implants was essential to understanding why failure occurred.These lessons must never be forgotten and must form the basis by which new or altered implants are introduced and how they should be monitored. This will enable safer innovation for patients, surgeons and manufacturers. The problems with MoM hips will not have been in vain.

  8. Metal-on-Metal Hip Arthroplasty: A Review of Adverse Reactions and Patient Management

    Directory of Open Access Journals (Sweden)

    James Drummond

    2015-06-01

    Full Text Available Recent alarming joint registry data highlighting increased revision rates has prompted further research into the area of metal-on-metal hip replacements and resurfacings. This review article examines the latest literature on the topic of adverse reactions to metal debris and summarises the most up-to-date guidelines on patient management. Adverse reactions to metal debris can cause significant damage to soft tissue and bone if not diagnosed early. Furthermore, not every patient with an adverse reaction to metal debris will be symptomatic. As such, clinicians must remain vigilant when assessing and investigating these patients in order to detect failing implants and initiate appropriate management.

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

    Science.gov (United States)

    Zografos, Angelos; Sayles, Ritchie S; Hart, Alister; Cann, Philippa

    2012-01-01

    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. PMID:22558836

  10. 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.

  11. Performance of the Birmingham Solar-Oscillations Network (BiSON)

    CERN Document Server

    Hale, S J; Chaplin, W J; Davies, G R; Elsworth, Y P

    2015-01-01

    The Birmingham Solar-Oscillations Network (BiSON) has been operating with a full complement of six stations since 1992. Over 20 years later, we look back on the network history. The meta-data from the sites have been analysed to assess performance in terms of site insolation, with a brief look at the challenges that have been encountered over the years. We explain how the international community can gain easy access to the ever-growing dataset produced by the network, and finally look to the future of the network and the potential impact of nearly 25 years of technology miniaturisation.

  12. Survivorship of Primary Hip Arthroscopy in New York State - A Population-Based Study

    Science.gov (United States)

    Nawabi, Danyal H.; Degen, Ryan; Pan, Ting; Ranawat, Anil S.; Kelly, Bryan T.; Lyman, Stephen

    2016-01-01

    Objectives: Hip arthroscopy utilization has significantly increased over the past decade, with annual rates increasing as much as 300-600% in that time period. While large sample data demonstrates significant improvement in clinical outcomes out to two years post-operatively, with low rates of associated post-operative complications, there is little information on the long-term survival of primary hip arthroscopy procedures. The purpose of this study is to report on the rates of revision hip arthroscopy and conversion to resurfacing or total hip arthroplasty (THA) following hip arthroscopy in the State of New York. We will also report on prognostic variables that may contribute to the need for repeat surgery. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database, a census of all hospital admissions and ambulatory surgery in New York State, was used to identify cases of outpatient primary hip arthroscopy. Demographic information was collected for these patients. After case identification, unique identifiers were utilized to identify those patients that underwent revision hip arthroscopy or subsequent ipsilateral hip resurfacing or THA. The risks of each of these outcomes were modeled with use of age, sex, socio-economic status, hospital and surgeon volume as potential risk factors. Patients were also tracked for 30-day and 90-day complications requiring re-admission. Results: We identified 8,267 hip arthroscopy cases from 1998-2012 performed by 295 surgeons in 137 different surgical centers. Demographics revealed that 46.1% of patients were male, with 80.2% carrying private insurance. Annual hip arthroscopy rates increased 88-fold over the observation period, with a 750% increase over the last 10 years. Revision surgery (scope or arthroplasty) was required in 1,087 cases (13.1%) at a mean of 622 ± 603 days. More specifically, revision hip arthroscopy was required in 310 cases (3.8%) at a mean of 649 ± 586 days after the index procedure

  13. Hip fracture - discharge

    Science.gov (United States)

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  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. 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

    2016-01-01

    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. PMID:27272103

  16. Metal-on-metal hip prostheses and systemic health: a cross-sectional association study 8 years after implantation.

    Directory of Open Access Journals (Sweden)

    Jennifer R Prentice

    Full Text Available There is public concern over the long term systemic health effects of metal released from hip replacement prostheses that use large-diameter metal-on-metal bearings. However, to date there has been no systematic study to determine which organs may be at risk, or the magnitude of any effect. We undertook a detailed cross-sectional health screen at a mean of 8 years after surgery in 35 asymptomatic patients who had previously received a metal-on-metal hip resurfacing (MoMHR versus 35 individually age and sex matched asymptomatic patients who had received a conventional hip replacement. Total body bone mineral density was 5% higher (mean difference 0.05 g/cm², P = 0.02 and bone turnover was 14% lower (TRAP 5b, mean difference -0.56IU/L, P = 0.006; osteocalcin, mean difference -3.08 ng/mL, P = 0.03 in the hip resurfacing versus conventional hip replacement group. Cardiac ejection fraction was 7% lower (mean absolute difference -5%, P = 0.04 and left ventricular end-diastolic diameter was 6% larger (mean difference 2.7 mm, P = 0.007 in the hip resurfacing group versus those patients who received a conventional hip replacement. The urinary fractional excretion of metal was low (cobalt 5%, chromium 1.5% in patients with MoMHR, but creatinine clearance was normal. Diuretic prescription was associated with a 40% increase in the fractional excretion of chromium (mean difference 0.5%, P = 0.03. There was no evidence of difference in neuropsychological, renal tubular, hepatic or endocrine function between groups (P>0.05. Our findings of differences in bone and cardiac function between patient groups suggest that chronic exposure to low elevated metal concentrations in patients with well-functioning MoMHR prostheses may have systemic effects. Long-term epidemiological studies in patients with well-functioning metal on metal hip prostheses should include musculoskeletal and cardiac endpoints to quantitate the risk of clinical disease.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    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......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...... 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...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    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......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...... 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...

  19. Resurfacing of the patella in total knee arthroplasty. A prospective, randomized, double-blind study.

    Science.gov (United States)

    Barrack, R L; Wolfe, M W; Waldman, D A; Milicic, M; Bertot, A J; Myers, L

    1997-08-01

    During a two-year period, eighty-nine patients who were scheduled to have a total knee arthroplasty for the treatment of degenerative osteoarthrosis were randomly assigned to one of two groups: resurfacing of the patella or retention of the patella. All patients received the same posterior cruciate-sparing prosthesis, and all operations were performed by, or under the direct supervision of, one of us. Three patients died in the early postoperative period. The remaining eighty-six patients (118 knees; fifty-eight that had had resurfacing of the patella and sixty that had not) formed the study group. They were followed for a mean of thirty months (range, twenty-four to forty-four months). Evaluation was performed with use of the clinical scoring system of The Knee Society, a patient-satisfaction questionnaire, specific questions regarding patellofemoral symptoms and function, and radiographs. All clinical evaluations were performed by the same research nurse, without the involvement of a physician, in a blinded manner (neither the nurse nor the patient had knowledge of whether the patella had been resurfaced). Preoperatively, the mean Knee Society score, on a scale ranging from 0 to 200 points, was 89.7 points (range, 33 to 132 points); postoperatively, this score improved to a mean of 172.7 points (range, 98 to 200 points). With the numbers available for study, we could detect no significant difference between the knees that had had patellar resurfacing and those that had not with regard to the over-all score (p = 0.63), the subscore for pain (p = 0.56), or the subscore for function (p = 0.77). We also could detect no difference between the treatment groups, with the numbers available, with regard to patient satisfaction or the responses to questions involving the function of the patellofemoral joint, including the ability to exit from an automobile, to rise from a chair, and to climb stairs. Thirty-two patients had bilateral total knee replacement with resurfacing

  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. Hip joint replacement

    Science.gov (United States)

    ... You will be asked to start moving and walking as soon as the first day after surgery. Some people need a short stay in a rehabilitation center ... may need a second replacement. Younger, more active people may wear out parts of their new hip. It may need to be replaced ... Hip fracture Osteoarthritis vs. rheumatoid ...

  2. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2016-01-01

    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 (18-6...

  3. 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.

  4. Clinical applications of CO2 laser resurfacing in the treatment of various pathologic skin disorders

    Science.gov (United States)

    Giler, Shamai

    1997-12-01

    CO2 laser skin resurfacing devices are widely used in cosmetic surgery for the treatment of facial rhytides, acne scars and aging skin. This technique is also useful in the treatment of various benign and premalignant or multiple pathological skin conditions and disorders originating in the epidermal, dermal and skin appendages, vascular lesions, epidermal nevi, infected wounds and ulcers, and keloids. Various surgical techniques have been developed in our clinic using laser resurfacing in the treatment of more than 2,000 patients with various skin pathologic disorders. We describe our experience with the various techniques used. The precise depth control and ablation properties combined with the hemostatic and sterilizing effects of the CO2 laser beam, reduction of the possibility of bleeding, infection and damage to healthy tissues, make the CO2 laser resurfacing techniques the treatment of choice for cosmetic surgery and treatment of benign, premalignant and multiple pathologic skin conditions.

  5. 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.

  6. "A Creative Psalm of Brotherhood": The (De)Constructive Play in Martin Luther King's "Letter from Birmingham Jail"

    Science.gov (United States)

    Gaipa, Mark

    2007-01-01

    Scholars have celebrated the spoken word in King's "Letter from Birmingham Jail," but they have overlooked the significance of the Letter's writing. In this essay I closely read King's act of writing the Letter, along with the figures of speech he employs in it, and I show how both--by enacting the mass media's ability to cross contexts--are…

  7. 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

    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...

  8. 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.

  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...

  10. Thermal damage during humeral reaming in total shoulder resurfacing

    Directory of Open Access Journals (Sweden)

    Philip A McCann

    2013-01-01

    Full Text Available Introduction: Total shoulder resurfacing (TSR provides a reliable solution for the treatment of glenohumeral arthritis. It confers a number of advantages over traditional joint replacement with stemmed humeral components, in terms of bone preservation and improved joint kinematics. This study aimed to determine if humeral reaming instruments produce a thermal insult to subchondral bone during TSR. Patients and Methods: This was tested in vivo on 13 patients (8 with rheumatoid arthritis and 5 with osteoarthritis with a single reaming system and in vitro with three different humeral reaming systems on saw bone models. Real-time infrared thermal video imaging was used to assess the temperatures generated. Results : Synthes (Epoca instruments generated average temperatures of 40.7°C (SD 0.9°C in the rheumatoid group and 56.5°C (SD 0.87°C in the osteoarthritis group (P = 0.001. Irrigation with room temperature saline cooled the humeral head to 30°C (SD 1.2°C. Saw bone analysis generated temperatures of 58.2°C (SD 0.79°C in the Synthes (Epoca 59.9°C (SD 0.81°C in Biomet (Copeland and 58.4°C (SD 0.88°C in the Depuy Conservative Anatomic Prosthesis (CAP reamers (P = 0.12. Conclusion: Humeral reaming with power driven instruments generates considerable temperatures both in vivo and in vitro. This paper demonstrates that a significant thermal effect beyond the 47°C threshold needed to induce osteonecrosis is observed with humeral reamers, with little variation seen between manufacturers. Irrigation with room temperature saline cools the reamed bone to physiological levels and should be performed regularly during this step in TSR.

  11. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with app...

  12. Does prosthesis design affect the need for secondary resurfacing in total knee arthroplasty?

    Science.gov (United States)

    Rotigliano, Niccolò; Hirschmann, Michael T.

    2016-01-01

    Aims and Objectives: The purpose of this retrospective consecutive study was to compare the rate of secondary resurfacing in consecutive series of five different TKA systems. It was our hypothesis that different brands of TKA show different rates of secondary resurfacing. Materials and Methods: A retrospective study was performed on data from patients who underwent TKA without primary patellar resurfacing from 2004 to 2012 in an university affiliated hospital. The study cohort included 784 patients (m:f=302:482, mean age at surgery±SD 71±10) operated with TKA during this period. Five different cruciate-retaining TKA systems were used in consecutives series. These were the following: A) Triathlon, Stryker, Switzerland (n=296), B) PFC Sigma, DepuySynthes, Switzerland (n=215), C) LCS, DepuySynthes, Switzerland (n=80), D) Balansys, Mathys, Bettlach, Switzerland (n=129), E) Duracon, Stryker, Switzerland (n=64). Data was retrospectively obtained from our different hospital archives. Patients demographics, age at surgery, type of total knee arthroplasty were noted. In addition, the data were screened for a secondary resurfacing in each patient. On anterior-posterior, lateral and skyline view radiographs different measurements were performed. TKA component position was assessed on radiographs with respect to "The knee society total knee arthroplasty roentgenographic evaluation and scoring system (TKA-RESS). Pearson Chi square test was used to compare differences between groups (p<0.05). There was no significant difference between the groups in terms of age, gender, and radiological outcomes. Results: Twenty-six of 784 patients (3.3%) underwent secondary resurfacing due to patellofemoral pain during follow-up. In group A four of 296 patients (1.4%), in group B fifteen of 215 patients (7%), in group C four of 80 patients (5%), in group D two of 129 patients (1.6%), in group E one of 64 patients (1.6%) underwent secondary patellar resurfacing during follow-up. There was a

  13. Prevention of hip fractures.

    Science.gov (United States)

    Meunier, P J

    1993-11-30

    For a 50-year old Caucasian woman today, the risk of a hip fracture over her remaining life-time is about 17%. Tomorrow the situation will clearly be worse because the continuous increase in life expectancy will cause a three-fold increase in worldwide fracture incidence over the next 60 years. Through diagnostic bone mass measurements at the hip and assessment of biochemical parameters, a great deal has been learned in recent years about reduction of hip fracture risk. Preventive strategies are based on prevention of falls, use of hip protectors, and prevention of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal estrogen replacement therapy, and also late prevention consisting in reversing senile secondary hyperparathyroidism, which plays an important role in the decrease of skeletal strength. This secondary hyperparathyroidism, which results from both vitamin D insufficiency and low calcium intake, is preventable with vitamin D3 and calcium supplements. They have recently been shown capable of providing effective prevention of hip fractures in elderly women living in nursing homes, with a reduction of about 25% in the number of hip fractures noted in a 3-year controlled study in 3,270 women (intention-to-treat analysis). In conclusion, it is never too early to reduce the risk of osteoporosis and never too late to prevent hip fractures.

  14. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  15. Toward a final design for the Birmingham boron neutron capture therapy neutron beam.

    Science.gov (United States)

    Allen, D A; Beynon, T D; Green, S; James, N D

    1999-01-01

    This paper is concerned with the proposed Birmingham accelerator-based epithermal neutron beam for boron neutron capture therapy (BNCT). Details of the final moderator design, such as beam delimiter, shield, and beam exit surface shape are considered. Monte Carlo radiation transport simulations with a head and body phantom have shown that a simple flat moderator beam exit surface is preferable to the previously envisioned spherical design. Dose rates to individual body organs during treatment have been calculated using a standard MIRD phantom. We have shown that a simple polyethylene shield, doped with natural lithium, is sufficient to provide adequate protection to the rest of the body during head irradiations. The effect upon the head phantom dose distributions of the use of such a shield to delimit the therapy beam has been evaluated.

  16. Recent results and experience with the Birmingham MC40 irradiation facility

    Science.gov (United States)

    Allport, P.; Baca, M.; Briglin, D.; Broughton, J.; Canavan, R.; Chisholm, A.; Gonella, L.; Knights, P.; Nikolopoulos, K.; Parker, D.; Price, T.; Thomas, J.; Wilson, J.; Affolder, A.; Casse, G.; Dervan, P.; Greenall, A.; Tsurin, I.; Wonsak, S.; Dixon, S.; Edwards, S.; French, R.; Hodgson, P.; Kemp-Russell, P.; Kourlitis, E.; Marin-Reyes, H.; Parker, K.

    2017-03-01

    Operational experience with the recently upgraded irradiation facility at the University of Birmingham is presented. This is based around the high intensity area of the MC40 medical cyclotron providing proton energies between 3 and 38 MeV and currents ranging from tens of fA to A. Accurate dosimetry for displacement damage and total ionizing dose, using a combination of techniques, is offered. Irradiations are carried out in a temperature controlled chamber that can be scanned through the beam, with the possibility for the devices to be biased, clocked, and read-out. Fluence up to several 1016 1 MeV neq/cm2 and GRad ionizing dose can be delivered within a day.

  17. HIP osteoarthritis and work.

    Science.gov (United States)

    Harris, E Clare; Coggon, David

    2015-06-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment.

  18. Hip Implant Systems

    Science.gov (United States)

    ... made of metal or ceramic, and the socket (acetabulum) is removed and replaced with a prosthetic cup. ... its socket in the hip bone (pelvis) Bone fracture Joint infection Local nerve damage with numbness/weakness ...

  19. Hip replacement in femoral head osteonecrosis: current concepts.

    Science.gov (United States)

    Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

    2015-01-01

    Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient's factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems.

  20. Hip-Hop

    Institute of Scientific and Technical Information of China (English)

    张敬伟

    2008-01-01

    Hip-Hop是一种美国街头黑人文化,可分成五个要素:音乐、舞蹈、涂鸦、刺青和衣著。源自80年代美国纽约的黑人社区BRONX,他们将生活上的娱乐发展成为现今多样的HIP-HOP文化,发挥黑

  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. The significance of orbital anatomy and periocular wrinkling when performing laser skin resurfacing.

    Science.gov (United States)

    Trelles, M A; Pardo, L; Benedetto, A V; García-Solana, L; Torrens, J

    2000-03-01

    Knowledge of orbital anatomy and the interaction of muscle contractions, gravitational forces and photoagingis fundamental in understanding the limitations of carbon dioxide (CO2) laser skin resurfacing when rejuvenating the skin of the periocular area. Laser resurfacing does not change the mimetic behavior of the facial muscles nor does it influence gravitational forces. When resurfacing periocular tissue, the creation of scleral show and ectropion are a potential consequence when there is an over zealous attempt at improving the sagging malar fat pad and eyelid laxity by performing an excess amount of laser passes at the lateral portion of the lower eyelid. This results in an inadvertent widening of the palpebral fissure due to the lateral pull of the Orbicularis oculi. Retrospectively, 85 patients were studied, who had undergone periorbital resurfacing with a CO2 laser using anew treatment approach. The Sharplan 40C CO2 Feather Touchlaser was programmed with a circular scanning pattern and used just for the shoulders of the wrinkles. A final laser pass was performed with the same program over the entire lower eyelid skin surface, excluding the outer lateral portion (e.g. a truncated triangle-like area),corresponding to the lateral canthus. Only a single laser pass was delivered to the lateral canthal triangle to avoid widening the lateral opening of the eyelid, which might lead to the potential complications of scleral show and ectropion. When the area of the crows' feet is to be treated, three passes on the skin of this entire lateral orbital surface are completed by moving laterally and upward toward the hairline. Patients examined on days 1, 7, 15, 30, 60, and one year after laser resurfacing showed good results. At two months after treatment, the clinical improvement was rated by the patient and physician as being "very good" in 81 of the 85 patients reviewed. These patients underwent laser resurfacing without complications. The proposed technique of

  3. 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

  4. Birmingham Mayor Larry Langford said mistakes were made in city draining of a pond that killed thousands of the endangered watercress darters

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Newspaper article highlighting a tour and comments by Birmingham Mayor Larry Langford after a significant fish kill in Roebuck Spring pond in 2008.

  5. 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

    2016-07-26

    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.

  6. 髋关节表面置换术的进展%Research progress in hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    杨寅; 张延平; 王坤正

    2011-01-01

    随着对髋关节力学认识的加深和材料学的进展,表面置换重新受到重视,因其精确重建股骨近端和髋关节的正常解剖结构,术后具备良好的生物力学和关节稳定性,运动能力的恢复更接近于正常,降低了髋关节二次手术的难度等等优点,成为当今关节外科的最主要进展,具有广阔的临床应用前景.但尚存在如股骨颈骨折、缺血性坏死、金属离子水平升高等特殊而严重的并发症等需要解决的问题,除选择合适的适应症患者,不断改进假体材料和工艺、提高临床技术外,尚需进一步随访观察和验证.

  7. 全髋关节表面置换术的进展%PROGRESS OF HIP RESURFACING ARTHROPLASTY

    Institute of Scientific and Technical Information of China (English)

    陈刚; 杨静

    2008-01-01

    目的 综述全髋关节表面置换术的基础和临床研究进展.方法 广泛查阅近年来国内外全髋关节表面置换的相关文献,并进行回顾和综合分析.结果 新一代全髋关节表面置换假体在材料工艺等方面作了很大改进,越来越多地用于治疗青年髋关节疾病,大量近期随访报道显示临床疗效满意,但金属离子在体内蓄积等相关问题也逐渐引起人们的关注.结论 新一代全髋关节表面置换有很好的应用前景,但其疗效尚需长期临床随访.

  8. 金属对金属髋关节表面置换术%Metal-on-Metal Hip Resurfacing Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Andrew Shimmin; Paul E.Beaule; Pat Campbell; 卢伟杰; 余楠生

    2008-01-01

    @@ 髋关节表面置换的主要优点是为患者保留骨质,以便将来可能进行人工关节置换.早期尝试髋关节表面置换失败的原因主要包括薄的聚乙烯髋臼假体过度磨损和股骨假体固定不良.

  9. 人工全髋表面置换术后护理%Nursing care after total hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    李喆雯

    2010-01-01

    对4例患者施行人工全髋表面置换术.结果 术后48h拔除负压引流管,7d后拄拐站立行走锻炼,12~14d拆线,12~18d康复出院.随访3~6月,患肢均恢复到术前活动水平,3例患者已回到工作岗位,未发现假体松动和股骨颈骨折等并发症.提出,因该术式假体脱位概率极低,术后加强卧床期护理,密切观察病情变化,及早督促进行肢体功能锻炼及详尽的日常生活行为指导,对维持髋关节的稳定和肌肉的张力,提高患者生活质量,有着重要的意义.

  10. Road Maintenance Districts, Road maintenance for resurfacing projects data located in Transportation database, Published in unknown, City of Roswell, GA.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Road Maintenance Districts dataset as of unknown. It is described as 'Road maintenance for resurfacing projects data located in Transportation database'. Data...

  11. HIP-HOP

    Institute of Scientific and Technical Information of China (English)

    QunyKing; 人在羽中; 钱李明

    2005-01-01

    自从一群摇滚青年开始跟风 Elvis 的《Blue SuedeShoes》风格,hip-hop 似乎就成为了全球最具影响力的音乐风格。它最初起源于美国的黑人和拉丁美洲人,之后迅速在全世界流行,成为80年代、90年代和新千年的主流音乐。无论是在广告界还是在电影业,从各类排行榜到各种酒吧,hip-hop 的影响逐年增加。在1997年,英国的 hip-hop 还只是一种地下音

  12. Developmental Dysplasia of the Hip

    Science.gov (United States)

    ... in the motion of the hip and obvious shortening of the affected leg in older kids, an ... socket. During the procedure, doctors loosen the tight muscles and tissues around the hip joint and then ...

  13. 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.

  14. 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

  15. X-Ray Exam: Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip A A A What's in ... español Radiografía: cadera What It Is A hip X-ray is a safe and painless test that ...

  16. Prevalence of Failure due to Adverse Reaction to Metal Debris in Modern, Medium and Large Diameter Metal-on-Metal Hip Replacements--The Effect of Novel Screening Methods: Systematic Review and Metaregression Analysis.

    Directory of Open Access Journals (Sweden)

    Aleksi Reito

    Full Text Available Metal-on-metal (MoM hip replacements were used for almost a decade before adverse reactions to metal debris (ARMD were found to be a true clinical problem. Currently, there is a paucity of evidence regarding the usefulness of systematic screening for ARMD. We implemented a systematic review and meta-analysis to establish the prevalence of revision confirmed ARMD stratified by the use of different screening protocols in patients with MoM hip replacements. Five levels of screening were identified: no screening (level 0, targeted blood metal ion measurement and/or cross-sectional imaging (level 1, metal ion measurement without imaging (level 2, metal ion measurement with targeted imaging (level 3 and comprehensive screening (both metal ions and imaging for all; level 4. 122 studies meeting our eligibility criteria were included in analysis. These studies included 144 study arms: 100 study arms with hip resurfacings, 33 study arms with large-diameter MoM total hip replacements (THR, and 11 study arms with medium-diameter MoM THRs. For hip resurfacing, the lowest prevalence of ARMD was seen with level 0 screening (pooled prevalence 0.13% and the highest with level 4 screening (pooled prevalace 9.49%. Pooled prevalence of ARMD with level 0 screening was 0.29% and with level 4 screening 21.3% in the large-diameter MoM THR group. In metaregression analysis of hip resurfacings, level 4 screening was superior with regard to prevalence of ARMD when compared with other levels. In the large diameter THR group level 4 screening was superior to screening 0,2 and 3. These outcomes were irrespective of follow-up time or study publication year. With hip resurfacings, routine cross-sectional imaging regardless of clinical findings is advisable. It is clear, however, that targeted metal ion measurement and/or imaging is not sufficient in the screening for ARMD in any implant concepts. However, economic aspects should be weighed when choosing the preferred screening

  17. INL HIP Plate Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    B. H. Park; C. R. Clark; J. F. Jue

    2010-02-01

    This document outlines the process used to bond monolithic fuel plates by Hot Isostatic Pressing (HIP). This method was developed at Idaho National Laboratory (INL) for the Reduced Enrichment for Research and Test Reactors (RERTR) program. These foils have been used in a number of irradiation experiments in support of the United States Global Threat Reduction Initiative (GTRI) program.

  18. "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.

  19. 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...

  20. 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

  1. 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.

  2. Conus hip prosthesis.

    Science.gov (United States)

    Wagner, H; Wagner, M

    2001-01-01

    50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even

  3. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint

    Science.gov (United States)

    Hunt, B. J.; Richardson, V. M.; Langton, D. J.; Smith, E.; Joyce, T. J.

    2017-01-01

    Objectives The high revision rates of the DePuy Articular Surface Replacement (ASR) and the DePuy ASR XL (the total hip arthroplasty (THA) version) have led to questions over the viability of metal-on-metal (MoM) hip joints. Some designs of MoM hip joint do, however, have reasonable mid-term performance when implanted in appropriate patients. Investigations into the reasons for implant failure are important to offer help with the choice of implants and direction for future implant designs. One way to assess the performance of explanted hip prostheses is to measure the wear (in terms of material loss) on the joint surfaces. Methods In this study, a coordinate measuring machine (CMM) was used to measure the wear on five failed cementless Biomet Magnum/ReCap/ Taperloc large head MoM THAs, along with one Biomet ReCap resurfacing joint. Surface roughness measurements were also taken. The reason for revision of these implants was pain and/or adverse reaction to metal debris (ARMD) and/or elevated blood metal ion levels. Results The mean wear rate of the articulating surfaces of the heads and acetabular components of all six joints tested was found to be 6.1 mm3/year (4.1 to 7.6). The mean wear rate of the femoral head tapers of the five THAs was 0.054 mm3/year (0.021 to 0.128) with a mean maximum wear depth of 5.7 µm (4.3 to 8.5). Conclusion Although the taper wear was relatively low, the wear from the articulating surfaces was sufficient to provide concern and was potentially large enough to have been the cause of failure of these joints. The authors believe that patients implanted with the ReCap system, whether the resurfacing prosthesis or the THA, should be closely monitored. Cite this article: S. C. Scholes, B. J. Hunt, V. M. Richardson, D. J. Langton, E. Smith, T. J. Joyce. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint. Bone Joint Res 2017;6:113–122. DOI: 10.1302/2046-3758.62.BJR-2016-0130.R2. PMID:28246095

  4. [Juvenile hip pain. 2. Femur head epiphysiolysis, hip dysplasia, tumors].

    Science.gov (United States)

    Hackenbruch, W; von Gumppenberg, S; Karpf, P M

    1978-11-09

    The early symptom in hip joint diseases in children is pain. Pain is localized in the groin and thight, but mostly in the knee. Other important signs are limping and reduced internal rotation. If a hip disease is suspected it is necessary to take X-rays in two planes. If diagnosis is early and special therapy started immediately, the results are usually excellent without deformation of the hip. Otherwise early osteoarthritis can develop. This is important because osteoarthritis in the hip joint is in 75% of the cases due to hip joint diseases in childhood. The problems of diagnosis and treatment of the most common hip joint diseases in children (transient synovitis, rheumatoid arthritis, osteomyelitis, Legg-Perthes disease, slipped capital femoral epiphysis, dysplasia, tumors) are discussed.

  5. Nonarthritic hip joint pain.

    Science.gov (United States)

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C

    2014-06-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain.

  6. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    OpenAIRE

    Sporer, Scott M.; Bernard R. Bach, Jr

    2009-01-01

    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, Sc...

  7. The Birmingham Burn Centre archive: A photographic history of post-war burn care in the United Kingdom.

    Science.gov (United States)

    Hardwicke, Joseph; Kohlhardt, Angus; Moiemen, Naiem

    2015-06-01

    The Medical Research Council Burns and Industrial Injuries Unit at the Birmingham Accident Hospital pioneered civilian burn care and research in the United Kingdom during the post-war years. A photographic archive has been discovered that documents this period from 1945 to 1975. The aim of this project was to sort, digitize and archive the images in a secure format for future reference. The photographs detail the management of burns patients, from injury causation and surgical intervention, to nursing care, rehabilitation and long-term follow-up. A total of 2650 images files were collected from over 600 patients. Many novel surgical, nursing, dressing and rehabilitation strategies are documented and discussed. We have chosen to report part of the archive under the sections of (1) aseptic and antimicrobial burn care; (2) burn excision and wound closure; (3) rehabilitation, reconstruction and long-term outcomes; (4) accident prevention; and (5) response to a major burns incident. The Birmingham collection gives us a valuable insight into the approach to civilian burn care in the post-war years, and we present a case from the archive to the modern day, the longest clinical photographic follow-up to date.

  8. 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......During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general...

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

    Institute of Scientific and Technical Information of China (English)

    Xiao-Bo Ma; Rong Zeng; Guo-Peng Wang; Shu-Sheng Gong

    2015-01-01

    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.

  10. 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.

  11. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels

    2016-01-01

    and Pincer resection in 93.5% of the cases. Labral refixation or repair was done in 70.3% of the cases. The most common type of acetabular chondral damage was grade II lesions (36.6%). Grade III and IV changes were seen in 36.1% of the cases. The preoperative iHOT12 was 45 (mean) based on all 12 items. EQ-5D....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  12. Trochanteric osteotomy in total hip replacement for congenital hip disease.

    Science.gov (United States)

    Hartofilakidis, G; Babis, G C; Georgiades, G; Kourlaba, G

    2011-05-01

    We studied the effect of trochanteric osteotomy in 192 total hip replacements in 140 patients with congenital hip disease. There was bony union in 158 hips (82%), fibrous union in 29 (15%) and nonunion in five (3%). The rate of union had a statistically significant relationship with the position of reattachment of the trochanter, which depended greatly on the pre-operative diagnosis. The pre-operative Trendelenburg gait substantially improved in all three disease types (dysplasia, low and high dislocation) and all four categories of reattachment position. A persistent Trendelenburg gait post-operatively was noticed mostly in patients with defective union (fibrous or nonunion). Acetabular and femoral loosening had a statistically significant relationship with defective union and the position of reattachment of the trochanter. These results suggest that the complications of trochanteric osteotomy in total hip replacement for patients with congenital hip disease are less important than the benefits of this surgical approach.

  13. The use of a pyrocarbon capitate resurfacing implant in chronic wrist disorders.

    Science.gov (United States)

    Marcuzzi, A; Ozben, H; Russomando, A

    2014-07-01

    The present study describes the technique and results of proximal row carpectomy with resection of the head of the capitate and replacement with a pyrocarbon capitate resurfacing implant. The major indication for surgical treatment was arthritic changes on the head of the capitate. Patients were assessed by range of motion, grip strength, pain and functional scoring, and radiographic studies. In most patients, wrist function was improved and pain relief was obtained. This surgical procedure may represent a good alternative to total and partial wrist arthrodesis.

  14. Long term follow up of clinical outcome between patellar resurfacing and nonresurfacing in total knee arthroplasty: Chinese experience

    Institute of Scientific and Technical Information of China (English)

    Feng Bin; Weng Xisheng; Lin Jin; Jin Jin; Qian Wenwei; Wang Wei; Qiu Guixing

    2014-01-01

    Background The long term outcome of patellar resurfacing in Chinese has not been well described.This study evaluated more than 10-year clinical outcomes and survivorship of patellar resurfacing or nonresurfacing in total knee arthroplasty.Methods From January 1993 to December 2002,265 patients accepted total knee arthroplasty in Department of Orthopaedic Surgery,Peking Union Medical College Hospital.Among them,226 patients (246 knees) were successfully followed up,with 176 knees for patellar resurfacing and 70 knees for nonresurfacing.The survivorship of total knee arthroplasty between two groups and the hospital for special surgery knee score (HSS),patellar score,patellar related complication and radiological results were studied at the latest follow-up.Results The HSS knee score increased from 55.9±12.2 preoperatively to 92.0±10.9 postoperatively for patellar resurfacing group and from 56.6±9.9 to 94.2±11.4 for nonresurfacing group after average 11.4-year follow-up.Patellar score increased from 13.93±2.42 preoperatively to 28.33±2.20 for resurfacing group and from 13.55±2.73 to 27.8±2.37 for nonresurfacing group.There was no statistically significant difference for both HSS score,patellar score between the two groups with higher rate of anterior knee pain for nonresurfacing group.Patellar nonresurfacing had higher lateral subluxation than resurfacing group according to radiological evaluation.Patients with rheumatoid arthritis had 5.5 fold patellar related complication than patients with osteoarthritis.The 10-year survival rate was not statistically significant different between the two groups (P=0.12).Conclusions There was no significant difference of long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing.Patellar nonresurfacing can be advisable during primary total knee arthroplasty especially in Chinese patients with osteoarthritis.Selective patellar resurfacing for patients with rheumatoid arthritis can achieve

  15. Social inequality and hip fracture

    DEFF Research Database (Denmark)

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

    2015-01-01

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...

  16. ICD-9-CM-3 Classification of Hip Replacement and Revision of Hip Replacement%髋关节置换术及置换修复术的ICD-9-CM-3分类

    Institute of Scientific and Technical Information of China (English)

    谭礼萍; 吴晓云; 林佩珊; 谢燕燕; 郑银雄

    2011-01-01

    目的 对髋关节置换术和置换修复术进行合理的ICD-9-CM-3分类.方法 分析临床对髋关节置换术中具体置换方法,与ICD-9-CM-3对该手术的分类进行对比.结果 髋关节置换术、髋关节表面置换术、髋关节置换修复术分类在不同的章节、亚目,各术式又根据不同的置换或修复成分分类在不同的细目.结论 对髋关节置换术及置换修复术进行ICD-9-CM-3编码时要注意髋关节置换的具体成分及其假体的材质,仔细翻阅病例和手术记录,做到准确编码.%Objective To classify hip replacement and Revision of Hip replacement reasonably using ICD-9-CM-3. Methods Analyze the differences between the clinical and ICD-9-CM-3 classification of hip replacement and Revision of Hip replacement. Results The hip replacement resurfacing arthroplasty and replacement prosthesis belong to different subcategories and mini-categories in ICD-9-CM-3. Conclusion The specific composition and prosthetie material of hip replacement and replacement prosthesis should be pay more attention to.

  17. Regression models for air pollution and daily mortality: analysis of data from Birmingham, Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.L. [University of North Carolina, Chapel Hill, NC (United States). Dept. of Statistics; Davis, J.M. [North Carolina State University, Raleigh, NC (United States). Dept. of Marine, Earth and Atmospheric Sciences; Sacks, J. [National Institute of Statistical Sciences, Research Triangle Park, NC (United States); Speckman, P. [University of Missouri, Columbia, MO (United States). Dept. of Statistics; Styer, P.

    2000-11-01

    In recent years, a very large literature has built up on the human health effects of air pollution. Many studies have been based on time series analyses in which daily mortality counts, or some other measure such as hospital admissions, have been decomposed through regression analysis into contributions based on long-term trend and seasonality, meteorological effects, and air pollution. There has been a particular focus on particulate air pollution represented by PM{sub 10} (particulate matter of aerodynamic diameter 10 {mu}m or less), though in recent years more attention has been given to very small particles of diameter 2.5 {mu}m or less. Most of the existing data studies, however, are based on PM{sub 10} because of the wide availability of monitoring data for this variable. The persistence of the resulting effects across many different studies is widely cited as evidence that this is not mere statistical association, but indeed establishes a causal relationship. These studies have been cited by the United States Environmental Protection Agency (USEPA) as justification for a tightening on particulate matter standards in the 1997 revision of the National Ambient Air Quality Standard (NAAQS), which is the basis for air pollution regulation in the United States. The purpose of the present paper is to propose a systematic approach to the regression analyses that are central to this kind of research. We argue that the results may depend on a number of ad hoc features of the analysis, including which meteorological variables to adjust for, and the manner in which different lagged values of particulate matter are combined into a single 'exposure measure'. We also examine the question of whether the effects are linear or nonlinear, with particular attention to the possibility of a 'threshold effect', i.e. that significant effects occur only above some threshold. These points are illustrated with a data set from Birmingham, Alabama, first cited by

  18. Total hip arthroplasty following failed fixation of proximal hip fractures

    Directory of Open Access Journals (Sweden)

    Srivastav Shekhar

    2008-01-01

    Full Text Available Background: Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA following failed fixation of proximal hip fracture. Materials and Methods: In a retrospective study, 21 hips in 20 patients (13 females and seven males with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years. Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T fracture and two for subtrochanteric (S/T fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients. Results: The average duration of follow-up was four years (2-13 years. The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval. Conclusion: Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

  19. 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…

  20. Gym for Free: The Short-Term Impact of an Innovative Public Health Policy on the Health and Wellbeing of Residents in a Deprived Constituency in Birmingham, UK

    Science.gov (United States)

    Rabiee, Fatemeh; Robbins, Anne; Khan, Maryam

    2015-01-01

    Background: This paper describes the process, impact and outcomes of an innovative health policy project entitled Gym for Free in Birmingham, UK. Objectives: To explore the short-term effectiveness of the pilot scheme in relation to access, utilisation, perceived benefits and sustainability. Design: Cross-sectional study using survey and focus…

  1. The prevalence of food insecurity and associated factors among households with children in Head Start programs in Houston, Texas and Birmingham, Alabama

    Science.gov (United States)

    This study measured food security and hunger of households enrolled in Head Start in Houston, Texas, and Birmingham, Alabama and assessed factors that could affect food security. Interviewers collected data from primary caregivers on demographic characteristics, dietary intake, and the six-item US f...

  2. 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

  3. In-phantom characterisation studies at the Birmingham Accelerator-Generated epIthermal Neutron Source (BAGINS) BNCT facility.

    Science.gov (United States)

    Culbertson, Christopher N; Green, Stuart; Mason, Anna J; Picton, David; Baugh, Gareth; Hugtenburg, Richard P; Yin, Zaizhe; Scott, Malcolm C; Nelson, John M

    2004-11-01

    A broad experimental campaign to validate the final epithermal neutron beam design for the BNCT facility constructed at the University of Birmingham concluded in November 2003. The final moderator and facility designs are overviewed briefly, followed by a summary of the dosimetric methods and presentation of a small subset of the results from this campaign. The dual ionisation chamber technique was used together with foil activation to quantify the fast neutron, photon, and thermal neutron beam dose components in a large rectangular phantom exposed to the beam with a 12 cm diameter beam delimiter in place. After application of a normalisation factor, dose measurements agree with in-phantom MCNP4C predictions within 10% for the photon dose, within 10% for thermal neutron dose, and within 25% for the proton recoil dose along the main beam axis.

  4. 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 nonablativ...

  5. 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.

  6. 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.

  7. 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

  8. Abstract: Lightweight Authentication for HIP

    Science.gov (United States)

    Heer, Tobias

    In recent years numerous solutions for overcoming the architectural constraints of the Internet have emerged. One of the most promising among them is the Host Identity Protocol (HIP) [2], which was recently approved as an experimental standard by the IETF. HIP adds an additional protocol layer between TCP and IP to implement the Identifier/Locator split. Apart from mobility and multihoming, HIP supports host authentication, payload encryption, and a cryptographic namespace without requiring changes to the network infrastructure or network applications. However, especially mobile devices with tightly limited CPU resources are slowed down by HIP. Its poor performance on these mobile devices is a result of the extensive use of public-key (PK) cryptography for securing the main protocol functions.

  9. 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.

  10. Hip: Anatomy and US technique

    OpenAIRE

    2011-01-01

    Ultrasound (US) has always had a relatively limited role in the evaluation of the hip due to the deep location of this joint. However, many hip diseases are well detectable at US, but before approaching such a study it is necessary to be thoroughly familiar with the normal anatomy and related US images. The study technique is particularly important as optimization of various parameters is required, such as probe frequency, focalization, positioning of the probe, etc. Also the patient’s positi...

  11. Conversion of hip arthrodesis to total hip arthroplasty.

    Science.gov (United States)

    Panagiotopoulos, K P; Robbins, G M; Masri, B A; Duncan, C P

    2001-01-01

    With the predictably good outcome now found with THA, hip arthrodesis has limited indications today. The procedure still has a role in the case of the young, heavy demand male with an isolated arthritic hip condition, and developments such as the Cobra head plate have considerably improved success rates. However, a long-term hip arthrodesis can have profound effects on a patient's daily function and activities of daily living. In addition, gait pattern is considerably affected as well as other joints such as the lower back, ipsilateral knee, and contralateral hip. Many patients with a hip arthrodesis will eventually require a takedown of the fused hip and conversion to a THA. The primary indications include fusion in malposition, pseudarthrosis, or severe pain in other joints. The surgeon undertaking such a task must be familiar with the arthrodesis techniques that have been used in the past as well as the equipment that may be required to extract the fixation hardware. Clinical assessment with particular attention to leg-length discrepancy, position of the arthrodesis, and function of the abductors is of paramount importance. The surgeon must carefully review preoperative radiographs to plan the procedure. The surgeon must also be aware of the presence of pathology in other joints. After takedown of a hip arthrodesis and conversion to a THA, patients cannot expect the result to equal the success rates of primary THA. Patients generally can expect an improvement in function and mobility. Back pain and ipsilateral knee pain are usually improved postoperatively, but the effect on contralateral hip pain is less predictable. Many patients will continue to show a positive Trendelenburg sign, but further improvement in strength of the hip abductors can be expected with time. Leg-length discrepancy is generally improved substantially after THA. However, a substantial number of patients will require a walking aid postoperatively. Overall, the risk of complications and the

  12. [Bionic surface design in metal on metal bearings for total hip arthroplasty--optimization of tribological characteristics].

    Science.gov (United States)

    Böhling, U; Scholz, J; Thomas, W; Grundei, H

    2005-04-01

    Bionic systems are aiming to integrate natural observing into mechanical solutions. This has been realized in the design of metal on metal bearing in total hip resurface arthroplasty. The articular side of the femoral cup is covered with a dimple like surface. Under laboratory condition this so called "surf-metal-cup" achieved a reduction of the mechanical wear to almost a third part in comparison to a metal-cup with plane surface. This advantage, caused by the reduced friction-coefficient due to improved hydrodynamic lubrication could also be proved under laboratory conditions. The clinical introduction is expected to offer a significant extension of durability in this prosthetic system and needs to be proved in a long-term study.

  13. Worse health-related quality of life and hip function in female patients with elevated chromium levels

    Science.gov (United States)

    Hussey, Daniel K; Madanat, Rami; Donahue, Gabrielle S; Rolfson, Ola; Muratoglu, Orhun K; Malchau, Henrik

    2016-01-01

    Background and purpose Blood metal ion levels can be an indicator for detecting implant failure in metal-on-metal (MoM) hip arthroplasties. Little is known about the effect of bilateral MoM implants on metal ion levels and patient-reported outcomes. We compared unilateral patients and bilateral patients with either an ASR hip resurfacing (HR) or an ASR XL total hip replacement (THR) and investigated whether cobalt or chromium was associated with a broad spectrum of patient outcomes. Patients and methods From a registry of 1,328 patients enrolled in a multicenter prospective follow-up of the ASR Hip System, which was recalled in 2010, we analyzed data from 659 patients (311 HR, 348 THR) who met our inclusion criteria. Cobalt and chromium blood metal ion levels were measured and a 21-item patient-reported outcome measures (PROMs) questionnaire was used mean 6 years after index surgery. Results Using a minimal threshold of ≥7 ppb, elevated chromium ion levels were found to be associated with worse health-related quality of life (HRQoL) (p hip function (p < 0.05) in women. These associations were not observed in men. Patients with a unilateral ASR HR had lower levels of cobalt ions than bilateral ASR HR patients (p < 0.001) but similar levels of chromium ions (p = 0.09). Unilateral ASR XL THR patients had lower chromium and cobalt ion levels (p < 0.005) than bilateral ASR XL THR patients. Interpretation Chromium ion levels of ≥7 ppb were associated with reduced functional outcomes in female MoM patients. PMID:27459602

  14. 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.

  15. Secondary Patellar Resurfacing after Primary Bicondylar Knee Arthroplasty did Not Meet Patients’ Expectations

    Science.gov (United States)

    Correia, João; Sieder, Marc; Kendoff, Daniel; Citak, Mustafa; Gehrke, Thorsten; Klauser, Wolfgang; Haasper, Carl

    2012-01-01

    Secondary patella resurfacing is a controversial procedure which is applied in patients with anterior knee pain after a bicondylar knee arthroplasty (with unresurfaced patella). A group of 46 patients were submitted to this procedure and their satisfaction, range of motion and pain improvement was evaluated. 52.2% of the patients were satisfied with the procedure, with an improvement in pain (Visual Analogue Scale) of 65% and an improvement in range of motion in 56,5%, with roundabout half of the patients having no resolution to their complaints. Whilst an improvement was not achieved in all patients, as it was initially hypothesised, this procedure should be considered when a revision knee arthroplasty is performed with an unresurfaced patella. PMID:23002412

  16. Secondary Patellar Resurfacing after Primary Bicondylar Knee Arthroplasty did Not Meet Patients' Expectations.

    Science.gov (United States)

    Correia, João; Sieder, Marc; Kendoff, Daniel; Citak, Mustafa; Gehrke, Thorsten; Klauser, Wolfgang; Haasper, Carl

    2012-01-01

    Secondary patella resurfacing is a controversial procedure which is applied in patients with anterior knee pain after a bicondylar knee arthroplasty (with unresurfaced patella). A group of 46 patients were submitted to this procedure and their satisfaction, range of motion and pain improvement was evaluated. 52.2% of the patients were satisfied with the procedure, with an improvement in pain (Visual Analogue Scale) of 65% and an improvement in range of motion in 56,5%, with roundabout half of the patients having no resolution to their complaints. Whilst an improvement was not achieved in all patients, as it was initially hypothesised, this procedure should be considered when a revision knee arthroplasty is performed with an unresurfaced patella.

  17. 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

  18. Ablative fractional resurfacing for the treatment of traumatic scars and contractures.

    Science.gov (United States)

    Uebelhoer, Nathan S; Ross, E Victor; Shumaker, Peter R

    2012-06-01

    After a decade of military conflict, thousands of wounded warriors have suffered debilitating and cosmetically disfiguring scars and scar contractures. Clearly, there is a need for effective scar treatment regimens to assist in the functional and cosmetic rehabilitation of these patients. Traditional treatments, including aggressive physical and occupational therapy and dedicated wound care, are essential. Adjunctive treatments with established laser technologies, such as vascular lasers and full-field ablative lasers, have had a somewhat limited role in scar contractures due to modest efficacy and/or an unacceptable side effect profile in compromised skin. Refractory scar contractures often require surgical revision, which can be effective, but is associated with additional surgical morbidity and a significant risk of recurrence. Furthermore, current scar treatment paradigms often dictate scar maturation for approximately a year to allow for spontaneous improvement before surgical intervention. Since 2009, the Dermatology Clinic at the Naval Medical Center San Diego has been treating scars and scar contractures in wounded warriors and others using ablative fractionated laser technology. Although traditionally associated with the rejuvenation of aged and photo-damaged skin, our clinical experience and a handful of early reports indicate that laser ablative fractional resurfacing demonstrates promising efficacy and an excellent side effect profile when applied to the functional and cosmetic enhancement of traumatic scars and contractures. This article discusses our clinical experience with ablative fractional resurfacing and its potential prominent role in rehabilitation from traumatic injuries, including a possible shift in scar treatment paradigms toward earlier procedural intervention. Potential benefits include the optimization of scar trajectory and higher levels of full or adapted function in a more favorable time course.

  19. Theory and practice of total hip prosthesis replacement therapy for sports hip injury%人工全髋关节假体置换治疗运动性髋损伤的理论与实践

    Institute of Scientific and Technical Information of China (English)

    张金成; 谢正阳

    2012-01-01

    BACKGROUND: Total hip surface replacement can maintain the original mechanical properties of hip joints as much as possible,the stability and activity of the joint after replacement are good, and no apparent age limitations are found.OBJECTIVE: To investigate the artificial hip prosthesis in the treatment of sports hip injuries, the materials and methods of hip prosthesis.METHODS: A computer-based retrieval of PubMed database and Chinese CNKI database from January 1998 to October 2011 was conducted for documents regarding the biomaterials and tissue engineered hip joints, with the key words of "hip joint injury,artificial hip joint, hip replacement, hip resurfacing arthroplasty" in both English and Chinese. Eventually 41 papers met the inclusive criteria.RESULTS AND CONCLUSION: Severe hip joint sports injuries should be treated with artificial hip joint replacement, to restore the patient's life skills, and even certain athletic ability. Currently, prosthesis material is a key factor in the hip replacement treatment, including metals, ceramics, polymers and new bone cement, each has their advantages and disadvantages. Due to long period of follow-up and clinical observations, the efficacy of various materials needs further study. Computer-based three-dimensional finite element analysis for simulation of the hip is a research focus, this means I s a combination of the sports biomechanics and the materials science. Research and development of new materials are essential for the manufacture of artificial hip prosthesis in tissue engineering, and for repair and reconstruction of hip joints.%背景:全髋关节表面置换尽可能保持了髋关节原有的力学性能,置换后关节稳定性及活动度好,且无明显的年龄限制.目的:探讨人工髋关节假体在髋关节运动损伤治疗中的临床应用,以及髋关节假体置换治疗的材料与方法进展.方法:应用计算机检索1998-01/2011-10 PubMed数据库及中国知网数据库有关生物

  20. Focal anatomic resurfacing implantation for bilateral humeral and femoral heads’ avascular necrosis in a patient with Hodgkin’s lymphoma and literature review

    Directory of Open Access Journals (Sweden)

    Onur Bilge

    2015-01-01

    Conclusion: This study is the first report to present the three-years’ clinical result of a single, relevant case, who was treated with sequential focal anatomic resurfacing implantations (HemiCAP® in four aforementioned joints.

  1. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Cerezal, Luis, E-mail: lcerezal@gmail.com [Diagnóstico Médico Cantabria, C/Castilla 6, 39002 Santander (Spain); Arnaiz, Javier; Canga, Ana; Piedra, Tatiana [Valdecilla University Hospital, 39011 Santander (Spain); Altónaga, José R. [Leon University, 24071 Leon (Spain); Munafo, Ricardo [CETEA, Buenos Aires (Argentina); Pérez-Carro, Luis [Valdecilla University Hospital, 39011 Santander (Spain)

    2012-12-15

    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.

  3. 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.

  4. The Birmingham parallel genetic algorithm and its application to the direct DFT global optimisation of IrN (N = 10-20) clusters

    Science.gov (United States)

    Davis, Jack B. A.; Shayeghi, Armin; Horswell, Sarah L.; Johnston, Roy L.

    2015-08-01

    A new open-source parallel genetic algorithm, the Birmingham parallel genetic algorithm, is introduced for the direct density functional theory global optimisation of metallic nanoparticles. The program utilises a pool genetic algorithm methodology for the efficient use of massively parallel computational resources. The scaling capability of the Birmingham parallel genetic algorithm is demonstrated through its application to the global optimisation of iridium clusters with 10 to 20 atoms, a catalytically important system with interesting size-specific effects. This is the first study of its type on Iridium clusters of this size and the parallel algorithm is shown to be capable of scaling beyond previous size restrictions and accurately characterising the structures of these larger system sizes. By globally optimising the system directly at the density functional level of theory, the code captures the cubic structures commonly found in sub-nanometre sized Ir clusters.A new open-source parallel genetic algorithm, the Birmingham parallel genetic algorithm, is introduced for the direct density functional theory global optimisation of metallic nanoparticles. The program utilises a pool genetic algorithm methodology for the efficient use of massively parallel computational resources. The scaling capability of the Birmingham parallel genetic algorithm is demonstrated through its application to the global optimisation of iridium clusters with 10 to 20 atoms, a catalytically important system with interesting size-specific effects. This is the first study of its type on Iridium clusters of this size and the parallel algorithm is shown to be capable of scaling beyond previous size restrictions and accurately characterising the structures of these larger system sizes. By globally optimising the system directly at the density functional level of theory, the code captures the cubic structures commonly found in sub-nanometre sized Ir clusters. Electronic supplementary information

  5. A soundscape approach to exploring design strategies for acoustic comfort in modern public libraries: a case study of the Library of Birmingham

    OpenAIRE

    Xiao Jieling; Aletta Francesco

    2016-01-01

    Taking the soundscape approach to a study of the Library of Birmingham, this paper explored acoustic comfort in modern public libraries and measured the quality of the perceived sound environment, focusing on the appropriateness of the spatial organisation to facilitate users’ activities of reading and writing. The research involved four groups of participants taking soundwalks which provided data at four main floors in the Library, identifying types of sounds, measuri...

  6. Primary and revision anterior supine total hip arthroplasty: an analysis of complications and reoperations.

    Science.gov (United States)

    Berend, Keith R; Kavolus, Joseph J; Morris, Michael J; Lombardi, Adolph V

    2013-01-01

    Anterior total hip arthroplasty (THA) has been touted by some as a muscle-sparing, less invasive procedure. Reports have focused on the high intraoperative and postoperative complication rates, the increased transfusion risk, and its questionable clinical benefits. The senior author's experience regarding complications and reoperations that occurred after primary and revision THA using an anterior supine intermuscular approach has been generally favorable. An electronic database was used to identify 906 patients treated with 1,035 consecutive anterior supine intermuscular THAs performed by a single surgeon between January 2007 and December 2010, which included 986 primary THAs, 2 resurfacings, 2 conversions of failed open reduction and internal fixation for fracture, and 45 revision THAs. The surgical technique used an anterior approach with a modified Smith-Petersen interval and was performed with the patient supine on a standard operating table without traction. The transfusion rate was 5%. There were three intraoperative calcar cracks and one canal perforation, which was treated with cerclage cables. Four wound complications required débridement, four hips had substantial lateral femoral cutaneous nerve paresthesias that had not resolved by the 12-month follow-up, and one femoral nerve palsy was reported. At up to 40 month's follow-up, there have been 25 revisions (2.4%), including 9 periprosthetic femoral fractures; 1 stem subsidence; 4 hips with aseptic loosening; 5 metal-on-metal bearing complications; 1 cup malpositioning, which was corrected the same day; 4 dislocations; and 1 infection. This 4-year experience with primary and revision anterior THAs has showed acceptable rates of perioperative transfusion, complications, and revisions.

  7. 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.

  8. [Uncemented arthroplasty of the hip].

    Science.gov (United States)

    von Schulze Pellengahr, C; Fottner, A; Utzschneider, S; Schmitt-Sody, M; Teske, W; Lichtinger, T; Esenwein, S A

    2009-05-01

    Prognosis of cemented total hip replacement seems to be excellent for elderly patients. In younger age the outcome is less favourable and early revision is more common. Thus, different concepts with better prognosis and preservation of bone stock for possible revisions were needed. After more than 30 years of application with excellent short-term and long-term results, uncemented total hip arthroplasty is nowadays generally regarded as the standard procedure for younger patients. New bone-preserving implants, such as surface replacement or short-stemmed femoral shaft prostheses, have been introduced especially for younger patients. Some of these new procedures are still under development, and the long-term results of new implant concepts have to be evaluated over the next decades. Regarding recently published scientific studies an overview about non-cemented total hip arthroplasty is given and current concepts and developments are presented.

  9. 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.

  10. In vivo TPEF-SHG microscopy for detecting collagen remodeling after laser micro-ablative fractional resurfacing treatment

    Science.gov (United States)

    Cicchi, Riccardo; Kapsokalyvas, Dimitrios; Troiano, Michela; Campolmi, Piero; Morini, Cristiano; Lotti, Torello; Pavone, Francesco S.

    2011-07-01

    Second-harmonic generation and two-photon excited fluorescence microscopy were used in combination in the same optical system for in vivo imaging. This work aimed at detecting collagen remodeling and reorganization in living subjects following laser micro-ablative fractional resurfacing treatment. Treated regions in the forearm of volunteers covering a wide age range were imaged with two-photon microscopy before and forty days after the treatment. A strong age-dependence of the treatment effectiveness was found, demonstrating a negligible effect in very young subjects (age 60 years). The amount of newly synthesized collagen as well as its organization were evaluated by means of both visual examination of two-photon images and an image analysis methods, based on second-harmonic to autofluorescence ageing index of dermis (SAAID) scoring. The obtained results demonstrate the performance of laser fractional micro ablative resurfacing without the need for an invasive biopsy.

  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...

  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...

  13. Hip-Hop发烧友

    Institute of Scientific and Technical Information of China (English)

    文泉; 张鹏

    2005-01-01

    我出生在布朗克斯。我只有三十岁。我一直是争论的焦点。我一年可以赚数十亿美元,而且非常非常红。你知道我是谁吗?我是Hip-Hop。三十年前“hip hop”这个词儿还不存在,如今它已经成为一种几乎难以定义的包罗万象的生活方式。

  14. Validation of solar-cycle changes in low-degree helioseismic parameters from the Birmingham Solar-Oscillations Network

    CERN Document Server

    Howe, R; Chaplin, W J; Elsworth, Y P; Hale, S J

    2015-01-01

    We present a new and up-to-date analysis of the solar low-degree $p$-mode parameter shifts from the Birmingham Solar-Oscillations Network (BiSON) over the past 22 years, up to the end of 2014. We aim to demonstrate that they are not dominated by changes in the asymmetry of the resonant peak profiles of the modes and that the previously published results on the solar-cycle variations of mode parameters are reliable. We compare the results obtained using a conventional maximum likelihood estimation algorithm and a new one based on the Markov Chain Monte Carlo (MCMC) technique, both taking into account mode asymmetry. We assess the reliability of the solar-cycle trends seen in the data by applying the same analysis to artificially generated spectra. We find that the two methods are in good agreement. Both methods accurately reproduce the input frequency shifts in the artificial data and underestimate the amplitude and width changes by a small amount, around 10 per cent. We confirm earlier findings that the frequ...

  15. 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.

  16. 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.

  17. 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.

  18. On HIP-HOP%HIP-HOP运动论

    Institute of Scientific and Technical Information of China (English)

    王丽娜; 兰健

    2009-01-01

    运用文献资料等方法,从文化社会学的角度对传入我国的HIP-HOP运动的文化背景及其文化表现进行分析.认为:HIP-HOP运动主要包括:街舞、街头篮球、滑板等运动.HIP-HOP运动以其流行的社会文化要素和独特魅力吸引亿万青少年,使其狂热地投入到这股新兴的运动时尚潮流中,影响和改变着青少年的现代生活.HIP-HOP运动创造了一种非冲突性的、娱乐休闲的,以及有理想化价值的身体娱乐体系,有着独有的体育文化功能.

  19. A study of the use of the supraclavicular artery flap for resurfacing of head, neck, and upper torso defects

    Directory of Open Access Journals (Sweden)

    Telang Parag

    2009-01-01

    Full Text Available The head and neck region is an aesthetically demanding area to resurface because of its high visibility. Tissue defects in this area often require distant flaps or free flaps to achieve an aesthetically acceptable result. The use of the Supraclavicular artery flap represents an extremely versatile and useful option for the resurfacing of head, neck and upper torso defects. Furthermore, islanding the flap gives it a wide arc of rotation and the color and texture match is superior to that of free flaps harvested from distant sites. In our study, we used the flap (both unexpanded and expanded predominantly for resurfacing neck defects resulting from the release of post-burn contractures. However, its applicability in other indications would also be similar. Except one, all our flaps survived almost completely and the post-operative morbidity was very low. We conclude that the supraclavicular artery flap not only provides a reasonably good color and texture match but also maintains the multi-directional activity in the neck region.

  20. Subject-specific hip geometry and hip joint centre location affects calculated contact forces at the hip during gait.

    Science.gov (United States)

    Lenaerts, G; Bartels, W; Gelaude, F; Mulier, M; Spaepen, A; Van der Perre, G; Jonkers, I

    2009-06-19

    Hip loading affects the development of hip osteoarthritis, bone remodelling and osseointegration of implants. In this study, we analyzed the effect of subject-specific modelling of hip geometry and hip joint centre (HJC) location on the quantification of hip joint moments, muscle moments and hip contact forces during gait, using musculoskeletal modelling, inverse dynamic analysis and static optimization. For 10 subjects, hip joint moments, muscle moments and hip loading in terms of magnitude and orientation were quantified using three different model types, each including a different amount of subject-specific detail: (1) a generic scaled musculoskeletal model, (2) a generic scaled musculoskeletal model with subject-specific hip geometry (femoral anteversion, neck-length and neck-shaft angle) and (3) a generic scaled musculoskeletal model with subject-specific hip geometry including HJC location. Subject-specific geometry and HJC location were derived from CT. Significant differences were found between the three model types in HJC location, hip flexion-extension moment and inclination angle of the total contact force in the frontal plane. No model agreement was found between the three model types for the calculation of contact forces in terms of magnitude and orientations, and muscle moments. Therefore, we suggest that personalized models with individualized hip joint geometry and HJC location should be used for the quantification of hip loading. For biomechanical analyses aiming to understand modified hip joint loading, and planning hip surgery in patients with osteoarthritis, the amount of subject-specific detail, related to bone geometry and joint centre location in the musculoskeletal models used, needs to be considered.

  1. Total Hip Arthroplasty in Failed Hip Fractures: A Case Series

    Directory of Open Access Journals (Sweden)

    Syed Shahid Noor

    2015-01-01

    Full Text Available Osteoporosis is epidemic in Asian countries. It is a major cause of fractures that orthopaedic surgeons deal in Pakistan, though proper epidemiological data is not available. Habiba U et al found that 75.3% of post menopausal women of Pakistan were predisposed to Osteoporosis; whereas Baig L has described an average T - score of -1.833±0.65 on bone mineral density calculation of post menopausal females of Pakistan. Osteoporotic hip fractures constitute a major cause of elderly mortality worldwide and recent figures supporting the idea that these patients have survival rates comparable to breast and thyroid cancer patients. Pakistan is a developing country with large burden of hip fractures. Patients living in remote areas are the ones which suffer more because of inadequate awareness, fear of surgical treatment and lack of availability of standard treatment. These patients are dealt by surgeons of various expertise and levels of experience. Lack of facilities in hospitals is well known and usage of sub-standard implant is a major cause of failure. Therefore these patients either because of their bone fragility or mal-treatment suffer frequently from failure of hip fracture surgeries. Being in a tertiary care centre we come across these types of cases very frequently. Six to eight such cases present to outpatient department of Liaquat National Hospital every month being referred from every part of the country. These patients may have been operated once, twice or even multiple times. Special attention is required to acquire an informative history from these cases and perform a comprehensive examination. Moreover previous records and radiographs provide invaluable information regarding cause of failure and deciding course of further treatment. We herein discuss few of the cases of failure of hip fractures which were treated by hip arthroplasty.

  2. Patterns of risk of cancer in patients with metal-on-metal hip replacements versus other bearing surface types: a record linkage study between a prospective joint registry and general practice electronic health records in England.

    Directory of Open Access Journals (Sweden)

    Arief Lalmohamed

    Full Text Available BACKGROUND: There are concerns that metal-on-metal hip implants may cause cancer. The objective of this study was to evaluate patterns and timing of risk of cancer in patients with metal-on-metal total hip replacements (THR. METHODS: In a linkage study between the English National Joint Registry (NJR and the Clinical Practice Research Datalink (CPRD, we selected all THR surgeries (NJR between 2003 and 2010 (n = 11,540. THR patients were stratified by type of bearing surface. Patients were followed up for cancer and Poisson regression was used to derive adjusted relative rates (RR. RESULTS: The risk of cancer was similar in patients with hip resurfacing (RR 0.69; 95% Confidence Interval [CI] 0.39-1.22 or other types of bearing surfaces (RR 0.96; 95% CI 0.64-1.43 compared to individuals with stemmed metal-on-metal THR. The pattern of cancer risk over time did not support a detrimental effect of metal hip implants. There was substantial confounding: patients with metal-on-metal THRs used fewer drugs and had less comorbidity. CONCLUSIONS: Metal-on-metal THRs were not associated with an increased risk of cancer. There were substantial baseline differences between the different hip implants, indicating possibility of confounding in the comparisons between different types of THR implants.

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

    OpenAIRE

    Kim, Chan; Nevitt, Michael C.; Niu, Jingbo; Clancy, Mary M; Nancy E Lane; 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 d...

  4. 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…

  5. 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...

  6. Improving hip surgery patients’ outcomes:

    DEFF Research Database (Denmark)

    Bagger, Bettan; Poulsen, Dorthe Varning; Taylor Kelly, Hélène;

    2013-01-01

    This presentation focuses upon the improvement of hip surgery patients’ outcomes with respect to health promotion and rehabilitation. The overall aims of the EU financed orthopedic nursing project will be introduced. Speakers highlight the project’s contribution to: -the development of nurse...

  7. Techniques and results for open hip preservation

    Directory of Open Access Journals (Sweden)

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

  8. 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.

  9. Tsunami waves extensively resurfaced the shorelines of an early Martian ocean.

    Science.gov (United States)

    Rodriguez, J Alexis P; Fairén, Alberto G; Tanaka, Kenneth L; Zarroca, Mario; Linares, Rogelio; Platz, Thomas; Komatsu, Goro; Miyamoto, Hideaki; Kargel, Jeffrey S; Yan, Jianguo; Gulick, Virginia; Higuchi, Kana; Baker, Victor R; Glines, Natalie

    2016-05-19

    It has been proposed that ~3.4 billion years ago an ocean fed by enormous catastrophic floods covered most of the Martian northern lowlands. However, a persistent problem with this hypothesis is the lack of definitive paleoshoreline features. Here, based on geomorphic and thermal image mapping in the circum-Chryse and northwestern Arabia Terra regions of the northern plains, in combination with numerical analyses, we show evidence for two enormous tsunami events possibly triggered by bolide impacts, resulting in craters ~30 km in diameter and occurring perhaps a few million years apart. The tsunamis produced widespread littoral landforms, including run-up water-ice-rich and bouldery lobes, which extended tens to hundreds of kilometers over gently sloping plains and boundary cratered highlands, as well as backwash channels where wave retreat occurred on highland-boundary surfaces. The ice-rich lobes formed in association with the younger tsunami, showing that their emplacement took place following a transition into a colder global climatic regime that occurred after the older tsunami event. We conclude that, on early Mars, tsunamis played a major role in generating and resurfacing coastal terrains.

  10. 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.

  11. Immunohistochemical evaluation of the heat shock response to nonablative fractional resurfacing

    Science.gov (United States)

    Hantash, Basil M.; Bedi, Vikramaditya P.; Struck, Steven K.; Chan, Kin F.

    2010-11-01

    Despite the emergence of nonablative fractional resurfacing (NFR) as a new therapeutic modality for skin photoaging, little is known about the molecular events that underlie the heat shock response to different treatment parameters. Human subjects are treated with a scanned 1550-nm fractional laser at pulse energies spanning 6 to 40 mJ and a 140-μm spot size. The heat shock response is assessed immunohistochemically immediately through 7 days posttreatment. At the immediately posttreatment time point, we observe subepidermal clefting in most sections. The basal epidermis and dermal zones of sparing are both found to express HSP47, but not HSP72. By day 1, expression of HSP72 is detected throughout the epidermis, while that of HSP47 remains restricted to the basal layer. Both proteins are detected surrounding the dermal portion of the microscopic treatment zone (MTZ). This pattern of expression persists through day 7 post-NFR, although neither protein is found within the MTZ. Immediately posttreatment, the mean collagen denaturation zone width is 50 μm at 6 mJ, increasing to 202 μm at 40 mJ. The zone of cell death exceeds the denaturation zone by 19 to 55% over this pulse energy range. The two zones converge by day 7 posttreatment.

  12. One-sheet spiraling full thickness skin graft for penile resurfacing after paraffinoma excision

    Directory of Open Access Journals (Sweden)

    Theddeus O.H. Prasetyono

    2011-08-01

    Full Text Available In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases of surgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft. The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relatively easy to be performed, is no doubt much thinner than a skin flap, while it also bears a smaller degree of secondary contraction than split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area of penis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibility of either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin to develop hypertrophic scar. However, this possible scar problem applies also to any other surgical scar with any donor tissue. Fortunately, the 3 cases posed no scar problem and normal appearance. All the patients have also regained their normal sexual function. (Med J Indones 2011; 20:222-5Keywords: full thickness skin graft, paraffinoma, siliconoma, sexual function

  13. Tsunami waves extensively resurfaced the shorelines of an early Martian ocean

    Science.gov (United States)

    Rodriguez, J. Alexis P.; Fairén, Alberto G.; Tanaka, Kenneth L.; Zarroca, Mario; Linares, Rogelio; Platz, Thomas; Komatsu, Goro; Miyamoto, Hideaki; Kargel, Jeffrey S.; Yan, Jianguo; Gulick, Virginia; Higuchi, Kana; Baker, Victor R.; Glines, Natalie

    2016-01-01

    It has been proposed that ~3.4 billion years ago an ocean fed by enormous catastrophic floods covered most of the Martian northern lowlands. However, a persistent problem with this hypothesis is the lack of definitive paleoshoreline features. Here, based on geomorphic and thermal image mapping in the circum-Chryse and northwestern Arabia Terra regions of the northern plains, in combination with numerical analyses, we show evidence for two enormous tsunami events possibly triggered by bolide impacts, resulting in craters ~30 km in diameter and occurring perhaps a few million years apart. The tsunamis produced widespread littoral landforms, including run-up water-ice-rich and bouldery lobes, which extended tens to hundreds of kilometers over gently sloping plains and boundary cratered highlands, as well as backwash channels where wave retreat occurred on highland-boundary surfaces. The ice-rich lobes formed in association with the younger tsunami, showing that their emplacement took place following a transition into a colder global climatic regime that occurred after the older tsunami event. We conclude that, on early Mars, tsunamis played a major role in generating and resurfacing coastal terrains. PMID:27196957

  14. Dust levitation as a major resurfacing process on the surface of a saturnian icy satellite, Atlas

    Science.gov (United States)

    Hirata, Naoyuki; Miyamoto, Hideaki

    2012-07-01

    A small inner satellite of Saturn, Atlas, has an enigmatic saucer-like shape explained by an accumulation of particles from A-ring of Saturn. However, its unusual smooth surface remains unexplained. Gardening through continuous particle impact events cannot be a unique explanation for the smoothness, because Prometheus does not exhibit a similar surface, though it too would have experienced a similar bombardment. Here, a detailed investigation using close-up images of Atlas reveals the surface to be (1) covered by fine particles (i.e., probably as small as several tens of micrometers); (2) mostly void of impact craters (i.e., only one has been thus far identified); and (3) continuously smooth, even between the equatorial ridge and the undulating polar region. These findings imply that some sort of crater-erasing process has been active on the surface of Atlas. From electro-static analyses, we propose that the upper-most layer of the fine particles can become electro-statically unstable and migrate as a result of dust levitation, which resulted in erasing craters on the surface of Atlas. If true, Atlas would represent the first recognized body where resurfacing is dominated by dust levitation.

  15. 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.

  16. Electricity Consumption Risk Map - The use of Urban Climate Mapping for smarter analysis: Case study for Birmingham, UK.

    Science.gov (United States)

    Antunes Azevedo, Juliana; Burghardt, René; Chapman, Lee; Katzchner, Lutz; Muller, Catherine L.

    2015-04-01

    Climate is a key driving factor in energy consumption. However, income, vegetation, building mass structure, topography also impact on the amount of energy consumption. In a changing climate, increased temperatures are likely to lead to increased electricity consumption, affecting demand, distribution and generation. Furthermore, as the world population becomes more urbanized, increasing numbers of people will need to deal with not only increased temperatures from climate change, but also from the unintentional modification of the urban climate in the form of urban heat islands. Hence, climate and climate change needs to be taken into account for future urban planning aspects to increase the climate and energy resilience of the community and decrease the future social and economic costs. Geographical Information Systems provide a means to create urban climate maps as part of the urban planning process. Geostatistical analyses linking these maps with demographic and social data, enables a geo-statistical analysis to identify linkages to high-risk groups of the community and vulnerable areas of town and cities. Presently, the climatope classification is oriented towards thermal aspects and the ventilation quality (roughness) of the urban areas but can also be adapted to take into account other structural "environmental factors". This study aims to use the climatope approach to predict areas of potential high electricity consumption in Birmingham, UK. Several datasets were used to produce an average surface temperature map, vegetation map, land use map, topography map, building height map, built-up area roughness calculations, an average air temperature map and a domestic electricity consumption map. From the correlations obtained between the layers it is possible to average the importance of each factor and create a map for domestic electricity consumption to understand the influence of environmental aspects on spatial energy consumption. Based on these results city

  17. Subject-specific hip geometry affects predicted hip joint contact forces during gait.

    Science.gov (United States)

    Lenaerts, G; De Groote, F; Demeulenaere, B; Mulier, M; Van der Perre, G; Spaepen, A; Jonkers, I

    2008-01-01

    Hip loading affects bone remodeling and implant fixation. In this study, we have analyzed the effect of subject-specific modeling of hip geometry on muscle activation patterns and hip contact forces during gait, using musculoskeletal modeling, inverse dynamic analysis and static optimization. We first used sensitivity analysis to analyze the effect of isolated changes in femoral neck-length (NL) and neck-shaft angle (NSA) on calculated muscle activations and hip contact force during the stance phase of gait. A deformable generic musculoskeletal model was adjusted incrementally to adopt a physiological range of NL and NSA. In a second similar analysis, we adjusted hip geometry to the measurements from digitized radiographs of 20 subjects with primary hip osteoarthrosis. Finally, we studied the effect of hip abductor weakness on muscle activation patterns and hip contact force. This analysis showed that differences in NL (41-74 mm) and NSA (113-140 degrees ) affect the muscle activation of the hip abductors during stance phase and hence hip contact force by up to three times body weight. In conclusion, the results from both the sensitivity and subject-specific analysis showed that at the moment of peak contact force, altered NSA has only a minor effect on the loading configuration of the hip. Increased NL, however, results in an increase of the three hip contact-force components and a reduced vertical loading. The results of these analyses are essential to understand modified hip joint loading, and for planning hip surgery for patients with osteoarthrosis.

  18. Pathogenesis of osteoporotic hip fractures.

    Science.gov (United States)

    McClung, Michael R

    2003-01-01

    Osteoporosis is characterized late in the course of the disease by an increased risk of fracture, particularly in the elderly. It occurs in both sexes, affecting approximately 8 million women and 2 million men aged > or = 50 years (1). While low bone density is a predictor of fractures, it is not the only determinant of fracture risk. Other factors include advanced age, altered bone quality, a personal or family history of falls, frailty, poor eyesight, debilitating diseases, and high bone turnover. A diet with sufficient calcium and vitamin D is important to minimize bone loss and, along with regular exercise, to maintain muscle strength. Bisphosphonates have been shown to reduce the risk of hip fracture. For elderly patients, the use of hip protectors may be used as a treatment of last resort. Regardless of the age of the patient, individual patient risk factors must be considered to target appropriate treatment and prevent fracture.

  19. Economic viability of geriatric hip fracture centers.

    Science.gov (United States)

    Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

    2013-12-01

    Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

  20. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  1. Metal ion interpretation in resurfacing versus conventional hip arthroplasty and in whole blood versus serum. How should we interpret metal ion data

    NARCIS (Netherlands)

    Smolders, J.M.; Bisseling, P.; Hol, A.; Straeten, C. Van Der; Schreurs, B.W.; Susante, J.L.C. van

    2011-01-01

    Metal ions generated from joint replacements are a cause for concern. There is no consensus on the best surrogate measure of metal ion exposure, and both serum and whole blood measurements are used in clinical practice. This study provides a guideline for interpretation of metal ion analysis in clin

  2. 髋关节表面置换术后生物力学参数的改变%Changes in biomechanical parameters after hip resurfacing arthroplasty

    Institute of Scientific and Technical Information of China (English)

    刘庆; 张洪; 周乙雄; 殷建华

    2007-01-01

    目的:与全髋关节置换手术对比,观察髋关节表面置换术后生物力学参数的变化特点.方法:选择2004-04/2006-08于北京积水潭医院矫形骨科完成手术的金属对金属髋关节表面置换患者13例作为表面置换组,全髋置换组为15例人工全髋置换手术病例.入选病例均知情同意.比较两组间术后髋关节旋转中心位置、重力臂、股骨偏心距和颈干角,以及Shenton's线是否连续等5个生物力学参数.结果:28例患者全部进入结果分析,无脱落.①两组患者髋关节旋转中心高度和重力臂的改变差异无显著性意义(P=0.194,0.125);股骨偏心距的改变两组差异具有显著性意义(表面置换组:-1.08 mm,全髋置换组:5.6 mm,P=0.042).②表面置换组患者手术前后的颈干角间存在明显相关性(r=0.87,P<0.01).③表面置换组中7例术前Shenton's线不连续,4例术后Shenton's线仍然不连续,全髋置换组有3例出现肢体延长.结论:髋关节表面置换手术可以较好的恢复髋关节旋转中心位置,但对股骨偏心距的恢复和颈干角的纠正及Shenton's的恢复不理想,其临床意义尚需观察.

  3. History and status quo of the total hip resurfacing%人工全髋表面置换技术的历史与现状

    Institute of Scientific and Technical Information of China (English)

    刘璠

    2007-01-01

    作为全髋置换术(THR)的一种替代技术,全髋表面置换术(THSR)通过保留股骨头、颈骨块而恢复髋关节正常的生物力学特性及关节的稳定性,并由于未破坏股骨髓腔结构而具有易翻修的潜力.在其发展长达半个多世纪的三个技术时期中,通过不断积累经验,使得假体系统在材料、设计及固定方法等技术参数方面获得长足改进.但仍存在尚待解决的问题.新一代金-金全髋表面假体系统的问世是髋关节置换术的一个重要历程碑,在不到10年的临床随访中其早期疗效非常满意,但中、长期疗效尚不确定,需待与其它方法作进一步长期的、随机化对照性研究.

  4. 人工髋关节表面置换术19例%Metal-on-metal Hip Resurfacing: Report of 19 Cases

    Institute of Scientific and Technical Information of China (English)

    夏春; 王承云; 王少杰; 张英; 石磊

    2010-01-01

    目的 总结人工髋关节表面置换术的初步经验与疗效. 方法 2007年8月~2009年6月对19例(19髋)髋关节疾病行人工髋关节表面置换术,假体均为金属对金属髋关节表面假体.取髋关节后外侧入路,直视下或定位器下钻入导向钉,根据股骨颈直径确定股骨头假体的大小,髋臼假体使用生物型压配技术固定,股骨头假体骨水泥固定. 结果 1例术后复查X线片时发现髋臼假体脱位再次手术复位成功;1例在股骨颈定位时发现导针严重偏差,重新定位定向后获得良好位置,术后X线位置良好;其余17例手术顺利和术后X线显示位置良好,出院时均屈髋达90°,步行出院.19例随访3~25个月,平均9.2月, 末次随访HSS评分为(91±11)分,较术前(43±10)分明显增高(t=14.465, P=0.000);UCLA 髋关节活动评分(7.4±1.6)分,较术前(4.4±1.3)分明显升高(t=8.364, P=0.000). 结论金属对金属髋关节表面置换术治疗某些髋关节疾病近期疗效优良,特别适合于年轻患者;但该术式有更长学习曲线,有一定的适用范围,且在行髋关节表面置换时需要准备全髋置换的器械.

  5. 全髋关节表面置换进展及若干问题的思考%Thoughts in Hip Resurfacing Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    俞芳; 李康华

    2009-01-01

    全髋关节表面置换术与传统的全髋关节置换术相比有众多优点,然而随着研究的深入,全髋关节表面置换的缺点不断暴露,其中牵涉到很多矛盾的思想观点,如骨水泥在假体固定中的应用与否,髋臼臼杯变形与臼杯厚度、植入技术的复杂关系等.分析存在的矛盾且深入探索,从而发现解决矛盾的办法.

  6. 髋关节表面置换术优势与临床应用%The advantage and clinical application of resurfacing arthroplasty of the hip

    Institute of Scientific and Technical Information of China (English)

    陈杰; 夏军

    2006-01-01

    髋关节疾病严重威胁着患者的生活质量,对于年轻患者尤甚.人工髋关节技术的日臻成熟,为广大患者提供了恢复关节功能的机会,在老年患者(>55岁)中取得了良好的临床疗效.由于年轻患者活动量大、预期寿命长以及全髋关节置换术需要截除正常的股骨颈而改变了生物力学关系,加上假体磨损和金属疲劳导致的使用年限缩短等问题,因此传统的全髋关节置换术后可能需行多次翻修手术,翻修手术在手术并发症、假体使用年限及临床疗效等方面均明显不如初次全髋关节置换术.相对传统的全髋关节置换术,髋关节表面置换术保留了较多的骨质,因此更多地保留了关节正常的生物力学和应力转移性能,增强了关节的稳定性,使以后的翻修手术更简单易行,尤其适用于年轻患者.

  7. Post-operation nursing care for 17 cases of hip resurfacing arthroplasty%17例髋关节表面置换术的术后护理

    Institute of Scientific and Technical Information of China (English)

    叶国凤; 金爱东; 胡江雁

    2009-01-01

    报告17例(21髋)髋部疾病施行髋关节表面置换术的术后护理.认为护理重点是加强患肢的肌力训练、关节活动度锻炼、步态训练,重视股骨颈骨折的预防和健康教育.17例均未发生股骨颈骨折,亦未发生体位性低血压、下肢深静脉血栓形成、髋关节脱位等并发症,髋关节疼痛基本缓解,Harris评分明显提高,步态基本恢复正常.

  8. Finite element analysis of resurfacing arthroplasty of hip%有限元分析在髋关节表面置换中的应用

    Institute of Scientific and Technical Information of China (English)

    展影; 雷新玮

    2010-01-01

    髋关节表面置换术是治疗股骨头缺血性坏死、骨性关节炎等髋关节疾病的有效方法.就近年来国内外髋关节表面置换术有限元模型的建立方法及有限元分析法在术式选择、术后并发症方面的研究进展进行综述.

  9. 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.

  10. 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

  11. 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

    PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant...... than 4 cm(2). Patients were followed for 2 years with American Knee Society Subjective outcome Scores (AKSS), pain scores and radiographic evaluations and for up to 6 years with complications and reoperations. RESULTS: At the 1- and 2-year follow-up mean AKSS clinical score, the mean AKSS function...... 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...

  12. 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

  13. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  14. Pelvic Incidence in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ibrahim Raphael

    2016-04-01

    Full Text Available Background: Hip osteoarthritis (OA is a major cause of pain and disability that results in considerable social and medical costs. Mechanics such as posture, alignment and orientation of the hips and the spinal column and the relationship between these factors have been implicated in the development of both hip and spine pathologies. This study aims to test the hypothesis if pelvic incidence varies in patients with and without osteoarthritis. We assessed the relationship between spinopelvic alignment as measured by pelvic incidence (PI and the presence of hip OA. Methods: We collected supine pelvis CT scans of 1,012 consecutive patients not known to have hip OA. Our first group consisted of 95 patients with moderate to severe hip OA as per radiology reports. The second group included 87 patients with no evidence of hip OA. Power analysis revealed the need for 77 patients per group to find a mean difference in PI of 5º or less between both groups. Two trained physicians independently measured the PI to account for inter-observer reliability. Results: Patients with moderate to severe hip OA had a mean PI of 56.5º±12.8º. The mean PI for patients without hip OA was 57.2º±7.5º. An independent samples t-test revealed no significant difference between the PI values of the two groups. Spearman’s correlation coefficient of 0.754 demonstrated a high inter-observer reliability. Conclusion: There was no difference in PI angle of hip OA patients and "healthy" patients. Our measurements of patients without OA were almost identical to the reported normal PI values in the literature. It appears that hip OA is not associated with PI angle, refuting the hypothesis made in previous studies, stating that elevated PI contributes to the future development of hip arthritis. CT scan seems to be a reliable and accurate way of assessing pelvic incidence.

  15. Wear debris in cemented total hip arthroplasty.

    Science.gov (United States)

    Huo, M H; Salvati, E A; Buly, R L

    1991-03-01

    One of the most prevalent clinical problems in long-term follow up of total hip arthroplasty patients is loosening of prosthetic fixation. Factors contributing to mechanical failure of total hip reconstruction are complex and multiple. It has become increasingly apparent that wear debris from the prosthetic components may contribute significantly to this process. The authors summarize some of the current concepts concerning the detrimental effects of metallic debris in total hip arthroplasty.

  16. [Treatment of infected total hip endoprostheses].

    Science.gov (United States)

    Zilkens, K W; Forst, R; Casser, H R

    1989-07-01

    In total hip arthroplasty the most serious complication besides aseptic loosening is infection. The results observed in 42 cases of infected hip arthroplasties are presented. In contrast to early superficial infection, deep infection following total hip replacement is difficult to treat. Depending on the general condition of the patient, a well-defined, adequate treatment is required. In patients at vital risk the provocation of a permanent fistula can be recommended as an alternative method in preference to revision arthroplasty.

  17. 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.

  18. 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.

  19. 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.

  20. 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...

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

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    on the hip. Women with hip fractures have a lower body weight compared with controls, and they may also have less soft tissue covering the hip even when adjusted for body mass index, indicating a more android body habitus. Experimental studies show that the passive energy absorption in soft tissue covering...

  2. A comparison of cardiovascular risk factors among Indo-Asian and caucasian patients admitted with acute myocardial infarction in Kuala Lumpur, Malaysia and Birmingham, England.

    Science.gov (United States)

    Dhanjal, T S; Lal, M; Haynes, R; Lip, G

    2001-12-01

    Indo-Asians in the UK are at an increased risk of coronary artery disease (CAD); this may be a reflection of their cardiovascular risk factor profile as well as of a more sedentary lifestyle. We hypothesised that Indo-Asians in Malaysia and the UK may exhibit a similar cardiovascular risk factor and physical activity profile, which would be more adverse compared with caucasians. We studied 70 consecutive Indo-Asian patients admitted to hospitals in Kuala Lumpur, Malaysia (n=42; 35 males; mean age 60.6 years, SD 11.8); and Birmingham, England (n=28; 20 males; mean age 60.8 years, SD 12.9). Both groups of Indo-Asian patients were compared with 20 caucasian patients (13 males; mean age 62.7 years, SD 9.4) admitted with myocardial infarction from Birmingham. There was a higher prevalence of diabetes among Indo-Asians in both countries than among caucasians (p=0.0225). By contrast, caucasians had a higher prevalence of hypercholesterolaemia (p=0.0113), peripheral vascular disease (p=0.0008), regular alcohol consumption (pMalaysia and the UK, may in part contribute to the high incidence of CAD in this ethnic group.

  3. 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.

  4. Escuela Greenfield, en Birmingham

    Directory of Open Access Journals (Sweden)

    Smith, Eberle M.

    1959-11-01

    Full Text Available Había que proyectar para un suburbio una escuela del grado primero al sexto, con 18 clases, dos jardines de infancia, biblioteca, amplio salón de actos, sala de arte y de música, clínica y oficina de administración; todo ello sin contar con ampliaciones en el futuro. La exigencia especial del cliente era la separación de la zona de juego para los cursos inferiores y superiores, y acceso fácil al jardín de infancia para las madres que traen sus niños en coche.

  5. 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.

  6. 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.)

  7. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  8. 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.

  9. 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

  10. 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

    Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength is decre......Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength...... is decreased in patients with external snapping hip compared with healthy matched controls, and to examine isometric hip abduction, adduction, extension, flexion, internal rotation, and external rotation in patients with external snapping hip and matched controls. Thirteen patients with external snapping hip....... 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...

  11. SOFT TISSUE BALANCING IN TOTAL HIP ARTHROPLASTY.

    Directory of Open Access Journals (Sweden)

    Pencho Kosev

    2015-03-01

    Full Text Available We present our experience with the soft tissue balancing in total hip arthroplasty. Detailed indications, planning and surgical technique are presented. The described procedures are performed on 278 hips for a period of 6 years (2008-2014. We conclude that the outcome of a THA can be improved by balancing the stability, ROM, muscle strength and limb length equality.

  12. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Bio

  13. 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.

  14. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

  15. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, RH; Rozendaal, M; Wouters-Wesseling, W; Buskens, E; Keller, P; Haalboom, JRE

    2004-01-01

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU wer

  16. 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

  17. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  18. A new modality for fractional CO2 laser resurfacing for acne scars in Asians.

    Science.gov (United States)

    Huang, Luping

    2013-02-01

    improvement of >75 %. This new modality of ablative conventional CO2 laser therapy with fractional CO2 laser resurfacing was shown to be safe and efficacious in the treatment of acne scars in Asian patients. It did not increase the risk of PIH compared to other reports of laser therapy and PIH. It is the hope that future study with combination therapy will further enhance the clinical results and thus lessen potential adverse events.

  19. IMAGING OF HIP JOINT PATHOLOGIES

    Directory of Open Access Journals (Sweden)

    Parul Dutta

    2016-08-01

    Full Text Available The hip joint is a large and complex articulation and can be involved by numerous pathologic conditions like congenital and developmental, infective, arthritic, and neoplastic. Early diagnosis and characterisation of pathology has vital role in proper management and follow up of the disease for the clinicians. Present study was conducted in 45 patients who underwent clinical, radiological, and pathological examination in GMCH. Maximum no of patient between age group of 10-30 yrs. male-female ratio was 1.8:1 and 30% cases are unilateral. FSE STAIR images were most useful in delineating pathologies. Gadolinium-enhanced scan were used to evaluate the extent of the disease and the pattern of involvement. AVN was the most common pathology detected comprising 29%. The next common abnormality detected was infective arthritis found in 26% of cases. In case of Legg-Calve-Perthes disease, there was abnormal linear increase in the signal intensity at junction of the epiphyseal cartilage. Ultrasonography is useful for the screening of paediatric hip cases and also for guided aspiration for histopathology. CT scan shows better resolution of soft tissue then the radiograph. The importance of early diagnosis can be gauzed from the fact that early initiation of treatment creates the difference between a responsible, worthwhile life, and a cripple handicapped life. The role of imaging can never be undermined considering the fact that early suspicion and detection is within the realms of imaging.

  20. Pertunjukan Teater Karo Hip Hop Kontemporer KAI

    Directory of Open Access Journals (Sweden)

    Silvia Anggreni Purba

    2013-11-01

    Full Text Available Pertunjukan ini berawal dari sebuah ide untuk mengkolaborasikan tradisi Karo dengan budaya populer. Dengan cara seperti ini pertunjukan bisa dinikmati tanpa batasan bahasa dan budaya. Proses menggabungkan dua budaya yang berbeda merupakan bentuk budaya hibrida dan terjadi akibat proses globalisasi. Melalui proses pengendapan pengamatan dan kesan yang kuat, pertunjukan ini dibawa ke dalam bentuk Hip Hop. Pertunjukan ini merupakan bagian dari sebuah tragedi modern dengan karakter destruktif, mengeksplorasi emosi dan menyampaikannya kepada penonton. Eksplorasi budaya Karo dan tari Hip Hop sebagai bahasa simbol mampu memperkuat kata-kata. Gerak tidak diungkapkan dengan kata lisan tetapi disajikan melalui gerak tari Hip Hop. Penafsiran legenda dan teks ke dalam gerak, melalui proses pelatihan di laboratorium sebagai proses pencarian dan eksperimentasi diwujudkan dengan mempertimbangkan unsur-unsur dasar dari Hip Hop, unsur budaya Karo dan tontonan. Karo Hip Hop diharapkan menjadi bentuk estetika teater modern yang diinginkan tanpa kehilangan tradisi.Kata kunci: Tari Karo kontemporer, Hip-hop, budaya hibridaABSTRACTPertunjukan 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

  1. Unstable total hip arthroplasty: detailed overview.

    Science.gov (United States)

    Berry, D J

    2001-01-01

    Hip dislocation is one of the most common complications of THA. Good preoperative planning, good postoperative patient education, accurate intraoperative component positioning, rigorous intraoperative testing of hip stability, and good repair of soft tissues during closure all help prevent dislocation. Early postoperative dislocations and first or second dislocations usually are treated with closed reduction and a hip guide brace or hip spica cast, but when dislocation becomes recurrent, surgical treatment usually is needed. When possible, surgical treatment is based on identifying and treating a specific problem leading to the dislocation, such as implant malposition, inadequate soft-tissue tension, or impingement. In selected circumstances, constrained implants or bipolar or tripolar implants provide powerful tools to restore hip stability.

  2. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  3. 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.

  4. South Pole-Aitken Basin: Evidence for Post-Basin Resurfacing from Lunar Orbiter Laser Altimeter (LOLA) Data

    Science.gov (United States)

    Head, J. W.; Fassett, C.; Kadish, S.; Smith, D. E.; Zuber, M. T.; Neumann, G. A.; Mazarico, E.

    2010-12-01

    The lunar farside South Pole-Aitken Basin is the largest and oldest documented basin on the Moon and is thus of interest from the point of view of the scale of production of impact melt at large basin-event sizes and its ring structure and potential depth of sampling at such a large diameter. We used new LOLA data from the Lunar Reconnaissance Orbiter 1) to characterize the basin interior topography, 2) to assess the nature of the nearby and relatively pristine Orientale basin and compare it to the SPA interior, and 3) to compile a new global crater database of all lunar craters ≥20 km in diameter and to assess the population of impact craters superposed on the SPA interior and exterior. We find that impact crater size-frequency distribution plots show that the exterior of the SPA basin is similar to the most heavily cratered regions of the Moon, but that the interior of the basin has a deficiency of craters in the 20-64 km diameter crater range. One interpretation of these data is that some resurfacing process (or processes) has modified the superposed crater population. Among the candidates are 1) impact crater proximity weathering/degradation by adjacent (e.g., Apollo) and nearby (e.g., Orientale) impact basin ejecta, 2) volcanic resurfacing by early non-mare volcanism, cryptomaria and/or maria, and 3) viscous relaxation removing crater topography. We consider viscous relaxation of crater topography to be the least likely due to the wavelength dependence of the process (rim-crests should be preserved and thus detected in our crater counts). Careful analysis of the impact ejecta thickness radial decay suggests that it is an important resurfacing mechanism within a basin radius from the rim crest, but is unlikely to be sufficient to explain the observed deficiency. Morphometric analysis of impact craters, modeling, and simulations of volcanic flooding suggest that the deficiency may be related to the patchy distribution of cryptomaria, suspected from mineralogic

  5. Efficacy and safety of fractional CO 2 laser resurfacing in non-hypertrophic traumatic and burn scars

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2015-01-01

    Full Text Available Background: Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different aetiologies. Aim: To assess the efficacy and safety of fractional CO 2 laser resurfacing treatment in the management of non-hypertrophic traumatic and burn scars. Materials and Methods: Twenty-five patients affected by non-hypertrophic traumatic and burn scars were treated with four sessions of fractional CO 2 laser resurfacing treatment at 6-weekly intervals. Patients were photographed at each visit and finally, 3 months after the end of treatment schedule. Response to treatment was assessed clinically as well as by comparing the initial photograph of the patient with the one taken at the last follow-up visit 3-months after the final treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as ′excellent′ if the mean score achieved was >2. A score of 1-2 was labeled as good response while a score below 1 was labeled as ′poor′ response. The subjective satisfaction of each patient with the treatment offered was also assessed at the last follow-up visit. Results: The commonest site of scarring treated was the face followed by hands. Response to treatment was rated as excellent in 60% (15/25 patients while 24% (6/25 and 16% (4/25 patients were labeled as good and poor responders, respectively. Skin texture showed better response than other variables with average score of 2.44. Linear post-traumatic scars were seen to respond less than other morphological types. Majority of the patients (19 out of 25 were highly satisfied with the treatment offered. No long-term adverse effects were noted in any patient. Conclusions: Fractional photothermolysis with a fractional CO 2 laser gives excellent results in patients with post-burn scars with

  6. 表面置换和全髋关节置换股骨近段应力遮挡的比较%Comparison of Stress Shielding Between Hip Resurfacing and Total Hip Replacement

    Institute of Scientific and Technical Information of China (English)

    王禹基; 孙俊英; 董天华; 王以进

    2008-01-01

    目的 试图验证表面置换术能否有效避免类似于全髋关节置换术所出现的股骨侧应力遮挡并发症.方法 采集8具青年正常新鲜髋关节标本,选择静止单腿站立的股骨头受力模型.依次测16根正常股骨在1 000 N载荷下股骨头表面置换前、后的应力值,以及全髋关节假体置换后的应力值,根据公式η=(1-δ全板/δ未板)×100%(η为应力遮挡率),计算两种不同假体在各点的应力遮挡率.结果 全髋关节置换后的股骨张力侧(外侧)应力遮挡率在15%~17%之间变化.压力侧应力遮挡率在30%~34%之间变化.表面置换后的股骨颈应力遮挡最大为3%~5%,股骨近段和中部应力遮挡为0.1%~0.6%.结论 表面置换能有效维持近段股骨的正常应力传递,能有效避免类似于全髋关节置换后的股骨近段应力遮挡性骨吸收,从而能有效保留近段股骨的骨量,为日后翻修提供良好条件.

  7. Right understanding of minimal invasive total hip arthroplasty and hip resurfacing arthroplasty%正确认识微创人工全髋关节置换术和髋关节表面置换术

    Institute of Scientific and Technical Information of China (English)

    张先龙

    2008-01-01

    近年来,人工髋关节外科的发展迅速,模型设计、假体材料、生物力学、部件可调换性、手术器械、手术技术等方面都有了很大进步,手术效果和假体存活率令人鼓舞,其中主要的进步之一就是微创全髋关节置换术的开展。微创全髋关节置换包含软组织的微创和骨的微创,而后者就是指髋关节的表面置换。

  8. Biomechanical reconstruction of the hip in metal-on-metal total hip resurfacing%金属对金属全髋关节表面置换术后解剖学重建的相关研究

    Institute of Scientific and Technical Information of China (English)

    林荔军; 靳安民; 方国芳; 李鉴轶; 丁超; 陈伟义; 韦葛堇; 李奇

    2008-01-01

    目的 分析髋关节表面置换术后生物力学重建情况及其对髋关节表面置换术后的功能影响.方法 2005年1月~2008年1月对30例30髋患者行全髋关节表面置换,所有患者均行术前后HARRIS评分、X线检查及解剖学重建评估.结果 术后髋关节表面置换术后患者下肢平均短缩2.4mm,股骨偏心距短缩约5.45mm,与健侧相比无显著性差异.患者术后无一例发生髋关节脱位,术前和术后髋关节HARRIS评分分别为36.69±7.16.和89.63±3.36(P<0.01).结论 髋关节表面置换术后可达到良好的生物力学重建,同时其大假体设计可有效保证关节置换术后的稳定性及良好的关节功能重建.

  9. 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.

  10. 结识Hip-Hop

    Institute of Scientific and Technical Information of China (English)

    尚劲

    2010-01-01

    Hip-Hop是一种美国街头黑人文化,可分成五个要素:音乐、舞蹈、涂鸦、刺青和衣着。源自80年代美国纽约的黑人社区BRONX,他们将生活上的娱乐发展成为现今多样的Hip—HOP文化,发挥黑人独有的特质,如节奏感及歌声进而舒缓情绪和消遣。因带有乐观开朗的特质,逐渐地在全美蔓延开来,进而扩散到全世界。

  11. 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.

  12. Low levels of human HIP14 are sufficient to rescue neuropathological, behavioural, and enzymatic defects due to loss of murine HIP14 in Hip14-/- mice.

    Directory of Open Access Journals (Sweden)

    Fiona B Young

    Full Text Available Huntingtin Interacting Protein 14 (HIP14 is a palmitoyl acyl transferase (PAT that was first identified due to altered interaction with mutant huntingtin, the protein responsible for Huntington Disease (HD. HIP14 palmitoylates a specific set of neuronal substrates critical at the synapse, and downregulation of HIP14 by siRNA in vitro results in increased cell death in neurons. We previously reported that mice lacking murine Hip14 (Hip14-/- share features of HD. In the current study, we have generated human HIP14 BAC transgenic mice and crossed them to the Hip14-/- model in order to confirm that the defects seen in Hip14-/- mice are in fact due to loss of Hip14. In addition, we sought to determine whether human HIP14 can provide functional compensation for loss of murine Hip14. We demonstrate that despite a relative low level of expression, as assessed via Western blot, BAC-derived human HIP14 compensates for deficits in neuropathology, behavior, and PAT enzyme function seen in the Hip14-/- model. Our findings yield important insights into HIP14 function in vivo.

  13. 21 CFR 890.3665 - Congenital hip dislocation abduction splint.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Congenital hip dislocation abduction splint. 890....3665 Congenital hip dislocation abduction splint. (a) Identification. A congenital hip dislocation abduction splint is a device intended for medical purposes to stabilize the hips of a young child...

  14. Dislocation following revision total hip arthroplasty.

    Science.gov (United States)

    Gioe, Terence J

    2002-04-01

    Dislocation is a relatively common complication following revision total hip arthroplasty. Risk factors include surgical approach, gender, underlying diagnosis, comorbidities, surgical experience, and previous surgery; for later dislocations, risk factors include wear/deformation of polyethylene, trauma, and decreased muscle strength. Prevention and precaution are the watchwords for dislocations following revision total hip arthroplasty. For dislocations that do occur, treatment rests first on identifying the source of instability. Most dislocations can be managed by closed reduction. Constrained components may increase success rates, but only for appropriate indications. Prevention and treatment of dislocations following revision total hip arthroplasty are discussed in this article.

  15. 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.

  16. Total hip arthroplasty after previous fracture surgery.

    Science.gov (United States)

    Krause, Peter C; Braud, Jared L; Whatley, John M

    2015-04-01

    Total hip arthroplasty can be a very effective salvage treatment for both failed fracture surgery and hip arthritis that may occur after prior fracture surgery. The rate of complications is significantly increased including especially infection, dislocation, and loosening. Complications are more likely to occur after failed open reduction and internal fixation than after posttraumatic arthritis. Adequately ruling out infection before hip arthroplasty can be difficult. The best predictor of infection is a prior infection. Long-term outcomes can be comparable to outcomes in other conditions if complications are avoided.

  17. 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.

  18. 够胆,Hip-Hop欢迎你

    Institute of Scientific and Technical Information of China (English)

    E.B.

    2012-01-01

    Hip-Hop音乐至今不过30多年历史,这个从无到有杀出重围的野孩子,血液里跳动着的满是突破条条框框、建立新秩序的冲劲。一切没有的,我们皆生造。没有比Hip-Hop圈的进入门槛再低的了。不问出身不论背景,只要你够胆,Hip-Hop欢迎你。

  19. The prevalence of predisposing deformity in osteoarthritic hip joints

    DEFF Research Database (Denmark)

    Klit, Jakob; Gosvig, Kasper; Jacobsen, Steffen;

    2011-01-01

    relationship in both sexes with the clinical presentation. The study cohort which fulfilled these inclusion criteria consisted of 322 females (149 right hips and 173 left hips) and 162 males (77 right hips and 85 left hips) with osteoarthritis. We found an overall prevalence of predisposing hip deformities...... in females of 62.4% and in males of 78.9%. Minor and major deformities showed the same prevalence. Both sexes had a comparable prevalence of minor and major hip joint deformity, except for pistol grip deformity, which was more prevalent in men. We concluded that 'idiopathic osteoarthritis' is uncommon......, and that even minor predisposing deformities are associated with hip osteoarthritis....

  20. 兔股骨头表面置换术对股骨头组织学的影响及临床意义%The effect of rabbit femoral head resurfacing on the histology of the femoral head

    Institute of Scientific and Technical Information of China (English)

    马江川; 陈江; 石铸; 毛剑; 王友华; 刘璠

    2012-01-01

    Objective To explore the effect of rabbit femoral head resurfacing on the histology of the femoral head and its clinical significance. Methods The femoral head resuffacing was performed at the left side (the surgery side) in 60 New Zealand white rabbits while at the tight side of the rabbits (the control side) the same operative approach was adopted to only expose the hip joint before the incisions were sutured.The animals were sacrificed 3,6,9 and 12 weeks postoperation,with 15 rabbits in each batch.Gross observation,HE staining under light microscopy,arterial ink perfusion and scanning electron microscopy were conducted to observe the histological effects of femoral head resurfacing on the normal femoral head.Results The lacunae empty rates for the surgery side and the control side were respectively 8.00% ±0.26% versus 7.96% ±0.32% at 3 weeks,8.11% ±0.15% versus 7.82% ±0.29% at 6 weeks,8.27% ±0.26% versus 8.04% ±0.24% at 9 weeks,8.33% ±0.27% versus8.00% ±0.27% at 12 weeks,with no significant differences between the 2 sides at all the time points ( P > 0.05).After operation,bone necrosis,fibrous tissue and bone resorption were seen in a small region at the bone-cement interface. At the bone-implant interface,bone neerosis and fibrous tissue were also found in a small region,but no bone resorption was observed.In regiona far from the coment and implant,neither bone necrosis nor bone resorption waa found,and the histology was.the same as in the healthy bone. Conclusion Femoral head resurfacing may not cause osteonecrosis of a nonml femoral head,and necrosis of femoral head may not be associated with the resurfacing surgery or the prosthesis.%目的 探讨兔股骨头表面置换术对股骨头组织学的影响及临床意义. 方法 取60只新西兰大白兔,左侧行股骨头表面置换术,作为手术侧;右侧采用相同手术路径暴露髋关节,随即缝合切口,作为对照侧.分别于术后3、6、9及12

  1. Flap prefabrication and stem cell-assisted tissue expansion: how we acquire a monoblock flap for full face resurfacing.

    Science.gov (United States)

    Li, Qingfeng; Zan, Tao; Li, Haizhou; Zhou, Shuangbai; Gu, Bin; Liu, Kai; Xie, Feng; Xie, Yun

    2014-01-01

    Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. To avoid the patchwork result seen in multiple flaps and skin grafts, 1 monoblock flap that has similar color, texture, and thickness might be an ideal option to minimize the incisional scars and several surgical procedures but is unavailable with current approaches because of the lack of sufficient matched tissue and the unreliable blood supply for such a large flap. To acquire a monoblock flap for full face reconstruction, we combine the prefabricated flaps, skin overexpansion, and bone marrow mononuclear stem cell transplantation for total facial resurfacing. In this article, we present our experience from our case series that provides universally matched skin and near-normal facial contour. It is a reliable and an excellent reconstructive option for massive facial skin defect.

  2. Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project

    OpenAIRE

    Best, A. J.; Fender, D.; Harper, W. M.; McCaskie, A. W.; Oliver, K; Gregg, P J

    1999-01-01

    As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. ...

  3. Changes in Hip and Knee Muscle Strength in Patients Following Total Hip Arthroplasty

    OpenAIRE

    Fukumoto, Yoshihiro; Ohata, Koji; Tsukagoshi, Rui; Kawanabe, Keiich; Akiyama, Haruhiko; Mata, Toshihiro; Kimura, Misaka; Ichihashi, Noriaki

    2013-01-01

    Objective: To investigate changes in hip and knee muscle strength in patients before and after total hip arthroplasty (THA) in comparison with that in healthy adults. Methods: The study included 21 women who underwent unilateral THA (THA group) and 21 age-matched healthy women (healthy group). Maximal isometric strengths of hip flexors, extensors, and abductors, and knee extensors and flexors were measured before surgery and at 4 weeks and 6 months after surgery. Results: Before surgery, musc...

  4. UNCEMENTED PRIMARY TOTAL HIP ARTHROPLASTY FOR OSTEONECROSIS OF HIP WITH SECONDARY OSTEOARTHRITIS IN YOUNG ADULTS

    Directory of Open Access Journals (Sweden)

    Chatla

    2016-03-01

    Full Text Available BACKGROUND Osteonecrosis of the femoral head is a progressive disease that generally affects patients in the third through fifth decade of life, if left untreated. Currently, 18% of all Total Hip Arthroplasty performed in USA are done for Osteonecrosis.(1 The aetiology for the Osteonecrosis varies from idiopathic, alcohol intoxication, steroid abuse or due to childhood hip disorders and hip trauma. We have selected 40 patients suffering from advanced femoral head osteonecrosis with subchondral collapse leading to Osteoarthritis of hip in young adults, treated by uncemented primary total hip replacement. This study is aimed to suggest that uncemented total hip arthroplasty can be applied predictably to this younger, potentially more active patient population. MATERIAL AND METHODS We have done 54 uncemented primary hips in 40 cases with mean follow-up of 5.5 years. The average age of the patient at the time of surgery was 43 years. All the hips are clinically and radiologically examined both pre- and post-operatively. All the cases are operated through postero-lateral approach and have used the fully Hydroxyapatite coated femoral straight stem designed for press fit insertion and hemispherical HA-coated cup inserted with press fit and in few cases we used an HA-coated screw. The patients are under regular follow-up. RESULTS All the patients are reviewed at 6 weeks, 3 months, 6 months and yearly thereafter. The clinical and functional status was recorded using the Harris Hip Score and WOMAC Hip Score. The mean Harris score has improved from an average of 44 points to an average of 93 points postoperatively; 94% showed good-to-excellent results, 2% of cases had shortening, one case developed hip dislocation after two weeks due to unguarded physiotherapy. CONCLUSION The short-term results of cementless total hip arthroplasty in patients with Osteonecrosis of the femoral head were encouraging. We await further follow-up to see if these promising

  5. Living history in current orthopaedic hip surgery: intrapelvic teflon granuloma after total hip replacement.

    Science.gov (United States)

    Gheorghiu, Daniel; Peter, Viju; Lynch, Martin

    2010-02-01

    The teflon hip arthroplasty design was used by Sir John Charnley in the early 60's but was taken off the market due to high complication rates. A case is reported of an intrapelvic granuloma after total hip arthroplasty following the use of a teflon socket. This appears to be the last surviving patient treated by Sir John Charnley using a Teflon hip socket design.

  6. Improving the outcome of fractional CO2 laser resurfacing using a probiotic skin cream: Preliminary clinical evaluation.

    Science.gov (United States)

    Zoccali, Giovanni; Cinque, Benedetta; La Torre, Cristina; Lombardi, Francesca; Palumbo, Paola; Romano, Lucia; Mattei, Antonella; Orsini, Gino; Cifone, Maria Grazia; Giuliani, Maurizio

    2016-11-01

    As known, fractional CO2 resurfacing treatments are more effective than non-ablative ones against aging signs, but post-operative redness and swelling prolong the overall downtime requiring up to steroid administration in order to reduce these local systems. In the last years, an increasing interest has been focused on the possible use of probiotics for treating inflammatory and allergic conditions suggesting that they can exert profound beneficial effects on skin homeostasis. In this work, the Authors report their experience on fractional CO2 laser resurfacing and provide the results of a new post-operative topical treatment with an experimental cream containing probiotic-derived active principles potentially able to modulate the inflammatory reaction associated to laser-treatment. The cream containing DermaACB (CERABEST™) was administered post-operatively to 42 consecutive patients who were treated with fractional CO2 laser. All patients adopted the cream twice a day for 2 weeks. Grades were given according to outcome scale. The efficacy of the cream containing DermaACB was evaluated comparing the rate of post-operative signs vanishing with a control group of 20 patients topically treated with an antibiotic cream and a hyaluronic acid based cream. Results registered with the experimental treatment were good in 22 patients, moderate in 17, and poor in 3 cases. Patients using the study cream took an average time of 14.3 days for erythema resolution and 9.3 days for swelling vanishing. The post-operative administration of the cream containing DermaACB induces a quicker reduction of post-operative erythema and swelling when compared to a standard treatment.

  7. Detecting volcanic resurfacing of heavily cratered terrain: Flooding simulations on the Moon using Lunar Orbiter Laser Altimeter (LOLA) data

    Science.gov (United States)

    Whitten, Jennifer L.; Head, James W.

    2013-09-01

    Early extrusive volcanism from mantle melting marks the transition from primary to secondary crust formation. Detection of secondary crust is often obscured by the high impact flux early in solar system history. To recognize the relationship between heavily cratered terrain and volcanic resurfacing, this study documents how volcanic resurfacing alters the impact cratering record and models the thickness, area, and volume of volcanic flood deposits. Lunar Orbiter Laser Altimeter (LOLA) data are used to analyze three different regions of the lunar highlands: the Hertzsprung basin; a farside heavily cratered region; and the central highlands. Lunar mare emplacement style is assumed to be similar to that of terrestrial flood basalts, involving large volumes of material extruded from dike-fed fissures over relatively short periods of time. Thus, each region was flooded at 0.5 km elevation intervals to simulate such volcanic flooding and to assess areal patterns, thickness, volumes, and emplacement history. These simulations show three primary stages of volcanic flooding: (1) Initial flooding is largely confined to individual craters and deposits are thick and localized; (2) basalt flows breach crater rim crests and are emplaced laterally between larger craters as thin widespread deposits; and (3) lateral spreading decreases in response to regional topographic variations and the deposits thicken and bury intermediate-sized and larger craters. Application of these techniques to the South Pole-Aitken basin shows that emplacement of ∼1-2 km of cryptomaria can potentially explain the paucity of craters 20-64 km in diameter on the floor of the basin relative to the distribution in the surrounding highlands.

  8. Efficacy and safety of Erbium-doped Yttrium Aluminium Garnet fractional resurfacing laser for treatment of facial acne scars

    Directory of Open Access Journals (Sweden)

    Balakrishnan Nirmal

    2013-01-01

    Full Text Available Background: Treatment of acne scars with ablative fractional laser resurfacing has given good improvement. But, data on Indian skin are limited. A study comparing qualitative, quantitative, and subjective assessments is also lacking. Aim: Our aim was to assess the improvement of facial acne scars with Erbium-doped Yttrium Aluminium Garnet (Er:YAG 2940 nm fractional laser resurfacing and its adverse effects in 25 patients at a tertiary care teaching hospital. Methods: All 25 patients received four treatment sessions with Er:YAG fractional laser at 1-month interval. The laser parameters were kept constant for each of the four sittings in all patients. Qualitative and quantitative assessments were done using Goodman and Barron grading. Subjective assessment in percentage of improvement was also documented 1 month after each session. Photographs were taken before each treatment session and 1 month after the final session. Two unbiased dermatologists performed independent clinical assessments by comparing the photographs. The kappa statistics was used to monitor the agreement between the dermatologists and patients. Results: Most patients (96% showed atleast fair improvement. Rolling and superficial box scars showed higher significant improvement when compared with ice pick and deep box scars. Patient′s satisfaction of improvement was higher when compared to physician′s observations. No serious adverse effects were noted with exacerbation of acne lesions forming the majority. Conclusion: Ablative fractional photothermolysis is both effective and safe treatment for atrophic acne scars in Indian skin.Precise evaluation of acne scar treatment can be done by taking consistent digital photographs.

  9. Resurfacing history of the northern plains of Mars based on geologic mapping of Mars Global Surveyor data

    Science.gov (United States)

    Tanaka, K.L.; Skinner, J.A.; Hare, T.M.; Joyal, T.; Wenker, A.

    2003-01-01

    Geologic mapping of the northern plains of Mars, based on Mars Orbiter Laser Altimeter topography and Viking and Mars Orbiter Camera images, reveals new insights into geologic processes and events in this region during the Hesperian and Amazonian Periods. We propose four successive stages of lowland resurfacing likely related to the activity of near-surface volatiles commencing at the highland-lowland boundary (HLB) and progressing to lower topographic levels as follows (highest elevations indicated): Stage 1, upper boundary plains, Early Hesperian, <-2.0 to -2.9 km; Stage 2, lower boundary plains and outflow channel dissection, Late Hesperian, <-2.7 to -4.0 km; Stage 3, Vastitas Borealis Formation (VBF) surface, Late Hesperian to Early Amazonian, <-3.1 to -4.1 km; and Stage 4, local chaos zones, Early Amazonian, <-3.8 to -5.0 km. At Acidalia Mensa, Stage 2 and 3 levels may be lower (<-4.4 and -4.8 km, respectively). Contractional ridges form the dominant structure in the plains and developed from near the end of the Early Hesperian to the Early Amazonian. Geomorphic evidence for a northern-plains-filling ocean during Stage 2 is absent because one did not form or its evidence was destroyed by Stage 3 resurfacing. Remnants of possible Amazonian dust mantles occur on top of the VBF. The north polar layered deposits appear to be made up of an up to kilometer-thick lower sequence of sandy layers Early to Middle Amazonian in age overlain by Late Amazonian ice-rich dust layers; both units appear to have outliers, suggesting that they once were more extensive.

  10. 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...

  11. 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...

  12. Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique.

    Science.gov (United States)

    Koulouvaris, Panagiotis; Stafylas, Kosmas; Sculco, Thomas; Xenakis, Theodore

    2008-10-01

    Successful total hip arthroplasty (THA) in congenital dislocated hips demands anatomical reduction in the normal center of rotation without overstretching the sciatic nerve and without excessive compression or abnormal forces across the joint. Proximal femoral and subtrochanteric shortening osteotomy has been described for THA for the treatment of dislocated hips. However, these osteotomies are demanding, associated with deformation of femoral canal and nonunion, and may increase the femoral stem stress. This study reports excellent results in 24 patients with a new surgical technique that combines THA with a distal femoral shortening in severely deformed hips using customized components.

  13. 时尚活力的Hip-hop

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    什么是Hip-hop Hip-hop起源于上世纪70年代中期的美国纽约,这个词语已经成为新生代族群的代名词。Hip-hop不是一个时代的热潮,它是一种感染了一代又一代的文化。总的来说Hip-hop是Hip-hop文化的统

  14. Microbial assisted High Impact Polystyrene (HIPS) degradation.

    Science.gov (United States)

    Mohan, Arya J; Sekhar, Vini C; Bhaskar, Thallada; Nampoothiri, K Madhavan

    2016-08-01

    The efficacy of newly isolated Pseudomonas and Bacillus strains to degrade brominated High Impact Polystyrene (HIPS) was investigated. Viability of these cultures while using e-plastic as sole carbon source was validated through Triphenyl Tetrazolium Chloride (TTC). Four days incubation of HIPS emulsion with Bacillus spp. showed 94% reduction in turbidity and was 97% with Pseudomonas spp. Confirmation of degradation was concluded by HPLC, NMR, FTIR, TGA and weight loss analysis. NMR spectra of the degraded film revealed the formation of aliphatic carbon chain with bromine and its release. FTIR analysis of the samples showed a reduction in CH, CO and CN groups. Surface changes in the brominated HIPS film was visualized through SEM analysis. Degradation with Bacillus spp showed a weight loss of 23% (w/w) of HIPS film in 30days.

  15. 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

  16. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  17. 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.

  18. 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.

  19. Celiac Disease in Women with Hip Fractures

    Science.gov (United States)

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

    2014-01-01

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

  20. 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.)

  1. Osteoarthritis of the hip; MR features

    Energy Technology Data Exchange (ETDEWEB)

    Kokubo, Takashi; Takatori, Yoshio; Sasaki, Yasuhito (Tokyo Univ. (Japan). Faculty of Medicine)

    1993-07-01

    Magnetic resonance imaging (MRI) is the modality of choice for evaluation of joint disease. Forty-one hips in 33 patients with osteoarthritis of the hip joint were examined by MRI and the features were analyzed. MR examinations were performed on a 1.5 T superconducting unit using the spin echo (SE) technique with short TR (600 ms)/short TE (23, 28, 35 ms) and short TR (600 ms)/long TE (70, 75 ms) sequences. MRI revealed deformity of the femoral head in all hips. Some outgrowths, which were isointense with normal bone marrow, were shown on the periphery of the femoral head in 22 hips (54%). These outgrowths represented marginal osteophytes. Short TE images showed hypointense areas, which varied in size, in the superior or supero-anterior aspect of the femoral head in all hips, and in the opposite position of the acetabulum in 38 hips (93%). These lesions showed a heterogenous signal with predominant low signal on long TE images. These images may indicate the presence of several components including subchondral cysts, bony sclerosis and fibrous tissue. In the joint space, areas of low signal intensity were shown on short TE images, which were high to intermediate signal intensity on long TE images in 16 hips (39%). These areas were presumably consistent with synovial proliferation, cartilageous hypertrophy or joint effusion. Both MR images revealed a mass locating just anterior to the femoral head in 2 hips (5%). The mass showed a low signal on short TE images and a high signal on long TE images, representing the distended iliopsoas bursa. (author).

  2. Dilemmas in Uncemented Total Hip Arthroplasty

    OpenAIRE

    Goosen, J. H. M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Biomet) was evaluated. In conclusion, at an average follow-up of 8 years, this proximally HA-coated femoral component showed favorable clinical and radiological outcome and excellent survivorship. In ...

  3. Hip joint pain in children with cerebral palsy and developmental dysplasia of the hip: why are the differences so huge?

    OpenAIRE

    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 ...

  4. 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; Gergely, I; 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...

  5. Invariant hip moment pattern while walking with a robotic hip exoskeleton.

    Science.gov (United States)

    Lewis, Cara L; Ferris, Daniel P

    2011-03-15

    Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 min of the powered condition and the unpowered condition. After completing three 30-min training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed.

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

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2014-01-01

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

  7. Influence of hip dysplasia on the development of osteoarthritis of the hip

    NARCIS (Netherlands)

    A.M. Lievense (Annet); S.M. Bierma-Zeinstra (Sita); A.P. Verhagen (Arianne); J.A.N. Verhaar (Jan); B.W. Koes (Bart)

    2004-01-01

    textabstractBACKGROUND: It has been suggested that in some patients with primary hip osteoarthritis (OA), the disease occurs as a consequence of acetabular dysplasia or hip dysplasia (HD). OBJECTIVE: To carry out a systematic review to investigate the association between acetabular

  8. Effects of perioperative factors and hip geometry on hip abductor muscle strength during the first 6 months after anterolateral total hip arthroplasty

    Science.gov (United States)

    Ikeda, Takashi; Jinno, Tetsuya; Aizawa, Junya; Masuda, Tadashi; Hirakawa, Kazuo; Ninomiya, Kazunari; Suzuki, Kouji; Morita, Sadao

    2017-01-01

    [Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data. Factors related to isometric hip abductor muscle strength 2 and 6 months after surgery were examined. [Results] Significant factors related to isometric hip abductor muscle strength at 2 and 6 months after surgery were, in extraction order: 1. isometric hip abductor muscle strength in the preoperative period; 2. BMI; and 3. the JHEQ mental score at 2 and 6 months after surgery. [Conclusion] Preoperative factors and postoperative mental status were related to postoperative isometric hip abductor strength. FO was not extracted as a significant factor related to postoperative isomeric hip abductor strength. PMID:28265161

  9. 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

    Summary Background 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. Methods 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. Conclusion 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. Level of evidence V. PMID:28066731

  10. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  11. Hip arthroscopy in children and adolescents.

    Science.gov (United States)

    Kocher, Mininder S; Kim, Young-Jo; Millis, Michael B; Mandiga, Rahul; Siparsky, Patrick; Micheli, Lyle J; Kasser, James R

    2005-01-01

    Hip arthroscopy has become an established procedure for certain indications in adults, but experience in children and adolescents has been more limited. The purpose of this study is to report the early-term results of hip arthroscopy in children and adolescents. A consecutive case series of 54 hip arthroscopies in 42 patients 18 years old and younger over a 3-year period at a tertiary-care children's hospital with a minimum of 1 year of follow-up was reviewed. Patients were assessed with the modified Harris hip score (HHS) before and after surgery. Overall results and results by common diagnoses were analyzed. Indications for surgery included isolated labral tear (n = 30), Perthes disease (n = 8), hip dysplasia with labral tear after prior periacetabular osteotomy (n = 8), inflammatory arthritis (n = 3), spondyloepiphyseal dysplasia (n = 2), avascular necrosis (n = 1), slipped capital femoral epiphysis (n = 1), and osteochondral fracture (n = 1). Overall, there was a significant improvement in HHS from 53.1 to 82.9 (P < 0.001), with 83% of patients improved. By diagnosis, significant improvement in HHS was seen for patients with isolated labral tears undergoing labral debridement (before surgery 57.6; after surgery 89.2; P < 0.001), for patients with Perthes disease undergoing chondroplasty and loose body excision (before surgery 49.5; after surgery 80.1; P < 0.001), and for patients with hip dysplasia after prior periacetabular osteotomy undergoing labral debridement (before surgery 51.8; after surgery 79.8; P < 0.001). Complications included transient pudendal nerve palsy (n = 3), instrument breakage (n = 1), and recurrent labral tear (n = 3). Hip arthroscopy in children and adolescents appears to be safe and efficacious for certain indications in the short term.

  12. Successful Treatment of Tattoo-Induced Pseudolymphoma with Sequential Ablative Fractional Resurfacing Followed by Q-Switched Nd: YAG 532 nm Laser

    OpenAIRE

    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 an...

  13. Accelerated reduction of post-skin-resurfacing erythema and discomfort with a combination of non-thermal blue and near infrared light.

    Science.gov (United States)

    Trelles, Mario; Elman, Monica; Slatkine, Michael; Harth, Yoram

    2005-06-01

    The prolonged crusting and erythematic phases following chemical and laser skin resurfacing create discomfort and aggravate patients. Depending on the aggressiveness of the procedure, post-procedure erythema may last from three weeks to several months. iClearXL (CureLight Ltd) is a non-contact, non-thermal blue (405-420 nm)/near infrared (850-900 nm) dual-band light source emitting up to 60 J/cm2 on a 30 cm by 30 cm treatment area. The blue component of the light source has been proven to have a significant anti-inflammatory effect, whereas the near infrared component enhances vascular circulation as well as lymphatic drainage in the thin, necrotized papillary layer. Facial skin laser resurfacing was performed on twelve patients. Starting one day after resurfacing, six patients received a daily 20-minute treatment of blue (405-420 nm)/near infrared (850-900 nm) light for six consecutive days, and six control patients were treated with the usual topical care protocol. Twelve days after the procedure, the treated group had a weighted average erythema score of 0.33 as compared to 1.33 in the control group. Two months after the procedure, the treated group had a weighted average erythema score of 0.16 as compared to 0.83 in the control group. Twelve days after the procedure, the treated group had a weighted average discomfort score of 0.33 as compared to 0.83 in the control group. The tested combination of non-thermal blue (405-420 nm)/near infrared (850-900 nm) dual-band light was found to significantly shorten the duration of post-laser-resurfacing erythema and discomfort with no side effects.

  14. Ability of lower teardrop edge to restore anatomical hip center height in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Lu Yufeng; Cheng Liming; Guo Wanshou; Yu Qingsheng; Gao Fuqiang; Zhang Qidong; Liu Zhaohui

    2014-01-01

    Background The acetabular teardrop is often used to guide acetabular component placement in total hip arthroplasty (THA).Placing the lower acetabular component aspect at the same level as the lower teardrop edge was assumed to restore the hip center of rotation.Here we radiographically analyzed the relationship between cup center and normal contralateral acetabulum center height on unilateral THA using this placement method.Methods A total of 106 unilateral THA cases with normal contralateral acetabula were reviewed and the vertical and horizontal distances in relation to the lower acetabular teardrop edge from both hip joint centers,cup inclination,and anteversion were measured radiographically.The paired t-test was used to compare left and right hip center heights.Scatter plots and Pearson's correlation coefficients were used to evaluate differences in hip center heights,cup anteversion,inclination angles,and medialized cup center distance compared to the contralateral hip joint.Results Cup center height was significantly greater (P <0.01) than contralateral hip joint center height (93.4% in the 0-5 mm range,6.6% >5 mm).There was a weak correlation between hip center height difference and inclination (r=0.376,P <0.01) and between difference and anteversion (r=0.310,P <0.01) but no correlation between difference and outer cup diameter (r=0.184,P=0.058) or difference and medialized cup center distance (r=-0.098,P=0.318).Conclusions Although this method did not exactly replicate anatomic hip center height,the clinical significance of cup center height and anatomic hip center height differences is negligible.This acetabular component placement method has high simplicity,reliability,and stability.

  15. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Tan Jixiang

    2014-04-01

    Full Text Available Objective: To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA patients undergoing anterolateral minimally invasive (ALMI approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF patients than in non-femoral neck fracture (nFNF patients. Methods:A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05. Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear. Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA. Key words: Arthroplasty, replacement, hip; Surgical procedures, minimally invasive; Recovery of function

  16. 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.

  17. 街球中的Hip-Hop文化

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    <正>提到街球,人们不可避免的说起Hip-Hop文化,如今的街球越来越和Hip-Hop文化结合在一起,Hip-Hop音乐,DJ,MC,街舞,街头涂鸦和Hip-Hop服饰已经成了街球文化中必不可少的一部分,那么到底什么是Hip-Hop文化?按照字面解释Hip是臀部,Hop是跳跃的意思,但实际上,它是一种生活文化的统称。Hip-Hop

  18. Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder: 837 operations reported to the Danish Shoulder Arthroplasty Registry.

    Science.gov (United States)

    Rasmussen, J V; Polk, A; Sorensen, A K; Olsen, B S; Brorson, S

    2014-04-01

    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 (7.5%) required revision; the cumulative five-year rate of revision was 9.9%. Patients aged < 55 years had a statistically significant inferior WOOS score, which exceeded the minimal clinically important difference, compared with older patients (mean difference 14.2 (8.8; 95% CI 19.6; p < 0.001), but with no increased risk of revision. There was no significant difference in the mean WOOS or the risk of revision between designs of resurfacing hemiarthroplasty.

  19. Ablative non-fractional lasers for atrophic facial acne scars: a new modality of erbium:YAG laser resurfacing in Asians.

    Science.gov (United States)

    Lee, Sang Ju; Kang, Jin Moon; Chung, Won Soon; Kim, Young Koo; Kim, Hei Sung

    2014-03-01

    Atrophic facial scars which commonly occur after inflammatory acne vulgaris can be extremely disturbing to patients both physically and psychologically. Treatment with fractional laser devices has become increasingly popular, but there has been disappointment in terms of effectiveness. The objective of this study was to assess the safety and efficacy of ablative full-face resurfacing on atrophic acne scars in the Korean population. A total of 22 patients, aged 25-44 years, underwent a new modality of resurfacing combining both short-pulsed and dual-mode erbium:yttrium-aluminum garnet (Er:YAG) laser. The patients had Fitzpatrick skin types ranging from III to V. Photographs were taken before and up to 6 months after treatment. Results were evaluated for the degree of clinical improvement and any adverse events. Degree of improvement was graded using a four-point scale: poor (1) = 75%. Based on the blinded photo assessments by two independent reviewers, clinically and statistically significant mean improvement of 3.41 was observed (one-sample Wilcoxon signed rank test, P laser resurfacing combining short-pulsed and dual-mode Er:YAG laser is a safe and very effective treatment modality for atrophic facial acne scars in Asians with darker skin tones.

  20. Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty.

    Science.gov (United States)

    Sugano, Nobuhiko

    2013-03-01

    . Fluoroscopic navigation is good for trauma and spine surgeries, but its benefits are limited in the hip and knee reconstruction surgeries. Several studies have shown that the cup alignment with navigation is more precise than that of the conventional mechanical instruments, and that it is useful for optimizing limb length, range of motion, and stability. Recently, patient specific templates, based on CT images, have attracted attention and some early reports on cup placement, and resurfacing showed improved accuracy of the procedures. These various CAOS systems have pros and cons. Nonetheless, CAOS is a useful tool to help surgeons perform accurately what surgeons want to do in order to better achieve their clinical objectives. Thus, it is important that the surgeon fully understands what he or she should be trying to achieve in THA for each patient.

  1. The Effect of Ligamentum Teres Integrity on Hip Scores

    Directory of Open Access Journals (Sweden)

    Engin Desteli

    2014-12-01

    Full Text Available We aimed to compare the clinical functioning of the hips with an intact Ligamentum Teres (LT to ruptured LT. Patients with resected LT have feelings of instability and discomfort. The effect of LT on hip stability in dysplastic hips and hyperlaxity has been emphasized before. Existence of sensory nerve endings demonstrates that LT has a function in joint proprioception and nociception. LT test was conducted to 92 consecutive patients with Grade 2-3 coxarthrosis. Pain on either internal or external rotation is consistent with a positive LT test result. Following LT test, Hip disability and osteoarthritis outcome score (HOOS and Harris Hip Score (HHS were conducted to all of the patients. Each patient underwent MRI Scanning of the involved hip. The efficacy of LT test was evaluated in comparison to MRI findings, sensitivity of the test was 87.37 % and spesificity was 73.47 positive and negative predictive values were found to be 74.51 % nd 80.43 % respectively. 36 hips which had intact LT according to MRI and LT test (Group 1 was compared to the 38 hips with ruptured LT in both LT test and MRI (Group 2 regarding HOOS and Harris Hip Scores. HOOS and Harris Hip Scores of Group 1 were found to be significantly higher than Group 2. As far as we know from the literature this is the first clinical study to investigate the effect of LT integrity on hip scores by comparing hips with ruptured LT to hips with intact LT.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Human hip joint center analysis for biomechanical design of a hip joint exoskeleton

    Institute of Scientific and Technical Information of China (English)

    Wei YANG; Can-jun YANG‡; Ting XU

    2016-01-01

    We propose a new method for the customized design of hip exoskeletons based on the optimization of the human- machine physical interface to improve user comfort. The approach is based on mechanisms designed to follow the natural tra-jectories of the human hip as the flexion angle varies during motion. The motions of the hip joint center with variation of the flexion angle were measured and the resulting trajectory was modeled. An exoskeleton mechanism capable to follow the hip center’s movement was designed to cover the full motion ranges of flexion and abduction angles, and was adopted in a lower extremity assistive exoskeleton. The resulting design can reduce human-machine interaction forces by 24.1% and 76.0% during hip flexion and abduction, respectively, leading to a more ergonomic and comfortable-to-wear exoskeleton system. The human- exoskeleton model was analyzed to further validate the decrease of the hip joint internal force during hip joint flexion or abduction by applying the resulting design.

  7. A new algorithm for hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Krasheninnikoff, Michael; Holck, Kim;

    2012-01-01

    Background and purpose Treatment of hip fracture patients is controversial. We implemented a new operative and supervision algorithm (the Hvidovre algorithm) for surgical treatment of all hip fractures, primarily based on own previously published results. Methods 2,000 consecutive patients over 50...... years of age who were admitted and operated on because of a hip fracture were prospectively included. 1,000 of these patients were included after implementation of the algorithm. Demographic parameters, hospital treatment, and reoperations within the first postoperative year were assessed from patient...... records. Results 931 of 1,000 operative procedures were performed according to the algorithm, as compared to only 726 of 1,000 prior to its introduction (p algorithm, junior registrars still performed half of the operations, but unsupervised procedures declined from...

  8. [Rotator cuff tear of the hip].

    Science.gov (United States)

    Jeanneret, Luc; Kurmann, Patric T; van Linthoudt, Daniel

    2008-05-14

    We report the observations of two women with a recurrent periarthritis of the hip complicated by a spontaneous rupture of the tendons of the gluteus medius and minimus. These patients usually complain from an acute lateral hip pain and show a Trendelenburg gait. When the rupture is complete, clinical evaluation reveals a drop of the pelvis on the non-stance side and resisted rotation starting from the extreme external rotation position is weak. MRI plays a key role in the diagnosis and the evaluation of a possible surgical repair. Hip rotator-cuff rupture is probably insufficiently diagnosed by ignorance. Nonetheless, optimized handling could relieve the pain of most these patients and improve the disability of some of them.

  9. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Tan Jixiang; Chen Hong; Chen Cheng; Liang Xi; Huang Wei

    2014-01-01

    Objective:To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA) patients undergoing anterolateral minimally invasive (ALMI) approach,and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF) patients than in non-femoral neck fracture (nFNF) patients.Methods:A total of 48 patients were enrolled in this study.Each patient underwent a clinical examination preoperatively and 6,12,24 and 48 weeks postoperatively.The abductor torque,Trendelenburg's sign,gait velocity,Harris hip score,Oxford hip score,Westren Ontario and McMaster Universities (WOMAC) score and visual analog scale pain score were recorded.Statistical evaluation was performed with SPSS software version 18.0.The significance level was set at P<0.05.Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up.Gait velocity,Harris hip score,Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively.In the FNF group,the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively,however,as time passed,this trend tended to disappear.Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis,rheumatoid arthritis,avascular necrosis of the femoral head could be significantly improved following ALMI THA.

  10. Rehabilitation following hip arthroscopy - A systematic review

    Directory of Open Access Journals (Sweden)

    Jeffrey S Grzybowski

    2015-05-01

    Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a

  11. Iliotibial band syndrome following hip arthroscopy: An unreported complication

    Directory of Open Access Journals (Sweden)

    Roberto Seijas

    2016-01-01

    Conclusions: This is a newly described observation within followup of hip arthroscopy. These findings may help orthopedic surgeons when planning rehabilitation after hip arthroscopy, including stretching exercises to prevent this syndrome.

  12. Dynamic ultrasound of the external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Sun; Song, Baek Yong; Paik, Sang Hyun; Lee, Tae Gyu; Yoon, Yong Kyu [Eulji Hospital, Eulji University School of Medicine, Deajeon (Korea, Republic of); Lee, Sung Moon [Keimyung University School of Medicine, Deagu (Korea, Republic of)

    2002-09-15

    Snapping hip syndrome has been described as a hip pain accompanied by an audible snapping during motion of the hip or while walking. The variable causes of its external, internal, and intra-articular origins have been described. The most common extemal snapping hip has been associated with a thickened posterior border of the iliotibial band or of the anterior border of the gluteus maximus muscle slipping over the greater trochanter. The aim of this study was to evaluate the dynamic ultrasound findings of external snapping hip syndrome with review of the literature. We studied 5 patients (7 cases) with external snapping hip and pain over the greater trochanter during walking or hip motion (3 males and 2 females, age range, 14-32 years; mean, 19 years). Two patients reported bilateral snapping hips.

  13. [Rapidly vanishing hip--a mystery].

    Science.gov (United States)

    Keren, Yaniv; Sigal, Amit; Greental, Arnan; Vlodavsky, Euvgeni; Soudry, Michael; Militianu, Daniela

    2013-01-01

    Rapidly destructive hip disease is a rare condition, the cause of which is yet to be clarified, and is described in the literature by scant case reports. The disease was first described by Forestier in 1957, and since then many names have been proposed to describe the rapid vanishing of the femoral head, and occasionally the acetabulum. This condition initially represents as acute hip pain, and rapidly progresses to complete vanishing of the proximal femur, within a few months. We briefly discuss the literature regarding this phenomenon, and describe a case of a female patient who suffered from complete disappearance of the femoral head within 9 weeks.

  14. Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

    Directory of Open Access Journals (Sweden)

    S. O'hEireamhoin

    2011-01-01

    Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

  15. Hip Arthroscopy for Incarcerated Acetabular Labrum following Reduction of Traumatic Hip Dislocation: Three Case Reports

    Science.gov (United States)

    Hwang, Jung-Mo; Lee, Woo-Yong; Noh, Chang-Kyun; Zheng, Long

    2016-01-01

    Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation. PMID:27777919

  16. Hip adduction and abduction strength profiles in elite soccer players

    DEFF Research Database (Denmark)

    Serner, Andreas; Petersen, Jesper; Madsen, Thomas Moller

    2011-01-01

    An ipsilateral hip adduction/abduction strength ratio of more than 90%, and hip adduction strength equal to that of the contralateral side have been suggested to clinically represent adequate strength recovery of hip adduction strength in athletes after groin injury. However, to what extent side-......-to-side symmetry in isometric hip adduction and abduction strength can be assumed in soccer players remains uncertain....

  17. Management of osteoporosis in patients hospitalized for hip fractures

    OpenAIRE

    Ip, T. P.; Leung, J.; Kung, A. W. C.

    2010-01-01

    Hip fracture is associated with high morbidity, mortality, and economic burden worldwide. It is also a major risk factor for a subsequent fracture. A literature search on the management of osteoporosis in patients with hip fracture was performed on the Medline database. Only one clinical drug trial was conducted in patients with a recent hip fracture. Further studies that specifically address post-fracture management of hip fracture are needed. The efficacy of anti-osteoporosis medication in ...

  18. Revolutionizing Environmental Education through Indigenous Hip Hop Culture

    Science.gov (United States)

    Gorlewski, Julie; Porfilio, Brad J.

    2012-01-01

    Based upon the life histories of six Indigenous hip hop artists of the Beat Nation artist collective, this essay captures how Indigenous hip hop has the potential to revolutionize environmental education. Hip hop provides Indigenous youth an emancipatory space to raise their opposition to neocolonial controls of Indigenous territories that…

  19. Large strengthening effect of a hip-flexor training programme

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Bandholm, Thomas Quaade; Zebis, Mette;

    2016-01-01

    PURPOSE: To investigate the effect on hip-flexion strength of a 6-week hip-flexor training programme using elastic bands as resistance. We hypothesized that the training group, compared to a control group, would increase their hip-flexion strength more. METHODS: Thirty-three healthy subjects (45 ...

  20. Pain distribution in primary care patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Poulsen, Erik; Overgaard, Søren; Vestergaard, Jacob T

    2016-01-01

    BACKGROUND: Hip osteoarthritis (OA) is the most common diagnosis in primary care adult patients presenting with hip pain but pain location and pain distribution in primary care patients with hip OA have been reported inadequately. OBJECTIVE: To describe pain location and pain distribution...