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Sample records for hip extracapsular patterns

  1. Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

    Science.gov (United States)

    Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

    2014-01-01

    Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

  2. Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip

    DEFF Research Database (Denmark)

    Tengberg, P T; Foss, N B; Palm, H

    2016-01-01

    AIMS: We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip. PATIENTS AND METHODS: A single...

  3. "Hidden" Preoperative Blood Loss With Extracapsular Versus Intracapsular Hip Fractures: What Is the Difference?

    Science.gov (United States)

    Harper, Katharine D; Navo, Paul; Ramsey, Frederick; Jallow, Sainabou; Rehman, Saqib

    2017-12-01

    Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study. Exclusion criteria included polytrauma, gunshot injuries, periprosthetic fractures, and non-operative management. Primary endpoint was hemoglobin (Hgb) drop from admission to day of surgery (DOS); secondary endpoint was need for pre-op transfusion and discharge location. 304 patients were analyzed who sustained a proximal femur fracture. Median IC Hgb drop was 0.6g/dL; median EC Hgb drop was 1.1g/dL from admission to DOS ( p = 0.0272). Rate of pre-operative transfusions was higher in EC (36/194 = 18.6%) than IC fractures (5/105 = 4.5%) ( p = 0.0006), and overall transfusion rates remained higher throughout hospital stay (55.7% EC vs. 32.7% IC; p = 0.0001). Breakdown of bleeding rate and tranfusion rates between IT and ST fractures were not significant ( p = 0.07; p = 0.4483). Extracapsular hip fractures were more likely to be discharged to a skilled nursing facility (SNF) (84.4% EC vs. 73.8% IC; p = 0.027). Intracapsular hip fractures have significantly less pre-operative blood loss and fewer pre-operative transfusions than their extracapsular counterparts. These findings can be used to establish appropriate pre-operative resuscitative efforts, ensuring that hip fracture protocols account for the increased likelihood of blood loss in extracapsular fractures.

  4. Comparison of accuracy of lag screw placement in cephalocondylic nails and sliding hip screw plate fixation for extracapsular fractures of the neck of femur

    OpenAIRE

    Shyam Kumar, A. J.; Parmar, V.; Bankart, J.; Williams, S. C.; Harper, W. M.

    2006-01-01

    This study compared the accuracy of lag screw placement between extracapsular femoral fractures fixed with sliding hip screw plate systems and those fixed with cephalocondylic nails. It involved 75 retrospective radiographs of fractures fixed with either a cephalocondylic nail (32) or a sliding hip screw plate system (43). Postoperative anteroposterior and lateral radiographs of the hip were scanned using a digital X-ray scanner and measured using computer software. Measurements were conducte...

  5. Decision Making in the Management of Extracapsular Fractures of the Proximal Femur - is the Dynamic Hip Screw the Prevailing Gold Standard?

    Science.gov (United States)

    Jacob, Joshua; Desai, Ankit; Trompeter, Alex

    2017-01-01

    Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the 'gold standard' implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extracapsular fractures can, and should, evolve.

  6. Decision Making in the Management of Extracapsular Fractures of the Proximal Femur – is the Dynamic Hip Screw the Prevailing Gold Standard?

    Science.gov (United States)

    Jacob, Joshua; Desai, Ankit; Trompeter, Alex

    2017-01-01

    Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the ‘gold standard’ implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extracapsular fractures can, and should, evolve. PMID:29290858

  7. Trans trochanteric approach with coronal osteotomy of the great trochanter: A new technique for extra-capsular trochanteric fracture patients treated by total hip arthroplasty (THA) in elderly.

    Science.gov (United States)

    Steffann, Francois; Prudhon, Jean-Louis; Puch, Jean-Marc; Ferreira, André; Descamps, Loys; Verdier, Régis; Caton, Jacques

    2015-06-05

    Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy), using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF) are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%-23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA) to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior) requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC), greater trochanter (GT) reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus) is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci approach could be use

  8. 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. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists.

    Science.gov (United States)

    Martin, Hal D; Kelly, Bryan T; Leunig, Michael; Philippon, Marc J; Clohisy, John C; Martin, RobRoy L; Sekiya, Jon K; Pietrobon, Ricardo; Mohtadi, Nicholas G; Sampson, Thomas G; Safran, Marc R

    2010-02-01

    The purpose of this study was to systematically evaluate the technique and tests used in the physical examination of the adult hip performed by multiple clinicians who regularly treat patients with hip problems and identify common physical examination patterns. The subjects included 5 men and 6 women with a mean age (+/-SD) of 29.8 +/- 9.4 years. They underwent physical examination of the hip by 6 hip specialists with a strong interest in hip-related problems. All examiners were blind to patient radiographs and diagnoses. Patient examinations were video recorded and reviewed. It was determined that 18 tests were most frequently performed (>or=40%) by the examiners, 3 standing, 11 supine, 3 lateral, and 1 prone. Of the most frequently performed tests, 10 were performed more than 50% of the time. The tests performed in the supine position were as follows: flexion range of motion (ROM) (percentage of use, 98%), flexion internal rotation ROM (98%), flexion external rotation ROM (86%), passive supine rotation test (76%), flexion/adduction/internal rotation test (70%), straight leg raise against resistance test (61%), and flexion/abduction/external rotation test (52%). The tests performed in the standing position were the gait test (86%) and the single-leg stance phase test (77%). The 1 test in the prone position was the femoral anteversion test (58%). There are variations in the testing that hip specialists perform to examine and evaluate their patients, but there is enough commonality to form the basis to recommend a battery of physical examination maneuvers that should be considered for use in evaluating the hip. Patients presenting with groin, abdominal, back, and/or hip pain need to have a basic examination to ensure that the hip is not overlooked. A comprehensive physical examination of the hip will benefit the patient and the physician and serve as the foundation for future multicenter clinical studies. (c) 2010 Arthroscopy Association of North America. Published

  10. patterns of knee, hip and hand osteoarthritis in kenyatta national

    African Journals Online (AJOL)

    studied to determine the prevalence of obesity in this cohort of patients. Results: A total of 201 patients with knee, hip or hand osteoarthritis were studied. Of these participants,. 77% had knee OA, 15% hip OA, 3% hand OA and 5% had combined knee and hip OA. Obese participants were 41% and 32% were overweight.

  11. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

  12. Exploring Older Adults' Patterns and Perceptions of Exercise after Hip Fracture

    OpenAIRE

    Gorman, Erin; Chudyk, Anna M.; Hoppmann, Christiane A.; Hanson, Heather M.; Guy, Pierre; Sims-Gould, Joanie; Ashe, Maureen C.

    2013-01-01

    Purpose: To identify exercise patterns and perceived barriers, enablers, and motivators to engaging in exercise for older adults following hip fracture. Method: Telephone interviews were conducted with older adults (aged 62–97 y) within 1 year after hip fracture. Participants were asked about basic demographic information; level of mobility before hip fracture; current level of mobility; and barriers, enablers, and motivators to participating in exercise. Results: A total of 32 older adults s...

  13. Specimen-specific modeling of hip fracture pattern and repair.

    Science.gov (United States)

    Ali, Azhar A; Cristofolini, Luca; Schileo, Enrico; Hu, Haixiang; Taddei, Fulvia; Kim, Raymond H; Rullkoetter, Paul J; Laz, Peter J

    2014-01-22

    Hip fracture remains a major health problem for the elderly. Clinical studies have assessed fracture risk based on bone quality in the aging population and cadaveric testing has quantified bone strength and fracture loads. Prior modeling has primarily focused on quantifying the strain distribution in bone as an indicator of fracture risk. Recent advances in the extended finite element method (XFEM) enable prediction of the initiation and propagation of cracks without requiring a priori knowledge of the crack path. Accordingly, the objectives of this study were to predict femoral fracture in specimen-specific models using the XFEM approach, to perform one-to-one comparisons of predicted and in vitro fracture patterns, and to develop a framework to assess the mechanics and load transfer in the fractured femur when it is repaired with an osteosynthesis implant. Five specimen-specific femur models were developed from in vitro experiments under a simulated stance loading condition. Predicted fracture patterns closely matched the in vitro patterns; however, predictions of fracture load differed by approximately 50% due to sensitivity to local material properties. Specimen-specific intertrochanteric fractures were induced by subjecting the femur models to a sideways fall and repaired with a contemporary implant. Under a post-surgical stance loading, model-predicted load sharing between the implant and bone across the fracture surface varied from 59%:41% to 89%:11%, underscoring the importance of considering anatomic and fracture variability in the evaluation of implants. XFEM modeling shows potential as a macro-level analysis enabling fracture investigations of clinical cohorts, including at-risk groups, and the design of robust implants. © 2013 Published by Elsevier Ltd.

  14. Walking pattern in 9 women with hip dysplasia 18 months after periacetabular osteotomy

    DEFF Research Database (Denmark)

    Pedersen, Eva N G; Alkjaer, Tine; Søballe, Kjeld

    2006-01-01

    . METHODS: The gait pattern of 9 women (median age 39 years) with hip dysplasia who were treated with unilateral periacetabular osteotomy was analyzed before periacetabular osteotomy and an average of 1.5 years afterwards. Data were collected using 5 video cameras and 2 force plates. An inverse dynamics...... upright walking pattern but continued to relieve the hip joint by maintaining a reduced flexor moment....

  15. The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain.

    Science.gov (United States)

    Hammoud, Sommer; Bedi, Asheesh; Voos, James E; Mauro, Craig S; Kelly, Bryan T

    2014-03-01

    In active individuals with femoroacetabular impingement (FAI), the resultant reduction in functional range of motion leads to high impaction loads at terminal ranges. These increased forces result in compensatory effects on bony and soft tissue structures within the hip joint and hemipelvis. An algorithm is useful in evaluating athletes with pre-arthritic, mechanical hip pain and associated compensatory disorders. A literature search was performed by a review of PubMed articles published from 1976 to 2013. Level 4. Increased stresses across the bony hemipelvis result when athletes with FAI attempt to achieve supraphysiologic, terminal ranges of motion (ROM) through the hip joint required for athletic competition. This can manifest as pain within the pubic joint (osteitis pubis), sacroiliac joint, and lumbosacral spine. Subclinical posterior hip instability may result when attempts to increase hip flexion and internal rotation are not compensated for by increased motion through the hemipelvis. Prominence of the anterior inferior iliac spine (AIIS) at the level of the acetabular rim can result in impingement of the anterior hip joint capsule or iliocapsularis muscle origin against the femoral head-neck junction, resulting in a distinct form of mechanical hip impingement (AIIS subspine impingement). Iliopsoas impingement (IPI) has also been described as an etiology for anterior hip pain. IPI results in a typical 3-o'clock labral tear as well as an inflamed capsule in close proximity to the overlying iliopsoas tendon. Injury in athletic pubalgia occurs during high-energy twisting activities in which abnormal hip ROM and resultant pelvic motion lead to shearing across the pubic symphysis. Failure to recognize and address concomitant compensatory injury patterns associated with intra-articular hip pathology can result in significant disability and persistent symptoms in athletes with pre-arthritic, mechanical hip pain. B.

  16. patterns of knee, hip and hand osteoarthritis in kenyatta national

    African Journals Online (AJOL)

    presented using tables, pie charts and graphs. RESULTS. Among the 2100 patients with rheumatic diseases, 201 patients had knee, hip or hand AO giving a ... hypertension, diabetes mellitus, heart disease and musculoskeletal disease. The evidence linking obesity to OA has been accumulating. The risk of developing.

  17. Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls.

    Science.gov (United States)

    Mendis, M Dilani; Wilson, Stephen J; Hayes, David A; Watts, Mark C; Hides, Julie A

    2014-10-01

    Acetabular labral tears are a source of hip pain and are considered to be a precursor to hip osteoarthritis. Hip flexor muscles contribute to hip joint stability and function but it is unknown if their size and function is altered in the presence of labral pathology. This study aimed to investigate hip flexor muscle size, strength and recruitment pattern in patients with hip labral pathology compared to control subjects. 12 subjects diagnosed with an unilateral acetabular labral tear were compared to 12 control subjects matched for age and gender. All subjects underwent magnetic resonance imaging (MRI) of their lumbo-pelvic region. Average muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius, tensor fascia latae and rectus femoris muscles were measured. Hip flexion strength was measured by an externally fixed dynamometer. Individual muscle recruitment pattern during a resisted hip flexion exercise task was measured by muscle functional MRI. Hip flexor muscle strength was found to be decreased in patients with labral pathology compared to control subjects (p muscle size (all p > 0.17) and recruitment pattern (all p > 0.53). Decreased hip flexor muscle strength may affect physical function in patients with hip labral pathology by contributing to altered gait patterns and functional tasks. Clinical rehabilitation of these patients may need to include strengthening exercises for the hip flexor muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Dietary patterns and longitudinal change in hip bone mineral density among older men.

    Science.gov (United States)

    Rogers, T S; Harrison, S; Judd, S; Orwoll, E S; Marshall, L M; Shannon, J; Langsetmo, L; Lane, N E; Shikany, J M

    2018-05-01

    Studying dietary patterns is often more informative than individual nutrients or foods. We found that a Prudent dietary pattern (rich in vegetables and fish) was associated with reduced loss of total hip BMD in older men. A Prudent dietary pattern may be a potential lifestyle strategy for minimizing bone loss. This study aimed to identify baseline dietary patterns using factor analysis in a cohort of older men and to evaluate whether the dietary patterns were associated with bone mineral density change (%ΔBMD) at the total hip and femoral neck over time. Participants (n = 4379; mean age 72.9 ± 5.5 years) were from the Osteoporotic Fractures in Men (MrOS) prospective cohort study and had dietary data collected at baseline (March 2000-April 2002) and BMD measured at baseline and Visit 2 (March 2005-May 2006). Dietary intake was assessed with a brief Block food frequency questionnaire (FFQ); factor analysis was used to derive dietary patterns. BMD was measured by dual-energy x-ray absorptiometry (DXA); %ΔBMD was calculated from baseline to Visit 2. We used generalized linear regression to estimate least square (LS) means of %ΔBMD in quartiles of the dietary pattern scores adjusted for potential confounding factors. Two major dietary patterns were derived: Prudent (abundant in vegetables, salad, and non-fried fish) and Western (rich in hamburger, fries, processed meats, cheese, and sweets/desserts). There was an inverse association between adherence to the Prudent pattern and total hip %ΔBMD (p-trend = 0.028 after adjusting for age and clinical site; p-trend = 0.033 after further adjustment for smoking, calcium supplement use, diabetes, hypertension, and total energy intake). No other consistent associations between dietary patterns and %ΔBMD were observed. Greater adherence to a Prudent dietary pattern may attenuate total hip BMD loss (%ΔBMD) in older men.

  19. Exploring older adults' patterns and perceptions of exercise after hip fracture.

    Science.gov (United States)

    Gorman, Erin; Chudyk, Anna M; Hoppmann, Christiane A; Hanson, Heather M; Guy, Pierre; Sims-Gould, Joanie; Ashe, Maureen C

    2013-01-01

    To identify exercise patterns and perceived barriers, enablers, and motivators to engaging in exercise for older adults following hip fracture. Telephone interviews were conducted with older adults (aged 62-97 y) within 1 year after hip fracture. Participants were asked about basic demographic information; level of mobility before hip fracture; current level of mobility; and barriers, enablers, and motivators to participating in exercise. A total of 32 older adults successfully recovering after hip fracture completed the telephone interviews. Participants reported few problems with their mobility, and all were engaging in exercise. There were few reported barriers to exercise; the most common were health-related concerns (pain, fatigue, illness, or injury). The most frequently reported enablers were intrinsic factors (determination, seeing improvements, and making exercise part of their daily routine); in particular, the most common motivator to exercise was recovery of function to improve mobility and complete daily and leisure activities. This study highlights the responses of a group of older adults recovering well after hip fracture. Older adults engage in exercise despite the potential limitations associated with a hip fracture. Participants' responses underscore the importance of intrinsic factors and suggest avenues for future investigation.

  20. Incidence and pattern of congenital dislocation of the hip in Aseer ...

    African Journals Online (AJOL)

    Objective: The aim of this paper is to determine the incidence, pattern, predisposing risk factors, treatment modalities and outcome of congenital dislocation of the hip (CDH) in the Aseer region of Saudin Arabia. Methods: A retrospective study of 300 cases of CDH seen during a 4year period between 1996 to 1999 was ...

  1. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-06-15

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score.

  2. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah

    2015-01-01

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score

  3. Complex and changing patterns of natural selection explain the evolution of the human hip.

    Science.gov (United States)

    Grabowski, Mark; Roseman, Charles C

    2015-08-01

    Causal explanations for the dramatic changes that occurred during the evolution of the human hip focus largely on selection for bipedal function and locomotor efficiency. These hypotheses rest on two critical assumptions. The first-that these anatomical changes served functional roles in bipedalism-has been supported in numerous analyses showing how postcranial changes likely affected locomotion. The second-that morphological changes that did play functional roles in bipedalism were the result of selection for that behavior-has not been previously explored and represents a major gap in our understanding of hominin hip evolution. Here we use evolutionary quantitative genetic models to test the hypothesis that strong directional selection on many individual aspects of morphology was responsible for the large differences observed across a sample of fossil hominin hips spanning the Plio-Pleistocene. Our approach uses covariance among traits and the differences between relatively complete fossils to estimate the net selection pressures that drove the major transitions in hominin hip evolution. Our findings show a complex and changing pattern of natural selection drove hominin hip evolution, and that many, but not all, traits hypothesized to play functional roles in bipedalism evolved as a direct result of natural selection. While the rate of evolutionary change for all transitions explored here does not exceed the amount expected if evolution was occurring solely through neutral processes, it was far above rates of evolution for morphological traits in other mammalian groups. Given that stasis is the norm in the mammalian fossil record, our results suggest that large shifts in the adaptive landscape drove hominin evolution. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; does it make a TAD of difference?

    Science.gov (United States)

    Walton, N P; Wynn-Jones, H; Ward, M S; Wimhurst, J A

    2005-11-01

    The effect of femoral neck-shaft angle and implant type on the accuracy of lag screw placement in extra-capsular proximal femoral fracture fixation was investigated. Radiographs of all extra-capsular proximal femoral fractures seen in one unit over 18 months were reviewed. Of 399 cases, 307 (237 female, 70 male) were included in the study as they had no contra-lateral proximal femoral metal work. Femoral neck-shaft angle (NSA) of the uninjured hip and magnification adjusted tip-apex distance (TAD) of femoral head lag screw were measured. Type of fixation implant was 135 degrees classic hip screw (CHS) (n=144) or 130 degrees intra-medullary hip screw (IMHS) (n=163). Mean contra-lateral NSA was 130.2 degrees (112.9--148 degrees ) and 64 patients (58 female, 6 male) had a NSA TAD was 18.7 mm (5.8--43.8mm) and 88.9% of cases had a TAD of less than 25 mm. TAD values were significantly greater using an IMHS if NSA was 125 degrees (p=0.028). This was not the case with the CHS. The use of the 130 degrees -IMHS in patients with a NSA 125 degrees and caution is advocated when using this device in such cases.

  5. Metabolic Pattern of Asymptomatic Hip-Prosthesis by 18F-FDG-Positron-Emission-Tomography

    International Nuclear Information System (INIS)

    Beslic, Nermina; Heber, Daniel; Walter Lipp, Rainer; Sonneck-Koenne, Charlotte; Knoll, Peter; Mirzaei, Siroos

    2015-01-01

    Joint replacement is a procedure with a major impact on the quality of life of patients with joint degenerative disease or traumatic injuries. However, some patients develop symptoms after the intervention caused by mechanical loosening or infection. Metabolic imaging by 18F-FDG-PET investigated in these patients isoften hampered by low specificity for diagnosis of possible septic vs. mechanical loosening. The reason for this shortcoming is to our opinion the unawareness of physiological remodeling processes that could be seen in asymptomatic patients. In order to overcome this drawback, we aimed to find out the physiological metabolic functional pattern in asymptomatic patients with implanted hip prosthesis Twelve patients (6 males, 6 females); mean age 73 ± 7 (range 58 - 91) years were prospectively enrolled in the study. The patients were admitted to our department for oncological referral with implanted hip prostheses. All patients explained no symptoms with regard to their implanted prosthesis. The attenuation corrected images were used for analysis. Fourteen hip prostheses in 12 patients were visually analyzed. Seven out of 14 prostheses among 12 patients showed focal periprosthetic enhanced metabolism, two of which showed two sites of enhanced uptake; whereas, the remaining five prostheses showed singular hypermetabolic areas within the periprosthetic site. The remaining seven prostheses in the other five patients showed no periprosthetic-enhanced uptake. Of the asymptomatic patients investigated, 58% showed focal enhanced periprosthetic glucose metabolism. This finding should be taken into consideration as a more probable unspecific metabolic pattern for correct interpretation of 18F-FDG-PET studies in patients with suspected septic loosening of the hip prosthesis

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

    Directory of Open Access Journals (Sweden)

    Bart Malfait

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

  7. Paralabral cysts in the hip joint: findings at MR arthrography

    International Nuclear Information System (INIS)

    Magerkurth, Olaf; Jacobson, Jon A.; Girish, Gandikota; Kalume Brigido, Monica; Fessell, David; Bedi, Asheesh

    2012-01-01

    The purpose of this research was to retrospectively characterize paralabral cysts of the hip as seen at MR arthrography. After Institutional Review Board approval, 704 patients who had MR arthrography were identified over a 3-year period and 40 patients were identified as having a cyst or fluid collection at the hip by MR report. MR images from these 40 patients were retrospectively reviewed by three radiologists where 18 were found to have a paralabral cyst, which were characterized as follows: location, configuration, contrast filling, size of the cyst, extent, direction, and whether associated osseous changes were present. In addition, the acetabular labrum was assessed for tears and, if present, the location and pattern were characterized. Paralabral cysts were located anterosuperiorly in 56%, anteriorly in 22%, posterosuperiorly in 17%, and anteroinferiorly in 6% of cases. The vast majority (94%) were multilocular and filled with intra-articular contrast medium. The average dimensions were 8 x 7 x 11 mm. The paralabral cyst demonstrated extracapsular extension in 72% of cases, with 39% located between the ilium and gluteus minimus, and 22% between the ilium and iliopsoas. Remodeling of the ilium adjacent to the cyst was observed in 50% of these cases. A labral tear was at the base of the labrum adjacent to the cyst in 78% of cases, while the tear was isolated to the body of the labrum in 22%. Tears were most commonly anterosuperior (55%) or anterior (28%) in location. Our results show that paralabral cysts of the hip are most commonly located anterosuperiorly, are multilocular, fill with intra-articular contrast medium, have average dimensions up to 11 mm, and often extend extracapsularly between muscle and bone where they may remodel the adjacent ilium. (orig.)

  8. Walking pattern in adults with congenital hip dysplasia: 14 women examined by inverse dynamics

    DEFF Research Database (Denmark)

    Pedersen, Eva Natalia G.; Simonsen, Erik B; Alkjaer, T

    2004-01-01

    Knowledge of the gait dynamics in patients with hip dysplasia may help to understand the consequences of the mechanical changes in the hip.......Knowledge of the gait dynamics in patients with hip dysplasia may help to understand the consequences of the mechanical changes in the hip....

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

    Science.gov (United States)

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

    2011-12-01

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

  10. Daily physical activity patterns from hip- and wrist-worn accelerometers

    DEFF Research Database (Denmark)

    Shiroma, Eric J; Schepps, M A; Harezlak, J

    2016-01-01

    Accelerometer wear location may influence physical activity estimates. This study investigates this relationship through the examination of activity patterns throughout the day. Participants from the aging research evaluating accelerometry (AREA) study (n men = 37, n women = 47, mean age (SD) = 78...... activity accrual provide support that each location is capable of estimating total physical activity volume. The examination of activity patterns over time may provide a more detailed way to examine differences in wear location and different subpopulations. © 2016 Institute of Physics and Engineering.......9 (5.5) years) were asked to wear accelerometers in a free-living environment for 7 d at three different wear locations; one on each wrist and one on the right hip. During waking hours, wrist-worn accelerometers consistently produced higher median activity counts, about 5 × higher, as well as wider...

  11. Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

    OpenAIRE

    Mantsopoulos, Konstantinos; Velegrakis, Stylianos; Iro, Heinrich

    2015-01-01

    Objective To evaluate the oncologic and functional outcome in cases in which a false preoperative working hypothesis “benign parotid tumor” led to a primary extracapsular dissection being performed rather than a traditional, more radical surgical modality. Study Design Case series with chart review. Setting Academic tertiary referral center. Subjects and Methods The records of all patients treated for malignant tumors of the parotid gland between 2006 and 2012 were...

  12. Manual small incision extracapsular cataract surgery in Australia.

    Science.gov (United States)

    van Zyl, Lourens; Kahawita, Shyalle; Goggin, Michael

    2014-11-01

    Examination of the results and describing the technique of manual small incision extracapsular cataract extraction on patients with advanced cataracts in urban Australia. A descriptive case series. Thirty-eight patients at three public hospitals, one tertiary and two secondary ophthalmic units in urban Australia. Forty eyes with dense mature cataracts with hand movement vision or worse underwent a planned manual small incision extracapsular cataract extraction instead of traditional phaco-emulsification. Postoperative visual aquity, surgically induced astigmatism and complications. Seventy-eight per cent of patients had an uncorrected visual acuity of 6/12 or better on the first postoperative day. Eighty-three per cent of patients had a distance corrected visual acuity of 6/9 or better 3 months postoperatively. One case was complicated by a posterior capsule rupture. No cases of endophthalmitis were reported. The summated vector mean of the surgically induced astigmatism was 0.089D at 93°. Manual small incision extracapsular cataract extraction is an efficacious cataract surgery technique with good visual outcome and is a safe alternative to phaco-emulsification in suitable cases in a first-world setting. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

  13. Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint.

    Science.gov (United States)

    Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K

    2017-12-01

    Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.

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

    Science.gov (United States)

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

    2016-01-01

    The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (phamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.

  15. Physician referral patterns and racial disparities in total hip replacement: A network analysis approach.

    Directory of Open Access Journals (Sweden)

    Hassan M K Ghomrawi

    Full Text Available Efforts to reduce racial disparities in total hip replacement (THR have focused mainly on patient behaviors. While these efforts are no doubt important, they ignore the potentially important role of provider- and system-level factors, which may be easier to modify. We aimed to determine whether the patterns of interaction among physicians around THR episodes differ in communities with low versus high concentrations of black residents.We analyzed national Medicare claims from 2008 to 2011, identifying all fee-for-service beneficiaries who underwent THR. Based on physician encounter data, we then mapped the physician referral networks at the hospitals where beneficiaries' procedures were performed. Next, we measured two structural properties of these networks that could affect care coordination and information sharing: clustering, and the number of external ties. Finally, we estimated multivariate regression models to determine the relationship between the concentration of black residents in the community [as measured by the hospital service area (HSA] served by a given network and each of these 2 network properties.Our sample included 336,506 beneficiaries (mean age 76.3 ± SD, 63.1% of whom were women. HSAs with higher concentrations of black residents tended to be more impoverished than those with lower concentrations. While HSAs with higher concentrations of black residents had, on average, more acute care beds and medical specialists, they had fewer surgeons per capita than those with lower concentrations. After adjusting for these differences, we found that HSAs with higher concentrations of black residents were served by physician referral networks that had significantly higher within-network clustering but fewer external ties.We observed differences in the patterns of interaction among physicians around THR episodes in communities with low versus high concentrations of black residents. Studies investigating the impact of these differences

  16. Three cases of extracapsular cataract extraction for radiation cataract

    International Nuclear Information System (INIS)

    Hirokane, Kenji; Kosaka, Toshiya; Nii, Hiroki; Kiuchi, Yoshiaki; Nakano, Kensuke; Choshi, Kanji

    1996-01-01

    Extracapsular cataract extraction and intraocular lens implantation was performed on 4 eyes of 3 patients with radiation cataract. Case 1 was a 60-year-old man who was exposed to the ionizing radiation of the atomic bomb in Hiroshima 730 meters from the center of the explosion. He developed atomic bomb radiation senile cataracts in both eyes. Despite cataract surgery, a central plaque remained on the posterior capsule in the region corresponding to the central dense opacity in both eyes. Case 2 was an 81-year-old man who was in a streetcar 1,000 meters from the center of the explosion at the time of the atomic bombing. Senile and radiation-induced cataract decreased the visual acuity in both eyes. After extracapsular cataract extraction in his right eye, central opacification and a fibrous white membrane remained on the posterior capsule. These were removed by Nd-YAG laser capsulotomy six days after surgery. Case 3 was a 56-year-old man who developed radiation cataract after radiation therapy to a malignant lymphoma in the right orbit. Phacoemulsification and aspiration could not remove the fibrous white membrane from the posterior capsule in this case. Central opacities and fibrous white membranes on the posterior capsule after cataract surgery appears to be a characteristic of radiation cataract. (author)

  17. Antioxidant status of dog aqueous humor after extracapsular lens extraction

    Directory of Open Access Journals (Sweden)

    Barros P.S.M.

    2003-01-01

    Full Text Available We determined the antioxidant status of the aqueous humor after extracapsular lens extraction in 14 mongrel dogs weighing about 10 kg. The animals were examined by slit lamp biomicroscopy, applanation tonometry and indirect ophthalmoscopy. One eye was submitted to conventional extracapsular lens extraction and the other was used as control. Samples of aqueous humor were obtained by anterior chamber paracentesis before and at days 1, 2, 3, 7 and 15 after surgery. Total antioxidant status was determined as the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis(2-amidopropane chlorine. Ascorbic acid concentration was measured by HPLC with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by ANOVA followed by the Tukey-Kramer test. Protein concentration increased from 0.61 to 22 mg/ml 24 h after surgery. These levels were maintained and returned to normal at day 7. Total antioxidant capacity was reduced from 50 to about 30 min until day 3 and at day 7 it was equal to control. Ascorbic acid levels were reduced from 252 to about 110 µM and then returned to control values at day 15. Considering the importance of ascorbic acid concentration in aqueous humor for the maintenance of the antioxidant status of the anterior segment of the eye, the decrease of antioxidant defenses suggests that the surgical procedures promote an oxidative stress condition in the eye.

  18. Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation?

    Science.gov (United States)

    Porter, David; Michael, Shona; Kirkwood, Craig

    2007-12-01

    To investigate: (a) associations between the direction of scoliosis, direction of pelvic obliquity, direction of windswept deformity and side of hip subluxation/ dislocation in non-ambulant people with cerebral palsy; and (b) the lateral distribution of these postural asymmetries. Cross-sectional observational study. Posture management services in three centres in the UK. Non-ambulant people at level five on the gross motor function classification system for cerebral palsy. Direction of pelvic obliquity and lateral spinal curvature determined from physical examination, direction of windswept hip deformity derived from range of hip abduction/adduction, and presence/side of unilateral hip subluxation defined by hip migration percentage. A total of 747 participants were included in the study, aged 6-80 years (median 18 years 10 months). Associations between the direction of scoliosis and direction of pelvic obliquity, and between the direction of windswept hip deformity and side hip subluxation/dislocation were confirmed. A significant association was also seen between the direction of scoliosis and the direction of the windswept hip deformity (P<0.001) such that the convexity of the lateral spinal curve was more likely to be opposite to the direction of windsweeping. Furthermore, significantly more windswept deformities to the right (P=0.007), hips subluxed on the left (P=0.002) and lateral lumbar/lower thoracic spinal curves convex to the left (P=0.03) were observed. The individual asymmetrical postural deformities are not unrelated in terms of direction and not equally distributed to the left/right. A pattern of postural deformity was observed.

  19. Use of an extracapsular stabilization technique to repair cruciate ligament ruptures in two avian species.

    Science.gov (United States)

    Chinnadurai, Sathya K; Spodnick, Gary; Degernes, Laurel; DeVoe, Ryan S; Marcellin-Little, Denis J

    2009-12-01

    An extracapsular stabilization technique was used to repair cruciate ligament ruptures in a trumpeter hornbill (Bycanistes bucinator) and an African grey parrot (Psittacus erithacus). The hornbill demonstrated cranial drawer motion and severe rotational instability of the stifle from ruptures of the cranial and caudal cruciate ligaments and stifle joint capsule. The luxation was reduced, and the fibula was cranially transposed, in relation to the tibiotarsus, and anchored with 2 positive profile threaded acrylic pins. A lateral extracapsular stabilization was then performed. The African grey parrot had a traumatic stifle luxation, and an open reduction and a lateral extracapsular stabilization were performed. Both birds regained function of the affected leg by 1 month after surgery. Extracapsular stabilization allows motion of the stifle joint to be maintained during the postoperative recovery period, an advantage over rigid stabilization. Maintaining motion in the stifle joint facilitates physical therapy and can aid in full recovery after avian stifle injuries.

  20. The epidemiology and functional outcomes of operative fixation of extracapsular proximal femoral fractures (AO 31-A) in young adults.

    Science.gov (United States)

    Ramoutar, D N; Kodumuri, P; Rodrigues, J N; Olewicz, S; Moran, C G; Ollivere, B J; Forward, D P

    2017-02-01

    Proximal femoral fractures in adults under 50 years are not as common as in the elderly, but may have just as significant an impact. There is little in the literature describing the functional outcomes of fixation in this age group. Our aim was to assess the clinical and functional outcomes of operative management of extracapsular proximal femoral fractures (AO 31-A) in the young adult (age was 39 years (range 17-50) with a male preponderance (73.8%). Mean hospital stay was 14 days (range 2-94). Seventeen (19.3%) patients had died at a mean of 40 months from their operation date. The 1-year mortality was 4.5%. There were five complications (5.7%). SF-36 and EuroQol 5D scores showed that 5-10% had severe problems with a 20% decrease in quality of life compared to population norms. The biggest differences were in the physical function modalities. One-third had fair to poor hip function as assessed by the Oxford Hip Score. Though these injuries are relatively rare in this age group, they do have significant mortality and functional impairment reflecting a higher energy of injury rather than the frailty seen in the elderly.

  1. Complications of hip fractures: A review

    Science.gov (United States)

    Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

    2014-01-01

    Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

  2. Electromyographic Analysis of the Hip Extension Pattern in Visually Impaired Athletes

    Directory of Open Access Journals (Sweden)

    Halski Tomasz

    2015-12-01

    Full Text Available The objective of the study was to determine the order of muscle recruitment during the active hip joint extension in particular positions in young visually impaired athletes. The average recruitment time (ART of the gluteus maximus (GM and the hamstring muscle group (HMG was assessed by the means of surface electromyography (sEMG. The sequence of muscle recruitment in the female and male group was also taken into consideration. This study followed a prospective, cross – sectional, randomised design, where 76 visually impaired athletes between the age of 18–25 years were enrolled into the research and selected on chosen inclusion and exclusion criteria. Finally, 64 young subjects (32 men and 32 women were included in the study (age: 21.1 ± 1.05 years; body mass: 68.4 ± 12.4 kg; body height: 1.74 ± 0.09 m; BMI: 22.20 ± 2.25 kg/m2. All subjects were analysed for the ART of the GM and HMG during the active hip extension performed in two different positions, as well as resting and functional sEMG activity of each muscle. Between gender differences were comprised and the correlations between the ART of the GM and HMG with their functional sEMG activity during hip extension in both positions were shown. No significant differences between the ART of the GM and HMG were found (p>0.05. Furthermore, there was no significant difference of ART among both tested positions, as well in male as female subjects (p>0.05.

  3. Radiological landmarks for the safe extra-capsular placement of supra-acetabular half pins for external fixation.

    Science.gov (United States)

    Lidder, Surjit; Heidari, Nima; Gänsslen, Axel; Grechenig, Wolfgang

    2013-03-01

    Low anterior external fixators are constructed by placing half pins in the dense bone tunnel of the supra-acetabular region in an anterior to posterior direction. Although the placement of these pins is extra-articular, they may still breach the hip capsule on the anterior inferior iliac spine and thus be intra-capsular. We aim to provide radiological markers for the most superior fibres of the capsule to allow safe extra-capsular pin placement within the supra-acetabular bone tunnel. Thirteen cadaveric pelves were used for this study. The supra-acetabular bone tunnel was visualised with an image intensifier. The proximal most fibres of the hip joint capsule were marked with a K-wire so that their relation to the bone tunnel could be clearly seen on the images. Once all images were acquired they were calibrated and analysed to estimate the dimensions of the supra-acetabular bone tunnel and the reflection of the hip capsule. The median height of the bone tunnel was 23.6 mm (18.9-33.2) and maximum width was 11.4 mm (7.6-16.3). The inferior margin of the bone tunnel was 6.7 mm (1.1-14.5) superior to the acetabular dome, and the most proximal fibres of the capsule were 9.3 mm (4.7-6.1) superior to the acetabular dome. The inferior portion of the tunnel was 3.7 mm (0.3-8.9) within the joint. Half pins for the construction of a pelvic external fixator should be placed in the upper half of the supra-acetabular bone corridor to minimise the risk of intra-capsular placement.

  4. Migration pattern of cementless press fit cups in the presence of stabilizing screws in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Zilkens C

    2011-03-01

    Full Text Available Abstract The aim of this study was to evaluate the initial acetabular implant stability and late acetabular implant migration in press fit cups combined with screw fixation of the acetabular component in order to answer the question whether screws are necessary for the fixation of the acetabular component in cementless primary total hip arthroplasty. One hundred and seven hips were available for follow-up after primary THA using a cementless, porous-coated acetabular component. A total of 631 standardized radiographs were analyzed digitally by the "single-film-x-ray-analysis" method (EBRA. One hundred 'and one (94.4% acetabular components did not show significant migration of more than 1 mm. Six (5.6% implants showed migration of more than 1 mm. Statistical analysis did not reveal preoperative patterns that would identify predictors for future migration. Our findings suggest that the use of screw fixation for cementless porous- coated acetabular components for primary THA does not prevent cup migration.

  5. "Vitreous loss: Incidence and complications in extracapsular Cataract extractions "

    Directory of Open Access Journals (Sweden)

    Nikeghbali A

    2000-09-01

    Full Text Available One of the dangerous complications of cataract extractions is vitreous loss. The purpose of this stuy is to evaluate the incidence of vitreous loss and its sepuale while teaching residents at Rasoul Akram Hospital in Iran. This study has been conducted on existing records of 730 eyes which were subjectd to extracapsular cataract extractions by 3rd and 4th year, right handed resident of Rasoul Akram hospital. The information was taken from the records of patients who had vitreous loss during cataract surgery and the following data was extracted. The presence of any systemic diseases, phase of operation where vitreous loss occurred, vision on the next day, one month and 3 months later, the cause of low vision and any post operative sequale of the eye were evaluated. Extracted data collected and the prevalence of vitreous loss and its sequale were indentified and presented. Forty-nine eyes (6.7% had vitreous loss, thirty-one of them were in the left eye (63.3% and eighteen of them were in the right eye (36.7%. Regarding the stage of operation in which vitrous loss had occurred: twenty –eight eyes while nucleous delivery (57.7% eighteen eyes during aspiration of cortical material (36.7% and in three cases during IOL implantation. Five eyes had pseudoexfoliaton syndrome, four patients were diabetic and three had high myopia. Post operational sequale of these 49 eyes were: thirty-five with transient corneal edema (71.4%. Nine with misshaped pupils (18.9%, four with high astigmatism (8.1%, tow with cystoid macular edema (4%, two with retinal detachment (4% and seven with cloudy vitreous. (14.3%. The incidence of vitreous loss is more than expected. More extensive research to evaluated the prognositc factors according to the eye (OD/OS and the stage of the operation the leads to vitreous loss and to decrease its incidence is still needed.

  6. Hip, Hip, Soret!

    Science.gov (United States)

    Müller-Plathe, Florian

    Many years ago, Ludwig did detect the behaviour now called the Soret effect. Sodium sulphate in eighteen-fifty-six did not obediently follow Fick's first law. But if he cooled down one side the salt went left, the water to the right. He was surprised in every way. Hip, hip, Soret!

  7. Biomechanical Alignment of Main Wear-Pattern on MOM Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Paul Burton

    2015-08-01

    Full Text Available In the majority of retrievals, femoral heads and cups are sent for analysis with no designation as to positioning in-vivo. In addition, when patients retain the femoral prosthesis, evidence of neck impingement damage is lost. In this case report we studied head and cup wear-patterns and stripe damage in a novel case that included a large diameter metal-on-metal THA that was retrieved with the head still fused to the stem. This provided anatomical positioning of head wear-pattern and stripe damage as represented by the orientation of the femoral stem in radiographic images. We investigated (1 size, shape and location of head and cup wear-patterns, (2 cup-to-stem impingement damage, and (3 head stripe-wear. The head wear-pattern was elliptical in shape, 40mm diameter with area covering 2200 sq.mm. Its hemispherical ratio was 56% with aspect ratio 1.2 and typical of large-diameter MOM retrievals. Wear-pattern extended from 12° above superior head-margin to approximately 40° inferior to polar axis. Centroidal vector in coronal plane was 13° posterior to polar axis and in transverse plane was 19° superior to polar axis. These vector data corresponded well with biomechanical predictions of resultant load axes in gait studies. Stripe damage was identified on the head, and the cup rim could thereby be aligned to verify neck impingement and also head subluxation mechanisms. Cup wear-pattern was not centrally contained, indicating this patient had experienced repetitive edge-wear during gait. Thinning of the cup rim by 350- 400μm indicated that posterior impingement with repetitive anterior subluxation of the head had created this edge-wear.

  8. Prognostic significance of extracapsular lymph node involvement in patients with adenocarcinoma of the ampulla of Vater

    NARCIS (Netherlands)

    van der Gaag, N. A.; ten Kate, F. J. W.; Lagarde, S. M.; Busch, O. R. C.; van Gulik, T. M.; Gouma, D. J.

    2008-01-01

    Background: Lymphatic dissemination is an important predictor of survival in patients with adenocarcinoma of the ampulla of Vater. The incidence and clinical consequences of extracapsular lymph node involvement (LNI) in patients who undergo resection are unknown. Methods: In a consecutive series of

  9. Knee joint motion and muscle activation patterns are altered during gait in individuals with moderate hip osteoarthritis compared to asymptomatic cohort.

    Science.gov (United States)

    Rutherford, Derek; Moreside, Janice; Wong, Ivan

    2015-07-01

    Knee replacements are common after hip replacement for end stage osteoarthritis. Whether abnormal knee mechanics exist in moderate hip osteoarthritis remains undetermined and has implications for understanding early osteoarthritis joint mechanics. The purpose of this study was to determine whether three-dimensional (3D) knee motion and muscle activation patterns in individuals with moderate hip osteoarthritis differ from an asymptomatic cohort and whether these features differ between contra- and ipsilateral knees. 3D motions and medial and lateral quadriceps and hamstring surface electromyography were recorded on 20 asymptomatic individuals and 20 individuals with moderate hip osteoarthritis during treadmill walking, using standardized collection and processing procedures. Principal component analysis was used to derive electromyographic amplitude and temporal waveform features. 3D stance-phase range of motion was calculated. A 2-factor repeated analysis of variance determined significant within-group leg and muscle differences. Student's t-tests identified between group differences, with Bonferroni corrections where applicable (α=0.05). Lower sagittal plane motion between early and mid/late stance (5°, P=0.004, effect size: 0.96) and greater mid-stance quadriceps activity was found in the osteoarthritis group (P=0.01). Compared to the ipsilateral knee, a borderline significant increase in mid-stance hamstring activity was found in the contra-lateral knee of the hip osteoarthritis group (P=0.018). Bilateral knee mechanics were altered, suggesting potentially increased loads and knee muscle fatigue. There was no indication that one knee is more susceptible to osteoarthritis than the other, thus clinicians should include bilateral knee analysis when treating patients with hip osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Dietary patterns among girls aged 16–18 years old according to their body mass index and waist-to-hip ratio

    Directory of Open Access Journals (Sweden)

    Agnieszka Dmitruk

    2018-03-01

    Full Text Available Aim: The study has been aimed at evaluating dietary patterns of girls aged 16–18 years old in groups identified according to measures such as their body mass index and waist-to-hip ratio. Material and methods: The study covered a total of 151 girls aged 16–18 years old from selected higher secondary schools in Biała Podlaska, Poland. Based on height, weight, waist and hip circumference measurements, body mass index was calculated for each of the participants of the study, allowing to identify two groups: group 1 with normal index and group 2 with overweight or obesity. Also, to determine the type of obesity in the overweight and obese respondents, their waist-to-hip ratio was calculated, identifying the subgroup of girls with abdominal obesity. The respondents’ dietary patterns were identified with the use of a diagnostic survey. The statistical significance of the differences between the participants with normal body mass index and the overweight and obese respondents (including those with abdominal obesity was tested with the chi-square test. Results: Numerous nutritional mistakes/unhealthy dietary patterns were identified in the studied group, largely involving the overweight and obese girls, including those with abdominal obesity. The respondents whose body mass index and waist-to-hip ratio were too high ate fewer meals per day, skipped breakfast more frequently, had their last meal of the day later than 8 p.m., reported less frequent fish and wholemeal bread intake, as opposed to more frequent fast food, sweets and sweetened beverages intake. Conclusion: The unhealthy dietary patterns found in the population of girls with high body mass index and abdominal obesity highlight the need for education in the scope of healthy nutrition aimed both at overweight/obese individuals and their families.

  11. Hip position and sex differences in motor unit firing patterns of the vastus medialis and vastus medialis oblique in healthy individuals.

    Science.gov (United States)

    Peng, Yi-Ling; Tenan, Matthew S; Griffin, Lisa

    2018-06-01

    Weakness of the vastus medialis oblique (VMO) has been proposed to explain the high prevalence of knee pain in female subjects. Clinicians commonly use exercises in an attempt to preferentially activate the VMO. Recently, our group found evidence to support clinical theory that the VMO is neurologically distinct from the vastus medialis (VM). However, the ability to voluntarily activate these muscle subsections is still disputed. The aim of this study was to determine if VM and VMO activation varies between sexes and if control of the two muscles is different between rehabilitation exercises. Thirteen men and 13 women performed isometric straight leg raises in two hip positions, neutral hip rotation and 30 degrees lateral hip rotation. Bipolar intramuscular fine-wire electrodes were inserted into the VM and VMO to obtain motor unit recruitment thresholds and initial firing rates at recruitment. Linear mixed models and Tukey post hoc tests were used to assess significant differences in 654 motor units. Women demonstrated faster motor unit firing rate at recruitment, 1.18 ± 0.56 Hz higher than men. Motor units fired 0.47 ± 0.19 Hz faster during neutral hip rotation compared with lateral hip rotation. The VMO motor units were recruited 2.92 ± 1.28% earlier than the VM. All motor units were recruited 3.74 ± 1.27% earlier during neutral hip rotation than lateral hip rotation. Thus the VM and the VMO can be activated differentially, and their motor unit recruitment properties are affected by sex and hip position. NEW & NOTEWORTHY This is the first study to reveal differential activation of the vastus medialis oblique from the vastus medialis in clinical exercise protocols. Our research group used fine-wire electrodes to examine EMG signals of the vastus medialis oblique and vastus medialis to avoid possible cross talk. We also consider the effect of sex on motor unit firing patterns because of higher prevalence of knee pain in women, and yet few

  12. Hip Fracture

    Science.gov (United States)

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

  13. [Acute traumatic and especially neglected traumatic hip dislocations are very rare in children].

    Science.gov (United States)

    Fernandez, F F; Wirth, T; Eberhardt, O

    2012-09-01

    We report about the first hip arthroscopies of extracapsular neglected hip dislocations with concomitant injuries in two children (2 and 4 years old). The major problem of traumatic hip dislocation is avascular necrosis. Further problems are possible concomitant injuries. It is important not to cause further damage by therapeutic procedures. In a 4-year-old child the hip could be reduced under visualization and in a 2-year-old child with epiphyseal fracture the extent of the operation could be reduced. In both children large avulsion injuries of the ligamentum capitis femoris could be resected via hip arthroscopy. Hip arthroscopy can reduce surgical morbidity considerably and can possibly contribute to prevention of the feared avascular necrosis of the femoral head.

  14. Visual pattern and serial quantitation of {sup 18}F-sodium fluoride PET/CT in asymptomatic patients after hip and knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Son, Hye Joo; Jeong, Young Jin; Yoon, Hyun Jin; Wang, Lih; Kim, Hyeon Jun; Kang, Do Young [Dong-A University Medical Center, Dong-A University College of Medicine, Busan (Korea, Republic of); Park, Jong Hwan [Institute of Convergence Bio-Health, Dong-A University, Busan (Korea, Republic of)

    2016-12-15

    We investigated the visual tracer distribution pattern and serial changes in uptake ratio in different anatomical zones during the natural postoperative course in order to establish a reference for evaluation of patients with complications. A total of 36 patients without symptoms after hip or knee arthroplasty were grouped according to the interval between surgery and the scan. The serial changes in SUVmean in each periprosthetic zone were quantified using the volume of interest isocontour method. Images were classified according to the uptake distribution pattern. The uptake ratios in the postoperative period groups were then compared using the Kruskal-Wallis test. The correlation between uptake ratio and postoperative period was then determined. Tracer distribution patterns in hip prostheses were classified into three types and the patterns in knee prostheses into five types. In hip prostheses, intense osteoblastic activity was observed during 3-6 months and then declined in most patients, but showed a slight increase over 15-25 months in 5-10 % of patients. The correlation coefficients varied among the zones. Significant differences in uptake ratios among the period groups was found for all zones, except zone 8. Porous coated areas showed higher uptake than uncoated areas only for the period the 3-6 months. In knee prostheses, uptake ratios showed a curvilinear pattern, increasing from 3-6 to 8-15 months and declining later. The uptake ratios were different among the period groups. Every zone showed a positive correlation from 3-6 to 8-15 months, and negative correlations from 8-15 to 22-25 months. This is the first {sup 18}F-sodium fluoride PET/CT study investigating the stability of implants and sets a reference for evaluation of patients with complications.

  15. Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI

    DEFF Research Database (Denmark)

    Boesen, Lars; Chabanova, Elizaveta; Løgager, Vibeke

    2015-01-01

    OBJECTIVES: To evaluate the diagnostic performance of preoperative multiparametric MRI with extracapsular extension (ECE) risk-scoring in the assessment of prostate cancer tumour stage (T-stage) and prediction of ECE at final pathology. MATERIALS AND METHODS: Eighty-seven patients with clinically....../87 (36 %) patients. ECE risk-scoring showed an AUC of 0.65-0.86 on ROC-curve for both readers, with sensitivity and specificity of 81 % and 78 % at best cutoff level (reader A), respectively. When tumour characteristics were influenced by personal opinion, the sensitivity and specificity for prediction...... technique for preoperative prostate cancer staging • ECE risk scoring predicts extracapsular tumour extension at final pathology • ECE risk scoring shows an AUC of 0.86 on the ROC-curve • ECE risk scoring shows a moderate inter-reader agreement (K = 0.45) • Multiparametric MRI provides essential knowledge...

  16. Patterns of bone tracer uptake on SPECT-CT in symptomatic and asymptomatic patients with primary total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schweizer, Thierry; Hirschmann, Michael T. [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); University of Basel, Basel (Switzerland); Schiapparelli, Filippo-Franco; Rotigliano, Niccolo [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); Rasch, Helmut [Kantonsspital Baselland, Institute of Radiology and Nuclear Medicine, Bruderholz (Switzerland); Amsler, Felix [Amsler Consulting, Basel (Switzerland)

    2018-02-15

    The primary purpose of this study was to compare bone tracer uptake (BTU) on SPECT/CT in symptomatic and asymptomatic total hip arthroplasty (THA) and identify a possible relationship between BTU patterns and patient's symptoms. The secondary purpose was to investigate if the fixation methods (cemented versus uncemented) lead to different BTU patterns. A total of 58 THAs, 31 symptomatic (group S) and 27 asymptomatic (group AS), were prospectively collected and retrospectively analyzed. All symptomatic patients underwent standardized detailed history, clinical examination, radiographs and 99mTc-HDP SPECT/CT. BTU in SPECT/CT was quantified in three dimensions and anatomically localized in a scheme of quadrants and levels using a customized previously validated software. T tests were used on both quadrants and levels inside and between groups. A Pearson correlation was performed for BTU within the quadrants. An area under receiver operating characteristic curves was drawn in order to find a BTU value that could differentiate the two groups. Within the groups, patients with cemented and uncemented stems were compared for influences on BTU intensity. The causes of pain were identified in 61% of the patients. The most common problem was aseptic loosening (n = 12). In group AS, levels 1, 2 and 5 had similar BTUs. BTUs in these levels were significantly higher than in level 3, 4 and 6. In group S, no significant differences were seen in terms of BTU in level 1-5. However, BTU here was significantly higher than at level 6 (p < 0.001). In both groups, level 1, the superior, had a significantly higher BTU than level 2 (group AS p < 0.01, group S p < 0.05). Comparing the BTU of the two groups among levels, significant differences were found for level 4, level 5 and the entire stem areas (p < 0.05). The ROC curve calculated on the whole stem allowed identification of a BTU ratio of 3.1 that separated the 92.6% patients of group AS with BTU < 3.1 from the 54.8% of patients

  17. The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.

    LENUS (Irish Health Repository)

    Al Sahaf, Osama

    2011-08-01

    The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.

  18. Hip pain

    Science.gov (United States)

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

  19. Subjects with hip osteoarthritis show distinctive patterns of trunk movements during gait-a body-fixed-sensor based analysis

    NARCIS (Netherlands)

    Reininga, Inge H. F.; Stevens, Martin; Wagenmakers, Robert; Bulstra, Sjoerd K.; Groothoff, Johan W.; Zijlstra, Wiebren

    2012-01-01

    Background: Compensatory trunk movements during gait, such as a Duchenne limp, are observed frequently in subjects with osteoarthritis of the hip, yet angular trunk movements are seldom included in clinical gait assessments. Hence, the objective of this study was to quantify compensatory trunk

  20. Analysis of 18 F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

    International Nuclear Information System (INIS)

    Cremerius, U.; Niethard, F.U.; Mumme, T.; Reinartz, P.; Wirtz, D.; Buell, U.

    2003-01-01

    Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (acetabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral femoral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population. (orig.) [de

  1. Efficacy on chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Xiao-Ning Peng

    2014-04-01

    Full Text Available AIM: To study the clinical effects of chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation.METHODS:A total of 75 cases(80 eyes, in which loop-pad and chop knife were performed to chop nucleus before implanting intraocular lens. Visual acuity, postoperative astigmatism degree, intraoperative and postoperative complications were observed. The post-operative follow-up periods ranged from 3 to 12mo.RESULTS: The visual acuity was 0.3-0.5 in 37 eyes and 0.6 or better in 21 eyes at 1d, while was respectively in 43 eyes and in 26 eyes at 1mo. Compared with preoperative astigmatism(0.85±0.29D, there were significant difference at postoperative 1wk(1.75±0.55D(PP>0.05. Intraoperative posterior capsule rupture occurred in 4 eyes, which implantation was successful in 1 eye and 3 eyes was managed viaciliary sulcus. Two eyes had dermatoglyphic pattern edema in corneal endothelium which recovered after about 3d. Two eyes had local patchy opacities which recovered in 2wk. Two eyes had transient high intraocular pressure.CONCLUSION: The surgery is efficient, low cost, easy process and less complications, it is worth to be popularized.

  2. Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

    International Nuclear Information System (INIS)

    Shortt, Conor P.; Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C.; Roberts, Catherine C.

    2009-01-01

    The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

  3. Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

    Energy Technology Data Exchange (ETDEWEB)

    Shortt, Conor P. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Roberts, Catherine C. [Mayo Clinic College of Medicine, Department of Radiology, Phoenix, AZ (United States)

    2009-04-15

    The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

  4. Hip joint replacement

    Science.gov (United States)

    Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...

  5. Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification

    Directory of Open Access Journals (Sweden)

    Mohd R.A. Manaf

    2007-03-01

    Full Text Available A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE and phacoemulsification (PEA was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques and six months (for ECCE only. Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14, quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72 and for PEA is USD 528 (± USD 125. VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001. However, there was no significant difference between them (p = 0.225. This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31 Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14

  6. Pressure sores and hip fractures.

    Science.gov (United States)

    Haleem, S; Heinert, G; Parker, M J

    2008-02-01

    Development of pressure sores during hospital admission causes morbidity and distress to the patient, increases strain on nursing resources, delaying discharge and possibly increasing mortality. A hip fracture in elderly patients is a known high-risk factor for development of pressure sores. We aimed to determine the current incidence of pressure sores and identify those factors which were associated with an increased risk of pressure sores. We retrospectively analysed prospectively collected data of 4654 consecutive patients admitted to a single unit. One hundred and seventy-eight (3.8%) of our patients developed pressure sores. Patient factors that increased the risk of pressure sores were increased age, diabetes mellitus, a lower mental test score, a lower mobility score, a higher ASA score, lower admission haemoglobin and an intra-operative drop in blood pressure. The risk was higher in patients with an extracapsular neck of femur fracture and patients with an increased time interval between admission to hospital and surgery. Our studies indicate that while co-morbidities constitute a substantial risk in an elderly population, the increase in incidence of pressure sores can be reduced by minimising delays to surgery.

  7. Contemporary management of benign parotid tumours - the increasing evidence for extracapsular dissection.

    Science.gov (United States)

    Brennan, P A; Ammar, M; Matharu, J

    2017-01-01

    Benign parotid tumours have historically often been managed surgically by superficial parotidectomy. While this approach usually gives a generous cuff of surrounding normal parotid tissue to increase tumour margins, it requires a much larger incision than the increasingly used extracapsular dissection (ECD) technique. Furthermore, superficial parotidectomy can result in marked facial hollowing, Frey syndrome and an increased risk of both temporary and permanent facial nerve weakness. ECD has been popularised as a safe alternative to parotidectomy primarily for the removal of mobile, benign parotid tumours with safe outcomes and reduced risk to the facial nerve. In this article, we review the growing body of evidence for ECD and include our own experience confirming the move away from superficial parotidectomy in contemporary practice for the treatment of benign parotid tumours. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. 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.

  9. Hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Henrique Antônio Berwanger de Amorim Cabrita

    2015-06-01

    Full Text Available Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff, although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

  10. Analysis of {sup 18} F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Cremerius, U.; Niethard, F.U. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Mumme, T.; Reinartz, P.; Wirtz, D. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Orthopaedische Klinik; Buell, U.

    2003-12-01

    Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (acetabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral femoral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population. (orig.) [German] Ziel: Identifikation von Befundmustern in der Positronenemissionstomographie (PET) mit {sup 18}F

  11. Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management.

    Science.gov (United States)

    Tsegga, Tibebu M; Britt, Jennifer D; Ellwanger, Aragon R

    2015-03-01

    Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely is it found evolving from an ectopic location of major salivary glandular tissue in the mid cheek. A healthy 56-year-old woman presented to our institution with a 20-year duration of a slowly growing right cheek soft tissue mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination showed a heterogeneous, hyperintense, well-delineated mass within the region of the right buccal fat pad. Fine-needle aspiration biopsy showed benign salivary gland elements consistent with pleomorphic adenoma. The decision was made to perform intraoral extracapsular dissection for removal. Discussion of the clinical assessment and magnetic resonance imaging evaluation with an emphasis on intraoral extracapsular dissection for definitive surgical therapy of longstanding benign salivary gland tumors is emphasized. Published by Elsevier Inc.

  12. Management of extra-capsular temporo-mandibular joint ankylosis: does conservative approach to treatment have a role?

    Science.gov (United States)

    Anyanechi, C E; Osunde, O D; Bassey, G O

    2015-06-01

    The conventional management of fibrous extracapsular temporo-mandibular joint (TMJ) ankylosis, a debilitating disease, is associated with surgical complications and financial burden on the patients. To assess the outcome of conservative approach to the management of fibrous extracapsular TMJ ankylosis. This is a prospective study of patients who presented at the Dental and Maxillofacial Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria, during the period from January 1999 to December 2012 with a history of inability to open the mouth diagnosed as fibrous extracapsular TMJ ankylosis. Twenty-one subjects were treated and their ages ranged from 11 to 22 years with mean at 15.0 years. There were 13 (61.9 %) males and 8 (38.1 %) females with male: female ratio of 1.6:1. The aetiological factor that predisposed to formation of extracapsular TMJ ankylosis was facial trauma. There was no facial asymmetry and the side distribution of the affliction showed that 1 (4.8 %) was bilateral while 20 (95.2 %) were unilateral. Eight cases (38.1 %) were incomplete ankylosis while the rest (n = 13, 61.9 %) were complete. The shorter the duration of fibrous ankylosis and the greater the initial inter-incisal distance before treatment, the better the treatment outcome. The outcome of treatment suggests that the conservative approach to management of this condition was beneficial to these patients because they presented early. However, randomized controlled clinical trials are needed to validate this treatment option.

  13. Two kinds of manual chopping methods applied in small incision extracapsular cataract extraction

    Directory of Open Access Journals (Sweden)

    Xia Jiang

    2016-02-01

    Full Text Available AIM:To research clinical effect of two manual chopping methods for small incision extracapsular cataract extraction. METHODS: We observed 143 cases(184 eyeswith grade Ⅳ or higher taken the small incision cataract extraction and intraocular lens implantation. Patients were given randomly knifed chopping with closed hook(92 eyesor double knifed chopping(92 eyes. The intra-operative posterior capsule rupture was observed and compared. At 1d, 1wk and 1mo postoperatively, visual acuity, corneal edema and corneal astigmatism were observed and analyzed. RESULTS:There were 10 eyes in patients accepting knifed chopping with closed hook with intra-operative posterior capsule rupture and 1 eye in patients accepting double knifed chopping. The difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(92 eyesat 1d postoperatively was 0.380±0.105, and that of patients accepting double knifed chopping(92 eyeswas 0.420±0.095; the difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(84 eyesat 1wk postoperatively was 0.480±0.123, and that of patients accepting double knifed chopping(86 eyeswas 0.520±0.085; the difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(60 eyesat 1mo postoperatively was 0.610±0.083, and that of patients accepting double knifed chopping(52 eyeswas 0.643±0.072; the difference between the two groups was not statistically significant. The differences on corneal edema and corneal astigmatism between the two methods at 1d, 1wk and 1mo postoperatively were not statistically significant. CONCLUSION:The application of knifed chopping with closed hook and double knifed chopping in small incision extracapsular cataract extraction and intraocular lens implantation can effectively treat with

  14. Trunk and hip muscle recruitment patterns during the prone leg extension following a lateral ankle sprain: A prospective case study pre and post injury

    Directory of Open Access Journals (Sweden)

    Lehman Gregory J

    2006-02-01

    Full Text Available Abstract Background and case presentation The prone leg extension (PLE is commonly used to identify dysfunction of muscle recruitment patterns. The prone leg extension is theorized to identify proximal muscle disturbances which are a result of distal injury or dysfunction (i.e. an ankle sprain. This case study compares the trunk and hip muscle (bilateral lower erector spine, ipsilateral hamstring and ipsilateral gluteus maximus timing during a PLE of a 27 year old female runner during a healthy state (pre ankle sprain and 2 and 8 weeks post ankle sprain. Results and discussion The gluteus maximus muscle onsets at 8 weeks post injury appeared to occur earlier compared with 2 weeks post injury. The Right Erector Spinae at 8 weeks post injury was also active earlier compared with the participant's non-injured state. A large degree of variability can be noted within trials on the same day for all muscle groups. Conclusion An acute ankle injury did not result in a delay in gluteus maximus muscle activation. The utility of the prone leg extension as a clinical and functional test is questionable due to the normal variability seen during the test and our current inability to determine what is normal and what is dysfunctional.

  15. Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

    Science.gov (United States)

    Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

    2011-08-01

    To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

  16. Sonographic findings after total hip arthroplasty: normal and complications

    International Nuclear Information System (INIS)

    Lee, Kyoung Rok; Seon, Young Seok; Choi, Ji He; Kim, Sun Su; Kim, Se Jong; Park, Byong Lan; Kim, Byoung Geun

    2002-01-01

    The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. Between Janvary 1997 and June 2000, 47 patients (35 men and 12 women aged 24 to 84 (mean, 61) years) using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck , and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fluid, infection had occurred

  17. Sonographic findings after total hip arthroplasty: normal and complications

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Rok; Seon, Young Seok; Choi, Ji He; Kim, Sun Su; Kim, Se Jong; Park, Byong Lan; Kim, Byoung Geun [Kwangju Christian Hospital, Kwangju (Korea, Republic of)

    2002-04-01

    The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. Between Janvary 1997 and June 2000, 47 patients (35 men and 12 women aged 24 to 84 (mean, 61) years) using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck , and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fluid, infection had occurred.

  18. [Trabeculotomy ab interno combined with extracapsular cataract extraction and IOL implantation].

    Science.gov (United States)

    Alekseev, B N; Ermolaev, A P

    2003-01-01

    We made a total of 96 surgeries of extracapsular cataract extraction and IOL implantation combined with trabeculotomy ab interno during a period of 7 years. Patients with both open-angle and narrow-angle glaucoma of stages I and II and with the intraocular pressure (IOP) below or equal to 23 mm Hg according to Goldman under the conditions of hypotensive medicamental regimen were selected for surgery. After IOL was implanted into the lens bag, trabeculotomy ab interno was implemented as stage 2. A special mirror, introduced through the cataract incision, was used for direct gonioscopic monitoring. The trabecula was incised by the edge of a curved surgical knife under direct visual control. We regarded bleeding from the opened sinus as a favorable sign indicative of that the intrascleral collectors were intact. Only minor hyphemas were registered as postoperative complications; there was not a single case of ciliary-and-choroidal detachment. IOP was compensated for, in 6 months after surgery, in 94% of patients--69.8% of them did not use any hypotensive drops.

  19. Hip dysplasia and congenital hip dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; Nebel, G.; von Torklus, D.

    1981-11-01

    In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

  20. Life quality assessment of patients after phacoemulsification or extracapsular cataract extraction

    Directory of Open Access Journals (Sweden)

    Paula Teixeira de Mendonça

    2014-01-01

    Full Text Available Purpose: To study the quality of life, treatment outcomes, and satisfaction in patients who have undergone cataract surgery Methods: This comparative case series study was conducted at the Ophthalmology Service of the Bettina Ferro de Souza University Hospital, Belém, Pará, Brazil. Totally, 60 patients with cataract were included; 50% underwent conventional extracapsular cataract extraction (ECEE and 50% underwent cataract extraction by phacoemulsification (PHACO. Patients were interviewed using the Visual Function 14 (VF-14 questionnaire to determine the quality of life before and 30 days after surgery. The results of ophthalmological examination were recorded in the patients' files and were available throughout this study. One-way ANOVA, Tukey's post-hoc comparison, and the sign test were used for statistical analyses. Results: The mean VF-14 satisfaction index was 38.0 and 89.4 before and after surgery, respectively, for the ECEE group and 47.0 and 94.1, respectively, for the PHACO group. The improvement in patient quality of life after surgery was significant in both groups (p<0.0001, with a similar amount of improvement in both groups. Conclusions: The observed improvement in quality of life was significant (p<0.0001 and directly related to patient satisfaction with surgical outcomes, which was also significant (p<0.0001 as assessed using the VF-14. Satisfaction and quality of life are individual factors; consequently, patient responses to questions regarding improvements in the ability to perform each activity are subjective and depend uniquely on individual perception.

  1. Outcome Analysis of Patients With Oral Cavity Cancer and Extracapsular Spread in Neck Lymph Nodes

    International Nuclear Information System (INIS)

    Liao, Chun-Ta; Lee, Li-Yu; Huang, Shiang-Fu; Chen, I-How; Kang, Chung-Jan; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Yen, Tzu-Chen

    2011-01-01

    Purpose: Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions. Methods and Materials: Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were the main outcome measures. Results: Level IV/V lymph node metastases and tumor depth ≥12 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60%, 66%, and 50%, respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth ≥12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39%, 41%, and 28%, respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14%, 12%, and 10%, respectively. Conclusions: Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth ≥12 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.

  2. Hip Injuries and Disorders

    Science.gov (United States)

    Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball ... fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. ...

  3. Hip Implant Systems

    Science.gov (United States)

    ... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

  4. Hip Replacement Surgery

    Science.gov (United States)

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

  5. A COMPARATIVE STUDY OF THE AMOUNT OF ASTIGMATISM FOLLOWING CONVENTIONAL EXTRACAPSULAR CATARACT EXTRACTION AND MANUAL SMALL INCISION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    Rajkumari Bigyabati

    2016-06-01

    Full Text Available BACKGROUND Cataract is the principal cause of avoidable blindness in India and throughout the world. Surgical removal of the cataractous lens remains the only effective treatment for management of cataract blindness. The success of cataract surgery is determined by best and earliest visual recovery. But the occurrence of postoperative astigmatism has become a major hurdle in achieving this goal. AIMS The study was designed to compare the amount of astigmatism following conventional extracapsular cataract extraction (ECCE and manual small incision cataract surgery (SICS. MATERIALS AND METHODS The study was carried out in 100 eyes of 75 patients aged between 50 and 80 years admitted for cataract surgery. Out of these, 50 eyes were operated by conventional extracapsular cataract extraction and 50 eyes by manual small incision cataract surgery. The patients were followed up at 2 nd , 4 th , 6 th and 8 th weeks. At each follow-up visual acuity, refraction and acceptance and keratometry were recorded and the findings analysed for astigmatism. RESULTS In the current study, the mean (SD astigmatism developed at the end of the 2 nd , 4 th and 6 th of follow-up was significantly lower in the SICS group as compared to the ECCE group (P<0.000. At the end of 8 weeks of follow-up, the mean (SD astigmatism of the SICS group was 0.64±0.56 D as compared to the mean (SD of the ECCE group of 1.39±86 D and the difference was found to be significant (p<0.014. CONCLUSION The current study concludes that manual small incision cataract surgery is a better technique to control postoperative astigmatism than conventional extracapsular cataract extraction.

  6. Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology

    International Nuclear Information System (INIS)

    Taljanovic, Mihra S.; Schwartz, Stephanie A.; Graham, Anna R.; Benjamin, James B.; Gmitro, Arthur F.; Krupinski, Elizabeth A.; Hunter, Tim B.; Resnick, Donald L.

    2008-01-01

    To correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA). The study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement. A spin echo (SE) sequence with four echoes and separate fast spin echo (FSE) proton density (PD)-weighted SE sequences of fat (F) and water (W) were acquired with water and fat suppression, respectively. T2 and water:fat ratio calculations were made for the outlined regions of interest. The calculated MRI values were correlated with the clinical, radiographic, and histopathologic findings. Analyses of variance were done on the MRI data for W/(W + F) and for T2 values (total and focal values) for the symptomatic and contralateral hips. The values were significantly higher in the study group. Statistically significant correlations were found between pain and total W/(W + F), pain and focal T2 values, and the number of microfractures and calculated BME for the focal W/(W + F) in the proximal femora. Statistically significant correlations were found between the radiographic findings and MRI values for total W/(W + F), focal W/(W + F) and focal T2 and among the radiographic findings, pain, and hip movement. On histopathology, only a small amount of BME was seen in eight proximal femora. The amount of BME in the OA hip, as measured by MRI, correlates with the severity of pain, radiographic findings, and number of microfractures. (orig.)

  7. Application on small incision extracapsular cataract extraction in large-scale vision recovery action in Shaanxi Province

    Directory of Open Access Journals (Sweden)

    Juan Zhang

    2014-09-01

    Full Text Available AIM: To investigate the characteristics of scale cataract operations and the effects and experiences of small incision extracapsular cataract extraction with intraocular lens(IOLimplantation in large-scale vision recovery action. METHODS: Four thousand eight hundred ninety-two cases(4 892 eyesof cataract were treated by small incision non-phacoemulcification cataract extraction from March 2010 to November 2011 in our hospital(Fuming No.1 surgery car of Shaanxi Provincewhich were retrospectively analyzed. Visual acuity, intraoperative and postoperative complications, the recovery of postoperative inflammation were observed. RESULTS: Visual acuity reached 0.3 or more in 4 521 eyes(92.42%at 1d after the operation, at 3d after the operation in 4 571 eyes(93.44%, there were 4 887 eyes with IOL implantation, implantation rate was 99.90%. All the cases had lesser intraoperative and postoperative complications, and the postoperative inflammation recovered quickly. CONCLUSION: Small incision extracapsular cataract extraction with IOL implantation is simple, effective, economical, safe and adapting for large-scale vision recovery action.

  8. The effect of extracapsular injuries on growth and development of the mandible condyle: an experimental study in growing dogs.

    Science.gov (United States)

    Liu, Siying; Tian, Lei; Ding, Mingchao; Liu, Yanpu; Li, Guiyu; Chen, Jinwu; Ding, Yin

    2016-11-01

    To investigate the effects of condylar extracapsular injuries on the development of the mandibular condyle and try to find a way to treat condylar hyperplasia by electively using such injuries to restrict the overdeveloped mandibular condyle. Sixty 6-month-old beagle puppies were divided randomly into five groups: blank control; unilateral fracture to the condylar neck; unilateral fracture to the condylar neck treated with rigid internal fixation; unilateral periosteum injury; unilateral decortication of the condylar neck. Computed tomography, 99 m Tc single-photon emission computed tomography, and tetracycline-calcein double-labeling were performed after surgery. The puppies were sacrificed 12 and 24 weeks after surgery. Morphologic analyses and examination of growth activity were done. Unilateral fracture of the condylar neck without fixation caused local morphologic changes during the early postoperative period, but compensatory growth of the condyle altered such changes after healing. The other types of injury failed to inhibit the growth of the condyle and the mandible, whereas functional deviation of the chin was found after unilateral fracture of the condylar neck with or without fixation. The four types of extracapsular injury described here failed to inhibit the growth of the mandibular condyle and could not be selected as alternatives to treat condylar hyperplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Study on the aqueous humor contents of IL-1β and IL-6 in rabbits after extracapsular extraction of lens

    International Nuclear Information System (INIS)

    Zhao Jun

    2007-01-01

    Objective: To explore the relationship between the development of posterior capsular opacification and the aqueous humor contents of IL-1β and IL-6 after extracapsular extraction of lens in rabbits. Methods: Extracapsular extraction of lens was performed in 30 New Zealand rabbits. Aqueous humor contents of IL-1β and IL-6 were repeatedly determined with RIA and ophthal-moscopic as well as slit-lamp examination were repeatedly performed to detect any posterior capsular opacification developed on dl, d3, 1w, 2w, 1 month, 3 month posteperatively. Results: The aqueous humor contents of IL-1β and IL-6 increased gradually after operation, reached the peak on d7-d14, then gradually returned to within normal range by 2nd or 3rd month. Beginning from one month post-operatively, posterior capsular opacification was observed in some rabbits. By the end of 3rd month, Grade I opacification was developed in 5 rabbits, Grade H in 9 rabbits with Grade III (fundus view obliterated) in 14 rabbits. Peak IL-1β and IL- 6 content values were positively correlated with grading of future opacification. Conclusion: IL-1β and IL-6 might play important roles in the development of posterior capsular opacification after lens extraction in rabbits. (authors)

  10. Scintigraphic presentation of hip joint synovial chondromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Zwas, S T; Friedman, B; Nerubay, J

    1988-09-01

    A case of hip joint synovial chondromatosis with an unusual scintigraphic pattern is described. This pattern was suggestive of a hip joint destructive reactive articular process or late manifestations of avascular necrosis of the femoral head. Concurrent radiographs were normal, as were laboratory investigations. Follow-up radiographs six months later showed radiolucencies and erosive bone changes in the diseased joint. Surgical and histopathological findings revealed well developed hip synovial chondromatosis (HSC) with thickened synovium and large, loose, cartilaginous bodies occupying and widening the tightened joint space, with destructive secondary juxta articular pressure and bone erosions. This and other scintigraphic patterns in HSC, and the differential diagnosis of the findings in patients with painful hip presentations are discussed.

  11. International Multicenter Study on the Impact of Extracapsular Lymph Node Involvement in Primary Surgery Adenocarcinoma of the Esophagus on Overall Survival and Staging Systems

    NARCIS (Netherlands)

    Nafteux, Philippe R.; Lerut, Antoon M.; Moons, Johnny; Hölscher, Arnulf H.; Bollschweiler, Elfriede; van Berge Henegouwen, Mark I.; Lagarde, Sjoerd M.; van Lanschot, Jan J.; Messager, Mathieu; Mariette, Christophe; D'Journo, Xavier B.; Thomas, Pascal A.; de Leyn, Paul R.

    2015-01-01

    Objective:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI)

  12. Force direction patterns promote whole body stability even in hip-flexed walking, but not upper body stability in human upright walking

    Science.gov (United States)

    Müller, Roy; Rode, Christian; Aminiaghdam, Soran; Vielemeyer, Johanna; Blickhan, Reinhard

    2017-11-01

    Directing the ground reaction forces to a focal point above the centre of mass of the whole body promotes whole body stability in human and animal gaits similar to a physical pendulum. Here we show that this is the case in human hip-flexed walking as well. For all upper body orientations (upright, 25°, 50°, maximum), the focal point was well above the centre of mass of the whole body, suggesting its general relevance for walking. Deviations of the forces' lines of action from the focal point increased with upper body inclination from 25 to 43 mm root mean square deviation (RMSD). With respect to the upper body in upright gait, the resulting force also passed near a focal point (17 mm RMSD between the net forces' lines of action and focal point), but this point was 18 cm below its centre of mass. While this behaviour mimics an unstable inverted pendulum, it leads to resulting torques of alternating sign in accordance with periodic upper body motion and probably provides for low metabolic cost of upright gait by keeping hip torques small. Stabilization of the upper body is a consequence of other mechanisms, e.g. hip reflexes or muscle preflexes.

  13. Patterns of subcutaneous fat deposition and the relationship between body mass index and waist-to-hip ratio: implications for models of physical attractiveness.

    Science.gov (United States)

    Cornelissen, Piers L; Toveé, Martin J; Bateson, Melissa

    2009-02-07

    Body mass index (BMI) and waist-to-hip ratio (WHR) are two widely used anthropometric indices of body shape argued to convey different information about health and fertility. Both indices have also been shown to affect attractiveness ratings of female bodies. However, BMI and WHR are naturally positively correlated, complicating studies designed to identify their relative importance in predicting health and attractiveness outcomes. We show that the correlation between BMI and WHR depends on the assumed model of subcutaneous fat deposition. An additive model, whereby fat is added to the waist and hips at a constant rate, predicts a correlation between BMI and WHR because with increasing fat, the difference between the waist and hips becomes smaller relative to total width. This model is supported by longitudinal and cross-sectional data. We parameterized the function relating WHR to BMI for white UK females of reproductive age, and used this function to statistically decompose body shape into two independent components. We show that judgements of the attractiveness of female bodies are well explained by the component of curvaceousness related to BMI but not by residual curvaceousness. Our findings resolve a long-standing dispute in the attractiveness literature by confirming that although WHR appears to be an important predictor of attractiveness, this is largely explained by the direct effect of total body fat on WHR, thus reinforcing the conclusion that total body fat is the primary determinant of female body shape attractiveness.

  14. HIP JOINT AND HIP ENDOPROSTHESIS BIOMECHANICS

    OpenAIRE

    Jakub Gryka

    2017-01-01

    This article contains a description of the basic issues related to anatomy, loading of hip joint and its endoprosthesis research methods. The methods of testing and simulating hip joint loads, factors that influence the selection of parameters during the design of prostheses, typical solutions to engineering problems related to this topic are presented. The article concludes with short summary of the finite element method for the design of hip replacements.

  15. Degeneration in dysplastic hips. A computer tomography study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2005-01-01

    BACKGROUND: Hip dysplasia is considered pre-osteoarthritic, causing degeneration in young individuals. OBJECTIVE: To determine the pattern of degenerative change in moderate to severely dysplastic hips in young patients. DESIGN AND PATIENTS: One hundred and ninety-three consecutively......-referred younger patients with hip pain believed to be caused by hip dysplasia constituted the study cohort. The average age was 35.5 years (range, 15-61 years). They were examined by close-cut transverse pelvic and knee computed tomography and antero-posterior radiographs (CT). We identified 197 hips...

  16. Immediate physical therapy in dogs with rupture of the cranial cruciate ligament submitted to extracapsular surgical stabilization

    Directory of Open Access Journals (Sweden)

    L. Berté

    2012-02-01

    Full Text Available The study evaluated the influence of immediate physical therapy on the functional recovery of hind limbs of dogs with experimental cranial cruciate ligament rupture which underwent surgical extracapsular stabilization as well as to verify its interference in joint stability. Eight dogs were randomly divided into two groups: GI (control (n=4 and GII (physical therapy (n=4. The dogs in GII underwent the following therapeutic treatments in the postoperative period: cryotherapy, passive joint movement, massage, passive straightening, neuromuscular electrical stimulation, hydrotherapy (bath and aquatic mat and therapeutic exercises. We performed evaluations of the thigh circumference, goniometry, X-ray, and knee stability (drawer test. Results did not demonstrate a significant difference between the groups nor between different post-operative times. Regarding gait analysis, we found that the 4 dogs in GI remained in degree 3 of lameness 45 and 90 days postoperatively. However, in GII, one dog remained in degree 3 45 and 90 days after surgery; one dog changed from degree 3 to 4 90 days after surgery and the other 2 dogs changed from degree 3 to 5 90 days after surgery. It is possible to conclude that dogs with CCL rupture that undergo immediate physical therapy demonstrate better results in regards to functional gait recovery. The therapeutic modalities used in the immediate post-operative period did not cause instability of the operated knee. Further studies are needed with a larger number of dogs to indicate the immediate physical therapy in dogs with CCL ligament rupture which underwent extracapsular stabilization.

  17. Efeito da facectomia no posicionamento palpebral superior: comparação entre as técnicas de facoemulsificação e a extracapsular Changes in the position of the upper eyelid after cataract surgery: a comparison between phacoemulsification and extracapsular techniques

    Directory of Open Access Journals (Sweden)

    Roberto Pinto Coelho

    2003-10-01

    Full Text Available OBJETIVO: Comparar o efeito de duas técnicas de facectomia (facoemulsificação e extracapsular no posicionamento da pálpebra superior. MÉTODOS: Foi analisado o posicionamento palpebral de dois grupos de pacientes submetidos à cirurgia de catarata: facoemulsificação e extracapsular. As imagens foram digitalizadas (antes e 30 dias após a cirurgia e processadas com o programa NIH 1.62. O posicionamento palpebral foi medido em relação a uma linha horizontal que unia os cantos medial e lateral da fenda palpebral, passando pelo centro da pupila. RESULTADOS: O posicionamento palpebral foi afetado de maneira diferente segundo a técnica utilizada. Na facoemulsificação a diferença média entre a posição palpebral superior pós e pré-operatória foi de -0,54 mm. Na extracapsular esta diferença aumentou para -1,41 mm. O teste t de Student (amostras pareadas mostrou que as médias das diferenças entre os dois grupos são significativamente diferentes (p=0,0068. CONCLUSÃO: A técnica de cirurgia de facoemulsificação induziu menor variação do posicionamento palpebral em relação à cirurgia extracapsular no pós-operatório recente.PURPOSE: To compare changes in the upper eyelid position after cataract surgery with phacoemulsification and extracapsular techniques. METHODS: The upper eyelid position was measured in two groups of patients before and 30 days after cataract surgery performed with phacoemulsification and extracapsular techniques. Palpebral fissure images (before and after the cataract surgery were digitized and then processed using the NIH 1.62 software. Eyelid position was measured relative to a horizontal line passing through the pupil center and connecting both canthi of the palpebral fissure. RESULTS: The palpebral position was differently affected according to the techniques. In phacoemulsification the mean difference between eyelids position before and after surgery was -0.54 mm. In the extracapsular technique this

  18. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  19. Hip joint replacement - slideshow

    Science.gov (United States)

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

  20. Hip Labral Tear

    Science.gov (United States)

    ... that joint in the future. Prevention Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid ...

  1. HPLC/DAD Intercomparison on Phytoplankton Pigments (HIP-1, HIP-2, HIP-3 and HIP-4)

    OpenAIRE

    CANUTI Elisabetta; RAS Josephine; GRUNG Merete; ROTTGERS Rudiger; COSTA GOELA Priscilla; ARTUSO Florinda; CATALDI Dario

    2016-01-01

    From 2009 to 2015, in the context of the MERIS (Medium Resolution Imaging Spectrometer) validation activities, the JRC Marine Optical Laboratory organised four HPLC Intercomparison exercises for Phytoplankton Pigment measurements (HIP-1, HIP-2, HIP-3 and HIP-4), involving seven European accredited and reference laboratories. The objectives of these intercomparison exercises were: creating a reference community at European level for phytoplankton pigment analysis capable of supporting satel...

  2. TREATMENT OF HIP DYSPLASIA

    OpenAIRE

    Iulian ICLEANU; Mariana CORDUN

    2015-01-01

    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 (g...

  3. Hip supporting device

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention relates to a device for limiting movements in one or more anatomical joints, such as a device for limiting movement in the human hip joint after hip replacement surgery. This is provided by a device for limiting movement in the human hip joint, said device comprising: at least...

  4. Bursitis of the Hip

    Science.gov (United States)

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

  5. HIPs at Ten

    Science.gov (United States)

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

    2017-01-01

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

  6. Predicted extracapsular invasion of hilar lymph node metastasis by fusion positron emission tomography/computed tomography in patients with lung cancer.

    Science.gov (United States)

    Makino, Takashi; Hata, Yoshinobu; Otsuka, Hajime; Koezuka, Satoshi; Isobe, Kazutoshi; Tochigi, Nobumi; Shiraga, Nobuyuki; Shibuya, Kazutoshi; Homma, Sakae; Iyoda, Akira

    2015-09-01

    Intraoperative detection of hilar lymph node metastasis, particularly with extracapsular invasion, may affect the surgical procedure in patients with lung cancer, as the preoperative estimation of hilar lymph node metastasis is unsatisfactory. The aim of this study was to investigate whether fusion positron emission tomography/computed tomography (PET/CT) is able to predict extracapsular invasion of hilar lymph node metastasis. Between April, 2007 and April, 2013, 509 patients with primary lung cancer underwent surgical resection at our institution, among whom 28 patients exhibiting hilar lymph node metastasis (at stations 10 and 11) were enrolled in this study. A maximum lymph node standardized uptake value of >2.5 in PET scans was interpreted as positive. A total of 17 patients had positive preoperative PET/CT findings in their hilar lymph nodes, while the remaining 11 had negative findings. With regard to extracapsular nodal invasion, the PET/CT findings (P=0.0005) and the histological findings (squamous cell carcinoma, P=0.05) were found to be significant predictors in the univariate analysis. In the multivariate analysis, the PET/CT findings were the only independent predictor (P=0.0004). The requirement for extensive pulmonary resection (sleeve lobectomy, bilobectomy or pneumonectomy) was significantly more frequent in the patient group with positive compared with the group with negative PET/CT findings (76 vs. 9%, respectively, P=0.01). Therefore, the PET/CT findings in the hilar lymph nodes were useful for the prediction of extracapsular invasion and, consequently, for the estimation of possible extensive pulmonary resection.

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

    Science.gov (United States)

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

  8. Correlation between podoplanin expression and extracapsular spread in squamous cell carcinoma of the oral cavity using subjective immunoreactivity scores and semiquantitative image analysis.

    Science.gov (United States)

    Mermod, Maxime; Bongiovanni, Massimo; Petrova, Tatiana V; Dubikovskaya, Elena A; Simon, Christian; Tolstonog, Genrich; Monnier, Yan

    2017-01-01

    The correlation between podoplanin expression and extracapsular spread in head and neck squamous cell carcinoma (HNSCC) has never been reported. The purpose of this study was to assess the predictive value of podoplanin expression for this parameter. Subjective immunoreactivity scores and semiquantitative image analysis of podoplanin expression were performed in 67 patients with primary oral squamous cell carcinoma and in their corresponding lymph nodes. Neck classification showed 34 cases (51%) of pN0 and 33 cases (49%) of pN+. Correlation between the levels of podoplanin expression and the histopathological data was established. In lymph nodes, a high level of podoplanin expression correlated with the presence of extracapsular spread by multivariate analysis (p = .03). A strong correlation between subjective and semiquantitative image analysis was observed (r = 0.77; p < .001). A high level of podoplanin expression in lymph node metastases of oral squamous cell carcinoma is independently associated with extracapsular spread. © 2016 Wiley Periodicals, Head Neck 39: 98-108, 2017. © 2016 Wiley Periodicals, Inc.

  9. Clinical observation of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract in the sight restoration project

    Directory of Open Access Journals (Sweden)

    Xiao-Jian Cheng

    2014-04-01

    Full Text Available AIM: To analyze the clinical effects of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract.METHODS:Totally 642 cases 676 eyes of cataract were treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Complication during and after operations and postoperative visual acuity was observed.RESULTS:Visual acuity of 670 eyes was ≥0.05 and off-blindness rate was 99.11%, and there was 627 eyes ≥0.3 and the off-disability rate was 92.75% after 1mo. Rupture of posterior capsule during surgery occurred in 24 eyes. Fifty-four eyes were corneal edema, and anterior chamber exudation were 26 eyes, and 23 eyes were hypertension after operation. CONCLUSION: There are a little complications during and after operation for cataract treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Patients have good recovery after operation. This operation does not need high-standard equipments and is suitable in the sight restoration project.

  10. Don't forget the hip! Hip arthritis masquerading as knee pain

    Directory of Open Access Journals (Sweden)

    Florian F. Dibra, MD

    2018-03-01

    Full Text Available Background: Hip osteoarthritis typically manifests with groin or thigh pain. Other atypical pain patterns, including knee pain, have been described. Except for 2 case reports, there is no literature on this subject. Methods: From our institutional database, between 2011 and 2016, we identified 21 patients who were referred for treatment of knee pain but ultimately diagnosed with hip pathology as the cause of their pain. This group was evaluated for duration of symptoms prior to diagnosis, previous interventions, presence of walking aids, and symptom resolution after treatment of the hip pathology. Results: Fifteen of the 21 patients were referred from musculoskeletal providers (12 from orthopaedic surgeons. Prior to diagnosis of the hip etiology, 16 patients were reduced to major assistive devices including wheelchairs. Twelve of 21 patients had undergone surgical knee interventions, including total knee arthroplasty, with minimal to no relief of their pain. Seventeen of 21 referred patients underwent total hip arthroplasty at our institution. Fourteen patients had complete resolution of knee pain after total hip arthroplasty. Conclusions: Although knee pain referred from hip disease may be considered a basic and common knowledge, it continues to be an overlooked phenomenon. Most of the cases were misdiagnosed by musculoskeletal providers including orthopaedic surgeons and this highlights the need for continued education and awareness of this clinical scenario. Keywords: Hip pain, Knee pain, Referred pain, Delay in diagnosis, Unnecessary surgery

  11. A study on management of extracapsular trochanteric fractures by proximal femoral nail

    Directory of Open Access Journals (Sweden)

    K Ramaprathap Reddy

    2016-01-01

    Full Text Available Background: Trochanteric fractures of femur like intertrochanteric and subtrochanteric fractures are a leading cause of hospital admissions in elderly people. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilizations such as bed sores, deep vein thrombosis, and respiratory infections. This study is done to analyze the surgical management of trochanteric fractures of the femur using a proximal femoral nail (PFN. Methodology: This is a prospective study of 40 cases of trochanteric and subtrochanteric fractures admitted to Government General Hospital, Vijayawada, Andhra Pradesh. Cases were taken according to inclusion and exclusion criteria, i.e., patients with trochanteric fractures femur above the age of 20 years. Medically unsuitable, open fractures and patients not willing for surgery were excluded from the study. Results: Forty percentage of cases were admitted due to slip and fall and with a slight predominance of the right side. Out of 40 cases, 26 were trochanteric, and 14 were subtrochanteric. In trochanteric class, 37.5% were body and griffin Type 2, in subtrochanteric class 12.5% were sinsheimer Type 3a and 10% were 2b. Out of 30 remaining cases, 25 were trochanteric, and 05 were subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 90% cases in subtrochanteric fractures. Conclusion: From this sample study, we consider that PFN is an excellent implant for the treatment of pertrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier, and exactly performed osteosynthesis.

  12. Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

    Science.gov (United States)

    Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

    2017-09-01

    To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

  13. Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI

    International Nuclear Information System (INIS)

    Bloch, B.N.; Genega, Elizabeth M.; Costa, Daniel N.; Pedrosa, Ivan; Rofsky, Neil M.; Smith, Martin P.; Kressel, Herbert Y.; Ngo, Long; Sanda, Martin G.; DeWolf, William C.

    2012-01-01

    To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T for determining extracapsular extension (ECE) of prostate cancer. In this IRB-approved study, ERC 3-T MRI of the prostate was performed in 108 patients before radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analysed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating characteristic curve. The overall sensitivity, specificity, positive predictive value and negative predictive value for ECE were 75 %, 92 %, 79 % and 91 %, respectively. Diagnostic accuracy for staging was 86 %, 80 % and 91 % for all readers, experienced and less experienced readers, respectively. ERC 3-T MRI of the prostate combining DCE and T2W imaging is an accurate pretherapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience. (orig.)

  14. 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.

  15. Assessment of bone quality in the isolated femoral head for intracapsular fractures of the femoral head. Analysis of bone architecture using micro-CT and pQCT, and comparison with extracapsular fractures

    International Nuclear Information System (INIS)

    Sando, Masaru

    2003-01-01

    Block sections were prepared from the five locations, central portion, superior portion, inferior portion, anterior portion, and posterior portion, of the region around the fracture of the femoral head isolated from 21 patients (16 patients with intracapsular fracture, 5 patients with extracapsular fracture). Cancellous bone microstructure, cortical bone thickness, and bone density were evaluated and analyzed for differences in the mechanism from which intracapsular versus extracapsular fracture and fragility developed. The method of evaluating the bone architecture differed from conventional bone histomorphometry of hard tissues and involved non-invasive micro-CT measurements, while the bone density was measured by peripheral quantitative computed topography (pQCT). The results indicate that in comparison to patients with extracapsular fractures, patients with intracapsular fractures showed significant decreases in the trabecular thickness of superior and posterior portions in the cancellous bone. The cortical bone thickness was significantly decreased in the superior portion. Bone density was significantly decreased in the superior portion, while in the extracapsular fracture group density tended to be lower in the inferior, anterior, and posterior portions, although this was not statistically significant. Although there have been previous studies on the bone quality of the femoral head isolated from intracapsular fracture of the femoral head, most reports are of two-dimensional analysis of coronal sections. As far as we are aware, there have been no previous reports comparing individual locations to extracapsular fractures. In view of the various reports that bone density is lower in the extracapsular fracture compared to the intracapsular fracture, we speculate that extracapsular fracture results from the effects of external forces on decreased bone density, while in the intracapsular fracture type, thinning of the superior portion of the cortical bone creates

  16. Imaging of the hip

    International Nuclear Information System (INIS)

    Karantanas, A.

    2012-01-01

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

  17. 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.

  18. Hip arthroplasty for ochronosis

    International Nuclear Information System (INIS)

    Kerimoglu, S.; Onder, C.; Aynaci, O.; Malkoc, C. H.

    2005-01-01

    Alkaptonuria is a metabolic disorder in which homogentisic acid oxidase is absent. Therefore, homogentisic acid accumulates in cartilage and connective tissues. We can diagnose ochronotic arthropathy, a manifestation of long standing alkaptonuria, through careful radiological, physical, and laboratory examination. In this report, we describe 4 cases of ochronotic arthropathy to which we applied cementless total hip prosthesis due to severe hip involvement. (author)

  19. Taking care of your new hip joint

    Science.gov (United States)

    Hip arthroplasty - precautions; Hip replacement - precautions; Osteoarthritis - hip; Osteoarthritis - knee ... After you have hip replacement surgery, you will need to be careful how you move your hip, especially for the first few months ...

  20. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...

  1. A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer.

    Science.gov (United States)

    Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

    2015-08-01

    Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.

  2. Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

    International Nuclear Information System (INIS)

    Devineni, V.R.; Simpson, J.R.; Sessions, D.; Spector, J.G.; Hayden, R.; Fredrickson, J.; Fineberg, B.

    1991-01-01

    Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as grave signs. The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%. This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal

  3. Effect of the Abdominal Hollowing and Bracing Maneuvers on Activity Pattern of the Lumbopelvic Muscles During Prone Hip Extension in Subjects With or Without Chronic Low Back Pain: A Preliminary Study.

    Science.gov (United States)

    Kahlaee, Amir H; Ghamkhar, Leila; Arab, Amir M

    2017-02-01

    The purpose of this study was to compare the effect of abdominal hollowing (AH) and abdominal bracing (AB) maneuvers on the activity pattern of lumbopelvic muscles during prone hip extension (PHE) in participants with or without nonspecific chronic low back pain (CLBP). Twenty women with or without CLBP participated in this cross-sectional observational study. The electromyographic activity (amplitude and onset time) of the contralateral erector spinae (CES), ipsilateral erector spinae (IES), gluteus maximus, and biceps femoris muscles was measured during PHE with and without abdominal maneuvers. A 3-way mixed model analysis of variance and post hoc tests were used for statistical analysis. Between-group comparisons showed that the CES onset delay during PHE alone was greater (P = .03) and the activity level of IES, CES, and biceps femoris in all maneuvers (P .05). Performance of the AH maneuver decreased the erector spinae muscle AMP in both groups, and neither maneuver altered the onset delay of any of the muscles in either group. The low back pain group showed higher levels of activity in all muscles (not statistically significant in gluteus maximus during all maneuvers). The groups were similar according to the onset delay of any of the muscles during either maneuver. Copyright © 2016. Published by Elsevier Inc.

  4. Ability of preoperative 3.0-Tesla magnetic resonance imaging to predict the absence of side-specific extracapsular extension of prostate cancer.

    Science.gov (United States)

    Hara, Tomohiko; Nakanishi, Hiroyuki; Nakagawa, Tohru; Komiyama, Motokiyo; Kawahara, Takashi; Manabe, Tomoko; Miyake, Mototaka; Arai, Eri; Kanai, Yae; Fujimoto, Hiroyuki

    2013-10-01

    Recent studies have shown an improvement in prostate cancer diagnosis with the use of 3.0-Tesla magnetic resonance imaging. We retrospectively assessed the ability of this imaging technique to predict side-specific extracapsular extension of prostate cancer. From October 2007 to August 2011, prostatectomy was carried out in 396 patients after preoperative 3.0-Tesla magnetic resonance imaging. Among these, 132 (primary sample) and 134 patients (validation sample) underwent 12-core prostate biopsy at the National Cancer Center Hospital of Tokyo, Japan, and at other institutions, respectively. In the primary dataset, univariate and multivariate analyses were carried out to predict side-specific extracapsular extension using variables determined preoperatively, including 3.0-Tesla magnetic resonance imaging findings (T2-weighted and diffusion-weighted imaging). A prediction model was then constructed and applied to the validation study sample. Multivariate analysis identified four significant independent predictors (P Tesla diffusion-weighted magnetic resonance imaging findings, ≥2 positive biopsy cores on each side and a maximum percentage of positive cores ≥31% on each side. The negative predictive value was 93.9% in the combination model with these four predictors, meanwhile the positive predictive value was 33.8%. Good reproducibility of these four significant predictors and the combination model was observed in the validation study sample. The side-specific extracapsular extension prediction by the biopsy Gleason score and factors associated with tumor location, including a positive 3.0-Tesla diffusion-weighted magnetic resonance imaging finding, have a high negative predictive value, but a low positive predictive value. © 2013 The Japanese Urological Association.

  5. MR findings of transient synovitis of the hip

    International Nuclear Information System (INIS)

    Lee, Jong Sea; Na, Jae Boem; Yoo, Jin Jong; Ahn, In Oak; Chung, Sung Hoon

    2000-01-01

    To evaluate the MR findings of transient synovitis of the hip in children. Between 1993 and 1997, MR imaging was performed in 30 children (male:female 22:8) in whom transient synovitis had been clinically diagnosed. In 20 of these 30 patients, Gd-enhanced study was also performed. The signal intensity of bone marrow of the femur, the synovial enhancement pattern and the amount of hip joint effusion in affected hips were evaluated; the last -mentioned was determined using the volume measurement method. In 29 patients (97%), no abnormal signal intensity was seen in bone marrow of the femur in affected hips. Gd-enhanced MR imaging revealed synovial enhancement of affected hip joints, as follows: minimal enhancement in eight patients (40%), moderate enhancement in eight (40%), and strong enhancement in four (20%). No abnormal enhancement was demonstrated in bone marrow of the femur or adjacent soft tissue. The mean amount of joint effusion of affected hips was 2.7±1.7 (range, 0.2-18.9)ml; statistically, this was much greater than that of contralateral hip (p less than 0.01). The MR findings of transient synovitis of the hip in children were normal bone marrow signal intensity of the femoral head, moderate or strong synovial enhancement, and asymmetric hip joint effusion. (author)

  6. Injury incidence in hip hop dance.

    Science.gov (United States)

    Ojofeitimi, S; Bronner, S; Woo, H

    2012-06-01

    Hip hop dance has rapidly become a popular international art form. There is limited information on injury patterns in this population. The purpose of this study was to determine injury incidence and patterns among three groups of hip hop dancers. Three hundred and twelve intermediate, advanced, and expert hip hop dancers were recruited at battles, dance conferences, clubs, and on dance related web sites within the United States and internationally. A Web-based survey was conducted over a 6-month period. Inclusion criteria included intermediate and advanced level dancers over the age of 13. Dancers were divided into three main categories: Breakers, Popper/Lockers, and New Schoolers. Separate analysis of variances were used to compare injury pattern differences between groups. Two hundred and thirty-two dancers reported a total of 738 injuries. Five hundred and six of these (sustained by 205 dancers) were time-loss (TL) injuries. Annual injury incidence was 237% (162% involving TL). Lower extremity injuries were 52% and upper extremity injuries 32% of total injuries. Breakers had a higher injury incidence compared with Popper/Lockers, and New Schoolers. Hip hop dancers report injury rates that are higher than other dance forms but similar to gymnastics. These dancers should be educated concerning injury prevention, biomechanics, and use of protective equipment. © 2010 John Wiley & Sons A/S.

  7. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

    McWalter, Patricia; Hassan Ahmed

    2007-01-01

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

  8. Transient osteoporosis of hip

    Directory of Open Access Journals (Sweden)

    Mahesh M Choudhary

    2015-01-01

    Full Text Available We report a case of transient osteoporosis of the hip (TOH in a 50-year-old man including the clinical presentation, diagnostic studies, management, and clinical progress. TOH is a rare self-limiting condition that typically affects middle-aged men or, less frequently, women in the third trimester of pregnancy. Affected individuals present clinically with acute hip pain, limping gait, and limited ranges of hip motion. TOH may begin spontaneously or after a minor trauma. Radiographs are typically unremarkable but magnetic resonance (MR imaging studies yield findings consistent with bone marrow edema. TOH is referred to as regional migratory osteoporosis (RMO if it travels to other joints or the contralateral hip. TOH often resembles osteonecrosis but the two conditions must be differentiated due to different prognoses and management approaches. The term TOH is often used interchangeably and synonymously with transient bone marrow edema (TBME.

  9. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

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

    2016-01-01

    Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DHAR...... was 0.65 and HAGOS sub-scores were 51 (pain), 49 (symptoms), 53 (ADL), 35 (sport), 20 (physical activity) and 29, respectively. We conclude that patients undergoing hip arthroscopy report considerable pain, loss of function, reduced level of activity and reduced quality-of-life prior to surgery....... 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...

  10. Osteoarthritis of the hip

    International Nuclear Information System (INIS)

    Kokubo, Takashi; Takatori, Yoshio; Sasaki, Yasuhito

    1993-01-01

    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)

  11. Athletic Hip Injuries.

    Science.gov (United States)

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

    2017-04-01

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

  12. Extracapsular cataract extraction training: junior ophthalmology residents' self-reported satisfaction level with their proficiency and initial learning barrier.

    Science.gov (United States)

    Ting, Daniel Shu Wei; Tan, Sarah; Lee, Shu Yen; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San

    2015-07-01

    To investigate residents' self-reported satisfaction level with their proficiency in extracapsular cataract extraction (ECCE) surgery and the initial barriers to learning the procedure. This is a single-centre prospective descriptive case series involving eight first-year ophthalmology residents in Singapore National Eye Center. We recorded the demographics, frequency of review by the residents of their own surgical videos and their satisfaction level with their proficiency at each of the ECCE steps using a 5-point Likert scale. All ECCE surgical videos between October 2013 and May 2014 were collected and analysed for the overall time taken for the surgery and the time taken to perform the individual steps of the procedure. The mean age of the residents was 27.6 ± 1.5 years and 62.5% (5/8) were women. More than half (62.5%, 5/8) reviewed their own surgical videos while 37.5% (3/8) discussed the surgical videos with their peers or supervisors. Of the ECCE steps, the residents were most dissatisfied with their proficiency in performing irrigation and aspiration (87.5%, 7/8), followed by suturing (62.5%, 5/8), intraocular lens insertion (62.5%, 5/8) and tin can capsulotomy (62.5%, 5/8). The average time taken for each ECCE case was 55.0 ± 12.2 min and, of all the steps, most time was spent on suturing (20.5 ± 6.8 min), followed by irrigation and aspiration (5.5 ± 3.6 min) and tin can capsulotomy (3.3 ± 1.8 min). The first-year ophthalmology residents were most dissatisfied with their proficiency in irrigation/aspiration, suturing and tin can capsulotomy. More training needs to be directed to these areas during teaching sessions in the operating room, wet laboratory or cataract simulation training sessions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Structural differences between hip endoprostheses, and implications on a hip kinetics

    Directory of Open Access Journals (Sweden)

    Mirza Biščević

    2005-11-01

    Full Text Available We compared kinetic characteristic of unipolar, bipolar and total hip endoprostheses, implanted after dislocated femoral neck fracture. Ninety patients were divided into three groups (30 patients in each group; a group with unipolar partial hip endoprosthesis (UPEP, a group with bipolar partial hip endoprosthesis (BPEP and a group with total hip endoprosthesis (TEP. The patients from different groups were paired by parameters which could influence the long term functional result: follow up period, comorbidities, functional capabilities before injury, etc. After the average follow up 3.8 +/- 1.9 years, a measuring of range of hip motions (ROM was conducted. The largest mean amplitudes in flexion (104 degrees, extension (13 degrees, abduction (35 degrees and external rotation (38 degrees was achieved BPEP, the largest adduction (14 degrees was achieved UPEP, and internal rotation (34 degrees TEP. Differences in ROMs are partially related to the clinical parameters such as: level of the hip pain, gait pattern, age and rehabilitation period (P < 0.05. Measuring of ROMs is the most reliable part of the clinical exam and it does not depend on subjectivity of patient, as opposed to other clinical parameters (level of pain, walking distance, aids usage, etc. The results obtained are favorable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between the three types of hip endoprostheses. Kinetic advantages of the BPEP as compared to the UPEP, can be explained by the BPEP's structure: two-level mobility and a thinner neck which delays impingement in the late motion phase. In comparison to the TEP, clinical advantages of the BPEP can be attributed to less extensive surgery and scarring.

  14. The efficacy of modified direct lateral versus posterior approach on gait function and hip muscle strength after primary total hip arthroplasty at 12months follow-up

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

    2016-01-01

    -spatial parameters and range of motion. Isometric maximal hip muscle strength in abduction, flexion and extension was also tested. FINDINGS: Post-operatively, no between-group difference in gait function was observed. However, both hip abductor and flexor muscle strength improved more in the posterior approach group......BACKGROUND: The lateral and the posterior approach are the most commonly used procedures for total hip arthroplasty. Due to the detachment of the hip abductors, lateral approach is claimed to cause reduced hip muscle strength and altered gait pattern. However, this has not been investigated...... in a randomised controlled trial. The aim was to compare the efficacy of total hip arthroplasty performed by lateral or posterior approach on gait function and hip muscle strength up to 12months post-operatively. We hypothesised that posterior approach would be superior to lateral approach. METHODS: Forty...

  15. Simultaneous anterior and posterior dislocation of hips: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Gupta Vinay

    2012-11-01

    Full Text Available 【Abstract】The presence of anterior hip dislocation along with contralateral posterior hip dislocation in the ab-sence of other major traumas is a distinctly rare injury pattern. We report such a case, along with a review of previous cases. A 40-year-old male patient after motorcycle skidding had posterior dislocation of the left hip and anterior dislo-cation of the right one without other associated injuries. The patient underwent successful closed reduction of both hips. The clinical course and follow-up assessment of the patient was uneventful. Key words: Wounds and injuries; Hip dislocation; Accidents, traffic

  16. ASYMMETRICAL BILATERAL HIP DISLOCATION WITH SEGMENTAL FRACTURE FEMUR: AN UNUSUAL CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-01-01

    Full Text Available Bilateral traumatic hip dislocation is rarely seen. A unique case is presented, consisting of asymmetric bilateral hip dislocation with associated segmental fracture femur, resulting from fall from bus. This case represents an unusual, severe combination of injuries resulting from the fall from bus under influence of alcohol. Traumatic hip dislocation represents a true orthopaedic emergency . Given the severity of associated complications, every effort should be made to ensure pr ompt diagnosis and immediate therapy. We report our experience in the management of this complex injury pattern and review the pertinent literature on this subject. Keywords: Bilateral hip dislocation , Asymmetric hip dislocation , Segmental femur fracture , Closed reduction , Fall from bus .

  17. The Hyperflexible Hip

    Science.gov (United States)

    Weber, Alexander E.; Bedi, Asheesh; Tibor, Lisa M.; Zaltz, Ira; Larson, Christopher M.

    2015-01-01

    Context: Dance, gymnastics, figure skating, and competitive cheerleading require a high degree of hip range of motion. Athletes who participate in these sports use their hips in a mechanically complex manner. Evidence Acquisition: A search of the entire PubMed database (through December 2013) and additional searches of the reference lists of pertinent articles. Study Design: Systematic review. Level of Evidence: Level 3. Results: Whether innate or acquired, dancers and gymnasts have some hypermobility that allows their hips to be placed in potentially impinging or unstable positions required for their given activity. Such extremes of motion can result in both intra-articular and extra-articular impingement as well as compensatory osseous and muscular pathology. In addition, dancers and gymnasts are susceptible to impingement-induced instability. Dancers with innate generalized hyperlaxity are at increased risk of injury because of their activities and may require longer recovery times to return to play. Both nonoperative and operative treatments (arthroscopic and open) have an important role in returning flexibility athletes to their preoperative levels of sport and dance. Conclusion: Because of the extreme hip motion required and the compensatory soft tissue laxity in dancers and gymnasts, these athletes may develop instability, impingement, or combinations of both. This frequently occurs in the setting of subtle pathoanatomy or in patients with normal bony anatomy. With appropriate surgical indications and the correct operative technique, the treating surgeon can anticipate high levels of return to play for the gymnast and dancer with hip pain. PMID:26137181

  18. Complications in Hip Arthroscopy

    Science.gov (United States)

    Nakano, Naoki; Khanduja, Vikas

    2016-01-01

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

  19. Hip Replacement: MedlinePlus Health Topic

    Science.gov (United States)

    ... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...

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

    NARCIS (Netherlands)

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

    2000-01-01

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

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

    NARCIS (Netherlands)

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

    2000-01-01

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

  2. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  3. Parálisis facial periférica después de amigdalectomía extracapsular

    Directory of Open Access Journals (Sweden)

    Erwin Alejandro Racines-Alava

    2018-05-01

    Full Text Available Introducción y objetivo: La amigdalectomía extracapsular es uno de los procedimientos más frecuentes en Otorrinolaringología. No suelen ocurrir complicaciones salvo las derivadas de problemas de sangrado. Presentamos dos casos de parálisis facial en el postoperatorio inmediato y sus posibles causas. Material y Método: Realizamos la adenoamigdalectomía siempre bajo anestesia general. Colocamos a los pacientes en posición de Rose, y usamos un abrebocas de Mc Ivor. La adenoidectomía se realizó mediante curetaje. Posteriormente se infiltró bupivacaina + epinefrina 2.5/0.005 mg/ml en cada pilar anterior. La amigdalectomía total se realizó con pinza bipolar con mínimo sangrado. Caso 1: Niña de 4 años con un peso de 11Kg con antecedente de retardo de crecimiento, diagnosticada de SAHOS moderado, se le realizo adenoamigdalectomía total. La paciente abandonó el quirófano en buenas condiciones. En la sala de recuperación se observa una parálisis facial periférica grado IV de la clasificación House-Brackmann. La parálisis facial se resolvió en las siguientes 12 horas, se administró una pauta descendente de prednisona 1mgkg/día. Caso 2: Niña de 2 años con un peso de 17 kg sin antecedentes de importancia, diagnosticada de SAHOS moderado, se le realizó una adenoamigdalectomía total. En el posoperatorio inmediato, al extubar a la paciente se observa una parálisis facial izquierda grado III de la clasificación de House-Brackmann. Finalmente, la parálisis mejoró progresivamente en 6 horas, se administró una dosis de prednisona 1mg/kg. Resultados: La dosis máxima de Bupivacaína en los niños es de 2mg/kg. La presencia de vasoconstrictor disminuye la velocidad de absorción, con lo que disminuye la toxicidad sistémica, prolonga la duración de acción, aumenta la intensidad del bloqueo y disminuye la hemorragia quirúrgica. En la literatura nos encontramos escasos casos descritos de parálisis facial siguiendo amigdalectom

  4. X-Ray Exam: Hip

    Science.gov (United States)

    ... for Educators Search English Español X-Ray Exam: Hip KidsHealth / For Parents / X-Ray Exam: Hip What's in this article? What It Is Why ... You Have Questions Print What It Is A hip X-ray is a safe and painless test ...

  5. Fratura proximal de tíbia após cirurgia extracapsular para correção de ruptura de ligamento cruzado cranial em cão Tibial fracture caused by complications after an extracapsular suture for the repair of cranial cruciate ligament rupture in a dog

    Directory of Open Access Journals (Sweden)

    Jaqueline França dos Santos

    2013-03-01

    Full Text Available Ruptura de ligamento cruzado cranial (RLCCr é a afecção ortopédica mais frequente no joelho de cães e a sutura fabelo-tibial é frequentemente utilizada na sua correção. Essa técnica pode estar associada com complicações incisionais, lesão tardia de menisco, edema associado ao material de sutura e infecção. O objetivo desta nota foi relatar a ocorrência de fratura proximal de tíbia em um cão, causada por complicação em sutura fabelo-tibial para correção de RLCCr. Um canino atendido em outro serviço foi submetido à osteossíntese com placa 2,0mm para correção de complicação em técnica extra-capsular, na qual houve fratura da tíbia na região do orifício criado para confecção da sutura fabelo-tibial. Houve falha dos implantes e a placa foi removida. A fratura foi estabilizada com fixador esquelético externo circular, sendo constatada, após 120 dias, consolidação.Cranial cruciate ligament rupture (CCLR is one of the most common orthopedic diseases in dogs and extracapsular suture with nylon is often used for its correction. This technique may be associated with incisional complications, post-surgical meniscus injury, swelling associated with suture material and infection. The objective of this study is to report a tibial fracture in a dog, caused by complications after an extracapsular suture for the repair of CCLR. An adult dog, which suffered a tibial fracture after an extracapsular fixation for a CCLR, underwent surgery for the fixation of the fracture with a 2.0mm plate, by a referring veterinarian, but the implant failed. The plate was removed and the fracture was stabilized with a circular fixator. Bone consolidation was observed after 120 days.

  6. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Lund, Bent; Nielsen, Torsten Grønbech

    2018-01-01

    PURPOSE: Predictors of outcome after femoroacetabular impingement (FAI) surgery are not well-documented. This study presents data from the Danish Hip Arthroscopy Registry (DHAR) for such analyses. The purpose of this study was to identify predictors of poor outcome after FAI surgery in a Danish FAI...

  7. Epidemiology of Hip Flexor and Hip Adductor Strains in National Collegiate Athletic Association Athletes, 2009/2010-2014/2015

    DEFF Research Database (Denmark)

    Eckard, Timothy G; Padua, Darin A; Dompier, Thomas P

    2017-01-01

    restriction time were examined. Injury rate ratios (IRRs) and proportion ratios were calculated to compare rates within and between sports by event type, sex, mechanism, recurrence, and participation restriction time. RESULTS: A total of 770 hip flexor and 621 hip adductor strains were reported, resulting....../2010-2014/2015 academic years. STUDY DESIGN: Descriptive epidemiology study. METHODS: Rates and patterns of hip flexor and adductor strains in collegiate sports were examined in a convenience sample of NCAA varsity teams from 25 sports. Rates and distributions of strains by mechanism, recurrence, and participation...... in overall injury rates of 1.60 and 1.29 per 10,000 athlete-exposures (AEs), respectively. In men, the rate of hip flexor strains was 1.81 per 10,000 AEs, and that for hip adductor strains was 1.71 per 10,000 AEs. In women, the rate of hip flexor strains was 1.59 per 10,000 AEs, and the rate of hip adductor...

  8. Scintimetry in transient synovitis of the hip in the child

    International Nuclear Information System (INIS)

    Hasegawa, Yukiharu; Wingstrand, H.; Gustafson, T.

    1988-01-01

    Fifty-five consecutive children presenting with transient synovitis of the hip were examined with 99m Tc-MDP scintigraphy and pin-hole collimator technique. Quantitative assessment was performed along a profile of interest across the hip joint. The criteria for the normal scintimetric pattern in the child's hip were established and the pathologic pattern of uptake in the acute phase, as well as in the follow-up after synovitis, was described. A decrease in isotope uptake in the proximal femoral epiphysis was observed in 13 children. This was correlated with a reduced uptake in the growth-plate, indicating a disturbance of blood supply to these regions. A characteristic pattern of isotope uptake with duration of symptoms was observed: a decrease in uptake during the first week followed by rebound hyperemia within 1 month. One child developed osteonecrosis (Legg-Calve-Perthes disease). (author)

  9. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

    International Nuclear Information System (INIS)

    Siddesh, N.D.; Shah, Hitesh; Joseph, Benjamin

    2012-01-01

    This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMD HG ). Radiographs of 271 adult patients with SEMD HG were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips. Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores. Degenerative arthritis of the hip develops in the majority of patients with SEMD HG ; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned. (orig.)

  10. Estudo prospectivo comparativo de duas técnicas cirúrgicas de extração extra-capsular planejada de catarata com implante de lente intra-ocular: incisão limbar e incisão escleral tunelizada Prospective comparative study of two techniques of planned extracapsular cataract extraction: limbal incision and scleral tunnel incision

    Directory of Open Access Journals (Sweden)

    Lincoln Lemes Freitas

    2001-06-01

    Full Text Available Introdução: A catarata é responsável por 50% da cegueira no mundo, com um número estimado de 15 milhões de casos que necessitariam cirurgia. Diferentes técnicas para a extração extra-capsular da catarata com implante de lente intra-ocular foram propostas. Objetivo: Comparar as técnicas para extração extra-capsular de catarata com implante de lente intra-ocular utilizando incisão limbar e incisão escleral tunelizada. Métodos: Foram avaliados, prospectivamente, 59 olhos de 54 pacientes com acompanhamento pós-operatório de 6 meses. Aleatoriamente, os pacientes foram divididos em dois grupos. No Grupo I (n=30, a técnica realizada foi a de extração extra-capsular com implante de lente intra-ocular com incisão limbar e no Grupo II (n=29, com incisão tunelizada. Foram avaliadas as medidas da acuidade visual corrigida, inflamação intra-ocular (células e "flare", tempo de cirurgia, microscopia especular, astigmatismo ceratométrico induzido e paquimetria. Resultados: O tempo de cirurgia, a perda de células endoteliais e o astigmatismo ceratométrico induzido foram estatisticamente maiores no Grupo I que no Grupo II. Não houve diferença estatisticamente significante entre os grupos I e II quanto à acuidade visual, a quantidade de células na câmara anterior, a quantidade de "flare" na câmara anterior e paquimetria. Conclusão: A técnica para extração extra-capsular de catarata com incisão tunelizada apresentou vantagens quanto ao tempo de cirurgia, perda de células endoteliais e astigmatismo induzido em relação à técnica com incisão limbar. Os passos utilizados nessa técnica visam facilitar a extração da catarata, além de treinar o cirurgião para uma transição mais segura para facoemulsificação, sem aumentar o custo da cirurgia.Purpose: Cataract is the main cause of blindness throughout the world, affecting more than 15 million people worldwide. There are different techniques for extracapsular cataract

  11. Spine–hip relations in patients with hip osteoarthritis

    Science.gov (United States)

    Rivière, Charles; Lazic, Stefan; Dagneaux, Louis; Van Der Straeten, Catherine; Cobb, Justin; Muirhead-Allwood, Sarah

    2018-01-01

    Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome. Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs. By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020 PMID:29657844

  12. Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw

    Directory of Open Access Journals (Sweden)

    Simon Craxford

    2013-01-01

    Full Text Available We report the case of an 82-year-old woman who developed extensive proximal thigh swelling and persistent anaemia following internal fixation of an extracapsular neck of femur fracture with a dynamic hip screw (DHS. This was revealed to be a pseudoaneurysm of a branch of profunda femoris artery on angiography. Her case was further complicated by a concurrent pulmonary embolism (PE. She underwent endovascular coil embolisation of the pseudoaneurysm. An IVC filter was inserted and the patient was fully anticoagulated once it had been ensured that there was no active bleeding. In this case, we review the potential for anatomical variations in the blood supply to this region and discuss treatment options for a complicated patient. We recommend that a pseudoaneurysm should be part of a differential diagnosis for postoperative patients with anaemia refractory to blood transfusion so as not to miss this rare but potentially serious complication.

  13. Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

    Science.gov (United States)

    Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

    2014-05-01

    To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    2010-04-01

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

  15. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

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

  16. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular...

  17. 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...... fracture (ICD10: S720, S721, S722 and S729) were identified from 1 January 1995 to 31 December 2011. Hip fracture patients were matched 1:1 on age, gender and year of fracture to a non-hip fracture control. An individual's education attainment was defined as basic, secondary or higher, and their income...

  18. A method to investigate the biomechanical alterations in Perthes’ disease by hip joint contact modeling

    DEFF Research Database (Denmark)

    Salmingo, Remel A.; Skytte, Tina Lercke; Traberg, Marie Sand

    2017-01-01

    for the preoperative planning to obtain stress relief for the highly stressed areas in the malformed hip. This single-patient study demonstrated that the biomechanical alterations in Perthes’ disease can be evaluated individually by patient-specific finite element contact modeling using MRI. A multi-patient study...... was to develop a method to investigate the biomechanical alterations in Perthes’ disease by finite element (FE ) contact modeling using MRI. The MRI data of a unilateral Perthes’ case was obtained to develop the three-dimensional FE model of the hip joint. The stress and contact pressure patterns...... in the unaffected hip were well distrib uted. Elevated concentrations of stress and contact pressure were found in the Perthes’ hip. The highest femoral cartilagev on Mises stress 3.9 MPa and contact pressure 5.3 M P a were found in the Perthes’ hip, whereas 2.4 M P a and 4.9 MP a in the healthy hip, respectively...

  19. The Hip-Hop club scene: Gender, grinding and sex.

    Science.gov (United States)

    Muñoz-Laboy, Miguel; Weinstein, Hannah; Parker, Richard

    2007-01-01

    Hip-Hop culture is a key social medium through which many young men and women from communities of colour in the USA construct their gender. In this study, we focused on the Hip-Hop club scene in New York City with the intention of unpacking narratives of gender dynamics from the perspective of young men and women, and how these relate to their sexual experiences. We conducted a three-year ethnographic study that included ethnographic observations of Hip-Hop clubs and their social scene, and in-depth interviews with young men and young women aged 15-21. This paper describes how young people negotiate gender relations on the dance floor of Hip-Hop clubs. The Hip-Hop club scene represents a context or setting where young men's masculinities are contested by the social environment, where women challenge hypermasculine privilege and where young people can set the stage for what happens next in their sexual and emotional interactions. Hip-Hop culture therefore provides a window into the gender and sexual scripts of many urban minority youth. A fuller understanding of these patterns can offer key insights into the social construction of sexual risk, as well as the possibilities for sexual health promotion, among young people in urban minority populations.

  20. Gluteal tendinopathy and hip osteoarthritis: Different pathologies, different hip biomechanics.

    Science.gov (United States)

    Allison, Kim; Hall, Michelle; Hodges, Paul W; Wrigley, Tim V; Vicenzino, Bill; Pua, Yong-Hao; Metcalf, Ben; Grimaldi, Alison; Bennell, Kim L

    2018-03-01

    Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. The epidemiology of hip fractures across western Victoria, Australia.

    Science.gov (United States)

    Holloway, Kara L; Sajjad, Muhammad A; Mohebbi, Mohammadreza; Kotowicz, Mark A; Livingston, Patricia M; Khasraw, Mustafa; Hakkennes, Sharon; Dunning, Trisha L; Brumby, Susan; Page, Richard S; Pedler, Daryl; Sutherland, Alasdair; Venkatesh, Svetha; Brennan-Olsen, Sharon L; Williams, Lana J; Pasco, Julie A

    2018-03-01

    Hip fractures are associated with considerable morbidity and mortality. Hip fracture incidence varies across different levels of accessibility/remoteness and socioeconomic status (SES). As part of the Ageing, Chronic Disease and Injury Study, we aimed to map the pattern of hip fractures across the western region of the Australian state of Victoria, which contains a range of remoteness levels and SES. Data on hip fractures resulting in hospital admission were extracted from the Victorian Admitted Episodes Dataset (VAED) for men and women aged 40+years during 2010-2013 inclusive. An age-adjusted incidence rate (per 10,000population/year) was calculated for the entire region. Crude incidence rates and length of acute care hospital stay (excluding rehabilitation) were calculated for each Local Government Area (LGA). The impact of aggregated age, accessibility/remoteness index of Australia (ARIA) and SES on hip fracture rates aggregated across LGAs was determined using Poisson regression. For men, the age-standardised rate of hospitalisations for hip fracture across the whole region was 19.2 per 10,000population/year (95%CI 18.0-20.4) and for women, 40.0 (95%CI 38.3-41.7). The highest incidence rates for both sexes occurred in the less accessible LGAs of Yarriambiack and Hindmarsh, as well as the LGA with the lowest SES, Central Goldfields. In both sexes, approximately two thirds of individuals were discharged from acute hospital care within 14days. Increasing age, higher remoteness and lower SES were all associated with higher hip fracture rates. Crude incidence rates varied by location. Given that a high proportion of patients had acute hospital care of ≤14days, and accessibility and SES were associated with hip fracture rates, these results can inform policy and provide a model for other groups to conduct similar research in their local environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Hip-Hop Education Resources

    Science.gov (United States)

    Hall, Marcella Runell

    2009-01-01

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

  3. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  4. The Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. STUDY POPULATION: The DHR is a Danish nationwide arthroplasty register established in January 1995...

  5. Hip sonography in the newborn

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  6. The anatomy of the hip abductor muscles.

    Science.gov (United States)

    Flack, N A M S; Nicholson, H D; Woodley, S J

    2014-03-01

    The anatomy of the hip abductors has not been comprehensively examined, yet is important to understanding function and pathology in the gluteal region. For example, pathology of the hip abductor muscle-tendon complexes can cause greater trochanteric pain syndrome, and may be associated with gluteal atrophy and fatty infiltration. The purpose of this study was to investigate the detailed morphology of gluteus medius (GMed), gluteus minimus (GMin), and tensor fascia lata (TFL), and determine whether the muscles comprised anatomical compartments. The gluteal region from 12 cadavers was dissected and data collected on attachment sites, volume, fascicular and tendinous anatomy, and innervation. Three sites of GMed origin were identified (gluteal fossa, gluteal aponeurosis, and posteroinferior edge of the iliac crest) and the distal tendon had lateral and posterior parts. GMed was the largest in volume (27.6 ± 11.6 cm(3); GMin 14.1 ± 11.1 cm(3); TFL 1.8 ± 0.8 cm(3)). Fascicles of GMin originated from the gluteal fossa, inserting onto the deep surface of its distal tendon and the hip joint capsule. TFL was encapsulated in the fascia lata, having no bony attachment. Primary innervation patterns varied for GMed, with three or four branches supplying different regions of muscle. Distinct secondary nerve branches entered four regions of GMin; no differential innervation was observed for TFL. On the basis of architectural parameters and innervation, GMed, and GMin each comprise of four compartments but TFL is a homogenous muscle. It is anticipated that these data will be useful for future clinical and functional studies of the hip abductors. Copyright © 2013 Wiley Periodicals, Inc.

  7. Hip arthroplasty today and tomorrow.

    Science.gov (United States)

    Amstutz, H C

    1987-12-01

    Acrylic-fixed total hip and surface replacement arthroplasty have been very effective in affording immediate relief of pain and providing improved function. Complications have been reduced by improvements in design, materials, and especially technique. They are now very low in the elderly, and the stem type acrylic-fixed design remains the procedure of choice. The failure rates in youthful patients and those with bone-stock deficiencies have been high in both THR and surface types, although the latter had the advantage of preserving femoral stock. On the femoral side, the new "macro" femoral designs from Europe and "micro" femoral porous designs have shown promise, but thigh pain, incomplete and difficult to predict bone ingrowth patterns, coupled with removal problems have influenced design and technique changes. Both press-fit stem types and porous surface replacements have produced promising initial results with less potential downside risks. On the acetabular side, both the cementless hemispherical with screw-type adjuvant fixation, or the chamfered cylinder designs, used primarily with the UCLA porous surface replacements, but also with stem-type devices, appear to achieve best short-term results, while the entire variety of screw rings are disappointing. The future will bring further refinements in technique and specific indications for certain types of replacement stem in specific types of bone stock deficiencies. The all ceramic-ceramic and ceramic-polyethylene bearings show promise of reducing wear and, hence, should improve longevity of implant fixation.

  8. Determining optimal clinical target volume margins in head-and-neck cancer based on microscopic extracapsular extension of metastatic neck nodes

    International Nuclear Information System (INIS)

    Apisarnthanarax, Smith; Elliott, Danielle D.; El-Naggar, Adel K.; Asper, Joshua A. P.A.; Blanco, Angel; Ang, K. Kian; Garden, Adam S.; Morrison, William H.; Rosenthal, David; Weber, Randal S.; Chao, K.S. Clifford

    2006-01-01

    Purpose: To determine the optimal clinical target volume margins around the gross nodal tumor volume in head-and-neck cancer by assessing microscopic tumor extension beyond cervical lymph node capsules. Methods and Materials: Histologic sections of 96 dissected cervical lymph nodes with extracapsular extension (ECE) from 48 patients with head-and-neck squamous cell carcinoma were examined. The maximum linear distance from the external capsule border to the farthest extent of the tumor or tumoral reaction was measured. The trends of ECE as a function of the distance from the capsule and lymph node size were analyzed. Results: The median diameter of all lymph nodes was 11.0 mm (range: 3.0-30.0 mm). The mean and median ECE extent was 2.2 mm and 1.6 mm, respectively (range: 0.4-9.0 mm). The ECE was <5 mm from the capsule in 96% of the nodes. As the distance from the capsule increased, the probability of tumor extension declined. No significant difference between the extent of ECE and lymph node size was observed. Conclusion: For N1 nodes that are at high risk for ECE but not grossly infiltrating musculature, 1 cm clinical target volume margins around the nodal gross tumor volume are recommended to cover microscopic nodal extension in head-and-neck cancer

  9. Comparison of the sensitivity and specificity of CT and MR imaging in the detection of cervical nodal tumor necrosis and extracapsular tumor spread

    International Nuclear Information System (INIS)

    Yousem, D.M.; Som, P.M.; Schjwaibold, F.; Hendrix, R.

    1991-01-01

    This paper evaluates if MR imaging can achieve the sensitivity and specificity of enhanced CT in detecting tumoral nodal necrosis (TNN) and extracapsular tumor spread (ETS). Enhanced CT scans and unenhanced and enhanced MR images were retrospectively and separately reviewed by a study-blinded radiologist. Fifty-eight lymph nodes were evaluated for TNN and ETS. Readings were given for CT, T1-weighted MR, T2-weighted MR, T1-weighted and T2-weighted MR, enhanced T1-weighted fat-suppressed MR, and T1-weighted, T2-weighted, and enhanced fat suppressed T1-weighted MR. Pathology proof was used to assess TNN; CT and used to assess ETS. Enhanced CT had the highest sensitivity for TNN. The sensitivity of unenhanced MR ranged from 33% to 50%; that of enhanced MR was 47%. All MR sequences and cT had specificities for TNN >92%. The highest accuracy of MR for TNN was the unenhanced T1-weighted and T2-weighted images alone; CT accuracy was 90%. MR sensitivity for ETS was maximal with T1-weighted images; all sequences had specificities >90%. Gadolinium-enhanced images did not improve accuracy in TNN or ETS

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

    Directory of Open Access Journals (Sweden)

    Saroj Kumar Suwal

    2016-06-01

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

  11. Study of wind forces on low-rise hip-roof building

    African Journals Online (AJOL)

    DR OKE

    to predict the wind loads and the flow patterns around the hip-roof building. .... various wind angle attack on the roof using CFD simulation. .... SIMPLE algorithm substitutes the flux correction equations into the discrete continuity equation to ...

  12. Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty

    International Nuclear Information System (INIS)

    Dobrindt, Oliver; Amthauer, Holger; Krueger, Alexander; Ruf, Juri; Wissel, Heiko; Grosser, Oliver S; Seidensticker, Max; Lohmann, Christoph H

    2015-01-01

    The diagnosis of hip pain after total hip replacement (THR) represents a highly challenging question that is of increasing concern to orthopedic surgeons. This retrospective study assesses bone scintigraphy with Hybrid SPECT/CT for the diagnosis of painful THR in a selected cohort of patients. Bone SPECT/CT datasets of 23 patients (mean age 68.9 years) with a painful hip after THR were evaluated. Selection of the patients required an inconclusive radiograph, normal serum levels of inflammatory parameters (CRP and ESR) or a negative aspiration of the hip joint prior to the examination. The standard of reference was established by an interdisciplinary adjudication-panel using all imaging data and clinical follow-up data (>12 month). Pathological and physiological uptake patterns were defined and applied. The cause of pain in this study group could be determined in 18 out of 23 cases. Reasons were aseptic loosening (n = 5), spine-related (n = 5), heterotopic ossification (n = 5), neuronal (n = 1), septic loosening (n = 1) and periprosthetic stress fracture (n = 1). In (n = 5) cases the cause of hip pain could not be identified. SPECT/CT imaging correctly identified the cause of pain in (n = 13) cases, in which the integrated CT-information led to the correct diagnosis in (n = 4) cases, mainly through superior anatomic correlation. Loosening was correctly assessed in all cases with a definite diagnosis. SPECT/CT of THA reliably detects or rules out loosening and provides valuable information about heterotopic ossifications. Furthermore differential diagnoses may be detected with a whole-body scan and mechanical or osseous failure is covered by CT-imaging. SPECT/CT holds great potential for imaging-based assessment of painful prostheses

  13. The pelvis and hips

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  14. Hip complications following chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  15. Hip complications following chemoradiotherapy

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  16. Chronic infections in hip arthroplasties

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Thomsen, Reimar W

    2012-01-01

    Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two-stage revisi......Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two......-stage revisions for chronic infection in hip arthroplasties....

  17. 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.

  18. Anatomical study of the articular branches innervated the hip and knee joint with reference to mechanism of referral pain in hip joint disease patients.

    Science.gov (United States)

    Sakamoto, Junya; Manabe, Yoshitaka; Oyamada, Joichi; Kataoka, Hideki; Nakano, Jiro; Saiki, Kazunobu; Okamoto, Keishi; Tsurumoto, Toshiyuki; Okita, Minoru

    2018-03-25

    Referred pain in the anterior knee joint is the most common symptom in hip disease patients. The development of referred pain is considered to be related to dichotomizing peripheral sensory fibers. However, no gross anatomical findings identify any dichotomizing fibers innervating both the hip and knee joints. We dissected the femoral and obturator nerves in human cadavers to investigate the distribution of the articular branches in the hip and knee joints. Fourteen embalmed left lower limbs from 14 Japanese adult cadavers (five from females, nine from males, average age 73.8 ± 14.1 years) were observed macroscopically. The articular branches of the femoral and obturator nerves were dissected at the anterior margin of the groin toward the thigh region. After dissections of the articular nerves of the hip joints, the femoral and obturator nerves were exposed from proximally to distally to identify the articular nerves of the knee joints. The branching pattern of the articular branches in the hip and knee joints was recorded. In six of 14 limbs (42.9%), the femoral nerve supplied articular branches to the anteromedial aspect of both the hip and knee joints. These articular branches were derived from the same bundle of femoral nerve. These gross anatomical findings suggested that dichotomizing peripheral sensory fibers innervate the hip and knee joints and these could relate to the referred pain confirmed in the anterior knee joints of patients with hip disease. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  19. MR imaging of transient osteoporosis of the hip: An update on 155 hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Klontzas, Michail E.; Vassalou, Evangelia E. [Department of Medical Imaging, University Hospital of Heraklion, Medical School, University of Crete (Greece); Zibis, Aristeidis H. [Department of Anatomy, University of Thessalia, Medical School, Larissa (Greece); Bintoudi, Antonia S. [Department of Radiology, “Papageorgiou” General Hospital of Thessaloniki (Greece); Karantanas, Apostolos H., E-mail: akarantanas@gmail.com [Department of Medical Imaging, University Hospital of Heraklion, Medical School, University of Crete (Greece)

    2015-03-15

    Highlights: •Characteristics of TOH are described based on the largest series of patients in the literature. •The chance of regional migratory osteoporosis progression is estimated to be 19.4%. •The pattern of bone marrow edema with respect to symptom duration is described. •The prevalence of subchondral microfractures is high in TOH patients. •Microfractures are not complicated with avascular necrosis or articular collapse. -- Abstract: Purpose: Transient osteoporosis of the hip (TOH) presents with acute onset pain and bone marrow edema (BMe) on MR imaging. The purpose of this study is to revise the MR imaging characteristics of TOH by analyzing the data derived from 155 hip examinations. We also sought to explore the relationship between the duration of symptoms and the presence of sparing and subchondral fractures. Materials and methods: MR images of 155 hips (141 TOH patients) were retrospectively evaluated for the presence of insufficiency fractures and the morphology of BMe. Sparing of the medial bone marrow of the femoral head was recorded together with demographic and clinical data. Progression to regional migratory osteoporosis (RMO) and postpartum cases were also recorded. Results: Our population consisted of 76.4% male and 23.6% female patients. RMO progression was recorded in 19.4% and 4 postpartum cases displayed bilateral disease. Sparing of the medial bone marrow was present at 87.7% of patients and disappeared as the disease progressed (P = 0.005). BMe was restricted within the femoral head in 11.0%, extended to the femoral neck in 40% and to the femoral shaft in 49% of the cases studied. Subchondral fractures were present at 48.7% of the hips. Conclusion: This study describes TOH patient characteristics, the MR imaging findings (BMe pattern, microfractures), their association with symptom duration and the chance of progressing to RMO.

  20. MR imaging of transient osteoporosis of the hip: An update on 155 hip joints

    International Nuclear Information System (INIS)

    Klontzas, Michail E.; Vassalou, Evangelia E.; Zibis, Aristeidis H.; Bintoudi, Antonia S.; Karantanas, Apostolos H.

    2015-01-01

    Highlights: •Characteristics of TOH are described based on the largest series of patients in the literature. •The chance of regional migratory osteoporosis progression is estimated to be 19.4%. •The pattern of bone marrow edema with respect to symptom duration is described. •The prevalence of subchondral microfractures is high in TOH patients. •Microfractures are not complicated with avascular necrosis or articular collapse. -- Abstract: Purpose: Transient osteoporosis of the hip (TOH) presents with acute onset pain and bone marrow edema (BMe) on MR imaging. The purpose of this study is to revise the MR imaging characteristics of TOH by analyzing the data derived from 155 hip examinations. We also sought to explore the relationship between the duration of symptoms and the presence of sparing and subchondral fractures. Materials and methods: MR images of 155 hips (141 TOH patients) were retrospectively evaluated for the presence of insufficiency fractures and the morphology of BMe. Sparing of the medial bone marrow of the femoral head was recorded together with demographic and clinical data. Progression to regional migratory osteoporosis (RMO) and postpartum cases were also recorded. Results: Our population consisted of 76.4% male and 23.6% female patients. RMO progression was recorded in 19.4% and 4 postpartum cases displayed bilateral disease. Sparing of the medial bone marrow was present at 87.7% of patients and disappeared as the disease progressed (P = 0.005). BMe was restricted within the femoral head in 11.0%, extended to the femoral neck in 40% and to the femoral shaft in 49% of the cases studied. Subchondral fractures were present at 48.7% of the hips. Conclusion: This study describes TOH patient characteristics, the MR imaging findings (BMe pattern, microfractures), their association with symptom duration and the chance of progressing to RMO

  1. Primary total hip replacement versus hip resurfacing - hospital considerations.

    Science.gov (United States)

    Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

    2011-01-01

    Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients.

  2. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM......-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy...

  3. An eleven gene molecular signature for extra-capsular spread in oral squamous cell carcinoma serves as a prognosticator of outcome in patients without nodal metastases.

    Science.gov (United States)

    Wang, Weining; Lim, Weng Khong; Leong, Hui Sun; Chong, Fui Teen; Lim, Tony K H; Tan, Daniel S W; Teh, Bin Tean; Iyer, N Gopalakrishna

    2015-04-01

    Extracapsular spread (ECS) is an important prognostic factor for oral squamous cell carcinoma (OSCC) and is used to guide management. In this study, we aimed to identify an expression profile signature for ECS in node-positive OSCC using data derived from two different sources: a cohort of OSCC patients from our institution (National Cancer Centre Singapore) and The Cancer Genome Atlas (TCGA) head and neck squamous cell carcinoma (HNSCC) cohort. We also sought to determine if this signature could serve as a prognostic factor in node negative cancers. Patients with a histological diagnosis of OSCC were identified from an institutional database and fresh tumor samples were retrieved. RNA was extracted and gene expression profiling was performed using the Affymetrix GeneChip Human Genome U133 Plus 2.0 microarray platform. RNA sequence data and corresponding clinical data for the TCGA HNSCC cohort were downloaded from the TCGA Data Portal. All data analyses were conducted using R package and SPSS. We identified an 11 gene signature (GGH, MTFR1, CDKN3, PSRC1, SMIM3, CA9, IRX4, CPA3, ZSCAN16, CBX7 and ZFP3) which was robust in segregating tumors by ECS status. In node negative patients, patients harboring this ECS signature had a significantly worse overall survival (p=0.04). An eleven gene signature for ECS was derived. Our results also suggest that this signature is prognostic in a separate subset of patients with no nodal metastasis Further validation of this signature on other datasets and immunohistochemical studies are required to establish utility of this signature in stratifying early stage OSCC patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Adjuvant low single dose cisplatin-based concurrent radiochemotherapy of oral cavity and oropharynx carcinoma. Impact of extracapsular nodal spread on distant metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kuhnt, Thomas; Klockenbrink, Ulf; Hildebrandt, Guido [Univ. Hospital of Rostock (Germany). Dept. of Radiation Oncology; Knipping, Stephan [Staedtisches Klinikum Dessau (Germany). Dept. of Otorhinolaryngology, Head and Neck Surgery; Lautermann, Juergen [Hospital Martha-Maria, Halle-Doelau (Germany). Dept. of Otorhinolaryngology, Head and Neck Surgery; Kriese, Karen; Hauptmann, Steffen [Martin-Luther-Univ. Halle-Wittenberg, Halle (Germany). Inst. of Pathology; Wienke, Andreas [Martin-Luther-Univ. Halle-Wittenberg, Halle (Germany). Inst. of Medical Epidemiology, Biostatistics and Informatics

    2011-05-15

    Background: The aim of this study was to analyze the prognostic importance of extracapsular nodal spread (ECS) in patients with locally advanced squamous cell carcinoma (SCC) of the oral cavity or oropharynx, and the impact of adjuvant low single dose cisplatin-based radiochemotherapy on distant metastases-free survival (DMFS). Patients and Methods: The study population was selected from 195 patients with high-risk oral cavity or oropharyngeal cancer, who had either adjuvant radiotherapy (RT) or radiochemotherapy (RCT) between January 1, 1997 and December 31, 2006, at the University Clinic of Radiation Oncology of the Martin-Luther-University Halle-Wittenberg. A total of 42 matched pairs of patients with UICC stage III-IVa,b disease were analyzed. The patients were matched (one to one) according to tumor site, sex, T stage, N stage, ECS, resection margin status, and Karnofsky performance status. To analyze the correlation between the treatment modality (RT vs. RCT) and the impact of ECS on DMFS, the Cox proportional hazard model was used. Survival rates were calculated using the Kaplan-Meier method. Results: There was a strong correlation between the degree of nodal involvement and ECS (pN1: 33%; pN2b: 45%; pN2c: 71%). Moreover, the 5-year locoregional control rates (LC) in patients with ECS were 76% vs. 63% (n.s.) for RT and RCT, respectively. However, for patients without ECS, the LC was more favorable after RCT (RT vs. RCT: 62% vs. 88%, p < 0.05). DMFS again was better after RT, and this observation was independent of the presence or absence of ECS. Finally, in multivariate analyses, the presence of ECS significantly decreased the DMFS (p = 0.04, hazard ratio (HR) 2.64). Conclusions: Patients with ECS have an increased risk of distant metastases. Adjuvant low single dose cisplatin-based concurrent chemotherapy seems to have no influence on occult microscopic systemic disease. (orig.)

  5. Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Magliocca, Kelly R. [Department of Pathology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hanasoge, Sheela [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Aiken, Ashley H.; Hudgins, Patricia A. [Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Chen, Susie A. [Department of Radiation Oncology, University of Texas Southwestern, Dallas, Texas (United States); Eaton, Bree R.; Higgins, Kristin A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Saba, Nabil F. [Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Beitler, Jonathan J. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-01-01

    Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initial surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.

  6. Hip morphology predicts posterior hip impingement in a cadaveric model.

    Science.gov (United States)

    Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

    2018-05-01

    Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

  7. 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

    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 o...... for women than men, but is evident in both genders. In this 'viewpoint', we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys....... 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...

  8. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

    Science.gov (United States)

    Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

    2014-01-01

    In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

  9. Longitudinal Changes in Hip Strength and Range of Motion in Female Youth Soccer Players: Implications for ACL Injury, A Pilot Study.

    Science.gov (United States)

    Nguyen, Anh-Dung; Zuk, Emma F; Baellow, Andrea L; Pfile, Kate R; DiStefano, Lindsay J; Boling, Michelle C

    2017-09-01

    Risk of anterior cruciate ligament (ACL) injuries in young female athletes increases with age, appearing to peak during maturation. Changes in hip muscle strength and range of motion (ROM) during this time may contribute to altered dynamic movement patterns that are known to increase risk of ACL injuries. Understanding the longitudinal changes in hip strength and ROM is needed to develop appropriate interventions to reduce the risk of ACL injuries. To examine the longitudinal changes in hip strength and ROM in female youth soccer players. Longitudinal descriptive study. Field setting. 14 female youth soccer athletes (14.1 ± 1.1 y, 165.8 ± 5.3 cm, 57.5 ± 9.9 kg) volunteered as part of a multiyear risk factor screening project. Clinical measures of hip strength and ROM were collected annually over 3 consecutive years. Passive hip internal rotation (IR), external rotation (ER), abduction (ABD), and adduction (ADD) ROM were measured with a digital inclinometer. Isometric hip ABD and extension (EXT) strength were evaluated using a hand-held dynamometer. Separate repeated-measures ANOVAs compared hip strength and ROM values across 3 consecutive years (P hip ABD (P = .830) or EXT strength (P = .062) across 3 consecutive years. Longitudinal changes in hip ROM were observed with increases in hip IR (P = .001) and ABD (P hip ADD (P = .009) and ER (P hip occur as youth female soccer players increase in age. While there are no changes in hip strength, there is an increase in hip IR and ABD ROM with a concomitant decrease in hip ER and ADD ROM. The resulting asymmetries in hip ROM may decrease the activation and force producing capabilities of the hip muscles during dynamic activities, contributing to altered lower extremity mechanics known to increase the risk of ACL injuries.

  10. Analysis of disease patterns and cost of treatments for prevention of deep venous thrombosis after total knee or hip replacement: results from the Practice Analysis of THromboprophylaxis after Orthopaedic Surgery (PATHOS study

    Directory of Open Access Journals (Sweden)

    Degli Esposti L

    2012-12-01

    Full Text Available Luca Degli Esposti,1 Guido Didoni,2 Teresa Simon,3 Stefano Buda,1 Diego Sangiorgi,1 Ezio Degli Esposti11CliCon Health, Economics and Outcomes Research, Ravenna, Italy; 2BMS Italy, Rome, Italy; 3BMS Global, Princeton, NJ, USAIntroduction: Venous thromboembolism (VTE is a well-known complication of total hip replacement (THR and total knee replacement (TKR. Various drugs have been introduced in an attempt to reduce the mortality as well as the short-term and long-term morbidity associated with the development of VTE. The aim of this study was to analyze drug utilization for thromboprophylaxis and the cost of illness in real clinical practice in patients with THR or TKR.Materials and methods: A multicenter, retrospective, observational cohort study based on local health unit administrative databases was conducted. All patients (≥18 years old discharged for THR/TKR procedures between January 1, 2007 and December 31, 2008 were included in the study. The date of first hospital discharge was the index date; patients were followed up for a period of 12 months.Results: A total of 10,389 patients were included: 3516 males (33.8%, 69.4 ± 10.4 years and 6873 females (66.2%, 71.7 ± 9.0 years, of which 5483 (52.8% were discharged for THR and 4906 (47.2% for TKR. First antithrombotic treatments after discharge were enoxaparin (3937, 37.9%, heparin (3752, 36.1%, antiplatelet agents (658, 6.3%, vitamin K antagonists (276, 2.7%, fondaparinux (136, 1.3%, combinations (185, 1.8%, and no therapy (1445, 13.9%. Overall, we observed 2347 (22.6% treatment changes; median duration of antithrombotic treatment was 23 days (range 11–47 for THR and 22 days (range 11–46 for TKR. During the follow-up period, we observed 129 cases of VTE (120 per 10,000 patients, five post-thrombotic syndrome (4.8 per 10,000 patients, and three heparin-induced thrombocytopenia (2.9 per 10,000 patients. Median cost for both THR and TKR was €9052.00 (range €8063.00–€9084.96, with

  11. Osteochondritis Dissecans of the Hip

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  12. 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.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  14. HIP AND GLENOHUMERAL PASSIVE RANGE OF MOTION IN COLLEGIATE SOFTBALL PLAYERS

    Science.gov (United States)

    Plummer, Hillary; Brambeck, Allison

    2016-01-01

    Background and Purpose Range of motion deficits at the hip and glenohumeral joint (GHJ) may contribute to the incidence of injury in softball players. With injury in softball players on the rise, softball related studies in the literature are important. The purpose of this study was to examine hip and GHJ passive range of motion (PROM) patterns in collegiate softball players. Hypothesis It was hypothesized that the position players would exhibit significantly different PROM patterns than pitchers. Additionally, position players would exhibit significantly different side-to-side differences in PROM for both the hip and GHJ compared to pitchers. Study Design Prospective cohort study. Methods Forty-nine collegiate softball players (19.63 ± 1.15 years; 170.88 ± 8.08 cm; 72.96 ± 19.41 kg) participated. Passive hip and GHJ internal (IR) and external rotation (ER) measures were assessed. Glenohumeral PROM was measured with the participants supine with the arm abducted to 90 °. The measurements were recorded when the scapula began to move or a firm capsular end-feel was achieved. The hip was positioned in 90 ° of flexion and passively rotated until a capsular end-feel was achieved. Total PROM was calculated by taking the sum of IR and ER for both the hip and GHJ. Results No significant side-to-side PROM differences were observed in pitchers, at the GHJ or hip joint. Position players throwing side hip IR was significantly greater than the non-throwing side hip (p = 0.002). The non-throwing side hip had significantly greater ER compared to the throwing side hip (p = 0.002). When examining side-to-side differences at the GHJ, IR was significantly greater in the non-throwing shoulder (p = 0.047). No significant differences in total range of motion of the hip and GHJ were observed. Conclusion In the current study, position players displayed side-to-side differences in hip and GHJ IR PROM while no statistically significant differences were

  15. 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.

  16. Brief concept of hip preservation

    Directory of Open Access Journals (Sweden)

    Sanjeev S. Madan

    2017-12-01

    Full Text Available Restoration of the anatomy of the hip joint and biomechanics across it, carry the immense importance to prevent future osteoarthritis of the joint. The aim of this review is to provide the brief concept of the methods to preserve the hip, especially in young adults. Attempts to preserve the hips start with the intense preoperative planning of the corrective procedure. Different parameters regarding the femur and acetabulum in all 3 dimensions need to be assessed. Especially, measurement of the anteversion of the femur and acetabulum is a significant step to avoid osteoarthritis. In addition, the suprapelvic and infrapelvic (spine and lower limb lengths alignment needs to be considered in the planning. Correction of the femoral side of the hip needs the understanding of the blood supply of the proximal femur which carries the risk of avascular necrosis more so with intracapsular osteotomies. Acetabular reorientation, to re-distribute the forces over the weight bearing part, can be carried out with re-directional osteotomy such as periacetabular osteotomy. It needs the understanding of the acetabular anatomy and the force distribution in it. To conclude, correction of both femoral and acetabular side parameters need to be considered in decision making depending on the alterations due to various etiologies causing the hip disorders.

  17. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Minhas, M.S.

    2010-01-01

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

  18. Intracyclic Velocity Variation of the Center of Mass and Hip in Breaststroke Swimming With Maximal Intensity.

    Science.gov (United States)

    Gourgoulis, Vassilios; Koulexidis, Stylianos; Gketzenis, Panagiotis; Tzouras, Grigoris

    2018-03-01

    Gourgoulis, V, Koulexidis, S, Gketzenis, P, and Tzouras, G. Intra-cyclic velocity variation of the center of mass and hip in breaststroke swimming with maximal intensity. J Strength Cond Res 32(3): 830-840, 2018-The aim of the study was to compare the center of mass (CM) and hip (HIP) intracyclic velocity variation in breaststroke swimming using 3-dimensional kinematic analysis. Nine male breaststrokes, of moderate performance level, swam 25-m breaststroke with maximal intensity, and their movements were recorded, both under and above the water surface, using 8 digital cameras. Their CM and HIP velocities and their intracyclic variations were estimated after manual digitization of 28 selected points on the body in a complete arm and leg breaststroke cycle. Paired sample t-tests or Wilcoxon tests, when the assumption of normality was broken, were used for statistical analyses. In both, CM and HIP velocity-time curves, the results revealed a similar pattern of 2 clear peaks associated with the leg and arm propulsive phases and 2 minimal velocities that corresponded to the arm and leg recovery phase and the lag time between the leg and arm propulsive phases, respectively. However, despite this similar general pattern, the HIP minimum resultant velocity was significantly lower, whereas its maximal value was significantly greater, than the corresponding CM values. Consequently, the HIP intracyclic swimming velocity fluctuation significantly overestimates the actual variation of the swimmer's velocity in breaststroke swimming.

  19. Cementless Hydroxyapatite Coated Hip Prostheses

    Science.gov (United States)

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

    2015-01-01

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

  20. 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.

  1. MRI of the hip joint

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  2. 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.

  3. Risks of hip and knee replacement

    Science.gov (United States)

    ... is normal to lose blood during and after hip or knee replacement surgery. Some people need a ... clot form are higher during and soon after hip or knee replacement surgery. Sitting or lying down ...

  4. Prognostic significance of classified extramural tumor deposits and extracapsular lymph node invasion in T3–4 colorectal cancer: a retrospective single-center study

    International Nuclear Information System (INIS)

    Yamano, Tomoki; Semba, Shuho; Noda, Masafumi; Yoshimura, Mie; Kobayashi, Masayoshi; Hamanaka, Michiko; Beppu, Naohito; Yano, Aya; Tsukamoto, Kiyoshi; Matsubara, Nagahide; Tomita, Naohiro

    2015-01-01

    Extramural tumor deposits (TDs) and extracapsular lymph node involvement (ECLNI) are considered to be poor prognostic factors in patients with T3–4, N0–2, M0 colorectal cancer (CRC). Although TDs are known to have multiple origins and pleomorphic features, the prognostic significances of the different type of TDs have not yet been established. We performed a retrospective review of 385 consecutive patients with T3–4, N0–2, M0 CRC who received curative resection at our institution between 2006 and 2012. We classified the TDs into two groups: invasive-type TD (iTD), which is characterized by the presence of lymphatic invasion, vascular invasion, perineural invasion, or undefined cancer cell clusters and nodular-type TD (nTD), which is characterized by a smooth or irregular-shaped tumor nodule other than an iTD. ECLNI was defined as invasion of cancer cells into capsular collagen tissues or adipose tissues beyond the capsular collagen. Multivariate analyses were used to assess the prognostic significance of iTD, ND, and ECLNI for relapse-free survival (RFS), disease-specific survival (DSS), and sites of recurrence. In patients without lymph node (LN) metastasis, the incidences of iTD and nTD were both in the range of 2–3 %. Conversely, in patients with LN metastasis, the incidences of iTD, nTD, and ECLNI were 31, 22, and 34 %, respectively. iTD, nTD, and ECLNI were all significant independent adverse factors for RFS in rectal cancer, and were all associated with pT, pN, and LN ratio. iTD was a significant independent adverse prognostic factor for DSS in rectal cancer, metastasis to the liver in colorectal cancer, and distant LN metastasis in colon cancer. ECLNI was a significant independent prognostic factor for RFS in colon cancer. Classifying TDs and assessing ECLNI may help establish significant prognostic factors for patients with T3–4, N0–2, M0 CRC

  5. Development and internal validation of a side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer.

    Science.gov (United States)

    Martini, Alberto; Gupta, Akriti; Lewis, Sara C; Cumarasamy, Shivaram; Haines, Kenneth G; Briganti, Alberto; Montorsi, Francesco; Tewari, Ashutosh K

    2018-04-19

    To develop a nomogram for predicting side-specific extracapsular extension (ECE) for planning nerve-sparing radical prostatectomy. We retrospectively analysed data from 561 patients who underwent robot-assisted radical prostatectomy between February 2014 and October 2015. To develop a side-specific predictive model, we considered the prostatic lobes separately. Four variables were included: prostate-specific antigen; highest ipsilateral biopsy Gleason grade; highest ipsilateral percentage core involvement; and ECE on multiparametric magnetic resonance imaging (mpMRI). A multivariable logistic regression analysis was fitted to predict side-specific ECE. A nomogram was built based on the coefficients of the logit function. Internal validation was performed using 'leave-one-out' cross-validation. Calibration was graphically investigated. The decision curve analysis was used to evaluate the net clinical benefit. The study population consisted of 829 side-specific cases, after excluding negative biopsy observations (n = 293). ECE was reported on mpMRI and final pathology in 115 (14%) and 142 (17.1%) cases, respectively. Among these, mpMRI was able to predict ECE correctly in 57 (40.1%) cases. All variables in the model except highest percentage core involvement were predictors of ECE (all P ≤ 0.006). All variables were considered for inclusion in the nomogram. After internal validation, the area under the curve was 82.11%. The model demonstrated excellent calibration and improved clinical risk prediction, especially when compared with relying on mpMRI prediction of ECE alone. When retrospectively applying the nomogram-derived probability, using a 20% threshold for performing nerve-sparing, nine out of 14 positive surgical margins (PSMs) at the site of ECE resulted above the threshold. We developed an easy-to-use model for the prediction of side-specific ECE, and hope it serves as a tool for planning nerve-sparing radical prostatectomy and in the reduction of PSM in

  6. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Svege, Ida; Nordsletten, Lars; Fernandes, Linda

    2015-01-01

    Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown.......Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown....

  7. Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study.

    Science.gov (United States)

    Pasco, Julie A; Holloway, Kara L; Brennan-Olsen, Sharon L; Moloney, David J; Kotowicz, Mark A

    2015-05-24

    Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years. This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition. Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass. There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.

  8. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

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

    2017-01-01

    Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty....... Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

  9. 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.

  10. Tomografia computadorizada na análise dos padrões de calcificações nos tumores ósseos da bacia em pediatria: nova abordagem Computed tomography in the analysis of calcification patterns in pediatric bone tumors of the hip: a new approach

    Directory of Open Access Journals (Sweden)

    Gabriel Antônio de Oliveira

    2006-12-01

    Full Text Available OBJETIVO: No grupo pediátrico, o diagnóstico radiológico dos tumores dos ossos ilíacos, ísquios e púbis apresenta dificuldades e peculiaridades próprias, mas a literatura revisada não trata especificamente desse tema. Este trabalho pretende investigar a existência de padrões radiológicos confiáveis para o diagnóstico diferencial desses tumores. MATERIAIS E MÉTODOS: Foram revistos os achados radiológicos de tumores dos ossos do quadril em dez pacientes com idades entre 8 e 19 anos. RESULTADOS: Reação óssea (esclerose ou lise, reação periosteal (lamelar em camada única, múltiplas camadas ou radial, extensão do tumor no osso e grau de invasão das partes moles revelaram baixa especificidade. As calcificações nas partes moles, consideradas em conjunto, foram inespecíficas. Contudo, separando as próximas do osso comprometido, que apresentam formas e tamanhos variados - padrão I -, daquelas afastadas do osso, finas e amorfas - padrão II -, observamos que o padrão I foi totalmente inespecífico e o padrão II foi identificado nos três casos de osteossarcoma (100% e em apenas um dos casos de Ewing (16,6%. CONCLUSÃO: Neste material, as calcificações padrão II revelaram sensibilidade de 100% e especificidade de 90% para osteossarcoma. Contudo, sua importância pode não se limitar ao diagnóstico radiológico. As calcificações padrão II indicam, provavelmente, os sítios ideais para biópsia.OBJECTIVE: In the pediatric group, the radiological diagnosis of bone tumors of the hip is difficult and presents some peculiarities, but reviewed literature does not approach this specific problem. The objective of the present study was to investigate the existence of reliable radiological patterns for the differential diagnosis of these tumors. MATERIALS AND METHODS: Radiological findings of bone tumors of the hip in ten patients in the age range between 8 and 19 years have been reviewed. RESULTS: Bone reaction (sclerosis or

  11. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

    Energy Technology Data Exchange (ETDEWEB)

    Siddesh, N.D.; Shah, Hitesh; Joseph, Benjamin [Kasturba Medical College, Paediatric Orthopaedic Service, Manipal, Karnataka State (India)

    2012-08-15

    This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMD{sub HG}). Radiographs of 271 adult patients with SEMD{sub HG} were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips. Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores. Degenerative arthritis of the hip develops in the majority of patients with SEMD{sub HG}; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned. (orig.)

  12. Adventure sports and sexual freedom hip replacement: the tripolar hip.

    Science.gov (United States)

    Pritchett, James W

    2018-01-01

    Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations. Between 1998 and 2011, the author performed 160 primary total hip replacements using tripolar prostheses in patients participating in adventure sports and other physically demanding activities. The institutional review board approved this study. The inclusion criteria were patients who needed unrestricted activity and who were not candidates for or did not choose hip resurfacing. Patients were followed every second year and assessed with radiographs, Harris Hip Score, WOMAC, SF-12, and UCLA functional outcome scores. Patients were asked about symptoms of instability and satisfaction with their hip replacement. Patients were asked both preoperatively and 2 years postoperatively four questions about their sexual activity. Mean follow-up was 11 years. At 2 years' postoperatively, 98% of patients reported their satisfaction as excellent or good and 99% were not limited for sexual activity following surgery. Seventy-four percent of patients reported they were recovered within 6 weeks of surgery. There were no dislocations. There were three revision procedures for implant loosening, infection, and periprosthetic fracture, but there were no failures of the tripolar articulation. The mean postoperative UCLA score was the highly athletic score of 8. There were no signs of osteolysis, wear, or metal

  13. Treatment of tuberculosis of the hip.

    African Journals Online (AJOL)

    The common presentation was a swollen hip, a limp, decreased range of hip movements, fixed flexion deformity and pain. Three patients had protrusio acetabuli and three had subluxed or dislocated hips. Twenty-three patients were anaemic and the erythrocyte sedimentation rate (ESR) was raised in all (mean. 6 5 d h r ...

  14. Hip-Hop and the Academic Canon

    Science.gov (United States)

    Abe, Daudi

    2009-01-01

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

  15. Ultrasonography of the painful hip in childhood

    NARCIS (Netherlands)

    S.G.F. Robben (Simon)

    1999-01-01

    textabstractThere are many diseases in childhood that affect the hip joint. Some diseases are systemic in origin and initially may present themselves as hip disorders, such as rheumatoid arthritis. other diseases are localized specifically in the hip joint, such as transient synovitis and Perthes'

  16. Biomechanics important to interpret radiographs of the hip

    International Nuclear Information System (INIS)

    Rosenthal, D.I.; Scott, J.A.

    1983-01-01

    Biomechanic principles have important implications to film interpretation. Angulation of the femoral neck results in four different types of forces: compression on the medial side, tension on the lateral side, shear stress in the center, and torque forces at the neck-shaft angle. The body's response to these forces results in recognicable trabecular patterns which respond in a predictable manner to disease states. Surgical intervention in the form of hip replacement or fracture fixation must reflect these engineering consideration. (orig.)

  17. 21 CFR 888.3390 - Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metal/polymer... § 888.3390 Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis is a two-part...

  18. 21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) trunnion-bearing... Devices § 888.3380 Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis is a two...

  19. Neuromuscular Activation of the Vastus Intermedius Muscle during Isometric Hip Flexion.

    Directory of Open Access Journals (Sweden)

    Akira Saito

    Full Text Available Although activity of the rectus femoris (RF differs from that of the other synergists in quadriceps femoris muscle group during physical activities in humans, it has been suggested that the activation pattern of the vastus intermedius (VI is similar to that of the RF. The purpose of present study was to examine activation of the VI during isometric hip flexion. Ten healthy men performed isometric hip flexion contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction at hip joint angles of 90°, 110° and 130°. Surface electromyography (EMG was used to record activity of the four quadriceps femoris muscles and EMG signals were root mean square processed and normalized to EMG amplitude during an isometric knee extension with maximal voluntary contraction. The normalized EMG was significantly higher for the VI than for the vastus medialis during hip flexion at 100% of maximal voluntary contraction at hip joint angles of 110° and 130° (P < 0.05. The onset of VI activation was 230-240 ms later than the onset of RF activation during hip flexion at each hip joint angle, which was significantly later than during knee extension at 100% of maximal voluntary contraction (P < 0.05. These results suggest that the VI is activated later than the RF during hip flexion. Activity of the VI during hip flexion might contribute to stabilize the knee joint as an antagonist and might help to smooth knee joint motion, such as in the transition from hip flexion to knee extension during walking, running and pedaling.

  20. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  1. 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…

  2. Improving hip surgery patients’ outcomes:

    DEFF Research Database (Denmark)

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

    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...

  3. Imaging of hip joint arthroplasty

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  4. THE NATURE OF THE HYPER-RUNAWAY CANDIDATE HIP 60350

    International Nuclear Information System (INIS)

    Irrgang, Andreas; Przybilla, Norbert; Heber, Ulrich; Fernanda Nieva, M.; Schuh, Sonja

    2010-01-01

    Young, massive stars in the Galactic halo are widely supposed to be the result of an ejection event from the Galactic disk forcing some stars to leave their place of birth as so-called runaway stars. Here, we present a detailed spectroscopic and kinematic analysis of the runaway B star HIP 60350 to determine which runaway scenario-a supernova explosion disrupting a binary system or dynamical interaction in star clusters-may be responsible for HIP 60350's peculiar orbit. Based on a non-local thermodynamic equilibrium approach, a high-resolution optical echelle spectrum was examined to revise spectroscopic quantities and for the first time to perform a differential chemical abundance analysis with respect to the B-type star 18 Peg. The results together with proper motions from the Hipparcos Catalog further allowed the three-dimensional kinematics of the star to be studied numerically. The abundances derived for HIP 60350 are consistent with a slightly supersolar metallicity agreeing with the kinematically predicted place of birth ∼6 kpc away from the Galactic center. However, they do not exclude the possibility of an α-enhanced abundance pattern expected in the case of the supernova scenario. Its outstanding high Galactic rest-frame velocity of 530 ± 35 km s -1 is a consequence of ejection in the direction of Galactic rotation and slightly exceeds the local Galactic escape velocity in a standard Galactic potential. Hence, HIP 60350 may be unbound to the Galaxy.

  5. Recurrent Hip Fracture Prevention With Osteoporosis Management

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2007-02-01

    Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

  6. Femoral head fracture without hip dislocation

    Directory of Open Access Journals (Sweden)

    Aggarwal Aditya K

    2013-10-01

    Full Text Available 【Abstract】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 en- ergy 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. Key words: Femur head; Hip dislocation; Classification; Arthroplasty, replacement, hip

  7. 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.

  8. Evolution of the hip and pelvis.

    Science.gov (United States)

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

    2009-08-01

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

  9. Movimento de gaveta em joelhos de cães submetidos à estabilização extracapsular após secção do ligamento cruzado cranial in vitro Drawer movement in canine knees undergoing extracapsular stabilization after cranial cruciate ligament rupture in vitro

    Directory of Open Access Journals (Sweden)

    Bernardo Kemper

    2013-06-01

    Full Text Available A técnica TightRope, que procura aperfeiçoar a estabilização extra-capsular com sutura lateral, por meio da realização de mínimas incisões e criação de túneis ósseos em pontos isométricos, que permitem a inserção de mecanismo que anula o movimento de gaveta, além de reduzir a ocorrência de complicações graves. Dessa forma, objetivou-se avaliar a modificação da técnica TightRope em joelhos de cadáveres caninos com a finalidade de disponibilizar um procedimento simples e de custo reduzido para tratamento da Ruptura do ligamento cruzado cranial (RLCCr. Experimentalmente, foram utilizados 20 membros pélvicos de dez cadáveres caninos, provenientes do setor de patologia da Universidade Norte do Paraná, os quais pesavam entre 6,3 e 24kg. Para estabilização do LCCr, rompido intencionalmente, foi adotada a técnica de TightRope modificada utilizando fio de poliamida, cavilha e emprego de um parafuso ortopédico para proporcionar a fixação óssea. Comparando os valores de deslocamento obtidos durante a realização do movimento de gaveta previamente à ruptura do LCCr e após a realização do procedimento cirúrgico, observou-se que a modificação da técnica TightRope promoveu estabilidade significativa para a maioria (12 de 20 dos joelhos testados (P=0,0033. Contudo, essa estabilidade foi inferior, quando comparada à estabilidade do ligamento intacto.The TightRope technique, that has been developed, aims to improve the extra-capsular stabilization with lateral suture through smaller incisions and creating isometric bone tunnels at points that allow the inclusion of a mechanism that overrides the movement of drawer and reduce the occurrence of serious complications. Therefore, the objective was to evaluate the TightRope modified technique in canine cadaver knees in order to provide a simple and cost effective treatment for cranial cruciate ligament rupture (CCrLR. Experimentally; we used 20 pelvic limbs of ten canine

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

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

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

  11. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

    joint space width (JSW) /=60 yr of age. Of factors entered into logistic regression analyses, only age (P LT 0.001 for right hips and P LT 0.001 for left hips) and hip dysplasia (P LT 0.001 for right hips and P = 0.004 for left hips) were significantly associated with hip OA prevalence in women. In men......, only hip dysplasia was associated with hip OA prevalence, P LT 0.001 in right hips and P = 0.001 in left hips. CONCLUSIONS: Of the individual risk factors investigated in this study, only age and hip dysplasia were associated with the development of hip osteoarthritis.......OBJECTIVES: The aim of this cross-sectional survey of 2232 women and 1336 men (age range 20-91 yr) was to investigate individual risk factors for hip joint osteoarthritis (OA). METHODS: Standardized, weight-bearing pelvic radiographs were evaluated. Radiological hip joint OA was defined as minimum...

  12. Unconstrained tripolar hip implants: effect on hip stability.

    Science.gov (United States)

    Guyen, Olivier; Chen, Qing Shan; Bejui-Hugues, Jacques; Berry, Daniel J; An, Kai-Nan

    2007-02-01

    Tripolar implants were developed to treat unstable total hip arthroplasties. However, there is limited confirmation that they achieve this purpose despite their increasing use. Because they have a larger effective head size, these implants are expected to increase range of motion to impingement and improve stability in situations at risk for impingement compared with conventional implants. We assessed the range of motion to impingement using a tripolar implant mounted to an automated hip simulator using 22.2-mm and 28-mm femoral head sizes. The 22 and 28-mm tripolar implants provided increases of 30.5 degrees in flexion, 15.4 degrees in adduction, and 22.4 degrees in external rotation compared with the conventional 22.2-mm femoral head diameter implant. At the critical position of 90 degrees hip flexion, there was an increase of 45.2 degrees in internal rotation. At 0 degrees and 30 degrees external rotation, extension increases were 18.8 degrees and 7.8 degrees, respectively. Bony impingement was the limiting factor. Tripolar implants increased the arc of motion before impingement in positions at risk for dislocation and are expected to provide greater stability.

  13. Colour doppler ultrasound assessment of the normal neonatal hip

    International Nuclear Information System (INIS)

    Ortiz-Neira, C.L.; Laffan, E.; Daneman, A.; Fong, K.; Roposch, A.

    2009-01-01

    To determine the morphology and hemodynamic characteristics of the arterial vessels of the proximal femur according to specific anatomic regions in asymptomatic neonates in 2 pediatric-based health care institutions. Forty-three neonates (29 female, 14 male; age range, 2 d-3 mo; median age, 3 d) were enrolled in the study. Thirty-two (37%) of 86 hips were classified as Graf type IIA joints (mean alpha angle, 56.0 o ± 2.7 o ), and 54 (63%) were classified as type I joints (mean alpha angle, 65.0 o ± 4.6 o ). Colour and spectral Doppler imaging identified vessels running along the acetabular labrum, epiphyseal vessels, and femoral neck. We showed 4 different patterns of vascularity of the hips: radial, parallel, mixed radial-parallel, and indeterminate, however, they were not related to the hip maturity (P = .3, coronal plane; P = .62, transverse plane) or to the amount of colour pixels identified in each region (P = .35). The mean number of pixels in the ligamentum teres region was significantly higher than that in other regions of interest (P =.03). Except for the acetabular labrum arteries, Doppler spectrum waveforms of proximal femur arteries presented with low resistivity. There was a tendency towards females' acetabular arteries presenting with lower peak systolic velocities than males' acetabular arteries (P =.06). Colour Doppler spectrum waveforms and intensity of vascularity in normal neonatal hips differ according to the anatomic region under evaluation. This observation deserves further investigation on its role on the physiopathogenesis of neonatal hip disorders. (author)

  14. BILATERAL PATHOLOGICAL HIP DISLOCATION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Yuriy E. Garkavenko

    2017-03-01

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

  15. The irreducible floating hip: a unique presentation of a rare injury.

    Science.gov (United States)

    Tiedeken, Nathan C; Saldanha, Vilas; Handal, John; Raphael, James

    2013-10-04

    A floating hip injury occurs in the setting of poly-trauma and is a rare and difficult problem to manage. Floating hip injuries require vigilant attention not only to the osseous injuries but also the surrounding compartments and soft tissue envelope. We report the case of a 35-year-old male with a lower extremity posterior wall acetabular fracture, ipsilateral femoral shaft fracture and a postero-superior hip dislocation. Closed reduction failed, necessitating an open reduction internal fixation of his hip dislocation and acetabular fracture. The patient then developed a thigh compartment syndrome requiring a fasciotomy. Despite the obvious bony injuries, orthopedic surgeons must be vigilant of the neurovascular structures and soft tissues that have absorbed a great amount of force. A treatment plan should be formulated based on the status of the overlying soft tissue, fracture pattern and the patient's physiologic stability. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2013.

  16. How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

    2018-03-01

    To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

  17. 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.

  18. Gait analysis in hip viscosupplementation for osteoarthritis: a case report

    Directory of Open Access Journals (Sweden)

    L. Di Lorenzo

    2013-10-01

    Full Text Available Hip is a site very commonly affected by osteoarthritis and the intra-articular administration of hyaluronic acid in the management of osteoarthritic pain is increasingly used. However, the debate about its usefulness is still ongoing, as not all results of clinical trials confirm its effectiveness. In order to achieve the best outcome, clinical assessment and treatment choices should be based on subjective outcome, pathological and mechanical findings that should be integrated with qualitative analysis of human movement. After viscosupplementation, clinical trials often evaluate as endpoint subjective outcomes (i.e. pain visual analogic scale and static imaging such as radiographs and magnetic resonance imaging. In our clinical practice we use gait analysis as part of rehabilitation protocol to measure performance, enhancement and changes of several biomechanical factors. Taking advantage of available resources (BTS Bioengineering gait analysis Elite System we studied a patient’s gait after ultrasound guided hip injections for viscosupplementation. He showed an early clinical and biomechanical improvement during walking after a single intra articular injection of hyaluronic acid. Gait analysis parameters obtained suggest that the pre-treatment slower speed may be caused by antalgic walking patterns, the need for pain control and muscle weakness. After hip viscosupplementation, the joint displayed different temporal, kinetic and kinematic parameters associated with improved pain patterns.

  19. Hip fractures in old men

    International Nuclear Information System (INIS)

    Martinez Rondanelli, Alfredo

    2005-01-01

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

  20. 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.

  1. MR features of bursitis around the hip

    International Nuclear Information System (INIS)

    Lee, Kyung Joo; Sung, Mi Sook; Yu, Won Jong; You, Ie Ryung; Yang, Hae Jeom; Lee, Hae Giu; Im, Jung Ik

    1998-01-01

    To determine the usefulness of MR imaging for differentiation between infectious and non-infectious bursitis. MR images of 16 patients (18 lesions) in whom bursitis around the hip had been diagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, and associated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgical findings) were available for correlation. The location of bursitis was trochanteric (n=3D9), ischiogluteal (n=3D5), iliopsoas (n=3D3), or ischiotrochanteric (n=3D1). Etiologies included infection in seven cases (3 pyogenic; 4 tuberculous) and noninfection in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients with infectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=3D7) association with changes in bone marrow signal intensity (n=3D2), bone erosion (n=3D2), and cellulitis (n=3D1). Of 11 cases of noninfectious bursitis, three demonstrated typical signal characteristics of hematoma within the distended bursa. In six of seven patients who underwent contrast-enhancement, thick and thin peripheral enhancement of the bursa was noted. Bone erosion was found in one case of tuberculous bursitis and two of metabolic disease. Internal septation (n=3D4) and internal debris (n=3D3) were found in both infected and noninfected patients. MR imaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement, associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.=20

  2. MR features of bursitis around the hip

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Joo; Sung, Mi Sook; Yu, Won Jong; You, Ie Ryung; Yang, Hae Jeom; Lee, Hae Giu; Im, Jung Ik [The Catholic Univ. of Korea Holy Family Hospital, Puchun (Korea, Republic of)

    1998-12-01

    To determine the usefulness of MR imaging for differentiation between infectious and non-infectious bursitis. MR images of 16 patients (18 lesions) in whom bursitis around the hip had been diagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, and associated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgical findings) were available for correlation. The location of bursitis was trochanteric (n=3D9), ischiogluteal (n=3D5), iliopsoas (n=3D3), or ischiotrochanteric (n=3D1). Etiologies included infection in seven cases (3 pyogenic; 4 tuberculous) and noninfection in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients with infectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=3D7) association with changes in bone marrow signal intensity (n=3D2), bone erosion (n=3D2), and cellulitis (n=3D1). Of 11 cases of noninfectious bursitis, three demonstrated typical signal characteristics of hematoma within the distended bursa. In six of seven patients who underwent contrast-enhancement, thick and thin peripheral enhancement of the bursa was noted. Bone erosion was found in one case of tuberculous bursitis and two of metabolic disease. Internal septation (n=3D4) and internal debris (n=3D3) were found in both infected and noninfected patients. MR imaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement, associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.=20.

  3. Osteoporotic Hip and Spine Fractures

    OpenAIRE

    Cannada, Lisa K.; Hill, Brian W.

    2014-01-01

    Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment...

  4. Secular trends in hip fractures worldwide: opposing trends East versus West.

    Science.gov (United States)

    Ballane, Ghada; Cauley, Jane A; Luckey, Marjorie M; Fuleihan, Ghada El-Hajj

    2014-08-01

    Despite wide variations in hip rates fractures worldwide, reasons for such differences are not clear. Furthermore, secular trends in the age-specific hip fracture rates are changing the world map of this devastating disease, with the highest rise projected to occur in developing countries. The aim of our investigation is to systematically characterize secular trends in hip fractures worldwide, examine new data for various ethnic groups in the United States, evidence for divergent temporal patterns, and investigate potential contributing factors for the observed change in their epidemiology. All studies retrieved through a complex Medline Ovid search between 1966 and 2013 were examined. For each selected study, we calculated the percent annual change in age-standardized hip fracture rates de-novo. Although occurring at different time points, trend breaks in hip fracture incidence occurred in most Western countries and Oceania. After a steep rise in age-adjusted rates in these regions, a decrease became evident sometimes between the mid-seventies and nineties, depending on the country. Conversely, the data is scarce in Asia and South America, with evidence for a continuous rise in hip fracture rates, with the exception of Hong-Kong and Taiwan that seem to follow Western trends. The etiologies of these secular patterns in both the developed and the developing countries have not been fully elucidated, but the impact of urbanization is at least one plausible explanation. Data presented here show close parallels between rising rates of urbanization and hip fractures across disparate geographic locations and cultures. Once the proportion of the urban population stabilized, hip fracture rates also stabilize or begin to decrease perhaps due to the influence of other factors such as birth cohort effects, changes in bone mineral density and BMI, osteoporosis medication use and/or lifestyle interventions such as smoking cessation, improvement in nutritional status and fall

  5. Hip arthroscopy for femoroacetabular impingement

    Science.gov (United States)

    Nasser, Rima; Domb, Benjamin

    2018-01-01

    The purpose of this article is to give a general overview of femoroacetabular impingement (FAI) and how it could be treated arthroscopically, with some details about indications, the procedure itself and some of the complications associated with the surgery. FAI is a dynamic condition of the hip that can be a source of pain and disability and could potentially lead to arthritis. When symptomatic, and if conservative treatment fails, FAI can be addressed surgically. The goal of surgical treatment for FAI is to recreate the spherical contour of the femoral head, improve femoral offset, normalize coverage of the acetabulum, repair/reconstruct chondral damage and repair/reconstruct the labrum to restore normal mechanics and joint sealing. Advances in equipment and technique have contributed to an increase in the number of hip arthroscopy procedures performed worldwide and have made it one of the more common treatment options for symptomatic FAI. Hip arthroscopy is a procedure with an extremely steep and long learning curve. Cite this article: EFORT Open Rev 2018;3:121-129. DOI: 10.1302/2058-5241.3.170041 PMID:29780619

  6. [Technology of cementless hip endoprosthetics].

    Science.gov (United States)

    Ungethüm, M; Blömer, W

    1987-06-01

    The success achieved with non-cemented hip arthroplasty depends mainly on the stability of the fixation, the quality of the stabilizing bone being just as important as favourable biomechanical conditions. The results of the intensive research and development with respect to the particular features of a non-cemented hip endoprosthesis can be divided into the following basic categories: Biomechanical aspects with special reference to bone related to the design of the prosthesis; material characteristics, such as fatigue strength, tribology, corrosion resistance, and biocompatibility; and development of new materials and coatings to permit direct bonding of implant and bone. With regard to the stem of hip prostheses, the different design parameters of various types are examined to determine their typical design characteristics, such as bearing surface of the collar, geometry of cross section, anatomically adapted shaping, and surface of the implant forming the contact with the bone. The latter can be divided into macroprofiles and macro- and micro-porous coated surfaces. On the other hand, the methods of cementless fixation of acetabular cups can be primarily divided into conical and spherical screw fixation and pegged fixation with additional macroprofiles of porous surfaces. In a separate study of the biomechanical aspects of screwed sockets, the special importance of socket shape and thread geometry are presented with reference to primary stability and long-term fixation of prostheses.

  7. A Hip Implant Energy Harvester

    Science.gov (United States)

    Pancharoen, K.; Zhu, D.; Beeby, S. P.

    2014-11-01

    This paper presents a kinetic energy harvester designed to be embedded in a hip implant which aims to operate at a low frequency associated with body motion of patients. The prototype is designed based on the constrained volume available in a hip prosthesis and the challenge is to harvest energy from low frequency movements (< 1 Hz) which is an average frequency during free walking of a patient. The concept of magnetic-force-driven energy harvesting is applied to this prototype considering the hip movements during routine activities of patients. The magnetic field within the harvester was simulated using COMSOL. The simulated resonant frequency was around 30 Hz and the voltage induced in a coil was predicted to be 47.8 mV. A prototype of the energy harvester was fabricated and tested. A maximum open circuit voltage of 39.43 mV was obtained and the resonant frequency of 28 Hz was observed. Moreover, the power output of 0.96 μW was achieved with an optimum resistive load of 250Ω.

  8. A Hip Implant Energy Harvester

    International Nuclear Information System (INIS)

    Pancharoen, K; Zhu, D; Beeby, S P

    2014-01-01

    This paper presents a kinetic energy harvester designed to be embedded in a hip implant which aims to operate at a low frequency associated with body motion of patients. The prototype is designed based on the constrained volume available in a hip prosthesis and the challenge is to harvest energy from low frequency movements (< 1 Hz) which is an average frequency during free walking of a patient. The concept of magnetic-force-driven energy harvesting is applied to this prototype considering the hip movements during routine activities of patients. The magnetic field within the harvester was simulated using COMSOL. The simulated resonant frequency was around 30 Hz and the voltage induced in a coil was predicted to be 47.8 mV. A prototype of the energy harvester was fabricated and tested. A maximum open circuit voltage of 39.43 mV was obtained and the resonant frequency of 28 Hz was observed. Moreover, the power output of 0.96 μW was achieved with an optimum resistive load of 250Ω

  9. Cost-effectiveness of hip protectors in frail institutionalized elderly

    NARCIS (Netherlands)

    van Schoor, N.M.; de Bruyne, M.C.; van der Roer, N.; Lommerse, E.; van Tulder, M.; Bouter, L.M.; Lips, P.T.A.M.

    2004-01-01

    A randomized controlled trial was performed to examine the cost-effectiveness of external hip protectors in the prevention of hip fractures. Since the hip protectors were not effective in preventing hip fractures in our study, the main objective became to examine whether the use of hip protectors

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    OBJECTIVE: To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. DESIGN: Cross-sectional study. SETTING: Clinical assessments at Sports Orthopaedic Research...... Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. PARTICIPANTS: Twenty-four male soccer players with unilateral long-standing hip and groin pain. INTERVENTIONS: The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion...... strength (Spearman rho = -0.44, P = 0.016). CONCLUSIONS: Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain....

  11. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  12. Hip biomechanics during stair ascent and descent in people with and without hip osteoarthritis.

    Science.gov (United States)

    Hall, Michelle; Wrigley, Tim V; Kean, Crystal O; Metcalf, Ben R; Bennell, Kim L

    2017-07-01

    Hip osteoarthritis (OA) is often associated with pain and impaired function. Understanding biomechanical alterations in patients with hip OA during challenging activities such as stair use is important to inform treatments. The aim of this study was to determine whether kinematics and kinetics during stair ambulation differed between people with hip OA and healthy controls. Fifteen participants with symptomatic and radiographic hip OA and 15 asymptomatic healthy controls underwent 3-D motion analysis during stair ascent and descent. Trunk, pelvis, and hip kinematics as well as hip kinetics were evaluated. Analyses were performed unadjusted and adjusted for speed and leg length. In both the unadjusted and adjusted analyses, participants with hip OA ascended stairs with less hip range of motion in all three planes and a lower peak external rotation moment compared to controls. In the unadjusted analysis, hip OA participants descended stairs with greater ipsilateral trunk lean, less sagittal plane range of motion, lower peak extension moment, lower peak external rotation moment, and greater hip adduction moment impulse compared to controls. In the adjusted results, peak internal rotation moment and hip adduction moment impulse were greater in hip OA participants compared to controls. Findings show that individuals with hip OA display limited range of hip joint movement, particularly during stair ascent, and overall indicate the use of strategies (e.g., trunk lean; lower peak external rotation moment; higher adduction moment impulse) that implicate altered hip abductor function. Future research is required to further understand the implications of these findings on hip OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1505-1514, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  13. 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.

  14. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

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

    2015-07-01

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

  15. Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer Calov; Kjærsgaard-Andersen, Per; Kehlet, Henrik

    2014-01-01

    STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient.......31-3.40)] but not hospital stay of hip...

  16. Resolving controversies in hip fracture care: the need for large collaborative trials in hip fractures

    NARCIS (Netherlands)

    Bhandari, Mohit; Sprague, Sheila; Schemitsch, Emil H.; Einhorn, Thomas; Guyatt, Gordon H.; Haidukewych, George; Keating, John; Koval, Kenneth; Rosen, Clifford; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Motsitsi, Silas; Pei, Fuxing; Yang, Tian-fu; Zhou, Zong-ke; Arora, Shobha; Babhulkar, Sushrut; Bhargava, Rakesh; Desai, Mohan M.; Dhillon, Mandeep S.; Gill, Harpreet Singh; Goel, S. C.; Reddy, A. V. Gurava; Jain, Anil K.; Kalore, Niraj V.; Kammatkar, Nitin; Kumar, Vijay; Malhorta, Rajesh; Marthandam, S. S. K.; Pankaj, Amite; Patinharayil, Gopinathan; Rai, B. Sachidanand; Ramteke, Alankar Ambadas; Sancheti, Parag K.; Thakkar, Navin N.; Thomas, George S.; Robinson, Dror; Steinberg, Ely; Higuchi, Fujio; Kawamura, Sumito; Ohashi, Hirotsugu; Sawaguchi, Takeshi; Park, Myung-Sik; Yun, Ho Hyun; Poduval, Murali; Siddiqui, Ahmed; Chang, Je-Ken; Wang, Gwo-Jaw; Goslings, J. Carel

    2009-01-01

    Hip fractures are a significant cause of morbidity and mortality worldwide and the burden of disability associated with hip fractures globally vindicate the need for high-quality research to advance the care of patients with hip fractures. Historically, large, multi-centre randomized controlled

  17. 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 dysplasia and hip

  18. 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.

  19. Differences in Site-Specific Fracture Risk Among Older Women with Discordant Results for Osteoporosis at Hip and Spine: the Study of Osteoporotic Fractures

    Science.gov (United States)

    Fink, Howard A.; Harrison, Stephanie L.; Taylor, Brent C.; Cummings, Steven R.; Schousboe, John T.; Kuskowski, Michael A.; Stone, Katie L.; Ensrud, Kristine E.

    2009-01-01

    To examine the fracture pattern in older women whose bone mineral density (BMD) T-score criteria for osteoporosis at hip and spine disagree, hip and spine BMD were measured in Study of Osteoporotic Fractures participants using dual energy x-ray absorptiometry (DXA). Hip osteoporosis was defined as T-score ≤-2.5 at femoral neck or total hip, and spine osteoporosis as T-score ≤-2.5 at lumbar spine. Incident clinical fractures were self-reported and centrally adjudicated. Incident radiographic spine fractures were defined morphometrically. Compared to women with osteoporosis at neither hip nor spine, those osteoporotic only at hip had a 3.0-fold age and weight-adjusted increased risk for hip fracture (95%CI 2.4-3.6), and smaller increases in risk of nonhip nonspine (HR=1.6), clinical spine (OR=2.2), and radiographic spine fractures (OR=1.5). Women osteoporotic only at spine had a 2.8-fold increased odds of radiographic spine fracture (95%CI 2.1-3.8), and smaller increases in risk of clinical spine (OR=1.4), nonhip nonspine (HR=1.6), and hip fractures (HR=1.2). Discordant BMD results predict different fracture patterns. DXA fracture risk estimation in these patients should be site-specific. Women osteoporotic only at spine would not have been identified from hip BMD measurement alone, and may have a sufficiently high fracture risk to warrant preventive treatment. PMID:18296090

  20. Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip.

    NARCIS (Netherlands)

    Hoeksma, H.L.; Ende, C.H.M. van den; Ronday, H.K.; Heering, A.; Breedveld, F.C.; Dekker, J.

    2003-01-01

    OBJECTIVE: To compare responsiveness of the Harris Hip Score with generic measures (that is, the Short Form-36 (SF-36), and a test of walking speed and pain during walking) in patients with osteoarthritis (OA) of the hip. METHOD: The first 75 cases within the population of a randomised clinical

  1. Unilateral hip osteoarthritis: can we predict the outcome of the other hip?

    International Nuclear Information System (INIS)

    Vossinakis, I.C.; Georgiades, G.; Hartofilakidis, G.; Kafidas, D.

    2008-01-01

    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.)

  2. Fasilitas Pelatihan dan Pergelaran Seni Tari Hip Hop di Surabaya

    OpenAIRE

    Yanuar, Sandy

    2014-01-01

    Fasilitas Pelatihan dan Pergelaran Seni Tari Hip Hop di Surabaya merupakan fasilitas yang disediakan bagi semua penari Hip Hop di Surabaya untuk berlatih menari dan mempertunjukan tarian Hip Hop. Fasilitas ini tersedia bagi semua penari Hip Hop termasuk penari difable, mengingat kaum difable juga dapat menari Hip Hop. Namun karena di Surabaya belum memiliki fasilitas yang memadai bagi semua penari Hip Hop termasuk penari difable untuk menari dan memiliki tempat pertunjukan yang berkarakter Hi...

  3. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  4. Management of metal-on-metal hip implant patients: Who, when and how to revise?

    Science.gov (United States)

    Berber, Reshid; Skinner, John A; Hart, Alister J

    2016-05-18

    The debate on how best to manage patients with metal-on-metal (MOM) hip implants continues. With over 1 million patients affected worldwide, the impact is far reaching. The majority of the aggressive failures of MOM hip implants have been dealt with by revision hip surgery, leaving patients with a much more indolent pattern of failure of devices that have been in situ for more than 10 years. The longer-term outcome for such patients remains unknown, and much debate exists on how best to manage these patients. Regulatory guidance is available but remains open to interpretation due to the lack of current evidence and long-term studies. Metal ion thresholds for concern have been suggested at 7 ppb for hip resurfacing arthroplasty and below this level for large diameter total hip arthroplasties. Soft tissue changes including pseudotumours and muscle atrophy have been shown to progress, but this is not consistent. New advanced imaging techniques are helping to diagnose complications with metal hips and the reasons for failure, however these are not widely available. This has led to some centres to tackle difficult cases through multidisciplinary collaboration, for both surgical management decisions and also follow-up decisions. We summarise current evidence and consider who is at risk, when revision should be undertaken and how patients should be managed.

  5. Outcomes After Diagnostic Hip Injection.

    Science.gov (United States)

    Lynch, T Sean; Steinhaus, Michael E; Popkin, Charles A; Ahmad, Christopher S; Rosneck, James

    2016-08-01

    To provide a comprehensive review of outcomes associated with local anesthetic (LA) or LA and corticosteroid (CS) diagnostic hip injections, and how well response predicts subsequent operative success. A systematic review from database (PubMed, Medline, Scopus, Embase) inception to January 2015 for English-language articles reporting primary patient outcomes data was performed, excluding studies with >50% underlying osteoarthritis. Studies were assessed by 2 reviewers who collected pertinent data. Seven studies were included, reporting on a total 337 patients undergoing diagnostic hip injection. The mean age was 34.4 years, with 5 studies reporting 94 (35.2%) males and 173 (64.8%) females. One study examined the rate of pain relief with LA (92.5%); 2 CS studies reported relief on a scale from 0% to 100% (no to complete relief), ranging from 61% to 82.3%; and 3 studies used 10-point pain scales, with a CS study noting a pain score of 1.0, an LA study with a score of 3.03, and 1 study using either CS or LA scores of 3 to 5.6. Duration of pain relief was 9.8 (CS) and 2.35 days (LA). By pathology, greatest relief was achieved in acetabular chondral injury (93.3%) and least in cam impingement (81.6%), with clinical and imaging findings being unreliable predictors of relief. One study showed nonresponse to be a strong predictor of negative surgical outcome for femoroacetabular impingement. Diagnostic hip injections provide substantial pain relief for patients with various hip pathologies, with limited data to suggest greatest relief for those with chondral injury. Clinical and imaging findings are unreliable predictors of injection response, and nonresponse to injection is a strong negative predictor of surgical outcome. Future research should focus on elucidating differences by underlying pathology and predicting future operative success. Level IV, systematic review. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights

  6. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D...

  7. 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.

  8. Maximum potential preventive effect of hip protectors

    NARCIS (Netherlands)

    van Schoor, N.M.; Smit, J.H.; Bouter, L.M.; Veenings, B.; Asma, G.B.; Lips, P.T.A.M.

    2007-01-01

    OBJECTIVES: To estimate the maximum potential preventive effect of hip protectors in older persons living in the community or homes for the elderly. DESIGN: Observational cohort study. SETTING: Emergency departments in the Netherlands. PARTICIPANTS: Hip fracture patients aged 70 and older who

  9. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  10. CT and MRI of hip arthroplasty

    International Nuclear Information System (INIS)

    Cahir, J.G.; Toms, A.P.; Marshall, T.J.; Wimhurst, J.; Nolan, J.

    2007-01-01

    Plain films are the initial imaging method of choice for evaluation of hip arthroplasty. Recent advances in technology and imaging techniques have largely overcome the problems of beam hardening in computed tomography (CT) and magnetic susceptibility artefact in magnetic resonance imaging (MRI). CT and MRI have now become useful imaging techniques in the assessment of hip arthroplasty

  11. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, R. H.; Rozendaal, M; Wouters-Wesseling, W; Buskens, E.; Keller, P; Haalboom, JRE

    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

  12. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  13. Pertunjukan Teater Karo Hip Hop Kontemporer KAI

    Directory of Open Access Journals (Sweden)

    Silvia Anggreni Purba

    2013-11-01

    Pertunjukan Teater Karo Hip Hop Kontemporer KAI. The performance of Karo Theater collaborated with Hip Hop stems from a simple idea to collaborate Karo cultural traditions with popular culture. The performances can be enjoyed without having limitation on the language and culture. The process of combining two different cultures is a form of hybrid culture, and it may occur due to the globalization process. Through the process of deposition of the observations and strong impression, this performance is then brought into the form of Hip Hop as a preferred form which is energetic, personal and global. This performance is part of a modern tragedy with its destructive character which has explored the emotion and has presented it to the audiences. The exploration of Karo cultural tradition and Hip Hop dance as a language of symbols is able to reinforce words. The movement is not revealed by the verbal phrase but is presented through the movement of Hip Hop dance. The interpretation of the legend and texts into movement is carried out through the training process at the laboratory as a searching process and experiment, and afterward can be realized by considering the basic elements of Hip Hop, Karo cultural elements and performance. Karo Hip Hop Theatre is expected to become a preferred aesthetic form of a modern theater without losing its tradition form. Keyword: a contemporary Karo theater, Hip Hop, hybrid culture.

  14. 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

  15. Avascular necrosis of the hip

    International Nuclear Information System (INIS)

    Lang, P.; Genant, H.K.; Lindquist, T.; Chafetz, N.; Steiger, P.; Sanny, J.; Rhodes, M.L.; Rothman, S.L.G.; Delamarter, R.; Kilgus, D.

    1988-01-01

    T1-weighted (repetition time [TR] = 450 msec, echo time [TE] = 20 msec), T2-weighted (TR = 1,800 msec, TE = 20 and 80 msec), and T2*-weighted gradient-echo gradient recalled acquisition in a steady state, TR = 70 msec, TE = 30 msec, theta = 15 0 ) MR images (General Electric Signa, 1.5 T) were generated in 11 patients with avascular necrosis of the hip. Three-dimensional MR image reconstruction was performed on an independent imaging system (IIS, Dimensional Medicine Inc). Pelvic and femoral bone contours were computed based on either the T1-weighted or the T2*-weighted images. Three-dimensional displays of necrotic zones and areas of granulation tissue were computed on the basis of the T2-weighted images. The tissues were simultaneously displayed in the three-dimensional images using different colors and transparencies. The three-dimensional MR images generated demonstrated the extent of the necrotic zone and adjacent granulation tissue and their position relative to the weight-bearing surface. They may soon prove to be useful in preoperative planning and intraoperative localization of complex surgical interventions in avascular necrosis of the hip

  16. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  17. [The hip joint in neuromuscular disorders].

    Science.gov (United States)

    Strobl, W M

    2009-07-01

    Physiologic motor and biomechanical parameters are prerequisites for normal hip development and hip function. Disorders of muscle activity and lack of weight bearing due to neuromuscular diseases may cause clinical symptoms such as an unstable hip or reduced range of motion. Disability and handicap because of pain, hip dislocation, osteoarthritis, gait disorders, or problems in seating and positioning are dependent on the severity of the disease, the time of occurrence, and the means of prevention and treatment. Preservation of pain-free and stable hip joints should be gained by balancing muscular forces and by preventing progressive dislocation. Most important is the exact indication of therapeutic options such as movement and standing therapy as well as drugs and surgery.

  18. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

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

  19. Hip strength and range of motion

    DEFF Research Database (Denmark)

    Mosler, Andrea B.; Crossley, Kay M.; Thorborg, Kristian

    2017-01-01

    Objectives To determine the normal profiles for hip strength and range of motion (ROM) in a professional football league in Qatar, and examine the effect of leg dominance, age, past history of injury, and ethnicity on these profiles. Design Cross-sectional cohort study. Methods Participants...... values are documented for hip strength and range of motion that can be used as reference profiles in the clinical assessment, screening, and management of professional football players. Leg dominance, recent past injury history and ethnicity do not need to be accounted for when using these profiles...... included 394 asymptomatic, male professional football players, aged 18–40 years. Strength was measured using a hand held dynamometer with an eccentric test in side-lying for hip adduction and abduction, and the squeeze test in supine with 45° hip flexion. Range of motion measures included: hip internal...

  20. Outcomes of Hip Arthroscopy in Competitive Athletes.

    Science.gov (United States)

    Perets, Itay; Hartigan, David E; Chaharbakhshi, Edwin O; Ashberg, Lyall; Ortiz-Declet, Victor; Domb, Benjamin G

    2017-08-01

    To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology. Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome scores including modified Harris hip score (mHHS), nonarthritic athletic hip score (NAHS), hip outcome score-sports-specific subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were as follows: 1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of 2 years postoperatively. Fifty-one hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum 2-year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (P arthroscopies allowed the patients to return to sports at follow-up. Thirty-four (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. The Role of Hip Arthroscopy in Investigating and Managing the Painful Hip Resurfacing Arthroplasty.

    Science.gov (United States)

    Mei-Dan, Omer; Pascual-Garrido, Cecilia; Moreira, Brett; McConkey, Mark O; Young, David A

    2016-03-01

    To determine the safety and efficacy of hip arthroscopy performed in the peripheral compartment as a diagnostic and therapeutic treatment option for patients with hip pain after hip resurfacing surgery. Indications for hip arthroscopy after hip resurfacing included patients with a symptomatic hip-resurfaced arthroplasties who did not respond to nonoperative treatment. Patients who underwent a hip arthroscopy after a painful hip resurfacing were included with a minimum of 1 year follow-up. Subgroup analysis was performed according to whether an established diagnosis was made before arthroscopic intervention or not. Subjective measures were based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, and results were calculated and analyzed. We included 68 patients (26 male [38%] and 42 female [62%]) who underwent subsequent hip arthroscopy from a population of 978 consecutive hip-resurfaced arthroplasties performed between 1999 and 2010. The average age was 58 (range, 37 to 78 years). The mean follow-up after hip arthroscopy was 3.4 years (range, 12 months to 5.8 years). Patients who had an established diagnosis (n = 41) before hip arthroscopy showed statistical improvement in their WOMAC scores (7 to 2, P arthroscopy showed statistical worsening of the WOMAC (15 to 21, P = .002). Ten (37%) of these 27 patients without a diagnosis failed and needed to be converted to a THR. A significant correlation was found between the collections found on ultrasound (psoas bursa and/or in the hip joint) and the need for synovectomy (P = .01). The overall revision rate to THR after hip resurfacing in our group of patients was 1.3% (n = 13). Female patients were more likely to require postresurfacing hip arthroscopy with 42 (60%) female to only 26 (40%) male patients undergoing this procedure. In our study population, 70% (14/21, P arthroscopy. Hip arthroscopy is a safe surgical treatment option for those patients with a painful hip resurfacing

  2. 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.

  3. Hip instability: a review of hip dysplasia and other contributing factors

    Science.gov (United States)

    Kraeutler, Matthew J.; Garabekyan, Tigran; Pascual-Garrido, Cecilia; Mei-Dan, Omer

    2016-01-01

    Summary Background Hip instability has classically been associated with developmental dysplasia of the hip (DDH) in newborns and children. However, numerous factors may contribute to hip instability in children, adolescents, and adults. Purpose This review aims to concisely present the literature on hip instability in patients of all ages in order to guide health care professionals in the appropriate diagnosis and treatment of the various disorders which may contribute to an unstable hip. Methods We reviewed the literature on the diagnosis and surgical management of hip dysplasia and other causes of hip instability. Conclusions Multiple intra- and extra-articular variables may contribute to hip instability, including acetabular bony coverage, femoral torsion, femoroacetabular impingement, and soft tissue laxity. Physical examination and advanced imaging studies are essential to accurately diagnose the pathology contributing to a patient’s unstable hip. Conservative management, including activity modification and physical therapy, may be used as a first-line treatment in patients with intra-articular hip pathology. Patients who continue to experience symptoms of pain or instability should proceed with arthroscopic or open surgical treatment aimed at correcting the underlying pathology. Level of evidence V. PMID:28066739

  4. Analysis of hip perfusion at early and reversible stages of aseptic hip necrosis

    International Nuclear Information System (INIS)

    Predic, P.; Dodig, D.; Karner, I.

    2002-01-01

    Aim: A proper early diagnosis of aseptic hip necrosis is very important for further therapy.Since there has always been a question of the amount of perfusion in hips at different stages of aseptic hip necrosis we tried to impartially examine the perfusion in hips at early and reversible stages of aseptic hip necrosis. Material and Methods:Study included 143 patients with aseptic hip necrosis.The 550-740 MBq of Tc-99m-DPD were on bolus injected.All patients were subjected to 3-phase scintigraphy of hips and quantitative calculation of relative perfusion in the artery phase (3T) at early and repeated at reversible stages of aseptic hip necrosis. Results: At the early stage of aseptic hip necrosis the obtained 3T was decreased from 0.94-0.69 (3T=0.80).Scintigrams showed a moderate increase or diffuse accumulation. At the reversible stages we obtained 3T decreased from 0.92-0.71 (3T=0.79) thus evidencing hypoperfusion.Scintigrams showed an diffuse increased accumulation. Conclusion: With the aseptic hip necrosis quantitative analysis of perfusion in the artery phase-3T indicates that the perfusion is decreased at all stages of the process which however shows a significantly falling trend with the progress of the disease

  5. Assessment of the hip reduction angle for predicting osteoarthritis of the hip in the Labrador Retriever.

    Science.gov (United States)

    Corfield, G S; Read, R A; Eastley, K A; Richardson, J L; Robertson, I D; Day, R

    2007-06-01

    Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.

  6. The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles.

    Science.gov (United States)

    Chan, Mandy Ky; Chow, Ka Wai; Lai, Alfred Ys; Mak, Noble Kc; Sze, Jason Ch; Tsang, Sharon Mh

    2017-07-21

    Core stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application of core exercises to promote training and rehabilitation outcome of the hip region. The aim of the present study was to examine the effects of abdominal core activation, which is monitored directly by surface electromyography (EMG), on hip muscle activation while performing different hip exercises, and to explore whether participant characteristics such as gender, physical activity level and contractile properties of muscles, which is assessed by tensiomyography (TMG), have confounding effect to the activation of hip muscles in enhanced core condition. Surface EMG of bilateral internal obliques (IO), upper gluteus maximus (UGMax), lower gluteus maximus (LGMax), gluteus medius (GMed) and biceps femoris (BF) of dominant leg was recorded in 20 young healthy subjects while performing 3 hip exercises: Clam, side-lying hip abduction (HABD), and prone hip extension (PHE) in 2 conditions: natural core activation (NC) and enhanced core activation (CO). EMG signals normalized to percentage of maximal voluntary isometric contraction (%MVIC) were compared between two core conditions with the threshold of the enhanced abdominal core condition defined as >20%MVIC of IO. Enhanced abdominal core activation has significantly promoted the activation level of GMed in all phases of clam exercise (P recruitment in Clam, HABD and PHE exercises, and this enhancement is correlated with higher physical activity and stiffer hip muscle. Our results suggest the potential application of abdominal core activation for

  7. Coordination of deep hip muscle activity is altered in symptomatic femoroacetabular impingement.

    Science.gov (United States)

    Diamond, Laura E; Van den Hoorn, Wolbert; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; O'Donnell, John; Hodges, Paul W

    2017-07-01

    Diagnosis of femoroacetabular impingement (FAI) is increasing, yet the associated physical impairments remain poorly defined. This morphological hip condition can cause joint pain, stiffness, impaired function, and eventually hip osteoarthritis. This exploratory study compared coordination of deep hip muscles between people with and without symptomatic FAI using analysis of muscle synergies (i.e., patterns of activity of groups of muscles activated in synchrony) during gait. Fifteen individuals (11 males) with symptomatic FAI (clinical examination and imaging) and 14 age- and sex-comparable controls without morphological FAI underwent testing. Intramuscular fine-wire and surface electrodes recorded electromyographic activity of selected deep and superficial hip muscles. A non-negative matrix factorization algorithm extracted three synergies which were compared between groups. Information regarding which muscles were activated together in the FAI group (FAI group synergy vector) was used to reconstruct individual electromyography patterns and compare groups. Variance accounted for (VAF) by three synergies was less for the control (94.8 [1.4]%) than FAI (96.0 [1.0]%) group (p = 0.03). VAF of obturator internus was significantly higher in the FAI group (p = 0.02). VAF of the reconstructed individual electromyography patterns with the FAI or control group vector were significantly higher for the FAI group (p hip muscles in the synergy related to hip joint control during early swing differed between groups. This phase involves movement towards the impingement position, which has relevance for the interpretation of synergy differences and potential clinical importance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1494-1504, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Comparative stress patterns in cemented total hip arthroplasty

    NARCIS (Netherlands)

    Huiskes, H.W.J.

    1990-01-01

    The wetting of thin oxide films on silicon by water is affected by fixed charge near the outer surface of the oxide. The authors show that existing data can be analysed to give both the depth and concentration of these fixed charges. The precise values indicate depths of a few angstroms and

  9. Hip joint mobility in dancers: preliminary report.

    Science.gov (United States)

    Drężewska, Marlena; Gałuszka, Renata; Sliwiński, Zbigniew

    2012-01-01

    The aim of this study was to evaluate the impact of dancing on hip joint mobility and to assess the relationship between active movements of the hips and injuries among dancers, which may be important in planning rehabilitation in this group. The sample comprised 49 dancers (37 women and 12 men) aged 15 to 32 years. The participants were the professional dancers of the Kielce Dance Theatre and members of two youth jazz dance teams from the Kielce Dance Theatre. The active range of motion of the hips was measured in three planes using a goniometer in order to assess the influence of dance training on hip joint mobility. A questionnaire-based survey was also conducted. The range of flexion, extension and external rotation was significantly greater in the group of long-time dancers (p <0.05). There was a significantly greater range of flexion, abduction and external rotation in previously injured hip joints (p<0.05). 1. Injuries to hip joints in dancers may result in increased ranges of motion, which may lead to disturbances of joint stability. 2. Being a long-time dancer and the female gender were associated with an increased range of hip joint motion.

  10. 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.

  11. Instability after total hip arthroplasty

    Science.gov (United States)

    Werner, Brian C; Brown, Thomas E

    2012-01-01

    Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

  12. 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.

  13. Risk factors for osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Filipović Karmela

    2013-01-01

    Full Text Available INTRODUCTION: Osteoarthritis of the hip is a degenerative disease of hip unknown origin, with pain, stiffness and diminished joint function. AIM: determine the influence of the load of the hip joint during professional activity and BMI as risk factors for the hip osteoarthritis. MATERIAL AND METHOD: We analysed 148 patients. Patients were divided into two groups ( I group with osteoarthritis of the hip, II group without osteoarthritis of the hip. In all, performed diagnostic procedure: anamnesis, physical examination (estimate of walking and hip joint movement, laboratory blood test and urine test radiological examination and taking data on the height and weight to calculated BMI. We assessed the data that is related to the load of the hip joint during professional activities (mostly sitting work and mostly standing job with carrying load. Statistical analysis was done using the software package SPSS 14.0, Microsoft Office Word 2003. RESULTS: In the first group, average age was 67.76 years, with females prevailing (67.6%. In this group the larger body mass was noted (81.82 ± 12.18, with statistically significant difference (T-test 2.923, p<0.01; the average BMI was higher the average BMI was higher (30.18 ± 4.6, with statistically significant difference (T-test 3.832, p<0.01. This group had more overweight patients (87.7%,with statistically significant difference (Fisher test, p<0.01. In I group 62,2% of patients were doing hard physical work (standing job with repeated carrying load and we found statistically significant difference between groups (Fisher test p<0,01. CONCLUSION: Patients with osteoarthritis of the hip had a higher body weight, higher BMI. Also we found the influence of hard physical labor at work, and they were performed mostly standing job with carrying load.

  14. Romani Music - Roma and the Hip-hop Culture

    OpenAIRE

    Dočkal, Tomáš

    2007-01-01

    This thesis is focused on Romani music and its importance for the Romani culture. It examines the popularity of hip-hop among the young Romani generation and Romani hip- hip production. It attempts to define the role of hip-hop culture in young Romanies' lives.

  15. Routine functional assessment for hip fracture patients

    DEFF Research Database (Denmark)

    Pedersen, Tonny J; Lauritsen, Jens M

    2016-01-01

    Background and purpose - Pre-fracture functional level has been shown to be a consistent predictor of rehabilitation outcomes in older hip fracture patients. We validated 4 overall pre-fracture functional level assessment instruments in patients aged 65 or more, used the prediction of outcome at 4...... months post-fracture, and assessed cutoff values for decision making in treatment and rehabilitation. Patients and methods - 165 consecutive patients with acute primary hip fracture were prospectively included in the study. Pre-fracture Barthel-20, Barthel-100, cumulated ambulation score, and new...... investigation of usage for guidance of clinical and rehabilitation decisions concerning hip fracture patients is warranted....

  16. 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.

  17. 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.

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

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Serner, Andreas; Petersen, Jesper

    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.......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...

  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. Migration characteristics and early clinical results of the NANOS® short-stem hip arthroplasty.

    Science.gov (United States)

    Kaipel, Martin; Grabowiecki, Phillip; Sinz, Katrina; Farr, Sebastian; Sinz, Günter

    2015-05-01

    Femoral short stems promise essential advantages in total hip arthroplasty. Up to now, only short- and midterm clinical studies exist. Data on early stem migration that could predict later aseptic loosening at an early stage are rare. The purpose of this study was to assess migration patterns and clinical outcome 2 years after hip replacement by a metaphyseal anchored cementless short stem. Migration data and clinical results were prospectively assessed in 49 patients. Clinical outcome was measured using the Harris Hip Score (HHS). Migration analyses were performed using the computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) system. At 2 years after surgery, none of the implants needed revision, and HHS increased from 47.9 up to 98.1. Of 49 patients, 5 (10%) showed increased vertical stem migration (1.5 mm/2a) that might predict late aseptic loosening. Of 49 stems, 44 (90%) showed stable migration patterns indicating a beneficial long-term outcome. Results of this study confirm the excellent clinical data of previous works. Migration patterns strongly suggest that short-stem arthroplasty is not only an innovative but also a reliable strategy in total hip replacement.

  1. Comparison between the Harris- and Oxford Hip Score to evaluate outcomes one-year after total hip arthroplasty

    NARCIS (Netherlands)

    Weel, Hanneke; Lindeboom, Robert; Kuipers, Sander E.; Vervest, Ton M. J. S.

    2017-01-01

    Harris Hip Score (HHS) is a surgeon administered measurement for assessing hip function before and after total hip arthroplasties (THA). Patient reported outcome measurements (PROMs) such as the Oxford Hip Score (OHS) are increasingly used. HHS was compaired to the OHS assessing whether the HHS can

  2. Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

    DEFF Research Database (Denmark)

    Engesæter, Lars B; Engesæter, Ingvild Ø; Fenstad, Anne Marie

    2012-01-01

    Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA.......9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival......). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3-1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip...

  3. [Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

    Science.gov (United States)

    Medenica, Ivica; Luković, Milan; Radoicić, Dragan

    2010-02-01

    The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  4. Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2010-01-01

    Full Text Available Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1. We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  5. Ipsilateral proximal femur and shaft fractures treated with hip screws and a reamed retrograde intramedullary nail.

    Science.gov (United States)

    Ostrum, Robert F; Tornetta, Paul; Watson, J Tracy; Christiano, Anthony; Vafek, Emily

    2014-09-01

    Although not common, proximal femoral fractures associated with ipsilateral shaft fractures present a difficult management problem. A variety of surgical options have been employed with varying results. We investigated the use of hip screws and a reamed retrograde intramedullary (IM) nail for the treatment of this combined fracture pattern in terms of postoperative alignment (malunion), nonunion, and complications. Between May 2002 and October 2011, a total of 95 proximal femoral fractures with associated shaft fractures were treated at three participating Level 1 trauma centers; all were treated with hip screw fixation (cannulated screws or sliding hip screws) and retrograde reamed IM nails. The medical records of these patients were reviewed retrospectively for alignment, malunion, nonunion, and complications. Followup was available on 92 of 95 (97%) of the patients treated with hip screws and a retrograde nail. Forty were treated with a sliding hip screw, and 52 were treated with cannulated screws. There were five proximal malunions in this series (5%). The union rate was 98% (90 of 92) for the femoral neck fractures and 91.3% (84 of 92) for the femoral shaft fractures after the initial surgery. There were two nonunions of comminuted femoral neck fractures after cannulated screw fixation. There was no difference in femoral neck union or alignment when comparing cannulated screws to a sliding hip screw. Four open comminuted femoral shaft fractures went on to nonunion and required secondary surgery to obtain union, and one patient developed symptomatic avascular necrosis. The treatment of ipsilateral proximal femoral neck and shaft fractures with hip screw fixation and a reamed retrograde nail demonstrated a high likelihood of union for the femoral neck fractures and a low risk of malunion. Comminution and initial displacement of the proximal femoral fracture may still lead to a small incidence of malunion or nonunion, and open comminuted femoral shaft fractures

  6. Season of birth and the risk of hip fracture in danish men and women aged 65+

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Heitmann, Berit L; Eiken, Pia Agnete

    2012-01-01

    calculated fracture rates and relative risks. The analysis covered 541,109 men and 691,522 women. In women, we observed a small but statistically significant difference between fracture rates by season of birth for all age intervals expect the youngest (age 65-69). A similar pattern was seen in men...... an epidemiological analysis of hip fracture rates as a function of season of birth, age, and sex. We retrieved information on all hip fractures in the 9-year period between 1997 and 2005 in all men and women aged 65-95, excluded hip fractures that occurred in current and recent prednisolone users, and subsequently......, but this was only statistically significant in the two oldest age groups (age 85-89 and 90-95). These findings suggest that vitamin D availability in the first and second trimester of intrauterine life could have a small but lasting impact on bone health and the risk of osteoporotic fractures. Further studies...

  7. MR imaging of the hip

    International Nuclear Information System (INIS)

    Kramer, J.

    2006-01-01

    Full text: MRI has been shown to gain increasing importance in recent years in the evaluation of disorders of the hip and pelvis. Nowadays, conventional or fast spin echo (T1, Turbo (Fast) T2 (or PD)) MR imaging sequences are used most commonly to examine the hip and pelvis. Three dimensional (3D) gradient echo (GE) imaging allows acquisition of very thin (1 mm) sections. MR imaging with fat suppression technique (STIR, TIRM, FAT SAT T2) represent an effective screening technique for the assessment of fluid, hemorrhage, pus, or tumor in the marrow, joint or soft tissues. These techniques increase the sensitivity for the detection of a variety of pathologic processes. Fat suppression MR imaging, when combined with intravenous (or intraarticular) administration of a gadolinium compound, also is effective and often is employed when evaluating neoplastic or infectious diseases (intravenous injection), abnormalities of articular cartilage or labrum, or possible intraarticular osteocartilaginous bodies (intraarticular injection). A lesion of the acetabular labrum based is one cause of chronic hip pain in patients with developmental dysplasia of the hips, as well as in patients with a history of hip trauma or femoroacetabular impingement. MR imaging and, in particular, MR arthrography, however, have been shown to be highly accurate in the detection of subtle intraarticular abnormalities such as labral lesion. Conventional MR imaging has shown poor accuracy in detecting labral lesions, due to its inability to depict small tears and the difficulty in determining if intralabral signal abnormalities extend to the surface of the labrum. MR arthrography, however has been shown to overcome these difficulties and to have excellent accuracy in detecting labral pathology. As labral abnormalities are believed to be a precursor of osteoarthritis, orthopedic surgeons believe that surgical intervention will be influenced substantially by the type, extension and location of labral

  8. Atraumatic Anterior Dislocation of the Hip Joint

    Directory of Open Access Journals (Sweden)

    Tadahiko Ohtsuru

    2015-01-01

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

  9. 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...... by reoperations was reduced from 24% of total hospitalization before the algorithm was introduced to 18% after it was introduced. Interpretation It is possible to implement an algorithm for treatment of all hip fracture patients in a large teaching hospital. In our case, the Hvidovre algorithm both raised...

  10. Traction-related problems after hip arthroscopy

    DEFF Research Database (Denmark)

    Frandsen, Lone; Lund, Bent; Grønbech Nielsen, Torsten

    2017-01-01

    . The questionnaire included questions on patients' perceptions of traction-related problems in the groin area, at the knee and ankle and how patients had coped with these problems. A total of 100 consecutive patients undergoing hip arthroscopy filled out the questionnaire. Primary findings of this study were that 74......% of patients reported some sort of traction-related problems after hip arthroscopy. About 32% of the patients had problems in the groin area and 49% of the patients complained of symptoms in the knee joint. A total of 37% of the patients had experienced problems from the traction boot in the ankle area....... The complications were found to be temporary and disappeared after 2-4 weeks. Five patients still had complaints after 3 months. All five patients had a pre-existing knee injury prior to undergoing hip arthroscopy. Traction-related problems after hip arthroscopy are a challenge and our study showed that 74...

  11. Robotic hip arthroscopy in human anatomy.

    Science.gov (United States)

    Kather, Jens; Hagen, Monika E; Morel, Philippe; Fasel, Jean; Markar, Sheraz; Schueler, Michael

    2010-09-01

    Robotic technology offers technical advantages that might offer new solutions for hip arthroscopy. Two hip arthroscopies were performed in human cadavers using the da Vinci surgical system. During both surgeries, a robotic camera and 5 or 8 mm da Vinci trocars with instruments were inserted into the hip joint for manipulation. Introduction of cameras and working instruments, docking of the robotic system and instrument manipulation was successful in both cases. The long articulating area of 5 mm instruments limited movements inside the joint; an 8 mm instrument with a shorter area of articulation offered an improved range of motion. Hip arthroscopy using the da Vinci standard system appears a feasible alternative to standard arthroscopy. Instruments and method of application must be modified and improved before routine clinical application but further research in this area seems justified, considering the clinical value of such an approach. Copyright 2010 John Wiley & Sons, Ltd.

  12. 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

  13. Endorectal 3D T2-weighted 1 mm-slice thickness MRI for prostate cancer staging at 1.5 Tesla: Should we reconsider the indirects signs of extracapsular extension according to the D’Amico tumor risk criteria?

    International Nuclear Information System (INIS)

    Cornud, F.; Rouanne, M.; Beuvon, F.; Eiss, D.; Flam, T.; Liberatore, M.; Zerbib, M.; Delongchamps, N.B.

    2012-01-01

    Purpose: To evaluate the accuracy of a 3D-endorectal 1 mm-thick slices MRI acquisition for local staging of low, intermediate and high D’Amico risk prostate cancer (PCa). Materials and methods: 178 consecutive patients underwent a multiparametric MRI protocol prior to radical prostatectomy (RP). T2W images were acquired with the 3D sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) sequence (5 mn acquisition time). Direct and indirect MRI signs of extracapsular extension (ECE) were evaluated to predict the pT stage. The likelihood of SVI (seminal vesicle invasion) was also assessed. Results: Histology showed ECE and SVI in 38 (21%) and 12 (7%) cases, respectively. MRI sensitivity and specificity to detect ECE were 55 and 96% if direct signs of ECE were used and 84 and 89% (p < 0.05), if both direct and indirect signs were combined. D’Amico criteria did not influence MRI performance. Sensitivity and specificity for SVI detection were 83% and 99%. Conclusions: 3D data sets acquired with the SPACE sequence provides a high accuracy for local staging of prostate cancer. The use of indirect signs of ECE may be recommended in low D’Amico risk tumors to optimise patient selection for active surveillance or focal therapy.

  14. 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.

  15. Late-presenting developmental dysplasia of the hip in Jordanian males. A retrospective hospital based study

    Directory of Open Access Journals (Sweden)

    Omar Q. Samarah

    2016-02-01

    Full Text Available Objectives: To describe the pattern of developmental dysplasia of the hip (DDH in late presenting Jordanian male patients and identify the risk factors and associated findings. Methods: This is a retrospective study of 1145 male patients who attended the Pediatric Orthopedic Clinic for a DDH check up. This study was carried out in the Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan between March 2011 and October 2014. Data was collected from medical records, and x-ray measurements were evaluated. Results: Of the 1145 male patients, 43 (3.75% with 70 involved hips were diagnosed with late- presenting DDH. Being a first-born baby resulted in 41.9% increased risk for DDH. Cesarian delivery was significantly associated with an increased risk of hip dislocation (p=0.004 while normal delivery was significantly associated with acetabular dysplasia (p=0.004. No predictable risk factors were found in 44.2% patients with DDH. Bilateral cases were more common than unilateral cases: (26 [60.5%] versus 17 [39.5%]. Limited abduction was a constant finding in all dislocated hips (p less than 0.001. Associated conditions, such as club foot and congenital muscular torticollis were not observed. Conclusion: Cesarian section is a significant risk for dislocated hips while normal delivery is significantly associated with acetabular dysplasia. Bilateral DDH is more common than the unilateral. Club foot and torticollis were not observed in this series.

  16. The gymnasts' hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Papavasiliou, A.; Sykaras, E. [Aristotle Univ., Thessaloniki (Greece). Sport Injuries Lab.; Siatras, T. [Aristotle Univ., Thessaloniki (Greece). Lab. of Excercise Physiology-Ergometry; Bintoudi, A. [Papageorgiu NHS General Hospital, Thessaloniki (Greece); Milosis, D. [Aristotle Univ., Thessaloniki (Greece). Dept. of Physical Education and Sport Sciences; Lallas, V. [Euromedica Diagnostic Centre, Thessaloniki (Greece); Karantanas, A. [University Hospital Heraklion (Greece). Dept. of Medical Imaging

    2014-08-15

    Specific patterns of developmental adaptation of the proximal femur have been recognized in some sports. Gymnastics are characterized by repetitive axial loading and hip rotations in combination with extreme hip positions. It is unknown how and if these forces can affect an immature skeleton in the long term. We sought to evaluate this, by means of magnetic resonance imaging of the hip and groin of such elite asymptomatic athletes. We performed a case-control comparative MR imaging study of both hips and groin of 12 (7 male, 5 female) skeletally mature young (mean age 18.6 years) asymptomatic international level gymnasts with a minimum of 10 years' training with age-matched non-athletes. At the time of recruitment, none of the athletes had a recorded musculoskeletal complaint or injury in the anatomical area around the hip. The study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal and are considered to be the result of adaptational changes to the specific sport: high centre-column-diaphysis angle (coxa valga140 on average), ligamentum teres hypertrophy, friction of the iliotibial band with oedema surrounding the greater trochanter, and a high incidence (62.5 %) of radiological appearances of ischiofemoral impingement. Our study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal. These findings were in asymptomatic subjects; hence, radiologists and sports physicians should be aware of them in order to avoid unnecessary treatment. (orig.)

  17. The gymnasts' hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes

    International Nuclear Information System (INIS)

    Papavasiliou, A.; Sykaras, E.; Milosis, D.; Karantanas, A.

    2014-01-01

    Specific patterns of developmental adaptation of the proximal femur have been recognized in some sports. Gymnastics are characterized by repetitive axial loading and hip rotations in combination with extreme hip positions. It is unknown how and if these forces can affect an immature skeleton in the long term. We sought to evaluate this, by means of magnetic resonance imaging of the hip and groin of such elite asymptomatic athletes. We performed a case-control comparative MR imaging study of both hips and groin of 12 (7 male, 5 female) skeletally mature young (mean age 18.6 years) asymptomatic international level gymnasts with a minimum of 10 years' training with age-matched non-athletes. At the time of recruitment, none of the athletes had a recorded musculoskeletal complaint or injury in the anatomical area around the hip. The study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal and are considered to be the result of adaptational changes to the specific sport: high centre-column-diaphysis angle (coxa valga140 on average), ligamentum teres hypertrophy, friction of the iliotibial band with oedema surrounding the greater trochanter, and a high incidence (62.5 %) of radiological appearances of ischiofemoral impingement. Our study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal. These findings were in asymptomatic subjects; hence, radiologists and sports physicians should be aware of them in order to avoid unnecessary treatment. (orig.)

  18. The Timing of Hip Arthroscopy After Intra-articular Hip Injection Affects Postoperative Infection Risk.

    Science.gov (United States)

    Wang, Dean; Camp, Christopher L; Ranawat, Anil S; Coleman, Struan H; Kelly, Bryan T; Werner, Brian C

    2017-11-01

    To evaluate the association of preoperative intra-articular hip injection with surgical site infection after hip arthroscopy. A large administrative database was used to identify all patients undergoing hip arthroscopy from 2007 to 2015 within a single private insurer and from 2005 to 2012 within Medicare in the United States. Those that received an ipsilateral preoperative intra-articular hip injection were identified. The patients were then divided into the following groups based on the interval between preoperative injection and ipsilateral hip arthroscopy: (1) 12 months) of preoperative hip injection. Patients developing a surgical site infection within 6 months following hip arthroscopy were identified using International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes associated with infection. Groups were compared using a multivariate logistic regression analysis to control for age, gender, body mass index, smoking status, alcohol usage, and multiple medical comorbidities including diabetes mellitus, hemodialysis use, inflammatory arthritis, and peripheral vascular disease. In total, 19% of privately insured and 6% of Medicare patients received a hip injection within 12 months of hip arthroscopy. The overall infection rate in privately insured and Medicare patients was 1.19% and 1.10%, respectively. Preoperative hip injection within 3 months of surgery was associated with a significantly higher risk of postoperative infection versus controls (2.16%, odds ratio [OR] 6.1, P arthroscopy increased when preoperative intra-articular hip injections were given within 3 months of surgery. Level III, retrospective comparative study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. HIP HOP for HIV Awareness: Using Hip Hop Culture to Promote Community-Level HIV Prevention

    Science.gov (United States)

    Hill, Mandy J.; Hallmark, Camden J.; McNeese, Marlene; Blue, Nike; Ross, Michael W.

    2014-01-01

    The goal of this paper was to determine the effectiveness of the HIP HOP for HIV Awareness intervention, an innovative model utilising an exchange of an HIV test for a hip hop concert ticket, in a metropolitan city among African American youth and young adults. A subset of intervention participants participated in standardised testing, sex…

  20. Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

    Science.gov (United States)

    Goldstein, Wayne M; Branson, Jill J

    2005-09-01

    The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

  1. Hip and ankle range of motion and hip muscle strength in young female ballet dancersand controls

    Science.gov (United States)

    Bennell, K.; Khan, K. M.; Matthews, B.; De Gruyter, M.; Cook, E.; Holzer, K.; Wark, J. D.

    1999-01-01

    OBJECTIVES: To compare the hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls. METHODS: Subjects were 77 dancers and 49 controls (mean (SD) age 9.6 (0.8) and 9.6 (0.7) years respectively). Supine right active hip external rotation (ER) and internal rotation (IR) were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. The measure of ER achieved from below the hip during turnout (non-hip ER) was calculated by subtracting hip ER range from turnout range, and hip ER:IR was derived by dividing ER range by IR range. Range of right weight bearing ankle dorsiflexion was measured in a standing lunge using two methods: the distance from the foot to the wall (in centimetres) and the angle of the shank to the vertical via an inclinometer (in degrees). Right calf muscle range was measured in weight bearing using an inclinometer. A manual muscle tester was used to assess right isometric hip flexor, internal rotator, external rotator, abductor, and adductor strength. RESULTS: Dancers had less ER (pballetic training. 


 PMID:10522638

  2. Reliability and Validity of the Hip Stability Isometric Test (HipSIT): A New Method to Assess Hip Posterolateral Muscle Strength.

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; das Neves Rodrigues, Helena Larissa; de Freitas, Bruno Wesley; de Paula Lima, Pedro Olavo

    2017-12-01

    Study Design Cross-sectional study. Background The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. Objectives To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). Methods The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. Results The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (Pstrength deficits in women with PFP. J Orthop Sports Phys Ther 2017;47(12):906-913. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7274.

  3. Radiation prophylaxis for heterotopic ossification about the hip joint - a multicenter study

    International Nuclear Information System (INIS)

    Seegenschmiedt, Michael Heinrich; Makoski, Hans-Bruno; Micke, Oliver

    2001-01-01

    Purpose: Prophylactic radiotherapy (RT) can prevent ectopic bone formation about the hip after total hip arthroplasty. The German Cooperative Group on Radiotherapy for Benign Diseases conducted a patterns of care study about this indication addressing the involved institutions, RT dose concepts, clinical handling, and treatment outcome of prophylactic RT about the hip joint. Methods and Materials: In 1999, a patterns of care study was conducted in all German institutions to analyze the accrual pattern, number of patients, and different indications for the use and performance of prophylactic RT about the hip. The applied RT concepts of prophylactic RT were evaluated with regard to the RT technique, timing of RT (pre- or postoperative), RT dose prescription (median, range of single and total doses), and treatment outcome. All institutions were asked about the radiologic and functional failure rates at least 1 year after the completion of RT using the established radiologic (Brooker) and functional (Harris) scores with objective and subjective evaluation components. Results: One hundred fourteen institutions reported their clinical experience with prophylactic RT for the prevention of heterotopic ossification about the hip joint: 70 community hospitals, 23 university hospitals, and 21 private RT practices. In 1999, 5677 patients (5989 hips) had received prophylactic RT. The median number per institution was 36 patients (range 8-240). The interdisciplinary referral included orthopedic surgery (89 institutions; 3763 patients), trauma surgery (82 institutions; 1611 patients), or other disciplines (8 institutions; 298 patients). Preoperative RT was applied in 53 institutions 0.5-24 h before surgery, and postoperative RT was applied in 54 institutions 1-120 h after surgery. Most patients received 1 x 7 Gy either pre- or postoperatively. The total dose range was 5-10 Gy (preoperative RT) or 5-16 Gy (postoperative RT); the median total RT dose of both RT concepts was 7 Gy

  4. Hamstring Muscle Use in Females During Hip-Extension and the Nordic Hamstring Exercise: An fMRI Study.

    Science.gov (United States)

    Messer, Daniel J; Bourne, Matthew N; Williams, Morgan D; Al Najjar, Aiman; Shield, Anthony J

    2018-04-23

    Study Design Cross-sectional study. Background Understanding hamstring muscle activation patterns in resistance training exercises may have implications for the design of strength training and injury prevention programs. Unfortunately, surface electromyography studies have reported conflicting results with regard to hamstring muscle activation patterns in women. Objectives To determine the spatial patterns of hamstring muscle activity during the 45º hip-extension and Nordic hamstring exercises, in females using functional magnetic resonance imaging. Methods Six recreationally active females with no history of lower limb injury underwent functional magnetic resonance imaging (fMRI) on both thighs before and immediately after 5 sets of 6 bilateral eccentric contractions of the 45º hip-extension or Nordic exercises. Using fMRI, the transverse (T2) relaxation times were measured from pre- and post- exercise scans and the percentage increase in T2 was used as an index of muscle activation. Results fMRI revealed a significantly higher biceps femoris long head (BF LongHead ) to semitendinosus ratio during the 45° hip-extension than the Nordic exercise (P = .028). The T2 increase after 45° hip-extension was greater for BF LongHead (P Nordic exercise, the T2 increase for semitendinosus was greater than that of BF ShortHead (P Nordic exercise preferentially recruits that muscle while the hip extension more evenly activates all of the biarticular hamstrings. J Orthop Sports Phys Ther, Epub 23 Apr 2018. doi:10.2519/jospt.2018.7748.

  5. Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty

    DEFF Research Database (Denmark)

    Karimi, Dennis; Kallemose, Thomas; Troelsen, Anders

    2018-01-01

    and prevalences of hip malformations were; CAM-deformity 50.9 and 25.5%, coxa profunda 33 and 27.4%, acetabular retroversion 33 and 29.2%, and acetabular dysplasia 10.4 and 3.8%. All patients showed minimum of one malformation. Prevalences of Tönnis grade 0-1 were 22.6% and 2-3 were 77.4%. CONCLUSION: All......INTRODUCTION: In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown...... that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA. MATERIALS AND METHODS: In this prospective two center...

  6. Automatic assessment of volume asymmetries applied to hip abductor muscles in patients with hip arthroplasty

    Science.gov (United States)

    Klemt, Christian; Modat, Marc; Pichat, Jonas; Cardoso, M. J.; Henckel, Joahnn; Hart, Alister; Ourselin, Sebastien

    2015-03-01

    Metal-on-metal (MoM) hip arthroplasties have been utilised over the last 15 years to restore hip function for 1.5 million patients worldwide. Althoug widely used, this hip arthroplasty releases metal wear debris which lead to muscle atrophy. The degree of muscle wastage differs across patients ranging from mild to severe. The longterm outcomes for patients with MoM hip arthroplasty are reduced for increasing degrees of muscle atrophy, highlighting the need to automatically segment pathological muscles. The automated segmentation of pathological soft tissues is challenging as these lack distinct boundaries and morphologically differ across subjects. As a result, there is no method reported in the literature which has been successfully applied to automatically segment pathological muscles. We propose the first automated framework to delineate severely atrophied muscles by applying a novel automated segmentation propagation framework to patients with MoM hip arthroplasty. The proposed algorithm was used to automatically quantify muscle wastage in these patients.

  7. HIGH PRECISION ABUNDANCES OF THE OLD SOLAR TWIN HIP 102152: INSIGHTS ON Li DEPLETION FROM THE OLDEST SUN

    Energy Technology Data Exchange (ETDEWEB)

    Monroe, TalaWanda R.; Melendez, Jorge; Tucci Maia, Marcelo; Freitas, Fabricio C. [Departamento de Astronomia do IAG/USP, Universidade de Sao Paulo, Rua do Matao 1226, Cidade Universitaria, 05508-900 Sao Paulo, SP (Brazil); Ramirez, Ivan [McDonald Observatory, The University of Texas at Austin, Austin, TX 78712 (United States); Yong, David; Asplund, Martin; Alves-Brito, Alan; Casagrande, Luca [Research School of Astronomy and Astrophysics, The Australian National University, Cotter Road, Weston, ACT 2611 (Australia); Bergemann, Maria [Max Planck Institute for Astrophysics, Postfach 1317, D-85741 Garching (Germany); Bedell, Megan; Bean, Jacob [Department of Astronomy and Astrophysics, University of Chicago, 5640 S. Ellis Ave., Chicago, IL 60637 (United States); Lind, Karin [Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA (United Kingdom); Castro, Matthieu; Do Nascimento, Jose-Dias [Departamento de Fisica Teorica e Experimental, Universidade Federal do Rio Grande do Norte, 59072-970 Natal, RN (Brazil); Bazot, Michael, E-mail: tmonroe@usp.br [Centro de Astrofisica da Universidade do Porto, Rua das Estrelas, 4150-762 Porto (Portugal)

    2013-09-10

    We present the first detailed chemical abundance analysis of the old 8.2 Gyr solar twin, HIP 102152. We derive differential abundances of 21 elements relative to the Sun with precisions as high as 0.004 dex ({approx}<1%), using ultra high-resolution (R = 110,000), high S/N UVES spectra obtained on the 8.2 m Very Large Telescope. Our determined metallicity of HIP 102152 is [Fe/H] = -0.013 {+-} 0.004. The atmospheric parameters of the star were determined to be 54 K cooler than the Sun, 0.09 dex lower in surface gravity, and a microturbulence identical to our derived solar value. Elemental abundance ratios examined versus dust condensation temperature reveal a solar abundance pattern for this star, in contrast to most solar twins. The abundance pattern of HIP 102152 appears to be the most similar to solar of any known solar twin. Abundances of the younger, 2.9 Gyr solar twin, 18 Sco, were also determined from UVES spectra to serve as a comparison for HIP 102152. The solar chemical pattern of HIP 102152 makes it a potential candidate to host terrestrial planets, which is reinforced by the lack of giant planets in its terrestrial planet region. The following non-local thermodynamic equilibrium Li abundances were obtained for HIP 102152, 18 Sco, and the Sun: log {epsilon} (Li) = 0.48 {+-} 0.07, 1.62 {+-} 0.02, and 1.07 {+-} 0.02, respectively. The Li abundance of HIP 102152 is the lowest reported to date for a solar twin, and allows us to consider an emerging, tightly constrained Li-age trend for solar twin stars.

  8. Hip fracture in hospitalized medical patients.

    Science.gov (United States)

    Zapatero, Antonio; Barba, Raquel; Canora, Jesús; Losa, Juan E; Plaza, Susana; San Roman, Jesús; Marco, Javier

    2013-01-08

    The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost. A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p patients with a hip fracture (20.7 days vs 9.8 days; p hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  9. [Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease].

    Science.gov (United States)

    Sun, Qi-Cai; Ru, Xuan-Liang; Xia, Yan-Fei; Liu, Xiao-Li; Song, Bai-Shan; Qiao, Song; Yan, Shi-Gui; Wang, Xiang-Hua

    2017-12-25

    To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor. Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.

  10. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Christoph Zilkens

    2011-09-01

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

  11. RAZVOJ OBLAČIL V HIP HOP KULTURI

    OpenAIRE

    Marić, Sanja

    2010-01-01

    V diplomskem delu smo raziskovali, kako so se hip hop oblačila razvijala skozi obdobja v hip hop kulturi. V teoretičnem deli smo ugotavljali ozadje in dejavnike, ki so vplivali na razvoj hip hop kulture, v empiričnem delu diplomske naloge pa smo izvedli anketni vprašalnik z glavnimi akterji hip hop kulture na slovenski hip hop sceni. Rezultati, ki smo jih dobili, kažejo da so imela oblačila velik vpliv na prepoznavnost in razvoj hip hop kulture po celem svetu. K temu so največ pripomogli ustv...

  12. Hip morphologic measurements in an Egyptian population.

    Science.gov (United States)

    Aly, Tarek A

    2011-04-11

    The study of acetabular morphology has shown that there are geographic differences in the morphology and prevalence of acetabular dysplasia among different ethnic groups. However, few data exist on the shape of the acetabulum in various populations around the world. In this study, we examined samples of pelvic radiographs from Egyptian adults. Acetabular dysplasia in adults is characterized by a shallow and relatively vertical acetabulum.The aim of this study was to examine acetabular morphology to determine the prevalence of hip dysplasia in adult Egyptians. This included 244 adults, 134 men and 110 women between 18 and 60 years, who were used to measure center edge angle, acetabular Sharp angle, acetabular head index on anteroposterior radiographic views of the hip joints, and vertical center anterior margin angle on false profile views. The radiographs were taken of patients with no hip complaints at Tanta University Hospital.The results were statistically studied according to the age, height, and weight of patients. The prevalence of acetabular dysplasia was 2.25% for Egyptian men and 3.6% for women with respect to center edge angles, vertical center anterior margin angle, and acetabular head index.We concluded that gender variations in the morphology of the acetabulum and sex influences geometrical measurements of the acetabulum. Egyptian women were more dysplastic than men using the 4 parameters of hip measurements. There are also racial variations in hip morphology. Copyright 2011, SLACK Incorporated.

  13. Schizophrenia, antipsychotics and risk of hip fracture

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Jensen, Signe O W; Nielsen, Jimmi

    2013-01-01

    In a nationwide study using linkage of Danish hospital registers we examined predictors of hip fracture (ICD-10: S72) in 15,431 patients with schizophrenia (ICD-10: F20 or ICD-8: 295) and 3,807,597 population controls. Shorter education, disability pension, lifetime alcohol abuse, somatic co......-morbidity, antipsychotics (IRR=1.19; 95% CI 1.15-1.24), antidepressant (IRR=1.18; 95% CI 1.16-1.20), anticholinergics (IRR=1.29; 95% CI 1.22-1.36), benzodiazepines (IRR=1.06; 95% CI 1.04-1.08) and corticosteroids (IRR=1.44; 95% CI 1.36-1.53) were significant predictors. In 556 persons with schizophrenia and hip fracture...... (matched to 1:3 to schizophrenia controls without hip fracture), antipsychotic polypharmacy predicted hip fracture. Analyses among antipsychotic monotherapy patients showed no differential effect of individual antipsychotics. A dose-response relationship of hip fracture and lifetime antipsychotics...

  14. Cystic lesion around the hip joint

    Science.gov (United States)

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

    2015-01-01

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

  15. [Clinical pathway for hip fracture patients].

    Science.gov (United States)

    Sáez López, Pilar; Sánchez Hernández, Natalia; Paniagua Tejo, Sonsoles; Valverde García, José Antonio; Montero Díaz, Margarita; Alonso García, Noelia; Freites Esteve, Alfonso

    2015-01-01

    Hip fracture in the elderly often occurs in patients with high co-morbidity. Effective management requires a comprehensive and multidisciplinary approach. To evaluate the effect of a quality improvement intervention in the detection and treatment of complications in elderly patients admitted for hip fracture. A comparative study was conducted between two groups of patients admitted for hip fracture prior to 2010, and after a quality improvement intervention in 2013. The intervention consisted of implementing improved multidisciplinary measures in accordance with recent scientific evidence. The degree of compliance of the implemented measures was quantified. Patients admitted due to hip fracture in 2010 (216 patients) and 2013 (196 patients) were similar in age, sex, Barthel Index, and a reduced Charlson Index, although there were more comorbidities in 2013. After implementation of the protocols, the detection of delirium, malnutrition, anemia, and electrolyte disturbances increased. A larger number of patients in 2013 were precribed intravenous iron (24% more) and osteoporosis treatment (61.3% more). The average stay was reduced by 45.3% and surgical delay by 29.4%, achieving better functional efficiency. The implementation of a clinical pathway in geriatric patients with hip fracture is useful to detect and treat complications at an early stage, and to reduce pre-operative and overall stay, all without a negative clinical or functional impact. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  16. Concomitant Hip Arthroscopy and Periacetabular Osteotomy.

    Science.gov (United States)

    Domb, Benjamin G; LaReau, Justin M; Hammarstedt, Jon E; Gupta, Asheesh; Stake, Christine E; Redmond, John M

    2015-11-01

    To detail our early experience using concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia. We prospectively collected and retrospectively reviewed the surgical and outcome data of 17 patients who underwent concomitant hip arthroscopy and PAO between October 2010 and July 2013. Preoperative and postoperative range of motion, outcome and pain scores, and radiographic data were collected. Intraoperative arthroscopic findings and postoperative complications were recorded. The group consisted of 3 male and 14 female patients with a mean follow-up period of 2.4 years. Three patients had undergone previous surgery on the affected hip. Chondrolabral pathology was identified in all 17 patients. Twelve patients underwent labral repair, and five patients underwent partial labral debridement. No patient was converted to total hip arthroplasty or required revision surgery at short-term follow-up. All 4 patient-reported outcome scores showed statistically significant changes from baseline to latest follow-up (P arthroscopy and PAO has been favorable. We noted that all our patients have evidence of chondrolabral damage at the time of PAO when the joint is distracted and evaluated. All patients in this series had intra-articular pathology treated arthroscopically and showed satisfactory mean clinical improvement. Hip arthroscopy with PAO did not appear to introduce complications beyond the PAO alone. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Hip and Groin Injuries in Baseball Players.

    Science.gov (United States)

    Mlynarek, Ryan A; Coleman, Struan H

    2018-03-01

    To discuss the clinical significance of the most common hip and groin injuries in baseball players, as well as an algorithmic approach to diagnosis and treatment of these injuries. (a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list. Injuries involving the hip and groin are relatively common in baseball players. Our knowledge of the mechanics of overhead throwing continues to evolve, as does our understanding of the contribution of power from the lower extremities and core. It is paramount that the team physician be able to accurately diagnose and treat injuries involving the hip/groin, as they may lead to significant disability and inability to return to elite levels of play. This review focuses on hip- and groin-related injuries in the baseball player, including femoroacetabular impingement, core muscle injury, and osteitis pubis.

  18. Screening for congenital dislocation of the hip

    International Nuclear Information System (INIS)

    Fendel, H.

    1987-01-01

    Although the prevalence of (idiopathic) congenital dislocation of the hip (CDH) within the Member States of the European Community is not exactly known, it must be considered as a major problem of public health care and protection. By assessment of available data one can assume that between 1 and 2% of all newborns have dislocation or instability of one or both hips. There is a female predominance of 4:1 and some risk factors are known. The reasons of a higher prevalence in some areas are not yet well understood. Most of instable hips will spontaneously become stable within the first days or weeks of life. However, a considerable number of infants (less than 1%) will remain with instable hips which may dislocate. Dislocation either present at birth or as a result of persistent instability leads to subsequent hip deformation. This is a serious event for each affected individual, and is a heavy load on health care and social costs for the public. Treatment of CDH is easy and usually effective when started early, i.e. before the fourth month of life. The earlier treatment is started the easier, shorter, safer and less expensive it is and its impairment on child development and mother-child interaction can be held to a minimum. Screening for CDH is therefore the most important part of health protection in early infancy. However, this paper concludes that neither sonography nor X-ray examinations are appropriate for CDH screening

  19. Hip arthroscopy: prevalence of intra-articular pathologic findings after traumatic injury of the hip.

    Science.gov (United States)

    Khanna, Vickas; Harris, Adam; Farrokhyar, Forough; Choudur, Hema N; Wong, Ivan H

    2014-03-01

    The purpose of this study was to document and compare the incidence of intra-articular hip pathologic findings identified using arthroscopy versus conventional imaging in patients with acute trauma to the hip. This was a blinded prospective case series study designed to review the incidence of intra-articular pathologic disorders in patients with post-traumatic injury between the ages of 18 and 65 years who were referred to a single surgeon. Injuries included hip dislocation, proximal femur fracture, pelvic ring fracture, acetabular fracture, penetrating injury (gunshot wound), and soft tissue injury. Preoperative radiographs, computed tomographic (CT) scans, or magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) scans (or a combination of these) were obtained. Findings were documented and compared with intraoperative findings. A total of 29 post-traumatic hips were enrolled in this study. Hip arthroscopy identified 17 of 29 hips (59%) as having loose bodies, 11 of 29 (38%) hips as having an intra-articular step deformity, 14 of 29 (49%) hips as having an osteochondral lesion, and 27 of 29 (93%) hips as having a labral tear. Plain radiographs and CT scans yielded low sensitivity when compared with arthroscopy for the identification of loose bodies and step deformities. MRI/MRA comparison with arthroscopic findings suggest that MRI/MRA is an accurate tool for identification of labral tears, because 91% of tears seen on arthroscopy were also identified by MRI/MRA. In 4 hips, however, MRI/MRA failed to identify osteochondral lesions that were subsequently identified by arthroscopy. Traumatic injuries of the hip result in substantial intra-articular pathologic findings, including loose bodies, labral tears, step deformities, and osteochondral lesions. The arthroscope is a powerful tool in identifying these injuries. Plain radiographs and CT scans appear to underestimate the true incidence of loose bodies and step deformities within the joint when

  20. Abnormal hip physical examination findings in asymptomatic female soccer athletes

    Science.gov (United States)

    Hunt, Devyani; Rho, Monica; Yemm, Ted; Fong, Kathryn; Brophy, Robert H.

    2016-01-01

    Purpose Examination of the hip provides information regarding risk for pre-arthritic hip disorders, knee injuries, and low back pain. The purpose of this study was to report a hip screening examination of asymptomatic female soccer athletes and to test the hypothesis that these findings vary by competition experience. Methods Asymptomatic females from a youth soccer club, a college, and a professional team were evaluated. Passive hip range of motion, hip abduction strength, and hip provocative tests were assessed. Data were compared for the grade/middle school, high school, college, and professional athletes. Results One hundred and seventy-two athletes with a mean age of 16.7 ± 5 years (range 10–30) participated. Professional athletes had less flexion (HF) for both hips (p hips as compared to all other groups (p hip abduction strength as compared to other groups (p hip tests were found in 22 % of all players and 36 % of the professionals. In professionals, a positive provocative test was associated with ipsilateral decreased HF (p = 0.04). Conclusion Asymptomatic elite female soccer athletes with the most competition experience had less bilateral hip flexion and preferred kicking leg IR than less-experienced athletes. Positive provocative hip tests were found in 22 % of athletes. Future studies are needed to show whether these findings link to risk for intra-articular hip or lumbar spine and knee disorders. Level of evidence III. PMID:24150125

  1. The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners

    DEFF Research Database (Denmark)

    Brund, René B. Korsgaard; Rasmussen, Sten; Nielsen, Rasmus O.

    2018-01-01

    Weak hip abductors may be related with increased hip adduction and knee abduction angular movement, which may be risk factors of lower extremity injuries. As the role of eccentric hip abduction strength (EHAS) on hip adduction angular movement and knee abduction angular movement (KABD) remains...... and Codamotion active marker system. Using multiple linear regression models (n=186 legs), no relationships between EHAS and hip and knee kinematics were found. A possible reason for the lack of relationship between EHAS and hip and knee kinematics may be owing to differences in the running kinematics. Some...

  2. Barefoot running and hip kinematics: good news for the knee?

    Science.gov (United States)

    McCarthy, Colm; Fleming, Neil; Donne, Bernard; Blanksby, Brian

    2015-05-01

    Patellofemoral pain and iliotibial band syndromes are common running injuries. Excessive hip adduction (HADD), hip internal rotation (HIR), and contralateral pelvic drop (CLPD) during running have been suggested as causes of injury in female runners. This study compared these kinematic variables during barefoot and shod running. Three-dimensional gait analyses of 23 habitually shod, uninjured female recreational athletes running at 3.33 m·s while shod and barefoot were studied. Spatiotemporal and kinematic data at initial contact (IC), 10% of stance (corresponding to the vertical impact peak), and peak angles were collected from each participant for HADD, HIR, and CLPD, and differences were compared across footwear conditions. Step rates when running barefoot were 178 ± 13 versus 172 ± 11 steps per minute when shod (P strike patterns changed from a group mean heel-toe latency indicating a rear-foot strike (20.8 ms) when shod, to one indicating a forefoot strike (-1.1 ms) when barefoot (P knee injuries in female runners, barefoot running could have potential for injury prevention or treatment in this cohort.

  3. A review of the anatomy of the hip abductor muscles, gluteus medius, gluteus minimus, and tensor fascia lata.

    Science.gov (United States)

    Flack, Natasha Amy May Sparks; Nicholson, Helen D; Woodley, Stephanie Jane

    2012-09-01

    The hip abductor muscles have the capability to contribute to numerous actions, including pelvic stabilization during gait, and abduction and rotation at the hip joint. To fully understand the role of these muscles, as well as their involvement in hip joint dysfunction, knowledge of their anatomical structure is essential. The clinical literature suggests anatomical diversity within these muscles, and that gluteus medius (GMed) and gluteus minimus (GMin), in particular, may be comprised of compartments. This systematic review of the English literature focuses on the gross anatomy of GMed, GMin, and tensor fascia lata (TFL) muscles. Although studies of this muscle group have generated useful descriptions, comparison of results is hindered by methodological limitations. Furthermore, there is no single comprehensive anatomical investigation of all three muscles. Several aspects of the morphology of attachment sites are unknown or unclear. There is little data on fascicle orientation, the interface between fascicles and tendons, and the specific patterning of the superior gluteal nerve. Consequently, the existence of anatomical compartmentalization within the hip abductor muscles is difficult to assess. Further research of the architecture and innervation of the hip abductor muscle group is required; a better understanding of the precise anatomy of these muscles should improve our understanding of their specific functions and their contribution to the pathogenesis of disorders affecting the hip joint. Copyright © 2011 Wiley Periodicals, Inc.

  4. Magnetic resonance imaging findings compared with histological findings of the labrum in hip osteoarthritis

    International Nuclear Information System (INIS)

    Kanezaki, Shiho; Nakamura, Shigeru; Matsushita, Takashi; Yamamoto, Asako; Osawa, Marie

    2015-01-01

    Patients with disorders such as acetabular dysplasia or femoroacetabular impingement are at risk of developing hip osteoartbritis. Assessment of the cartilage and labrum in the hip joint based on magnetic resonance imaging (MRI) has been challenging because of the low signal-to-noise ratio (SNR) due to its deep location, ball and socket structure, and small volume of those structures compared with the whole joint size. To achieve better imaging assessment, direct MR. arthrography (d-MRA) and other techniques such as T2* mapping, T2 mapping, Tlrho, and delayed gadolinium-enhanced MRI (dGEMRIC) have been developed along with the increasing use of high-field MRI. In patients with no apparent osteoarthritic changes such as joint space narrowing or osteophyte and subchondral cyst formation on radiographs, these techniques can detect early cartilage or labral damage. A recently developed semiquantitative MRI-based scoring system for hip osteoarthritis includes evaluation of the labrum, and its application as a potential therapeutic monitoring tool is anticipated. The labrum shows pathological changes such as macroscopic hypertrophy and histological degeneration in hip osteoartbritis, but the pathological background is not well understood when evaluated by MRI. Kubo et al. compared radial MRI findings with histological changes of the labrum in ll hips with osteoarthritis using 1.5-T MRJ and found that fibrous separation and mucoid deposition occurred in the labrum with a ''diffuse high signal'' or ''obscure'' pattern. However, to the best of our knowledge, no studies have demonstrated a correlation between MRI fmdings and histological evidence of the severity of degeneration of the labrum. We hypothesized that radially reconstructed images of the acetabular labrum acquired by 3-T MRI can depict degenerative changes of the labrum. In this study, we sought to determine the correlation between MRI and histological findings of the

  5. Magnetic resonance imaging findings compared with histological findings of the labrum in hip osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kanezaki, Shiho; Nakamura, Shigeru; Matsushita, Takashi [Teikyo University School of Medicine, Department of Orthopaedic Surgery, Itabashi-ku, Tokyo (Japan); Yamamoto, Asako; Osawa, Marie [Teikyo University School of Medicine, Department of Radiology, Itabashi-ku, Tokyo (Japan)

    2015-06-01

    Patients with disorders such as acetabular dysplasia or femoroacetabular impingement are at risk of developing hip osteoartbritis. Assessment of the cartilage and labrum in the hip joint based on magnetic resonance imaging (MRI) has been challenging because of the low signal-to-noise ratio (SNR) due to its deep location, ball and socket structure, and small volume of those structures compared with the whole joint size. To achieve better imaging assessment, direct MR. arthrography (d-MRA) and other techniques such as T2* mapping, T2 mapping, Tlrho, and delayed gadolinium-enhanced MRI (dGEMRIC) have been developed along with the increasing use of high-field MRI. In patients with no apparent osteoarthritic changes such as joint space narrowing or osteophyte and subchondral cyst formation on radiographs, these techniques can detect early cartilage or labral damage. A recently developed semiquantitative MRI-based scoring system for hip osteoarthritis includes evaluation of the labrum, and its application as a potential therapeutic monitoring tool is anticipated. The labrum shows pathological changes such as macroscopic hypertrophy and histological degeneration in hip osteoartbritis, but the pathological background is not well understood when evaluated by MRI. Kubo et al. compared radial MRI findings with histological changes of the labrum in ll hips with osteoarthritis using 1.5-T MRJ and found that fibrous separation and mucoid deposition occurred in the labrum with a ''diffuse high signal'' or ''obscure'' pattern. However, to the best of our knowledge, no studies have demonstrated a correlation between MRI fmdings and histological evidence of the severity of degeneration of the labrum. We hypothesized that radially reconstructed images of the acetabular labrum acquired by 3-T MRI can depict degenerative changes of the labrum. In this study, we sought to determine the correlation between MRI and histological findings of the

  6. 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.

  7. 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.

  8. The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

    Science.gov (United States)

    2010-01-01

    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. PMID:20670440

  9. Impact of a second FDG PET scan before adjuvant therapy for the early detection of residual/relapsing tumours in high-risk patients with oral cavity cancer and pathological extracapsular spread

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Chun-Ta; Huang, Shiang-Fu; Chen, I-How; Kang, Chung-Jan [Chang Gung Memorial Hospital and Chang Gung University, Department of Otorhinolaryngology, Head and Neck Surgery, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Fan, Kang-Hsing; Lin, Chien-Yu [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Oncology, Taoyuan (China); Ng, Shu-Hang [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Diagnostic Radiology, Taoyuan (China); Hsueh, Chuen; Lee, Li-Yu [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Lin, Chih-Hung [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Plastic and Reconstructive Surgery, Taoyuan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China)

    2012-06-15

    Extracapsular spread (ECS) to the cervical lymph nodes is a major adverse prognostic factor in oral cavity squamous cell carcinoma (OSCC). We prospectively examined the value of FDG PET immediately before postoperative radiotherapy/concurrent chemoradiotherapy (pre-RT/CCRT PET) to detect residual/relapsing disease in the early postsurgical follow-up period in high-risk OSCC patients with ECS. We examined 183 high-risk OSCC patients with ECS who underwent preoperative FDG PET/CT for staging purposes. Of these patients, 29 underwent a second pre-RT/CCRT FDG PET/CT scan. The clinical utility of the second FDG PET/CT was examined using Kaplan-Meier curve analysis. Patients who underwent the second FDG PET/CT scan had baseline clinicopathological characteristics similar to those who did not undergo a second scan. Of the patients who underwent the second scan, seven (24 %) had unexpected, newly discovered lesions. Five eventually died of the disease, and two had no evidence of recurrence after a change in RT field and dose. In an event-based analysis at 2 months, rates of neck control (6/29 vs. 6/154, p = 0.001), distant metastases (3/29 vs. 4/154, p = 0.046), and disease-free survival (7/29 vs. 10/154, p = 0.003) were significantly higher in patients who received a second PET scan than in those who did not. The second pre-RT/CCRT PET scan was of particular benefit for detecting new lesions in OSCC patients with both ECS and lymph node standardized uptake value (SUV) of {>=}5.2 in the first PET scan. The present findings support the clinical value of pre-RT/CCRT FDG PET for defining treatment strategy in OSCC patients with both ECS and high nodal SUV, even when FDG PET had already been performed during the initial staging work-up. (orig.)

  10. Wear mechanisms in ceramic hip implants.

    Science.gov (United States)

    Slonaker, Matthew; Goswami, Tarun

    2004-01-01

    The wear in hip implants is one of the main causes for premature hip replacements. The wear affects the potential life of the prosthesis and subsequent removals of in vivo implants. Therefore, the objective of this article is to review various joints that show lower wear rates and consequently higher life. Ceramics are used in hip implants and have been found to produce lower wear rates. This article discusses the advantages and disadvantages of ceramics compared to other implant materials. Different types of ceramics that are being used are reviewed in terms of the wear characteristics, debris released, and their size together with other biological factors. In general, the wear rates in ceramics were lower than that of metal-on-metal and metal-on-polyethylene combinations.

  11. Traumatic hip dislocation: early MRI findings

    International Nuclear Information System (INIS)

    Laorr, A.; Greenspan, A.; Anderson, M.W.; Moehring, H.D.; McKinley, T.

    1995-01-01

    Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries. Prospective MRI of both hips was performed on 18 patients within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the imaging studies ranged from 2 to 35 days. Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2 * (MPGR) sequences. MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation. (orig./VHE)

  12. HIP technologies for fusion reactor blankets fabrication

    International Nuclear Information System (INIS)

    Le Marois, G.; Federzoni, L.; Bucci, P.; Revirand, P.

    2000-01-01

    The benefit of HIP techniques applied to the fabrication of fusion internal components for higher performances, reliability and cost savings are emphasized. To demonstrate the potential of the techniques, design of new blankets concepts and mock-ups fabrication are currently performed by CEA. A coiled tube concept that allows cooling arrangement flexibility, strong reduction of the machining and number of welds is proposed for ITER IAM. Medium size mock-ups according to the WCLL breeding blanket concept have been manufactured. The fabrication of a large size mock-up is under progress. These activities are supported by numerical calculations to predict the deformations of the parts during HIP'ing. Finally, several HIP techniques issues have been identified and are discussed

  13. Acute cognitive dysfunction after hip fracture

    DEFF Research Database (Denmark)

    Bitsch, M S; Foss, N B; Kristensen, B B

    2006-01-01

    hip fracture surgery in an optimized, multimodal, peri-operative rehabilitation regimen. METHODS: One hundred unselected hip fracture patients treated in a well-defined, optimized, multimodal, peri-operative rehabilitation regimen were included. Patients were tested upon admission and on the second......BACKGROUND: Patients undergoing hip fracture surgery often experience acute post-operative cognitive dysfunction (APOCD). The pathogenesis of APOCD is probably multifactorial, and no single intervention has been successful in its prevention. No studies have investigated the incidence of APOCD after......, fourth and seventh post-operative days with the Mini Mental State Examination (MMSE) score. RESULTS: Thirty-two per cent of patients developed a significant post-operative cognitive decline, which was associated with several pre-fracture patient characteristics, including age and cognitive function...

  14. Osteoblastoma in the region of the hip

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Yang

    2013-02-01

    Full Text Available Osteoblastoma occurring in the region of the hip is very rare, and vague symptoms with uncharacteristic radiographic features often lead to misdiagnosis. Because of radiographic and histological similarities, it must be carefully distinguished from osteoid osteoma, aneurysmal bone cyst, giant cell tumor, and osteosarcoma. Computed tomography is the preferred imaging modality as it is able to detect the nidus and images will not exhibit the flare phenomenon caused by surrounding inflammation seen with magnetic resonance imaging. For hip joint lesions in weight-bearing areas, intralesional curettage may achieve satisfactory outcomes as compared with wide resection. We herein report two cases of osteoblastoma in the hip region in which diagnosis was delayed that were successfully treated with curettage and followed by high-speed burring.

  15. Arthroscopic approach and anatomy of the hip.

    Science.gov (United States)

    Aprato, Alessandro; Giachino, Matteo; Masse, Alessandro

    2016-01-01

    Hip arthroscopy has gained popularity among the orthopedic community and a precise assessment of indications, techniques and results is constantly brought on. In this chapter the principal standard entry portals for central and peripheral compartment are discussed. The description starts from the superficial landmarks for portals placement and continues with the deep layers. For each entry point an illustration of the main structures encountered is provided and the principal structures at risk for different portals are accurately examined. Articular anatomical description is carried out from the arthroscope point of view and sub-divided into central and peripheral compartment. The two compartments are systematically analyzed and the accessible articular areas for each portal explained. Moreover, some anatomical variations that can be found in the normal hip are reported. The anatomical knowledge of the hip joint along with a precise notion of the structures encountered with the arthroscope is an essential requirement for a secure and successful surgery. Level of evidence: V.

  16. Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.

    Science.gov (United States)

    Wellsandt, E; Zeni, J A; Axe, M J; Snyder-Mackler, L

    2017-12-01

    Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Dynamic ultrasound of the external snapping hip syndrome

    International Nuclear Information System (INIS)

    Choi, Yun Sun; Song, Baek Yong; Paik, Sang Hyun; Lee, Tae Gyu; Yoon, Yong Kyu; Lee, Sung Moon

    2002-01-01

    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.

  18. Getting your home ready - knee or hip surgery

    Science.gov (United States)

    Hip or knee surgery - getting your home ready; Osteoarthritis - knee ... Cabrera JA, Cabrera AL. Total hip replacement. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; ...

  19. 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.

  20. 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

  1. Do hip prosthesis related infection codes in administrative discharge registers correctly classify periprosthetic hip joint infection?

    DEFF Research Database (Denmark)

    Lange, Jeppe; Pedersen, Alma B; Troelsen, Anders

    2015-01-01

    PURPOSE: Administrative discharge registers could be a valuable and easily accessible single-sources for research data on periprosthetic hip joint infection. The aim of this study was to estimate the positive predictive value of the International Classification of Disease 10th revision (ICD-10...... in future single-source register based studies, but preferably should be used in combination with alternate data sources to ensure higher validity....... decreased to 82% (95% CI: 72-89). CONCLUSIONS: Misclassification must be expected and taken into consideration when using administrative discharge registers for epidemiological research on periprosthetic hip joint infection. We believe that the periprosthetic hip joint infection diagnosis code can be of use...

  2. Ideologia hip-hopowa na przykładzie tekstów hip-hopowych

    OpenAIRE

    Kozłowska, Monika

    2012-01-01

    The article is asort of analysis of hip hop lyrics in the context of their importance for identity formation process of young generation. Rap music, as one of the elements of hip hop culture, is a kind of special innovation for its audience. With rising interest for this musical genre and hip hop culture the discussion on formulating the issues through the prism of rap music’s message has been increasing. The article presents certain aspects of making sense to the reality, w...

  3. Radiological evaluation of failed total hip replacement

    International Nuclear Information System (INIS)

    Raspa, V.; Aldrovandi, S.; Pompei, G.

    1988-01-01

    The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

  4. Hip Arthroscopy: Common Problems and Solutions.

    Science.gov (United States)

    Casp, Aaron; Gwathmey, Frank Winston

    2018-04-01

    The use of hip arthroscopy continues to expand. Understanding potential pitfalls and complications associated with hip arthroscopy is paramount to optimizing clinical outcomes and minimizing unfavorable results. Potential pitfalls and complications are associated with preoperative factors such as patient selection, intraoperative factors such as iatrogenic damage, traction-related complications, inadequate correction of deformity, and nerve injury, or postoperative factors such as poor rehabilitation. This article outlines common factors that contribute to less-than-favorable outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Hip fracture in hospitalized medical patients

    OpenAIRE

    Zapatero Antonio; Barba Raquel; Canora Jesús; Losa Juan E; Plaza Susana; San Roman Jesús; Marco Javier

    2013-01-01

    Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057%) admittances were coded with an in-hosp...

  6. Innovations in the management of hip fractures.

    Science.gov (United States)

    Teasdall, Robert D; Webb, Lawrence X

    2003-08-01

    Hip fractures include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region that is exposed to large compressive stresses. Implants used to address these fractures must accommodate significant loads while the fractures consolidate. Complications secondary to hip fractures produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

  7. Hot-isostatic pressing (HIP). Pt. 2

    International Nuclear Information System (INIS)

    Bayer, E.; Moser, G.; Seilstorfer, H.

    1981-01-01

    After the description of the microstructure and strengthening mechanism of nickel- and cobalt-base superalloys, claims for the production of suitable powders for the HIP-technology are pointed out and methods to its realization are discussed. Taking the manufacture of turbine discs (ultrasonic form) as an example the possibilities of the near-net-shape-technology are shown. Investigations on mechanical properties and on microstructures are carried out to determine the effect of HIP-process-parameters on these features. (orig.) [de

  8. 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.

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

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Serner, Andreas; Petersen, Jesper

    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....

  10. The hip adductor muscle group in caviomorph rodents: anatomy and homology.

    Science.gov (United States)

    García-Esponda, César M; Candela, Adriana M

    2015-06-01

    Anatomical comparative studies including myological data of caviomorph rodents are relatively scarce, leading to a lack of use of muscular features in cladistic and morphofunctional analyses. In rodents, the hip adductor muscles constitute an important group of the hindlimb musculature, having an important function during the beginning of the stance phase. These muscles are subdivided in several distinct ways in the different clades of rodents, making the identification of their homologies hard to establish. In this contribution we provide a detailed description of the anatomical variation of the hip adductor muscle group of different genera of caviomorph rodents and identify the homologies of these muscles in the context of Rodentia. On this basis, we identify the characteristic pattern of the hip adductor muscles in Caviomorpha. Our results indicate that caviomorphs present a singular pattern of the hip adductor musculature that distinguishes them from other groups of rodents. They are characterized by having a single m. adductor brevis that includes solely its genicular part. This muscle, together with the m. gracilis, composes a muscular sheet that is medial to all other muscles of the hip adductor group. Both muscles probably have a synergistic action during locomotion, where the m. adductor brevis reinforces the multiple functions of the m. gracilis in caviomorphs. Mapping of analyzed myological characters in the context of Rodentia indicates that several features are recovered as potential synapomorphies of caviomorphs. Thus, analysis of the myological data described here adds to the current knowledge of caviomorph rodents from anatomical and functional points of view, indicating that this group has features that clearly differentiate them from other rodents. Copyright © 2015 Elsevier GmbH. All rights reserved.

  11. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

  12. Total hip replacement for Mseleni Joint Disease undertaken in a ...

    African Journals Online (AJOL)

    found that hip surgery in this setting is of great benefit to Mseleni Joint Disease ... Conclusions: Hip surgery in this setting is of great benefit to the Mseleni Joint Disease patients but further attention .... The total hip score was divided into pain.

  13. Hip-Hopping across China: Intercultural Formulations of Local Identities

    Science.gov (United States)

    Barrett, Catrice

    2012-01-01

    The linguistic dimensions of globalized hip-hop cannot be understood simply as a byproduct of English as an American export. As hip-hop mobilizes, it is common (and arguably necessary) for global hip-hop communities to struggle through purposeful, semiotically rooted dialectics over what constitutes "authentic" and respectable forms of…

  14. Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...

    African Journals Online (AJOL)

    These cases illustrate the maxim that any painful movement of the hip joint with associated unexplained fever should raise suspicion of septic arthritis. The close relationship of the hip joint to the pelvis sometimes confuses hip diseases with pelvic pathologies. Key Words: Septic arthritis, acute abdomen, pathological ...

  15. Higher incidence of hip fracture in newly diagnosed schizophrenic ...

    African Journals Online (AJOL)

    Higher incidence of hip fracture in newly diagnosed schizophrenic patients in Taiwan. Hip fracture is a major public health concern due to its poor outcome and serious socioeconomic burden in older people (1). Evidence has shown that many factors are related to increased risk of hip fracture, but psychiatric diseases are ...

  16. 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 ...

  17. The Amsterdam Hip Protector Study: Compliance and determinants of compliance

    NARCIS (Netherlands)

    van Schoor, N.M.; Asma, G.; Smit, J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2003-01-01

    Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from

  18. Perioperative blood saving measures in total hip and knee arthroplasty

    NARCIS (Netherlands)

    Horstmann, W.G.

    2011-01-01

    This dissertation explores and discusses different aspects of blood loss and blood-saving measures in total hip and knee arthroplasty. Background: Worldwide, approximately 1 million total hip and 1 million total knee prostheses are implanted each year. Total hip arthroplasty and total

  19. 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...

  20. 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…

  1. Sleep disturbances after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Krenk, L; Jennum, P; Kehlet, H

    2012-01-01

    BACKGROUND: /st>Major surgery is followed by pronounced sleep disturbances after traditional perioperative care potentially leading to prolonged recovery. The aim was to evaluate the rapid eye movement (REM) sleep duration and sleep architecture before and after fast-track hip and knee replacement......, and on the fourth postoperative night at home. Sleep staging was performed according to the American Academy of Sleep Medicine manual. Opioid use, pain, and inflammatory response (C-reactive protein) were also evaluated. RESULTS: /st>The mean LOS was 1.5 (1-2) days. The mean REM sleep time decreased from a mean...... on the fourth postoperative night. There was no association between opioid use, pain scores, and inflammatory response with a disturbed sleep pattern. CONCLUSIONS: /st>Despite ultra-short LOS and provision of spinal anaesthesia with multimodal opioid-sparing analgesia, REM sleep was almost eliminated...

  2. The Influence of Hip Abductor Weakness on Frontal Plane Motion of the Trunk and Pelvis in Patients with Cerebral Palsy

    Science.gov (United States)

    Krautwurst, Britta K.; Wolf, Sebastian I.; Heitzmann, Daniel W. W.; Gantz, Simone; Braatz, Frank; Dreher, Thomas

    2013-01-01

    Trendelenburg walking pattern is a common finding in various disorders, including cerebral palsy (CP), where it is seen in children and adults. Clinically, this deviation is viewed as a consequence of hip abductor weakness resulting in pelvic obliquity. Trunk lean to the ipsilateral side is a common compensatory mechanism to counteract pelvic…

  3. Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis

    DEFF Research Database (Denmark)

    Deseyne, Nicolas; Conrozier, Thierry; Lellouche, Henri

    2018-01-01

    OBJECTIVE: To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection. METHOD: Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline...... SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively. CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients........64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months. RESULTS: In total, 45.5% of patients...

  4. MR imaging findings in transient osteoporosis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Malizos, Konstantinos N. E-mail: kmalizos@otenet.gr; Zibis, Aristidis H.; Dailiana, Zoe; Hantes, Michael; Karahalios, Theophilos; Karantanas, Apostolos H

    2004-06-01

    Purpose: The authors sought to describe the magnetic resonance (MR) imaging findings including perfusion imaging, in association with the course of acute bone marrow oedema syndrome (aBMEs), in a group of patients with acute hip pain and a final diagnosis of transient osteoporosis of the hip (TOH). Materials and methods: From 217 patients referred with a probable diagnosis of avascular necrosis (AVN) of the femoral head, we identified 42 patients who had clinical and radiographic findings not relevant to AVN. MR imaging examinations were performed on a 1.0T scanner. Perfusion imaging was performed in 20 patients. The bone marrow oedema (BME) was classified in four stages. In addition, the presence or absence of oedema in the subchondral area and the presence of other subchondral lesions were recorded. Acetabular bone marrow was also assessed for the presence of oedema. The quantitative measurements included: maximum size of the effusion, percentage of enhancement (PE) and time of peak enhancement of abnormal marrow compared to the first pass, on the perfusion images. Results: Osteopenia was present on plain radiographs in 87% of cases. The most common pattern of BME was extending to the femoral head and neck. Acetabulum was involved in 16.6%. In 22.6% the BME spared the subchondral region of the femoral head. There were two cases (4.7%) with subchondral changes. A joint effusion was noted in 33 of the 42 patients. On perfusion imaging, a delayed peak enhancement was noted in 20 patients between 40 and 65 s after the first pass of contrast. No patient had any evidence of femoral head collapse or change in sphericity on follow-up MRI. None of the patients developed avascular necrosis in a time frame of 18 months from the onset of the acute hip pain. Conclusion: The aBMEs MR imaging pattern varies and is most commonly appearing on X-rays as osteopenia. Absence of subcondral lesions, delayed peak enhancement of the abnormal marrow on perfusion images, and sparing of

  5. MR imaging findings in transient osteoporosis of the hip

    International Nuclear Information System (INIS)

    Malizos, Konstantinos N.; Zibis, Aristidis H.; Dailiana, Zoe; Hantes, Michael; Karahalios, Theophilos; Karantanas, Apostolos H.

    2004-01-01

    Purpose: The authors sought to describe the magnetic resonance (MR) imaging findings including perfusion imaging, in association with the course of acute bone marrow oedema syndrome (aBMEs), in a group of patients with acute hip pain and a final diagnosis of transient osteoporosis of the hip (TOH). Materials and methods: From 217 patients referred with a probable diagnosis of avascular necrosis (AVN) of the femoral head, we identified 42 patients who had clinical and radiographic findings not relevant to AVN. MR imaging examinations were performed on a 1.0T scanner. Perfusion imaging was performed in 20 patients. The bone marrow oedema (BME) was classified in four stages. In addition, the presence or absence of oedema in the subchondral area and the presence of other subchondral lesions were recorded. Acetabular bone marrow was also assessed for the presence of oedema. The quantitative measurements included: maximum size of the effusion, percentage of enhancement (PE) and time of peak enhancement of abnormal marrow compared to the first pass, on the perfusion images. Results: Osteopenia was present on plain radiographs in 87% of cases. The most common pattern of BME was extending to the femoral head and neck. Acetabulum was involved in 16.6%. In 22.6% the BME spared the subchondral region of the femoral head. There were two cases (4.7%) with subchondral changes. A joint effusion was noted in 33 of the 42 patients. On perfusion imaging, a delayed peak enhancement was noted in 20 patients between 40 and 65 s after the first pass of contrast. No patient had any evidence of femoral head collapse or change in sphericity on follow-up MRI. None of the patients developed avascular necrosis in a time frame of 18 months from the onset of the acute hip pain. Conclusion: The aBMEs MR imaging pattern varies and is most commonly appearing on X-rays as osteopenia. Absence of subcondral lesions, delayed peak enhancement of the abnormal marrow on perfusion images, and sparing of

  6. The Formation of "Hip-Hop Academicus"--How American Scholars Talk about the Academisation of Hip-Hop

    Science.gov (United States)

    Soderman, Johan

    2013-01-01

    Social activism and education have been associated with hip-hop since it emerged in New York City 38 years ago. Therefore, it might not be surprising that universities have become interested in hip-hop. This article aims to highlight this "hip-hop academisation" and analyse the discursive mechanisms that manifest in these academisation…

  7. No clinical difference between large metal-on-metal total hip arthroplasty and 28-mm-head total hip arthroplasty?

    NARCIS (Netherlands)

    Zijlstra, Wierd P; van den Akker-Scheek, Inge; Zee, Mark J M; van Raay, Jos J A M

    2011-01-01

    PURPOSE: We aimed to test the claim of greater range of motion (ROM) with large femoral head metal-on-metal total hip arthroplasty. METHODS: We compared 28-mm metal-on-polyethylene (MP) total hip arthroplasty with large femoral head metal-on-metal (MM) total hip arthroplasty in a randomised clinical

  8. Editorial Commentary: Hip Arthroscopy Plays a Role in Painful Hip Resurfacing Arthroplasty but a Prearthroscopy Diagnosis Is Critical to Outcome.

    Science.gov (United States)

    Rossi, Michael J

    2016-03-01

    Whereas hip arthroscopy plays a role in the investigation and treatment of the painful hip resurfacing arthroplasty, a diagnosis before arthroscopy is critical to improved outcome. The rate of conversion to total hip arthroplasty jumps from 7% to 37% when a pre-arthroscopy diagnosis is not known. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. Featherless Dinosaurs and the Hip-Hop Simulacrum: Reconsidering Hip-Hop's Appropriateness for the Music Classroom

    Science.gov (United States)

    Kruse, Adam J.

    2016-01-01

    This article offers considerations for music teachers interested in including hip-hop music in their classrooms but who might feel concerned with or overwhelmed by issues of appropriateness. Two concerns related to hip-hop music are examined: language and negative social themes. Commercial interests in hip-hop music have created a simulacrum (or…

  10. Vojta method in the treatment of developmental hip dysplasia – a case report

    Directory of Open Access Journals (Sweden)

    Kiebzak W

    2016-08-01

    Full Text Available Wojciech Kiebzak,1,2 Arkadiusz Żurawski,2 Michał Dwornik3 1Center for Pediatrics, Regional Hospital in Kielce, Kielce, Poland; 2Department of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland; 3Department of Osteopathic Medicine and Physiotherapy, Medical College of Podkowa Lesna, Podkowa Lesna, Poland Background: Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. Purpose: The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. Case report: This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling. Results: During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum’s Graff type from the baseline D to IIb after 41 days of treatment. Conclusion: The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child’s neuro­muscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible. Keywords: global pattern

  11. vein thrombosis in elective hip replacement

    African Journals Online (AJOL)

    A consensus forum was convened to evaluate the economic considerations associated with prophylaxis against thrombo-embolic disease in patients undergoing hip replacement therapy in South Africa. This forum consists of orthopaedic surgeons, vascular surgeons and a statistician. Methods. The forum was instructed to ...

  12. Screening for Developmental Dysplasia of the Hip

    NARCIS (Netherlands)

    Boere-Boonekamp, Magdalena M.; Verkerk, Paul H.

    1998-01-01

    The success rates of screening programmes for Developmental Dysplasia of the Hip (DDH) vary widely. Studies on screening programmes for DDH based on a Medline search for the years 1966–1997 are reviewed. The percentage treated in most studies, especially those using ultrasound, are high and suggest

  13. Total hip reconstruction in acetabular dysplasia.

    NARCIS (Netherlands)

    Schller, H.M.; Dalstra, M.; Huiskes, R.; Marti, R.K.

    1993-01-01

    In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

  14. Recommendations for hip fracture management in Slovenia

    Directory of Open Access Journals (Sweden)

    Radko Komadina

    2012-03-01

    Full Text Available Professional societies for traumatology, osteology and physiatrics have written the recommendations for management of acute hip fracture in the elderly in Slovenia, which include acute surgical treatment, medical rehabilitation and secondary prevention with treatment of osteoporosis. The recommendations were adopted by the Board for Surgery at the Ministry of Health of the Republic of Slovenia in June and September 2011.

  15. Uudised : Ooper. Hip-hop. Madonna

    Index Scriptorium Estoniae

    2005-01-01

    Rumeenia sopran Nelly Miricioiu Vincenzo Bellini ooperi "Norma" nimiosas Nederlandse Operas Amsaterdamis 7.-28. märtsini. 4. märtsil Tallinna klubis Hollywood üritusel "Hip-Hop Café" New Yorgi duo Camp Lo. Ameerika poplaulja Madonna võttis vastu filmirolli

  16. Contralateral Total Hip Arthroplasty After Hindquarter Amputation

    Directory of Open Access Journals (Sweden)

    Scott M. M. Sommerville

    2006-01-01

    Full Text Available We describe the management and outcome of a 62-year old lady who developed severe osteoarthritis of the hip, nine years after a hindquarter amputation for radiation-induced sarcoma of the contralateral pelvis. The difficulties of stabilising the pelvis intraoperatively and the problems of postoperative rehabilitation are outlined. The operation successfully relieved her pain and restored limited mobility.

  17. TOTAL HIP REPLACEMENTS AT KIKUYU HOSPITAL, KENYA

    African Journals Online (AJOL)

    equipments, few trained personnel and the high cost of implants. It is mainly in the ..... function more affected than the sensory a day after. There was a foot drop. .... 60: Issue 2, 217-. 220. 13. NIH Consensus Development Panel on Total Hip.

  18. Hip adductor muscle function in forward skating.

    Science.gov (United States)

    Chang, Ryan; Turcotte, Rene; Pearsall, David

    2009-09-01

    Adductor strain injuries are prevalent in ice hockey. It has long been speculated that adductor muscular strains may be caused by repeated eccentric contractions which decelerate the leg during a stride. The purpose of this study was to investigate the relationship of skating speed with muscle activity and lower limb kinematics, with a particular focus on the role of the hip adductors. Seven collegiate ice hockey players consented to participate. Surface electromyography (EMG) and kinematics of the lower extremities were measured at three skating velocities 3.33 m/s (slow), 5.00 m/s (medium) and 6.66 m/s (fast). The adductor magnus muscle exhibited disproportionately larger increases in peak muscle activation and significantly prolonged activation with increased speed. Stride rate and stride length also increased significantly with skating velocity, in contrast, hip, knee and ankle total ranges of motion did not. To accommodate for the increased stride rate with higher skating speeds, the rate of hip abduction increased significantly in concert with activations of adductor magnus indicating a substantial eccentric contraction. In conclusion, these findings highlight the functional importance of the adductor muscle group and hip abduction-adduction in skating performance as well as indirectly support the notion that groin strain injury potential increases with skating speed.

  19. The Philippine "Hip Hop Stick Dance"

    Science.gov (United States)

    Lewis, Lisa

    2012-01-01

    This article introduces a dance that blends the traditional cultural heritage of the Philippines with modern music and moves. "Hip Hop Stick Dance" incorporates Tinikling (the Philippine national dance) and Arnis (a Filipino style of martial arts) to create a contemporary combination of rhythm, dance, and fitness. It was designed to introduce…

  20. Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction.

    Science.gov (United States)

    Jadhav, Siddharth P; More, Snehal R; Shenava, Vinitha; Zhang, Wei; Kan, J Herman

    2018-04-25

    Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH). To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention. Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed. The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4-24 months) and for the open reduction group was 23.7 months (range: 5-63 months), which was significant (P-value open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute. Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.

  1. A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement

    OpenAIRE

    ?yp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; W?ostowska, Ewa; Stanis?awska, Iwona; Szypu?a, Jan; Tomaszewski, Wies?aw

    2016-01-01

    Background Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. Material/Methods A total of 192 patients (the mean age 61.03?10.89) suffering from hip osteoarthritis (OA) were evaluated before an...

  2. [Hip Fracture--Epidemiology, Management and Liaison Service. Risk factor for hip fracture].

    Science.gov (United States)

    Fujiwara, Saeko

    2015-04-01

    Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.

  3. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    Science.gov (United States)

    Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  4. Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

    Directory of Open Access Journals (Sweden)

    Karen Junius

    2017-01-01

    Full Text Available A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton.

  5. Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

    Science.gov (United States)

    Degelaen, Marc; Lefeber, Nina; Swinnen, Eva; Vanderborght, Bram; Lefeber, Dirk

    2017-01-01

    A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF) in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton. PMID:28790799

  6. A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

    Science.gov (United States)

    Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

    2016-07-25

    BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (pwater exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

  7. Surgical Dislocation of the Hip for the Treatment of Pre-Arthritic Hip Disease.

    Science.gov (United States)

    Beaulé, Paul E; Singh, Amardeep; Poitras, Stéphane; Parker, Gillian

    2015-09-01

    The purpose of this study was to report the clinical results of surgical dislocation of the hip in the treatment of pre-arthritic hip disease. Between 2005 and 2010, eighty-two patients (89 hips) underwent a surgical dislocation of the hip at a mean age of 30.5 years (range 14.8-51.7); 10 females and 72 males. At a mean follow-up of 7.1 years (range 5-9.6) clinical function improved significantly. 6 patients were converted to total hip arthroplasty and 3 patients underwent an arthroscopy and an additional three patients had >1mm of joint space narrowing at latest follow-up giving us a 9-year cumulative Kaplan-Meier survivorship of 86.4% (CI, 79% to 94%). Thirty-four patients underwent internal fixation removal at a mean of 12.0 months (range 0.3-40.8 months). Although effective in the treatment of early hip disease, the surgical dislocation approach carries a high re-operation rate for removal of internal fixation; consequently, less invasive approaches should be considered for less complex deformities. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Probability and heritability estimates on primary osteoarthritis of the hip leading to total hip arthroplasty

    DEFF Research Database (Denmark)

    Skousgaard, Søren Glud; Hjelmborg, Jacob; Skytthe, Axel

    2015-01-01

    INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk and heritab......INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk...... and heritability of primary osteoarthritis of the hip leading to a total hip arthroplasty, and if this heritability increased with increasing age. METHODS: In a nationwide population-based follow-up study 118,788 twins from the Danish Twin Register and 90,007 individuals from the Danish Hip Arthroplasty Register...... not have had a total hip arthroplasty at the time of follow-up. RESULTS: There were 94,063 twins eligible for analyses, comprising 835 cases of 36 concordant and 763 discordant twin pairs. The probability increased particularly from 50 years of age. After sex and age adjustment a significant additive...

  9. Persistently High Hip Circumference after Bariatric Surgery Is a Major Hurdle to Successful Hip Replacement

    Directory of Open Access Journals (Sweden)

    Menachem M. Meller

    2014-01-01

    Full Text Available The prevalence of class III obesity (BMI≥40 kg/m2 in black women is 18%. As class III obesity leads to hip joint deterioration, black women frequently present for orthopedic care. Weight loss associated with bariatric surgery should lead to enhanced success of hip replacements. However, we present a case of a black woman who underwent Roux-en-Y gastric bypass with the expectation that weight loss would make her a better surgical candidate for hip replacement. Her gastric bypass was successful as her BMI declined from 52.0 kg/m2 to 33.7 kg/m2. However, her hip circumference after weight loss remained persistently high. Therefore, at surgery the soft tissue tunnel geometry presented major challenges. Tunnel depth and immobility of the soft tissue interfered with retractor placement, tissue reflection, and surgical access to the acetabulum. Therefore a traditional cup placement could not be achieved. Instead, a hemiarthroplasty was performed. After surgery her pain and reliance on external support decreased. But her functional independence never improved. This case demonstrates that a lower BMI after bariatric surgery may improve the metabolic profile and decrease anesthesia risk, but the success of total hip arthroplasties remains problematic if fat mass in the operative field (i.e., high hip circumference remains high.

  10. TOTAL HIP REPLACEMENT IN LEGG-CALVÉ-PERTHES DISEASE

    DEFF Research Database (Denmark)

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

    2009-01-01

    INTRODUCTION Poor long-time results in patients with Legg-Calvé-Perthes disease (LCP) are most often due to degenerative hip disease. The purpose of this study was to investigate if patients with LCP have an increased rate of total hip replacement (THR) compared to sex- and age-matched persons....... MATERIAL AND METHODS 167 LCP patients presented to our institution from 1941 to 1962. All patients were treated conservatively by a Thomas splint. Retrospectively medical records and radiographs were retrieved. Data from the Danish Hip Replacement Register and the Registries of the National Board of Health...... to follow-up and 3) patients with previous surgery to pelvis or lower limbs. 135 patients (156 hips) were enrolled in this study and 32 patients (35 hips) were excluded. RESULTS 20 hips out of 156 hips in patients with LCP have had a THR. Mean age at operation for the women was 50 years and 44 years...

  11. Refractory pain following hip arthroscopy: evaluation and management

    Science.gov (United States)

    de SA, Darren L; Burnham, Jeremy M; Mauro, Craig S

    2018-01-01

    ABSTRACT With increased knowledge and understanding of hip pathology, hip arthroscopy is rapidly becoming a popular treatment option for young patients with hip pain. Despite improved clinical and radiographic outcomes with arthroscopic treatment, some patients may have ongoing pain and less than satisfactory outcomes. While the reasons leading to failed hip arthroscopy are multifactorial, patient selection, surgical technique and rehabilitation all play a role. Patients with failed hip arthroscopy should undergo a thorough history and physical examination, as well as indicated imaging. A treatment plan should then be developed based on pertinent findings from the workup and in conjunction with the patient. Depending on the etiology of failed hip arthroscopy, management may be nonsurgical or surgical, which may include revision arthroscopic or open surgery, periacetabular osteotomy or joint arthroplasty. Revision surgery may be appropriate in settings including, but not limited to, incompletely treated femoroacetabular impingement, postoperative adhesions, heterotopic ossification, instability, hip dysplasia or advanced degeneration. PMID:29423245

  12. Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation.

    Science.gov (United States)

    Hwang, Jung-Taek; Lee, Woo-Yong; Kang, Chan; Hwang, Deuk-Soo; Kim, Dong-Yeol; Zheng, Long

    2015-12-01

    Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays the progression of traumatic osteoarthritis.

  13. Hip hop jako kulturní styl, jeho spicifika a vliv na teenagery

    OpenAIRE

    POSPÍŠIL, Jan

    2008-01-01

    This thesis involves history of hip hop, its specifics and elements, it talks about influence of hip hip subculture on teenagers and points to positive and negative aspects connected to this culture style. In this way is work sectionalized into chapters. First part talks about history of hip hop, connection between religion and hip hop and also about Czech hip hop. Second part specifies on main elements of hip hop culture as DJing, MCing, breakdance, beatbox and graffiti. Last part focuses on...

  14. FUNCTIONAL OUTCOMES OF HIP ARTHROSCOPY IN AN ACTIVE DUTY MILITARY POPULATION UTILIZING A CRITERION-BASED EARLY WEIGHT BEARING PROGRESSION.

    Science.gov (United States)

    Shaw, K Aaron; Jacobs, Jeremy M; Evanson, J Richard; Pniewski, Josh; Dickston, Michelle L; Mueller, Terry; Bojescul, John A

    2017-10-01

    Hip arthroscopy allows surgeons to address intra-articular pathology of the hip while avoiding more invasive open surgical dislocation. However the post-operative rehabilitation protocols have varied greatly in the literature, with many having prolonged periods of limited motion and weight bearing. The purpose of this study was to describe a criterion-based early weight bearing protocol following hip arthroscopy and investigate functional outcomes in the subjects who were active duty military. Active duty personnel undergoing hip arthroscopy for symptomatic femoroacetabular impingement were prospectively assessed in a controlled environment for the ability to incorporate early postoperative weight-bearing with the following criteria: no increased pain complaint with weight bearing and normalized gait pattern. Modified Harris Hip (HHS) and Hip Outcome score (HOS) were performed preoperatively and at six months post-op. Participants were progressed with a standard hip arthroscopy protocol. Hip flexion was limited to not exceed 90 degrees for the first three weeks post-op, with progression back to running beginning at three months. Final discharge was dependent upon the ability to run two miles at military specified pace and do a single leg broad jump within six inches of the contralateral leg without an increase in pain. Eleven participants met inclusion criteria over the study period. Crutch use was discontinued at an average of five days following surgery based on established weight bearing criteria. Only one participant required continued crutch use at 15 days. Participants' functional outcome was improved postoperatively, as demonstrated by significant increases in HOS and HHS. At the six month follow up, eight of 11 participants were able to take and complete a full Army Physical Fitness Test. Following completion of the early weight bearing rehabilitation protocol, 81% of participants were able to progress to full weight bearing by four days post

  15. Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain

    International Nuclear Information System (INIS)

    Bencardino, Jenny T.; La Rocca Vieira, Renata; Kassarjian, Ara; Schwartz, Richard; Mellado, Jose M.; Kocher, Mininder

    2011-01-01

    The appearance and distribution of the intra-articular plicae of the hip have been addressed in few reports in the anatomic and radiological literature. This study aims to determine the prevalence of visible synovial hip plicae using MR arthrography and to measure the association of visible synovial hip plicae with MR arthrographic diagnosis of labral tears, femoroacetabular impingement, and osteoarthritis. Following institutional review board approval, 63 direct MR arthrographic examinations of the hip in 61 patients with a clinical history of hip pain were retrospectively reviewed by two experienced musculoskeletal radiologists in consensus. The following variables were measured using a binary system (0 = absent; 1 = present): labral plica, neck plica, ligamental plica, labral tear, femoroacetabular impingement, and osteoarthritis. The surgical reports and arthroscopic images of 10 patients were reviewed. Statistical analysis was performed using the Fisher's exact test. In all 63 cases at least one plica was visualized on MR-arthrographic images. Labral, neck, and ligamental plicae were found with a prevalence of 76, 97, and 78%, respectively. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis among patients with visible labral, neck, and ligamental plicae. The prevalence of labral tears, femoroacetabular impingement, and osteoarthritis in our patient population was 79, 28, and 28%, respectively. The presence of intra-articular plicae was the only MR-arthrographic finding in 5 of our 63 symptomatic cases. Visible labral, neck, and/or ligamental plicae are highly prevalent on MR-arthrographic images of the hip performed in the setting of hip pain. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis and visible labral, neck, and ligamental plicae. (orig.)

  16. Comparison of the carboxy-terminal DP-repeat region in the co-chaperones Hop and Hip.

    Science.gov (United States)

    Nelson, Gregory M; Huffman, Holly; Smith, David F

    2003-01-01

    Functional steroid receptor complexes are assembled and maintained by an ordered pathway of interactions involving multiple components of the cellular chaperone machinery. Two of these components, Hop and Hip, serve as co-chaperones to the major heat shock proteins (Hsps), Hsp70 and Hsp90, and participate in intermediate stages of receptor assembly. In an effort to better understand the functions of Hop and Hip in the assembly process, we focused on a region of similarity located near the C-terminus of each co-chaperone. Contained within this region is a repeated sequence motif we have termed the DP repeat. Earlier mutagenesis studies implicated the DP repeat of either Hop or Hip in Hsp70 binding and in normal assembly of the co-chaperones with progesterone receptor (PR) complexes. We report here that the DP repeat lies within a protease-resistant domain that extends to or is near the C-terminus of both co-chaperones. Point mutations in the DP repeats render the C-terminal regions hypersensitive to proteolysis. In addition, a Hop DP mutant displays altered proteolytic digestion patterns, which suggest that the DP-repeat region influences the folding of other Hop domains. Although the respective DP regions of Hop and Hip share sequence and structural similarities, they are not functionally interchangeable. Moreover, a double-point mutation within the second DP-repeat unit of Hop that converts this to the sequence found in Hip disrupts Hop function; however, the corresponding mutation in Hip does not alter its function. We conclude that the DP repeats are important structural elements within a C-terminal domain, which is important for Hop and Hip function.

  17. Effects of illness and hip fracture perceptions on coping strategies of elderly rehabilitation clients

    Directory of Open Access Journals (Sweden)

    Tone Brejc

    2006-12-01

    Full Text Available The objective of this pilot study was to evaluate, using Leventhal's self-regulatory model of illness perceptions, the effects of subjective representations of health and hip fracture on coping strategies in a sample of 52 clients more than 65 years old at the beginning of intensive hospital rehabilitation programme. The results revealed that rehabilitation clients suffering from hip fracture preserved their sense of good general and mental health. Negative representation of hip fracture was related only to perception of temporary decline in physical activity and not to perception of other personal, social and economic consequences neither to perception of their controllability. Perception of poor physical competence influenced the use of less preferred coping strategies of behavioural, mental and alcohol/drug based disengagement, and denial. Rehabilitation clients preferred those cognitive-behavioural and emotional strategies which confirmed their perception of self-efficiency and confidence in therapeutic assistance.Strategies were thus selected according to active and planned endeavour to cope, and were based on acceptance, turning to religion, focusing and venting emotions, and seeking instrumental and social support. The study confirmed the hypothesis that negative representation of hip fracture and poor sense of physical competence had a restraining effect on the use of coping strategies. There was no evidence that coping strategies of hip fracture in elderly rehabilitation clients created a specific pattern, depending on the perception of its consequences and the appraisal of possibility to regain health control. The validity of the findings is limited by a relatively small and selected sample of cognitive intact and motivated older rehabilitation clients, use of specific, non-standardised instruments, and a cross-sectional approach.

  18. Worldwide variation in hip fracture incidence weakly aligns with genetic divergence between populations.

    Science.gov (United States)

    Wallace, I J; Botigué, L R; Lin, M; Smaers, J B; Henn, B M; Grine, F E

    2016-09-01

    This study investigates the influence of genetic differentiation in determining worldwide heterogeneity in osteoporosis-related hip fracture rates. The results indicate that global variation in fracture incidence exceeds that expected on the basis of random genetic variance. Worldwide, the incidence of osteoporotic hip fractures varies considerably. This variability is believed to relate mainly to non-genetic factors. It is conceivable, however, that genetic susceptibility indeed differs across populations. Here, we present the first quantitative assessment of the effects of genetic differentiation on global variability in hip fracture rates. We investigate the observed variance in publically reported age-standardized rates of hip fracture among 28 populations from around the world relative to the expected variance given the phylogenetic relatedness of these populations. The extent to which these variances are similar constitutes a "phylogenetic signal," which was measured using the K statistic. Population genetic divergence was calculated using a robust array of genome-wide single nucleotide polymorphisms. While phylogenetic signal is maximized when K > 1, a K value of only 0.103 was detected in the combined-sex fracture rate pattern across the 28 populations, indicating that fracture rates vary more than expected based on phylogenetic relationships. When fracture rates for the sexes were analyzed separately, the degree of phylogenetic signal was also found to be small (females: K = 0.102; males: K = 0.081). The lack of a strong phylogenetic signal underscores the importance of factors other than stochastic genetic diversity in shaping worldwide heterogeneity in hip fracture incidence.

  19. Tuberculosis of the hip in children: A retrospective analysis of 27 patients.

    Science.gov (United States)

    Agarwal, Anil; Suri, Tarun; Verma, Indereshwar; Kumar, Shashi Kant; Gupta, Neeraj; Shaharyar, Abbas

    2014-09-01

    We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria. The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial "triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  20. Tuberculosis of the hip in children a retrospective analysis of 27 patients

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2014-01-01

    Full Text Available Background: We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. Materials and Methods: We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon′s criteria. Results: The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10. The average age was 7.37 years (range, 2-12 years. In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae. There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed. There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial ′"triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. Conclusions: The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  1. Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.

    Science.gov (United States)

    Kierkegaard, Signe; Mechlenburg, Inger; Lund, Bent; Søballe, Kjeld; Dalgas, Ulrik

    2017-12-01

    Patients with femoroacetabular impingement (FAI) experience hip pain as well as decreased function and lowered quality of life. The aim was to compare maximal isometric and isokinetic muscle strength (MVC) during hip flexion and extension and rate of force development (RFD) during extension between patients with FAI and a matched reference group. Secondary, the aim was to compare patient hips and subgroups defined by gender and age as well as to investigate associations between hip muscle strength and self-reported outcomes. Design Cross-sectional, comparative study Methods Sixty patients (36±9 years, 63% females) and 30 age and gender matched reference persons underwent MVC tests in an isokinetic dynamometer. During hip flexion and extension, patients' affected hip showed a strength deficit of 15-21% (phip of the patients was significantly weaker than their contralateral hip. RFD was significantly decreased for both patient hips compared to the reference group (phip muscle strength. Patients with FAI demonstrate decreased hip flexion and extension strength when compared to (1) reference persons and (2) their contralateral hip. There seems to be a gender specific affection which should be investigated further and addressed when planning training protocols. Furthermore, self-reported measures were associated with isometric muscle strength, which underlines the clinical importance of the reduced muscle strength. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  2. CT findings of traumatic posterior hip dislocation after reduction

    International Nuclear Information System (INIS)

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook; Jin Wook

    2008-01-01

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients

  3. Relationship between flexible flat foot and developmental hip dysplasia.

    Science.gov (United States)

    Ponce de León Samper, M C; Herrera Ortiz, G; Castellanos Mendoza, C

    2015-01-01

    To evaluate the possible relationship between flexible flat foot and developmental hip dysplasia in children between six and 15 years of age. Cross-sectional study including 65 patients that had undergone surgery due to residual hip dysplasia or hip dislocation and compared against 75 healthy patients. Flexible flat foot prevalence was measured in each group, with the results showing that 61% of the group with residual hip dysplasia or hip dislocation had this condition, vs. 12% in the healthy group. The statistical analysis shows that the chances of suffering from flexible flat foot, are five times greater in the hip dysplasia or hip dislocation group, than in the healthy group. There is no evidence in the literature showing a relationship between these two conditions, even though they have a common etiology. This study shows a potential measurable relation between this two conditions. Patients with hip dysplasia or dislocation may have a higher chance of presenting flexible flat foot during late childhood, adolescence and adulthood, a fact that suggests a relationship between these two pathologies. Also, patients who seek assistance for the first time because of a flexible flat foot condition without having been evaluated during the first year of life for hip dysplasia, would be better off if evaluated for residual hip dysplasia. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Second hip fractures at Chiang Mai University Hospital.

    Science.gov (United States)

    Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

    2015-02-01

    Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

  5. Ultrasonography of the pediatric hip and spine

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeo Ryang; Koo, Joon Bun [Dept. of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of)

    2017-07-15

    Ultrasonography (US) is a useful screening method for the diagnosis of developmental dysplasia of the hip (DDH) and congenital spinal anomalies in infants. In addition, US is a useful, noninvasive imaging modality for the diagnosis of transient synovitis in children. The early detection of DDH leads to a better prognosis without surgical intervention. Moreover, spinal US allows the detection of congenital malformations and can also demonstrate normal anatomy and normal variants that may resemble disorders. Therefore, radiologists should be familiar with the sonographic anatomy of the normal infant hip, scanning and measurement techniques for DDH, the US features of transient synovitis in children, spinal US techniques, and the US features of normal anatomical structures, normal variants, and congenital spinal anomalies.

  6. Anatomic and radiographic evaluation of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Llopis, Eva, E-mail: evallopis@gmail.com [Hospital de la Ribera, Carretera de Corbera km1, Alzira 46600, Valencia (Spain); Higueras, Victoria; Vaño, Maria [Hospital de la Ribera, Carretera de Corbera km1, Alzira 46600, Valencia (Spain); Altónaga, José R. [Leon University, 24071 Leon (Spain)

    2012-12-15

    The hip is a challenging joint to study is deeply located in the pelvis and surrounding by a large group of muscles with complex tendinous attachments. Our knowledge has recently increased together with the advent of new surgical techniques but further research is needed to better understand hip biomechanics and the relevance of some of radiological findings. Although recent techniques such as MR show anatomy exquisitely is essential to start with pelvis plain radiography for a good evaluation of bone structures and pelvis alignment. During this chapter we will be give a short overview of pelvis normal structures and some key points of MR and MR arthrography technique, because more detailed description is done on every specific chapter.

  7. Biomimetic Composite-Metal Hip Resurfacing Implant

    Directory of Open Access Journals (Sweden)

    Habiba Bougherara

    2008-01-01

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

  8. Arthrography of the hip in children

    International Nuclear Information System (INIS)

    Loennerholm, T.

    1980-01-01

    A method by which bilateral hip arthrography was performed under general anaesthesia in 130 infants and children 1 month to 7 years of age is described. Significant contractures of the adductor muscles had been corrected before the examination. Most of the children were girls with unilateral congenital idiopathic hip instability detected before the age of one year. From films exposed in standardized projections valuable information was obtained about the configuration of the joint cavity and the size and shape of the femoral head. Criteria for normal appearance in infants of ages 2 to 12 months are presented. More reliable details on the relation between the articular surfaces, the radiographic anatomy of the acetabulum and the distribution of the contrast medium were yielded by stereoradiography. Closed reduction was usually accomplished successfully during the arthrography, which made beginning of definitive treatment under the same anaesthesia possible. (Auth.)

  9. Fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik

    2012-01-01

    Fast-track hip and knee arthroplasty aims at giving the patients the best available treatment at all times, being a dynamic entity. Fast-track combines evidence-based, clinical features with organizational optimization including a revision of traditions resulting in a streamlined pathway from...... on clinical and organizational aspects of fast-track hip and knee arthroplasty (I–IX). A detailed description of the fast-track set-up and its components is provided. Major results include identification of patient characteristics to predict length of stay and satisfaction with different aspects...... of the hospital stay (I); how to optimize analgesia by using a compression bandage in total knee arthroplasty (II); the clinical and organizational set-up facilitating or acting as barriers for early discharge (III); safety aspects following fast-track in the form of few readmissions in general (IV) and few...

  10. Ultrasonography of the pediatric hip and spine

    International Nuclear Information System (INIS)

    Kang, Yeo Ryang; Koo, Joon Bun

    2017-01-01

    Ultrasonography (US) is a useful screening method for the diagnosis of developmental dysplasia of the hip (DDH) and congenital spinal anomalies in infants. In addition, US is a useful, noninvasive imaging modality for the diagnosis of transient synovitis in children. The early detection of DDH leads to a better prognosis without surgical intervention. Moreover, spinal US allows the detection of congenital malformations and can also demonstrate normal anatomy and normal variants that may resemble disorders. Therefore, radiologists should be familiar with the sonographic anatomy of the normal infant hip, scanning and measurement techniques for DDH, the US features of transient synovitis in children, spinal US techniques, and the US features of normal anatomical structures, normal variants, and congenital spinal anomalies

  11. Influence of bone mineral density and hip geometry on the different types of hip fracture.

    Science.gov (United States)

    Li, Yizhong; Lin, Jinkuang; Cai, Siqing; Yan, Lisheng; Pan, Yuancheng; Yao, Xuedong; Zhuang, Huafeng; Wang, Peiwen; Zeng, Yanjun

    2016-01-01

    The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

  12. Influence of bone mineral density and hip geometry on the different types of hip fracture

    Directory of Open Access Journals (Sweden)

    Yizhong Li

    2016-01-01

    Full Text Available The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

  13. Three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage at 3 T: A prospective controlled study

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph, E-mail: christoph.zilkens@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Miese, Falk, E-mail: falk.miese@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Kim, Young-Jo, E-mail: young-jo.kim@childrens.harvard.edu [Department of Orthopaedic Surgery, The Children' s Hospital Boston, 300 Longwood Ave., Boston, MA 02115 (United States); Hosalkar, Harish, E-mail: hhosalkar@rchsd.org [Department of Orthopaedic Surgery, Rady Children' s Hospital San Diego, 3030 Childrens Way Ste 410, San Diego, CA 92123 (United States); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Krauspe, Ruediger, E-mail: krauspe@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Bittersohl, Bernd, E-mail: bbittersohl@partners.org [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany)

    2012-11-15

    Purpose: To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage. Methods and materials: A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8 {+-} 10.2 years, range: 18-57 years) with different hip joint deformities including femoroacetabular impingement (n = 35), residual hip dysplasia (n = 3) and coxa magna due to Legg-Calve-Perthes disease in childhood (n = 2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5 {+-} 1.8 years, range: 21-29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1{sub Gd} assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions. Results: T1{sub Gd} mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1{sub Gd} values were significantly higher in the control group than in the patient group whereas significant differences in T1{sub Gd} values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group. Conclusions: Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities.

  14. Arthrodiastasis for stiff hips in young patients

    OpenAIRE

    Cañadell, J.M. (J. M.); Gonzales, F. (F.); Barrios, R.H. (Raúl H.); Amillo, S. (Santiago)

    1993-01-01

    Joint distraction (arthrodiastasis) with a unilateral fixator was used to treat 9 patients with stiffness of the hip which had followed Perthes' disease (3), epiphysiolysis (2), congenital dysplasia (2), tuberculosis (1) and idiopathic chondrolysis (1). Their average age was 14 years, and they all had pain, limp and shortening of the leg. Distraction of 0.5 to 1 cm was maintained for an average of 94 days. The average range of movement subsequently was 65 degrees compared with 20 degrees befo...

  15. Complications of hip fractures: A review

    OpenAIRE

    Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

    2014-01-01

    Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleedin...

  16. Endotoxins in surgical instruments of hip arthroplasty

    OpenAIRE

    Goveia, Vania Regina; Mendoza, Isabel Yovana Quispe; Guimarães, Gilberto Lima; Ercole, Flavia Falci; Couto, Bráulio Roberto Gonçalves Marinho; Leite, Edna Marilea Meireles; Stoianoff, Maria Aparecida Resende; Ferreira, José Antonio Guimarães

    2016-01-01

    Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60...

  17. Uudised : Pop-karneval. Hip-hop

    Index Scriptorium Estoniae

    2005-01-01

    Muusika- ja kunstikarnevalist "Beta Bubble" 1. apr. Tallinnas Von Krahlis. Pärnu taasühinenud hip-hop-bänd Noizmakaz (TommyBoy ja Alko) sõlmis lepingu plaadifirmaga Mindnote ja annab selle alt apr. keskel välja oma teise albumi "Valitud mõtted".1. apr. tuleb müügile Noizmakazi singel "Miski muu ei loe", debüüt "Social Poetry" ilmus aastal 2001

  18. Traction-related problems after hip arthroscopy

    Science.gov (United States)

    Lund, Bent; Grønbech Nielsen, Torsten; Lind, Martin

    2017-01-01

    Abstract Traction-related problems are poorly described in the existing literature. The purpose of this prospective study was to describe traction-related problems and how patients perceive these problems. The study was a descriptive cohort study and data were collected from questionnaires and patient files. The questionnaire included questions on patients’ perceptions of traction-related problems in the groin area, at the knee and ankle and how patients had coped with these problems. A total of 100 consecutive patients undergoing hip arthroscopy filled out the questionnaire. Primary findings of this study were that 74% of patients reported some sort of traction-related problems after hip arthroscopy. About 32% of the patients had problems in the groin area and 49% of the patients complained of symptoms in the knee joint. A total of 37% of the patients had experienced problems from the traction boot in the ankle area. The complications were found to be temporary and disappeared after 2–4 weeks. Five patients still had complaints after 3 months. All five patients had a pre-existing knee injury prior to undergoing hip arthroscopy. Traction-related problems after hip arthroscopy are a challenge and our study showed that 74% of the patients reported traction-related problems. This is significantly higher than previously reported. The present study found a high rate of complaints from the knee and ankle joints that have not previously been reported. The presented data suggest the need for more pre-surgery patient information about possible traction-related problems. PMID:28630721

  19. Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.

    Science.gov (United States)

    Esola, M A; McClure, P W; Fitzgerald, G K; Siegler, S

    1996-01-01

    This study analyzed two groups of subjects during forward bending. Group 1 (n = 20) contained subjects with a history of low back pain and Group 2 (n = 21) included subjects without a history of low back pain. The purposes of this study were to establish the amount and pattern of lumbar spine and hip motion during forward bending, and determine differences in motion in subjects with and without a history of low back pain. Reported values for lumbar spine motion during forward bending vary from 23.9 degrees to 60 degrees and hip motion during forward bending ranges from 26 degrees to 66 degrees. There has been no direct study of both lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain to establish differences in total amounts or pattern of lumbar spine and hip motion during forward bending. A three-dimensional optoelectric motion analysis system was used to measure the amount and velocity of lumbar spine and hip motion during forward bending. Each subject performed three trials of forward bending that were averaged and used for statistical analysis. Hamstring flexibility was also assessed by two clinical tests, the passive straight leg raising and active knee extension tests. Mean total forward bending for all subjects was 111 degrees: 41.6 degrees from the lumbar spine and 69.4 degrees from the hips. There were no group differences for total amounts of lumbar spine and hip motion or velocity during forward bending. The pattern of motion was described by calculating lumbar-to-hip flexion ratios for early (0-30 degrees), middle (30-60 degrees), and late (60-90 degrees) forward bending. For all subjects, mean lumbar-to-hip ratios for early, middle, and late forward bending were 1.9, 0.9, and 0.4, respectively. Therefore, the lumbar spine had a greater contribution to early forward bending, the lumbar spine and hips contributed almost equally to middle forward bending, and the hips had a greater contribution to

  20. Friction measurement in a hip wear simulator.

    Science.gov (United States)

    Saikko, Vesa

    2016-05-01

    A torque measurement system was added to a widely used hip wear simulator, the biaxial rocking motion device. With the rotary transducer, the frictional torque about the drive axis of the biaxial rocking motion mechanism was measured. The principle of measuring the torque about the vertical axis above the prosthetic joint, used earlier in commercial biaxial rocking motion simulators, was shown to sense only a minor part of the total frictional torque. With the present method, the total frictional torque of the prosthetic hip was measured. This was shown to consist of the torques about the vertical axis above the joint and about the leaning axis. Femoral heads made from different materials were run against conventional and crosslinked polyethylene acetabular cups in serum lubrication. Regarding the femoral head material and the type of polyethylene, there were no categorical differences in frictional torque with the exception of zirconia heads, with which the lowest values were obtained. Diamond-like carbon coating of the CoCr femoral head did not reduce friction. The friction factor was found to always decrease with increasing load. High wear could increase the frictional torque by 75%. With the present system, friction can be continuously recorded during long wear tests, so the effect of wear on friction with different prosthetic hips can be evaluated. © IMechE 2016.

  1. Rapidly Destructive Inflammatory Arthritis of the Hip

    Directory of Open Access Journals (Sweden)

    Jenny Shu

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is a rare syndrome that involves aggressive hip joint destruction within 6–12 months of symptom onset with no single diagnostic laboratory, pathological, or radiographic finding. We report an original case of RDC as an initial presentation of seronegative rheumatoid arthritis (RA in a 57-year-old Caucasian woman presenting with 6 months of progressive right groin pain and no preceding trauma or chronic steroid use. Over 5 months, she was unable to ambulate and plain films showed complete resorption of the right femoral head and erosion of the acetabulum. There were inflammatory features seen on computed tomography (CT and magnetic resonance imaging (MRI. She required a right total hip arthroplasty, but arthritis in other joints showed improvement with triple disease modifying antirheumatic drugs (DMARD therapy and almost complete remission with the addition of adalimumab. We contrast our case of RDC as an initial presentation of RA to 8 RDC case reports of patients with established RA. Furthermore, this case highlights the importance of obtaining serial imaging to evaluate a patient with persistent hip symptoms and rapid functional deterioration.

  2. Congenital hip dislocation: Radiological screening or diagnosis?

    International Nuclear Information System (INIS)

    Kalifa, G.; Faure, C.

    1987-01-01

    Congenital hip dislocation is a perfect example of public health problems: its incidence is high 0.6, to 2% of newborns in France and an early detection allows an easy and successful treatment. The current situation in our country is not satisfactory for several reasons: - Too many children are treated without reasons because of misleading radiological pictures; - Conversely, some dislocations are discovered only at the walking age, the treatment becoming then more difficult and less effective; - Almost 300,000 radiological examinations of the hip for screening are performed each year and among them 100,000 in newborns. This is not satisfactory as it is commonly admitted now that radiological examination at birth is unreliable and frequently misleading. For all these reasons a special working group has been settled up by the General Direction of Health, including physicians of different practices, from different specialities. The conclusion of this group will be published in a special booklet and can be summarized as follows: The group recommends to perform detection of congenital hip dislocation mainly by the clinical examination. This examination may be difficult but it must be performed very early, the first day of life, repeated several times, at the end of the first week and during the first, second, and third month. Every baby in this country must undergo several clinical examinations up to one year of age

  3. Imaging of neuropathies about the hip

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, Carlo, E-mail: carlo.martinoli@unige.it [Radiologia – DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Miguel-Perez, Maribel [Unit of Human Anatomy and Embryology, Department of Pathology and Experimental Therapy, Faculty of Medicine (C Bellvitge), University of Barcelona, Barcelona (Spain); Padua, Luca [Fondazione Don Gnocchi Onlus and Department of Neurology, Policlinico “A. Gemelli”, Università Cattolica del Sacro Cuore, Rome (Italy); Gandolfo, Nicola [IM2S – Institut Monégasque de Médecine and Chirurgie Sportive, Montecarlo (Monaco); Zicca, Anna [Radiologia – DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Tagliafico, Alberto [Radiologia – National Institute for Cancer Research, Genoa (Italy)

    2013-01-15

    Neuropathies about the hip may be cause of chronic pain and disability. In most cases, these conditions derive from mechanical or dynamic compression of a segment of a nerve within a narrow osteofibrous tunnel, an opening in a fibrous structure, or a passageway close to a ligament or a muscle. Although the evaluation of nerve disorders primarily relies on neurological examination and electrophysiology, diagnostic imaging is currently used as a complement to help define the site and aetiology of nerve compression and exclude other disease possibly underlying the patient’ symptoms. Diagnosis of entrapment neuropathies about the hip with US and MR imaging requires an in-depth knowledge of the normal imaging anatomy and awareness of the anatomic and pathologic factors that may predispose or cause a nerve injury. Accordingly, the aim of this article is to provide a comprehensive review of hip neuropathies with an emphasis on the relevant anatomy, aetiology, clinical presentation, and their imaging appearance. The lateral femoral cutaneous neuropathy (meiralgia paresthetica), femoral neuropathy, sciatic neuropathy, obturator neuropathy, superior and inferior gluteal neuropathies and pudendal neuropathy will be discussed.

  4. Rethinking Pedagogy in Urban Spaces: Implementing Hip-Hop Pedagogy in the Urban Science Classroom

    Science.gov (United States)

    Adjapong, Edmund S.; Emdin, Christopher

    2015-01-01

    A significant amount of research regarding Hip-Hop Based Education (HHBE) fails to provide insight on how to incorporate elements of Hip-Hop into daily teaching practices; rather Hip-Hop based educators focus mainly on incorporating Hip-Hop culture into curricula. This study explores the benefits of using two specific Hip-Hop pedagogical practices…

  5. "Tripolar" hip arthroplasty for failed hip resurfacing: nineteen years follow-up.

    Science.gov (United States)

    Scheerlinck, T; Casteleyn, P P

    2001-10-01

    The authors describe the case of a 37-year-old patient who sustained a subcapital femoral neck fracture six months after ICLH double-cup hip resurfacing. As the polyethylene acetabular resurfacing component was undamaged and well fixed, a standard femoral stem with a bipolar head was inserted. The outer diameter of the bipolar head was chosen to fit the resurfacing socket. The "tripolar" hip arthroplasty has functioned well for 19 years and was revised for aseptic cup loosening. The cemented femoral stem was still well fixed and was not revised. Although the "tripolar" hip has functioned well in our case, we believe it is not indicated for metal on metal bearings. In this case the use of an appropriate modular head with a correct head-socket clearance is preferred.

  6. The relationship of hip joint space to self reported hip pain

    DEFF Research Database (Denmark)

    Jacobsen, S.; Holm, S.S.; Lund, B.

    2004-01-01

    OBJECTIVES: (1) To evaluate the effect of pelvic orientation on measurements of hip joint space widths (JSW) in cadaver pelvic radiographs, thereby validating the pelvic radiographs of the Copenhagen City Heart Study: The Osteoarthritis Substudy (CCHS III) cohort of 4.152 subjects, and (2......) to investigate the relationship between minimal JSW and self reported hip pain of the cohort. METHODS: (1) Cadaver pelves and proximal femora of one male and one female donor were mounted in holding devices permitting independent rotation (total arc of 42 degrees), and inclination/reclination (total arc of 24...... degrees). At each 3 degrees increment an anteroposterior radiograph was recorded. Measurements of JSW were performed. (2) Self reported recurrent pain in or around the hip joint during 12 months prior to baseline examinations, and minimum JSW in pelvic radiographs of the cohort were registered...

  7. Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

    DEFF Research Database (Denmark)

    Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

    2018-01-01

    INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

  8. Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip

    Directory of Open Access Journals (Sweden)

    Dhaon B

    2005-01-01

    Full Text Available Background: High rates of loosening of cemented implants led to change in technique of fixation of the implant. Methods: Fifty-nine hips were operated in 42 patients with non-cemented acetabular and cemented femoral components between January 1999 and July 2003. The average age of the patient was 45.2 years in our study. Preoperative diagnosis was avascular necrosis (28, ankylosing spondylitis (18, fracture neck femur (9, rheumatoid arthritis (2 and osteoarthritis (2. Results: At an average follow up of 3.6 years (range 1.2-5.8 years excellent to good results were obtained 92% according to Harris hip criteria. No radiological loosening was noted in any femoral or acetabular component on follow up. One poor result was seen in a case of bilateral ankylosing spondylitis operated on one side. Conclusion: Hybrid THA provides a viable and highly acceptable method of treatment of diseases of hip in young patients.

  9. Evaluation of Complications of Extracapsular Cataract Extraction ...

    African Journals Online (AJOL)

    hanumantp

    Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, 1Department of Ophthalmology, Guinness. Eye Centre, Onitsha, Nigeria. Abstract .... Br J Ophthalmol 2007;91:1315‑7. 6. Hennig A. Sutureless non‑phaco cataract surgery: A solution to reduce worldwide cataract blindness? Community Eye.

  10. HIP FRACTURES IN THE ELDERLY PATIENT

    Directory of Open Access Journals (Sweden)

    Franci Koglot

    2001-11-01

    Full Text Available Background. Hip fractures are typical of the ageingpopulation. They represent a severe trauma for the elderlypatient due to significant impact on life quality and morbidity.We analyzed the characteristics of patients with hip fractures,the methods and success of treatment. In conclusion, theimportance of continuous team approach and surgical treatmentwithin 24 hours are stressed. Methods. We retrospectively evaluated patients admitted forfemoral neck and intertrochanteric fractures between 1994–1999. The incidence of these fractures, patient age and sex, comorbidity,methods of treatment, hospital stay and success oftreatment with regard to ambulatory status were established.Results. 662 patients were treated in the above mentioned period,yielding a 1‰ annual incidence for the choosen population.The mean patient age was 76 years; there were 426 female(64% and 236 male patients (36%. 336 patients (51%had a history of accompanying disease, in 73 patients (11%additional fractures were diagnosed. 30 patients (4.5% weretreated conservatively, 632 (95.5% underwent surgery. Themean hospital stay length was 17 days. Success of treatmentwas evaluated as good in 441 patients (67%, satisfactory in112 patients (17% and poor in 78 patients (12%. 31 patients(5% died during hospital admission. Conclusions. Patients with hip fractures represent 10% of allin-hospital trauma patients; with hospital stays twice as longas average trauma patients and considering the financial demandsof surgical treatment they are a challenge in traumawards organization and management in the Slovenian environment.Here as well as abroad the number of these patientsis increasing, along with their mean age and co-morbidity. Itis evident that hip fractures, regardless the way of treatment,implicate a partial or complete loss of ambulancy and henceloss of life-quality in one-third of patients. We advise early aspossible surgery –within 24 h– where not absolutely

  11. Evolution of the human hip. Part 1: the osseous framework.

    Science.gov (United States)

    Hogervorst, Tom; Vereecke, Evie E

    2014-10-01

    Extensive osseous adaptations of the lumbar spine, pelvis, hip and femur characterize the emergence of the human bipedal gait with its 'double extension' of the lumbar spine and hip. To accommodate lumbar lordosis, the pelvis was 'compacted', becoming wider and shorter, as compared with the non-human apes. The hip joint acquired a much more extended position, which can be seen in a broader evolutionary context of verticalization of limbs. When loaded in a predominantly vertical position, the femur can be built lighter and longer than when it is loaded more horizontally because bending moments are smaller. Extension of the hip joint together with elongation of the femur increases effective leg length, and hence stride length, which improves energy efficiency. At the hip joint itself, the shift of the hip's default working range to a more extended position influences concavity at the head-neck junction and femoral neck anteversion.

  12. Design of biped hip simulator using SolidWorks

    Science.gov (United States)

    Zainudin, M. R.; Yahya, A.; Fazli, M. I. M.; Syahrom, A.; Harun, F. K. C.; Nazarudin, M. S.

    2017-10-01

    The increasing number of people who underwent both hip implant surgery based on World Health Organization (WHO) has received massive attention from researchers lately to develop various types of hip simulators in order to test the hip implant. Various number of hip simulator have been developed with different functions and capabilities. This paper presents the design development of biped hip simulator using SolidWorks software by taking into consideration some improvement and modifications. The finite element method is used to test the design whether it is safe to be used or not. The biped hip simulator has been successfully designed and ready to be fabricated as the endurance testing shown a positive results. The von Mises stress induced in the material is an alloy steel which is 2,975,862.3 N/m2 lower than the yield strength. Thus, the design is safe to be used as it obey the safety criterion.

  13. Perceived loading and muscle activity during hip strengthening exercises

    DEFF Research Database (Denmark)

    Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian

    2013-01-01

    hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG). METHODS: EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women......, using elastic resistance and isotonic exercise machines. These recordings were normalized to maximal voluntary contraction (MVC) EMG (nEMG). The exercises were performed at four levels of perceived loading reported using the Borg CR10: light (Borg ≤2), moderate (Borg >2-... (r =0.62±0.54). The abduction exercise performed with elastic resistance displayed significantly higher gluteus medius nEMG recruitment than the in machine exercise. CONCLUSIONS: The results of this study show that the Borg CR10 scale can be a useful tool for estimating intensity levels during...

  14. Late total hip arthroplasty dislocation due to yoga

    Directory of Open Access Journals (Sweden)

    Murillo Adrados, MD

    2018-06-01

    Full Text Available Yoga has become a popular form of exercise, recreation, and meditation for adults in the United States. As the popularity of both yoga and the incidence of hip replacements have both coincidentally increased over the last 2 decades, we imagine that the number of total hip replacement patients partaking in the practice of yoga has also increased. There are no clear guidelines available for yoga practice following hip replacement. To date, there have been no published reports of prosthetic hip dislocations during yoga. We present 2 cases of late total hip dislocations during yoga and provide a review of the available orthopaedic literature and our recommendations on patient restrictions and education with respect to practicing yoga after a hip replacement.

  15. Anterior Hip Dislocation in a Football Player: A Case Report

    Directory of Open Access Journals (Sweden)

    Alexander Schuh

    2009-01-01

    Full Text Available Hip dislocations during sporting activities represent only 2%–5% of all hip dislocations. Most hip dislocations in sports can be categorised as “less complicated traumatic hip dislocations” by the Stewart-Milford classification due to the fact that minimal force is involved. The incidence of avascular necrosis of the femoral head greatly increases if the time to reduction is more than six hours. We report the case of a 38-year-old football player who suffered hip dislocation while kicking the ball with the medial aspect of the right foot in an external rotated manner of the right hip. Closed reduction was performed within 2 hours; postoperative follow-up was uneventful. Six months later the patient is out of any complaints; there is no sign of AVN of the femoral head.

  16. History and physical examination of hip injuries in elderly adults.

    Science.gov (United States)

    Hamedan Al Maqbali, Mohammed Abdullah

    2014-01-01

    Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

  17. Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.

    Science.gov (United States)

    de Sa, Darren; Horner, Nolan S; MacDonald, Austin; Simunovic, Nicole; Slobogean, Gerard; Philippon, Marc J; Belzile, Etienne L; Karlsson, Jon; Ayeni, Olufemi R

    2016-12-01

    Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods. EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon's patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted. There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379). There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year. Systematic Review of Level IV Studies, Level IV.

  18. Muscle atrophy and metal-on-metal hip implants: a serial MRI study of 74 hips.

    Science.gov (United States)

    Berber, Reshid; Khoo, Michael; Cook, Erica; Guppy, Andrew; Hua, Jia; Miles, Jonathan; Carrington, Richard; Skinner, John; Hart, Alister

    2015-06-01

    Muscle atrophy is seen in patients with metal-on-metal (MOM) hip implants, probably because of inflammatory destruction of the musculo-tendon junction. However, like pseudotumors, it is unclear when atrophy occurs and whether it progresses with time. Our objective was to determine whether muscle atrophy associated with MOM hip implants progresses with time. We retrospectively reviewed 74 hips in 56 patients (32 of them women) using serial MRI. Median age was 59 (23-83) years. The median time post-implantation was 83 (35-142) months, and the median interval between scans was 11 months. Hip muscles were scored using the Pfirrmann system. The mean scores for muscle atrophy were compared between the first and second MRI scans. Blood cobalt and chromium concentrations were determined. The median blood cobalt was 6.84 (0.24-90) ppb and median chromium level was 4.42 (0.20-45) ppb. The median Oxford hip score was 34 (5-48). The change in the gluteus minimus mean atrophy score between first and second MRI was 0.12 (p = 0.002). Mean change in the gluteus medius posterior portion (unaffected by surgical approach) was 0.08 (p = 0.01) and mean change in the inferior portion was 0.10 (p = 0.05). Mean pseudotumor grade increased by 0.18 (p = 0.02). Worsening muscle atrophy and worsening pseudotumor grade occur over a 1-year period in a substantial proportion of patients with MOM hip implants. Serial MRI helps to identify those patients who are at risk of developing worsening soft-tissue pathology. These patients should be considered for revision surgery before irreversible muscle destruction occurs.

  19. Successful staged hip replacement in septic hip osteoarthritis in osteopetrosis: a case report

    Directory of Open Access Journals (Sweden)

    Manzi Giovanni

    2012-04-01

    Full Text Available Abstract Background Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function. Only one case of osteomyelitis of the proximal third of the femur has been previously reported, treated with several repeated debridements and finally with femoral head resection. Here we present for the first time a case of a staged implant of a cementless total hip prosthesis for the treatment of a septic hip in femoral neck nonunion in osteopetrosis. Case presentation A 36-years-old woman, affected by autosomal dominant osteopetrosis was referred to our department because of a septic hip arthritis associated with femoral neck septic non-union, with draining fistulas. The infection occurred early after a plate osteosynthesis for a closed perthrocanteric fracture of the femur and persisted in spite of osteosynthesis removal, surgical debridement and external fixation. In our hospital the patient underwent accurate debridement, femoral head and greater trochanter resection, preparation of the diaphyseal intramedullary canal and implant of an antibiotic-loaded cement spacer. The spacer was exchanged after one month, due to infection recurrence and four months later, a cementless total hip arthroplasty was implanted, with no clinical and laboratory signs of infection recurrence at two years follow-up. Conclusions In case of hip septic arthritis and proximal femur septic non-union, femoral head resection may not be the only option available and staged total hip arthroplasty can be considered.

  20. Quality of life following hip fractures: results from the Norwegian hip fracture register.

    Science.gov (United States)

    Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

    2016-07-07

    Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

  1. Psychological factors as risk factors for poor hip function after total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Benditz A

    2017-02-01

    Full Text Available Achim Benditz,1 Petra Jansen,2 Jan Schaible,1 Christina Roll,1 Joachim Grifka,1 Jürgen Götz1 1Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, 2Department of Sport Science, University of Regensburg, Regensburg, Germany Abstract: Recovery after total hip arthroplasty (THA is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure. Additional objectives were perioperative changes in the psychological status and their influence on perioperative outcome. This observational study analyzed depression, anxiety, resilience, and personality traits in 50 patients after primary unilateral THA. Hip functionality was measured by means of the Harris Hip Score. Depression, state anxiety, and resilience were evaluated preoperatively as well as 1 and 5 weeks postoperatively. Trait anxiety and personality traits were measured once preoperatively. Patients with low depression and anxiety levels had significantly better outcomes with respect to early hip functionality. Resilience and personality traits did not relate to hip functionality. Depression and state anxiety levels significantly decreased within the 5-week stay in the acute and rehabilitation clinic, whereas resilience remained at the same level. Our study suggests that low depression and anxiety levels are positively related to early functionality after THA. Therefore, perioperative measurements of these factors seem to be useful to provide the best support for patients with risk factors. Keywords: total hip arthroplasty, psychological factors, depression, state anxiety, trait anxiety, resilience, personality traits

  2. Total hip arthroplasty using a short-stem prosthesis: restoration of hip anatomy.

    Science.gov (United States)

    Amenabar, Tomas; Marimuthu, Kanniraj; Hawdon, Gabrielle; Gildone, Alessandro; McMahon, Stephen

    2015-04-01

    To evaluate hip parameters such as vertical centre of rotation (VCR), horizontal centre of rotation (HCR), femoral offset, and leg length after total hip arthroplasty (THA) using the Nanos short-stem prosthesis. Medical records of 73 men and 74 women aged 25 to 92 (mean, 63) years who underwent THA using the Nanos short-stem prosthesis by a single surgeon were reviewed. Prior to the surgery, the optimal cup and stem size, head length, and level of the neck osteotomy were determined using radiographs. Intra-operatively, the leg length and femoral offset were checked, and the level of neck resection and head length were adjusted. VCR, HCR, femoral offset, and leg length of the operated and contralateral sides were compared. Functional outcomes were assessed using the Harris Hip Score (HHS). Compared with the normal contralateral hips, the operated hips had a mean increase of 0.4 mm in VCR (p=0.032), a mean decrease of 1.4 mm in HCR (p=0.027), a mean increase of 0.6 mm in femoral offset (p=0.043), and a mean increase of 0.36 mm in leg length (p=0.035). For these respective parameters, the difference between the normal contralateral side and the operated side was within 5 mm in 89%, 80%, 71%, and 96% of patients. The HHS improved from a mean of 53 to 91 at one year (pNanos short-stem prosthesis enabled restoration of hip anatomy (VCR, HCR, femoral offset, and leg length).

  3. Cementless Hip Stem Anteversion in the Dysplastic Hip: A Comparison of Tapered Wedge vs Metaphyseal Filling.

    Science.gov (United States)

    Taniguchi, Naofumi; Jinno, Tetsuya; Koga, Daisuke; Hagino, Tetsuo; Okawa, Atsushi; Haro, Hirotaka

    2017-05-01

    Appropriate stem anteversion is important for achieving stability of the prosthetic joint in total hip arthroplasty. Anteversion of a cementless femoral stem is affected by the femoral canal morphology and varies according to stem geometry. We investigated the difference and variation of the increase in anteversion between 2 types of cementless stems, and the correlation between each stem and the preoperative femoral anteversion. We retrospectively compared 2 groups of hips that underwent total hip arthroplasty using a metaphyseal filling stem (78 hips) or a tapered wedge stem (83 hips). All the patients had osteoarthritis due to hip dysplasia. Computed tomography was used to measure preoperative femoral anteversion at 5 levels and postoperative stem anteversion. The increase in anteversion of the tapered wedge stem group (22.7° ± 11.6°) was more than that of the metaphyseal filling stem group (17.2° ± 8.3°; P = .0007). The variation of the increase in the tapered wedge stem group was significantly larger than that in the metaphyseal filling stem group (P = .0016). The metaphyseal filling stem group was more highly and positively correlated with femoral anteversion than the tapered wedge stem group. Femoral anteversion affects stem anteversion differently according to stem geometry. The tapered wedge stems had greater variation of the increase in anteversion than did the metaphyseal filling stems. Based on the results of this study, it is difficult to preoperatively estimate the increase in stem anteversion for tapered wedge stems. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The influence of heterotopic ossification on functional status of hip joint following total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pohl, F.; Seufert, J.; Flentje, M.; Koelbl, O. [Wuerzburg Univ. (Germany). Dept. of Radiotherapy; Tauscher, A.; Springorum, H.W. [Caritas Krankenhaus Bad Mergentheim (Germany). Orthopedic Clinic; Lehmann, H. [Caritas Krankenhaus Bad Mergentheim (Germany). Inst. of Radiology

    2005-08-01

    Purpose: The functional failure induced by heterotopic ossification (HO) following total hip arthroplasty (THA) was analyzed and correlated to the radiologic failure. Patients and methods: From July 1997 to July 2001, 315 patients (345 hips) received THA indicated by a hypertrophic osteoarthritis of higher degree (Kellgren grade III, IV). All patients were irradiated prophylactically for prevention of HO on the evening before surgery with a 7-Gy single fraction. The patients' median age was 66.3 years. Radiologic failure was assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). Analysis of radiographs was performed according to the Brooker Score. Clinical failure was appraised by measurement of passive range of motion (ROM) of the hip joint with a standard goniometer. The t-test was used for statistical analysis. Results: 281 patients (81.5%) did not develop HO. HO of Brooker grade I or II was found in 58 patients (16.8%). Six patients (1.7%) developed HO Brooker grade III or IV. There was a significant negative correlation between the degree of radiologic and clinical failure. ROM differed significantly between patients with HO Brooker grade 0, I, II and patients with HO Brooker grade III, IV. Comparing the pre- and postoperative ROM, all patients with Brooker grade 0, I and II showed a significant improvement of flexion, internal and external rotation, abduction and adduction movement. Patients with HO Brooker grade III and IV showed no improvement of ROM in the postoperative follow-up. Conclusion: The development of HO following THA influences the physical function of the hip joint dependent on the degree of ossification. HO of lower degree (Brooker I, II) does not influence the clinical outcome, whereas HO of higher degree (Brooker III, IV) reduces the function of hip arthroplasty. Therefore, the purpose of a prophylactic therapy must be to reduce HO of higher degree. (orig.)

  5. Persistent non-specific FDG uptake on PET imaging following hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Hongming; Chacko, Thomas K.; Hickeson, Marc; Stevenson, Karen; Feng, Qi; Ponzo, Fabio; Alavi, Abass [Division of Nuclear Medicine, Department of Radiology, The Hospital of University of Pennsylvania, 110 Donner Building, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Garino, Jonathan P. [Department of Orthopedic Surgery, The Hospital of University of Pennsylvania, Philadelphia, PA 19802 (United States)

    2002-10-01

    Hip arthroplasty is a common surgical procedure, but the diagnosis of infection associated with hip arthroplasty remains challenging. Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) has been shown to be a promising imaging modality in settings where infection is suspected. However, inflammatory reaction to surgery can result in increased FDG uptake at various anatomic locations, which may erroneously be interpreted as sites of infection. The purpose of this study was to assess the patterns and time course of FDG accumulation following total hip replacement over an extended period of time. Firstly, in a prospective study nine patients with total hip replacement were investigated to determine the patterns of FDG uptake over time. Three FDG-PET scans were performed in each patient at about 3, 6 and 12 months post arthroplasty. Secondly, in a retrospective analysis, the medical and surgical history and FDG-PET imaging results of 710 patients who had undergone whole-body scans for the evaluation of possible malignant disorders were reviewed. The history of arthroplasty and FDG-PET findings in the hip region were reviewed for this study. Patients with symptomatic arthroplasties or related complaints during FDG-PET scanning were excluded from the analysis. During the entire study period, all nine patients enrolled in the prospective study were demonstrated to have increased FDG uptake around the femoral head or neck portion of the prosthesis that extended to the soft tissues surrounding the femur. Among the patients reviewed in the retrospective study, 18 patients with a history of 21 hip arthroplasties who were asymptomatic at the time of FDG-PET scan met the criteria for inclusion. The time interval between the hip arthroplasty and the FDG-PET study ranged from 3 months to 288 months (mean{+-}SD: 80.4{+-}86.2 months). In 81% (17 of 21) of these prostheses, increased FDG uptake could be noted around the femoral head or neck portion of the

  6. Rare Cause of Hip Pain: Transient Osteoporosis of the Hip-Two Case Reports

    Directory of Open Access Journals (Sweden)

    Senem Şaş

    2015-12-01

    Full Text Available Transient osteoporosis of the hip (TOH is a rare disease affecting especially middle-aged men and women in the third trimester of pregnancy with unknown etiology. It has a benign course with spontaneous resolution. Transient osteoporosis may be confused with other diseases such as avascular necrosis. Early diagnosis is important to identify and plan correct treatment. In this report, two male cases with complaint of hip pain and difficulty in walking, which were diagnosed with TOH was presented by reviewing current literature.

  7. X-Ray Hip Examination in Patients with Cerebral Palsy

    OpenAIRE

    Holiuk, Ye.L.

    2017-01-01

    Background. X-ray indicators of the hip are important diagnostic factors of spastic hip dislocation in cerebral palsy. Correct X-ray examination has a decisive influence on the treatment strategy. Correct positioning parameters are well known, but their importance is often underestimated. This could be a trigger factor for further diagnostic and treatment errors. Materials and me-thods. The material was radiographs of the hip joints of 126 patients with cerebral palsy aged 2 to 18 years. Retr...

  8. Healing incisional surgical wounds using Rose Hip oil in rats

    OpenAIRE

    Lainy Carollyne da Costa Cavalcante; Thyago Cezar Prado Pessôa; Rubens Fernando Gonçalves Ribeiro Júnior; Edson Yuzur Yasojima; Rosa Helena de Figueiredo Chaves Soares; Marcus Vinicius Henriques Brito; Eduardo Henrique Herbster Gouveia; Lucas Nascimento Galvão; Suzana Rodrigues Ramos; Adan Kristian Almeida Carneiro; Yuri Aarão Amaral Serruya; Mateus Malta de Moraes

    2017-01-01

    Purpose: To evaluate incisional surgical wound healing in rats by using Rose Hip (Rosa rubiginosa L.) oil. Methods: Twenty-one days after the oophorectomy procedure, twenty-seven female, adult, Wistar rats were distributed into three groups: Control group (wound treatment with distilled water); Collagenase group (treatment with collagenase ointment); and Rose Hip group (wound treatment with Rose Hip oil). Each group was distributed according to the date of euthanasia: 7, 14 and 21 days. ...

  9. Studies on hip fracture patients : effects of nutrition and rehabilitation

    OpenAIRE

    Flodin, Lena

    2015-01-01

    Hip fracture in the elderly is a serious condition associated with increased mortality. Survivors experience an increase in morbidity and disability that affect their independence and quality of life; the outcome for patients with dementia is particularly poor. Many hip fracture patients have signs of malnutrition already on admission and this patient group has been shown to have a lower body mass index (BMI) than aged-matched controls. A catabolic state develops following hip fracture, chara...

  10. Hip Dysplasia: Clinical Signs and Physical Examination Findings.

    Science.gov (United States)

    Syrcle, Jason

    2017-07-01

    Hip dysplasia is a common developmental disorder of the dog, consisting of varying degrees of hip laxity, progressive remodeling of the structures of the hip, and subsequent development of osteoarthritis. It is a juvenile-onset condition, with clinical signs often first evident at 4 to 12 months of age. A tentative diagnosis of hip dysplasia can be made based on signalment, history, and physical examination findings. The Ortolani test is a valuable tool for identifying juvenile dogs affected with this condition. Further diagnostics can then be prioritized, contributing to prompt diagnosis and appropriate treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Hip pain in adults: MR imaging appearance of common causes

    Energy Technology Data Exchange (ETDEWEB)

    Mengiardi, Bernard; Pfirrmann, Christian W.A.; Hodler, Juerg [Orthopaedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland)

    2007-07-15

    To determine the exact origin of hip pain can be challenging. Symptoms apparently originating from the hip may arise from the pelvis, the sacroiliac joint, the lumbar spine, periarticular structures such as muscles and bursae, or from unexpected sites such as the abdominal wall, the genitourinary tract, or the retroperitoneal space. This article reviews the differential diagnosis of hip pain arising from the hip and surrounding structures and the role of different imaging methods with emphasis on magnetic resonance imaging where most recent advances have occurred. (orig.)

  12. Characteristics of children with hip displacement in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2007-10-01

    Full Text Available Abstract Background Hip dislocation in children with cerebral palsy (CP is a common and severe problem. The dislocation can be avoided, by screening and preventive treatment of children with hips at risk. The aim of this study was to analyse the characteristics of children with CP who develop hip displacement, in order to optimise a hip surveillance programme. Methods In a total population of children with CP a standardised clinical and radiological follow-up of the hips was carried out as a part of a hip prevention programme. The present study is based on 212 children followed until 9–16 years of age. Results Of the 212 children, 38 (18% developed displacement with Migration Percentage (MP >40% and further 19 (9% MP between 33 and 39%. Mean age at first registration of hip displacement was 4 years, but some hips showed MP > 40% already at two years of age. The passive range of hip motion at the time of first registration of hip displacement did not differ significantly from the findings in hips without displacement. The risk of hip displacement varied according to CP-subtype, from 0% in children with pure ataxia to 79% in children with spastic tetraplegia. The risk of displacement (MP > 40% was directly related to the level of gross motor function, classified according to the gross motor function classification system, GMFCS, from 0% in children in GMFCS level I to 64% in GMFCS level V. Conclusion Hip displacement in CP often occurs already at 2–3 years of age. Range of motion is a poor indicator of hips at risk. Thus early identification and early radiographic examination of children at risk is of great importance. The risk of hip displacement varies according to both CP-subtype and GMFCS. It is sometimes not possible to determine subtype before 4 years of age, and at present several definitions and classification systems are used. GMFCS is valid and reliable from 2 years of age, and it is internationally accepted. We recommend a hip

  13. The role of the acetabular labrum in hip dysplasia

    DEFF Research Database (Denmark)

    Hartig-Andreasen, Charlotte; Søballe, Kjeld; Troelsen, Anders

    2013-01-01

    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should...... be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral anatomy and function, the etiology of labral tears in hip dysplasia, and diagnostic assessment of labral...... tears, and we discuss treatment strategies for coexisting labral tears and hip dysplasia....

  14. Interventions for Hip Pain in the Maturing Athlete

    Science.gov (United States)

    Gomberawalla, M. Mustafa; Kelly, Bryan T.; Bedi, Asheesh

    2014-01-01

    Context: Femoroacetabular impingement (FAI) alters hip mechanics, results in hip pain, and may lead to secondary osteoarthritis (OA) in the maturing athlete. Hip impingement can be caused by osseous abnormalities in the proximal femur or acetabulum. These impingement lesions may cause altered loads within the hip joint, which result in repetitive collision damage or sheer forces to the chondral surfaces and acetabular labrum. These anatomic lesions and resultant abnormal mechanics may lead to early osteoarthritic changes. Evidence Acquisition: Relevant articles from the years 1995 to 2013 were identified using MEDLINE, EMBASE, and the bibliographies of reviewed publications. Level of Evidence: Level 4. Results: Improvements in hip arthroscopy have allowed FAI to be addressed utilizing the arthroscope. Adequately resecting the underlying osseous abnormalities is essential to improving hip symptomatology and preventing further chondral damage. Additionally, preserving the labrum by repairing the damaged tissue and restoring the suction seal may theoretically help normalize hip mechanics and prevent further arthritic changes. The outcomes of joint-preserving treatment options may be varied in the maturing athlete due to the degree of underlying OA. Irreversible damage to the hip joint may have already occurred in patients with moderate to advanced OA. In the presence of preexisting arthritis, these patients may only experience fair or even poor results after hip arthroscopy, with early conversion to hip replacement. For patients with advanced hip arthritis, total hip arthroplasty remains a treatment option to reliably improve symptoms with good to excellent outcomes and return to low-impact activities. Conclusion: Advances in the knowledge base and treatment techniques of intra-articular hip pain have allowed surgeons to address this complex clinical problem with promising outcomes. Traditionally, open surgical dislocations for hip preservation surgery have shown good

  15. US of the hips in skeletal dysplasias and chromosomal aberrations

    International Nuclear Information System (INIS)

    Langer, R.; Langer, M.F.J.; Zwicker, C.

    1987-01-01

    Since January 1984 all newborns and infants with skeletal dysplasias and chromosomal aberrations were investigated by hip US, in addition to plain x-ray surveys. The authors observed one chondroectodermal dysplasia, one congenital spondyloepiphysial dysplasia, one cleidocranial dysplasia, one fibrochondrogenesis, two diastrophic dysplasias, and eight trisomies. The abnormalities of the hip joints could be demonstrated, and were compared with the findings on plain films. Especially skeletal dysplasias with abundant presence of cartilage were well visible. The newborn with trisomies showed normal hip joints. In the authors' opinion, all newborns with skeletal dysplasias should be investigated by hip sonography, in addition to skeletal radiography

  16. Traumatic Anterior Dislocation of Hip in a Child- Case Report

    Directory of Open Access Journals (Sweden)

    S Ahmad

    2015-03-01

    Full Text Available Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

  17. Comparison of three methods to diagnose hip dysplasia in dogs

    International Nuclear Information System (INIS)

    Sharma, Vikas; Mohindroo, J.

    2009-01-01

    The present study was designed to compare the usefulness of goniometry, radiography and distraction index in diagnosis of hip dysplasia in dogs. During the study 25 clinical cases (50 joints) suspected for hip dysplasia were evaluated. Norberg angle was found to have a significant positive correlation with extension, flexion, abduction, and adduction angles and a significant negative correlation with distraction index (DI) measurements. It could be inferred that all the six parameters (NA, DI, extension, flexion, abduction, and adduction) were reliable indicators for early diagnosis of hip dysplasia.Goniometry could be used as a safe and easy method for preliminary suspicion of hip dysplasia

  18. Hip pain in adults: MR imaging appearance of common causes

    International Nuclear Information System (INIS)

    Mengiardi, Bernard; Pfirrmann, Christian W.A.; Hodler, Juerg

    2007-01-01

    To determine the exact origin of hip pain can be challenging. Symptoms apparently originating from the hip may arise from the pelvis, the sacroiliac joint, the lumbar spine, periarticular structures such as muscles and bursae, or from unexpected sites such as the abdominal wall, the genitourinary tract, or the retroperitoneal space. This article reviews the differential diagnosis of hip pain arising from the hip and surrounding structures and the role of different imaging methods with emphasis on magnetic resonance imaging where most recent advances have occurred. (orig.)

  19. Early diagnosis of congenital dislocation of the hip

    International Nuclear Information System (INIS)

    Grill, F.

    1984-01-01

    Neonatal hip examination is only effective with the help of a large number of experts. Teamwork between pediatrician, pediatric orthopedic surgeon and general practitioner seems to be essential. Best results can be achieved with a hip examination during the first 4 days of life and controls with 3 months and with 12 months. The technic of clinical examination and diagnosis is described. Because of hip dysplasias without any clinical signs the importance of an x-ray of the hip with an age of 3 months is emphasized. (Author)

  20. Case of Transient Osteoporosis of the Hip in Pregnancy

    Directory of Open Access Journals (Sweden)

    Hamza Sucuoğlu

    2014-12-01

    Full Text Available Transient osteoporosis of the hip is an uncommon disease, the cause is not known. It is usually seen in women in the third trimester of pregnancy and in middle-aged men. Patients present with acute, severe hip pain which generally resulting in gait disorder. Prognosis of transient osteoporosis of the hip is good. Within few months of appropriate conservative aproach and bed rest patient’s complains can be fully recovered. In this article; we present the clinical features, diagnosis and treatment options of patients presented to our clinic with severe bilateral hip pain during the third trimester of pregnancy diagnosed as transient osteoporosis accompanied by literature review.

  1. Hip arthroscopy versus open surgical dislocation for femoroacetabular impingement

    Science.gov (United States)

    Zhang, Dagang; Chen, Long; Wang, Guanglin

    2016-01-01

    Abstract Background: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. Methods: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. Results: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate. Open surgical dislocation resulted in a significantly improved alpha angle by the Dunn view in patients with cam osteoplasty from preoperation to postoperation, compared with hip arthroscopy. This meta-analysis demonstrated no significant differences in the modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, or Hip Outcome Score-Sport Specific Subscale at 12 months of follow-up, or in complications (including nerve damage, wound infection, and wound dehiscence). Conclusion: Hip arthroscopy resulted in higher NAHS and lower reoperation rates, but had less improvement in alpha angle in patients with cam osteoplasty, than open surgical dislocation. PMID:27741133

  2. Prosthetic hip joint infection due to Campylobacter fetus.

    OpenAIRE

    Bates, C J; Clarke, T C; Spencer, R C

    1994-01-01

    A case of postoperative prosthetic hip joint infection due to Campylobacter fetus subsp. fetus is described. Difficulties in isolation and antimicrobial susceptibility testing of this organism are discussed.

  3. A preliminary biomechanical study of a novel carbon-fibre hip implant versus standard metallic hip implants.

    Science.gov (United States)

    Bougherara, Habiba; Zdero, Rad; Dubov, Anton; Shah, Suraj; Khurshid, Shaheen; Schemitsch, Emil H

    2011-01-01

    Total hip arthroplasty is a widespread surgical approach for treating severe osteoarthritis of the human hip. Aseptic loosening of standard metallic hip implants due to stress shielding and bone loss has motivated the development of new materials for hip prostheses. Numerically, a three-dimensional finite element (FE) model that mimicked hip implants was used to compare a new hip stem to two commercially available implants. The hip implants simulated were a novel CF/PA12 carbon-fibre polyamide-based composite hip stem, the Exeter hip stem (Stryker, Mahwah, NJ, USA), and the Omnifit Eon (Stryker, Mahwah, NJ, USA). A virtual axial load of 3 kN was applied to the FE model. Strain and stress distributions were computed. Experimentally, the three hip stems had their distal portions rigidly mounted and had strain gauges placed along the surface at 3 medial and 3 lateral locations. Axial loads of 3 kN were applied. Measurements of axial stiffness and strain were taken and compared to FE analysis. The overall linear correlation between FE model versus experimental strains showed reasonable results for the lines-of-best-fit for the Composite (Pearson R(2)=0.69, slope=0.82), Exeter (Pearson R(2)=0.78, slope=0.59), and Omnifit (Pearson R(2)=0.66, slope=0.45), with some divergence for the most distal strain locations. From FE analysis, the von Mises stress range for the Composite stem was much lower than that in the Omnifit and Exeter implants by 200% and 45%, respectively. The preliminary experiments showed that the Composite stem stiffness (1982 N/mm) was lower than the metallic hip stem stiffnesses (Exeter, 2460 N/mm; Omnifit, 2543 N/mm). This is the first assessment of stress, strain, and stiffness of the CF/PA12 carbon-fibre hip stem compared to standard commercially-available devices. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  4. Gait symmetry and hip strength in women with developmental dysplasia following hip arthroplasty compared to healthy subjects : A cross-sectional study

    NARCIS (Netherlands)

    Leijendekkers, Ruud A.; Marra, Marco A.; Kolk, Sjoerd; Van Bon, Geert; Schreurs, B. Wim; Weerdesteyn, Vivian; Verdonschot, Nico

    2018-01-01

    Introduction: Untreated unilateral developmental dysplasia of the hip (DDH) results in asymmetry of gait and hip strength and may lead to early osteoarthritis, which is commonly treated with a total hip arthroplasty (THA). There is limited knowledge about the obtained symmetry of gait and hip

  5. The Failure Patterns of Oral Cavity Squamous Cell Carcinoma After Intensity-Modulated Radiotherapy-University of Iowa Experience

    International Nuclear Information System (INIS)

    Yao Min; Chang, Kristi; Funk, Gerry F.; Lu Heming; Tan Huaming; Wacha, Judith C; Dornfeld, Kenneth J.; Buatti, John M.

    2007-01-01

    Purpose: Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence. Results: The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for 1 patient who failed in contralateral lower neck outside the radiation field, all failed in areas that had received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension. Conclusions: Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension

  6. Changes in gluteal muscle forces with alteration of footstrike pattern during running.

    Science.gov (United States)

    Vannatta, Charles Nathan; Kernozek, Thomas W; Gheidi, Naghmeh

    2017-10-01

    Gait retraining is a common form of treatment for running related injuries. Proximal factors at the hip have been postulated as having a role in the development of running related injuries. How altering footstrike affects hip muscles forces and kinematics has not been described. Thus, we aimed to quantify differences in hip muscle forces and hip kinematics that may occur when healthy runners are instructed to alter their foot strike pattern from their habitual rear-foot strike to a forefoot strike. This may gain insight on the potential etiology and treatment methods of running related lower extremity injury. Twenty-five healthy female runners completed a minimum of 10 running trials in a controlled laboratory setting under rear-foot strike and instructed forefoot strike conditions. Kinetic and kinematic data were used in an inverse dynamic based static optimization to estimate individual muscle forces during running. Within subject differences were investigated using a repeated measures multi-variate analysis of variance. Peak gluteus medius and minimus and hamstring forces were reduced while peak gluteus maximus force was increased when running with an instructed forefoot strike pattern. Peak hip adduction, hip internal rotation, and heel-COM distance were also reduced. Therefore, instructing habitual rearfoot strike runners to run with a forefoot strike pattern resulted in changes in peak gluteal and hamstring muscle forces and hip kinematics. These changes may be beneficial to the development and treatment of running related lower extremity injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Perioperative lateral trochanteric wall fractures: sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures.

    Science.gov (United States)

    Langford, Joshua; Pillai, Gita; Ugliailoro, Anthony D; Yang, Edward

    2011-04-01

    This study was performed to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a percutaneous compression plate (PCCP) using identical meticulous closed reduction techniques in both groups. Retrospective analysis of a prospective trauma registry. Urban Level I trauma center. Over a 7-year period, 337 patients with intertrochanteric hip fractures were treated with either a SHS or a PCCP at our institution. The PCCP group (Group 1) consisted of 200 patients, of which 141 (71%) had adequate images to be included in the study. The SHS group (Group 2) consisted of 137 patients, of which 100 (73%) had adequate images to be included in the study. Closed reduction and plate application with either a standard sliding hip screw or a percutaneous compression plate for an Orthopaedic Trauma Association 31A1 or 31A2 intertrochanteric hip fracture. : Radiographic evidence of lateral trochanteric wall fracture as measured by intraoperative and perioperative radiographs. There was an overall lateral wall fracture incidence of 20% in the SHS group versus 1.4% in the PCCP group (P fracture types, there was a lateral wall fracture incidence of 29.8% in the SHS group versus 1.9% in the PCCP group (P trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.

  8. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyun Soo; Juhng, Seon Kwan; Kim, Eun A; Kim, Jeong Ho; Song, Ha Heon; Shim, Dae Moo [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2002-12-01

    To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14{sup x}17{sup f}ilm was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.

  9. Primary abductor hip contracture as diagnostic, prognostic and therapeutic problem in child hip pathology

    Directory of Open Access Journals (Sweden)

    Pajić Miloš

    2007-01-01

    Full Text Available Coxa obliqua represents a special functional entity in the pathology of the child hip. Authors have confirmed the results of S.L. Weissman and B. Strinovic which claimed that the abductor contracture of the hip was a primary congenital condition that developed as a result of intrauterine malposition, leading later to the contralateral adductor contracture. Critical period for the development of complications was between 6 and 8 month after birth, adductor contracture might keep persisting together with the development of acetabular dysplasia, and later on with ipsilateral subluxation. This malformation has usually been diagnosed within 3 and 6 months of age. It could be connected with some other signs of malposition, such as plagiocephaly, torticollis or infantile thoracic C scoliosis. For the diagnosis of coxa obliqua, the examination of hips in the prone position was very important and the ultrasonic and radiological examinations were crucial. The applied treatment used to be exclusively physical rehabilitation. Wide diapering has been contraindicated. In this study, we included 2,500 newborns, 1,300 boys and 1,200 girls (5,000 hips. In 22 cases of coxa obliqua (10‰, the excellent results were obtained in 96% of cases. In two unsuccessfully treated cases, a contralateral dysplasia developed, and in one untreated, subluxation. The authors are advocating a systematic and early detection and treatment of the primary coxa obliqua. .

  10. Hip-Hop Is the Healer: Sense of Belonging and Diversity among Hip-Hop Collegians

    Science.gov (United States)

    Sulé, V. Thandi

    2016-01-01

    Sense of belonging is recognized as a factor contributing to persistence to graduation. Furthermore, interactional diversity is associated with learning and civic outcomes--touted higher education goals. Hip-hop culture, one of the most influential cultural creations of the mid-20th century, has succeeded in attracting devotees from diverse…

  11. Influence of Minimally Invasive Total Hip Replacement on Hip Reaction Forces and Their Orientations

    NARCIS (Netherlands)

    Weber, Tim; Al-Munajjed, Amir A.; Verkerke, Gijsbertus Jacob; Dendorfer, Sebastian; Renkawitz, Tobias

    2014-01-01

    Minimally invasive surgery (MIS) is becoming increasingly popular. Supporters claim that the main advantages of MIS total hip replacement (THR) are less pain and a faster rehabilitation and recovery. Critics claim that safety and efficacy of MIS are yet to be determined. We focused on a

  12. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement

    DEFF Research Database (Denmark)

    Nilsdotter, Anna K; Lohmander, L Stefan; Klässbo, Maria

    2003-01-01

    The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score...

  13. Transient osteoporosis of the hip: A mysterious cause of hip pain in adults

    Directory of Open Access Journals (Sweden)

    Raju Vaishya

    2017-01-01

    Full Text Available Background: Transient osteoporosis of the hip (TOH is a poorly understood and forgotten clinical entity. The diagnosis is often delayed, and inappropriate treatment is provided, due to the lack of its awareness among the clinicians. Materials and Methods: Twelve patients (11 male and one female within the age group of 35–50 years, were identified retrospectively from the hospital records between July 2011 and June 2015 who had evidence of TOH on clinical and radiological parameters. Results: All the patients were treated conservatively by nonweight bearing mobilization, anti-inflammatory drugs, bisphosphonates, calcium, and Vitamin D supplements. None of our patients had any symptoms after 6 months of conservative management. The disease did not progress, and there was no evidence of hip joint involvement in any of the cases. Plain radiographs were not diagnostic in the early detection of TOH. Magnetic resonance imaging was found to be highly specific and sensitive in diagnosing TOH. The clinical condition of TOH is characterized by its acute onset of hip pain in middle-aged people, and its symptoms are out of proportion to the radiological findings. Conclusion: The TOH is a nondestructive and self-limiting condition of the hip, which responds well to the conservative treatment. We believe that TOH could be a subset of complex regional pain syndrome type 1, as it has many similarities in clinical presentation and management. Awareness of this entity is important to the clinicians for an early diagnosis and to avoid unnecessary treatment for other mimicking conditions.

  14. Being Hipped to Their Hop: Tapping into Young Minds through Hip Hop Play

    Science.gov (United States)

    Broughton, Anthony

    2017-01-01

    Adults gain a wealth of knowledge from listening to the voices of children through intentional observations and interactions [Owocki, G., and Y. M. Goodman. 2002. "Kidwatching: Documenting Children's Literacy Development." Portsmouth: Heinemann]. Hip Hop play may provide optimal opportunities for teachers to tap into the young minds of…

  15. Dual X-ray absortiometry(DXA) in the detection of loosening in the total hip replacement arthroplasty: preliminary study

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung; Kang, Heung Sik; Han, Man Chung; Kim, Hee Joong; Kim, Young Min

    1994-01-01

    Algorithms to get cross-sectional bone density pattern(transverse histogram) to predict the loosening of hip prosthesis using DXA(Dual X-ray Absorptiometry) have been developed. We performed this study to analyze the correlation between radiologic findings and densitometric pattern of the THRA(Total Hip Replacement Arthroplasty) patients. Thirty-six hips of 32 THRA patients were evaluated. The duration between THRA and DXA was from 1 year 7 months to 15 years. On transverse histogram, the periprosthetic bone density patterns were classified as 3 types; type I , rigid fixation in 17, type II definite loosening in 8, and type III, partial loosening in 11 cases. Surgical findings, plain X-ray findings and transverse histogram using DXA were correlated. Among 14 cases performing revision for acetabular prosthesis loosening, 5 cases revealed loosening of femoral stems while 9 cases revealed rigid fixation of femoral stems. Sensitivity was 100% for either plain X-ray or DXA. Specificity was 88%, 77% for plain X-ray and DXA respectively. This preliminary study reveals that periprosthetic bone density pattern on transverse histogram on DXA may be useful in the evaluation of the loosening. However, further study will be needed for clinical application

  16. Ultrasound screening and follow-up of congenital hip dislocation

    International Nuclear Information System (INIS)

    Ballerini, G.; Avanzini, A.; Colombo, T.; Micucci, E.

    1990-01-01

    US screening for hip dysplasia was performed on 1421 full-term newborns. The study was aimed at: 1) evaluating US feasibility in an unselected maternity ward population; 2) determining the frequency of the different types of hips, and correlating ours with literature data; 3) evaluating the efficacy of both an early prevention and treatment. All US examination were performed within the first week of life and the 2842 hips classified according to Graf. At birth, normal hips (Ia, Ib) were 2064 (72.6%) (group I); Physiologically immature hips (IIa) were 721 (25.4%) (group II); pathological hips (group III) were: 43 (1.5%) IIc, 8 (o.3%) IId, 6 (0.2%) III. Hips in group B were cheked at 3 months: 502 were normal, 51 were type IIb, and 1 was type IId: the latter 52 hips were treated and normalized in the following months. Hips in group C (types IIc, IId, and III=57 hips) were treated and cheked every seventh week until normalization. Our experience confirm US value in the evaluation of hip dysplasia in the newborn. In our opinion, the use of this method shoul be encouraged, although US screening of all newborns remains controversial on a cost-benefit ratio. Multicentric studies will better define US sensitivity, specificity and reliability. The correlation of ours results with literature data was difficult, because study populations are not always homogeneous. As for therapy, we found the plastic splint very effective and easy to use: In 2 cases, Milgram devices were used for a few months

  17. Physical activity of elderly patients after total hip arthroplasty.

    Science.gov (United States)

    Cukras, Zbigniew; Praczko, Katarzyna; Kostka, Tomasz; Jegier, Anna

    2007-01-01

    Total hip arthroplasty (THA) is the most common method of treatment of severe hip osteoarthritis. There is little data concerning the physical activity of total hip arthroplasty patients in Poland and investigations to explore this area are useful. The aim of the study was to describe the post-operative physical activity of total hip arthroplasty patients. A total of 146 adult people were examined, among which 28 men and 41 women had undergone total hip arthroplasty due to primary osteoarthritis of the hip, while another 32 men and 41 women matched for age who had not undergone hip surgery for osteoarthritis served as controls. The physical activity of study participants was assessed with the 7-Day Physical Activity Recall Questionnaire. All participants were also asked about the type and amount of physical activity they engaged in to maintain good health. Physical activity measured as the total amount of calories expended through physical activity per week was similar in the post-THA patients compared to the controls. The only differences were a smaller amount of calories expended during low-intensity physical activity by men after total hip arthroplasty compared to men who had not undergone surgery for osteoarthritis and a smaller amount of calories expended through high-intensity physical activity by women after total hip arthroplasty compared to female controls. The kinds of recreational physical activity most commonly practised by patients a mean of two years after total hip arthroplasty were marching, bicycling and general body conditioning exercises (usually the continuation of exercises recommended during post-operative rehabilitation). The percentage of post-THA patients undertaking physical activity for the prevention of non-communicable diseases was low. Physical activity should be more effectively encouraged in patients after total hip arthroplasty.

  18. CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2016-01-01

    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

  19. Hip fusion takedown to a total hip arthroplasty-is it worth it? A systematic review.

    Science.gov (United States)

    Jauregui, Julio J; Kim, Joseph K; Shield, William P; Harb, Matthew; Illical, Emmanuel M; Adib, Farshad; Maheshwari, Aditya V

    2017-08-01

    Patients with surgically or spontaneously fused hips are often dissatisfied with their overall function and the debilitating effect on adjacent joints. Therefore, in properly selected patients, hip fusion-takedown and conversion to total hip arthroplasty (THA) can result in improved function and decreased pain. We aimed to (1) evaluate the indications for conversion, (2) evaluate the clinical outcomes, (3) analyze the overall complications, and (4) identify the overall satisfaction following the procedure. A systematic and comprehensive literature search was performed to analyze studies evaluating conversion of hip fusion to THA. After reviewing 3,882 studies, 27 total studies (1,104 hips) met our inclusion/exclusion criteria and were included in our final analysis. A weighted mean of rates was determined for each complication, including infection, instability, loosening, nerve-related, abductor-related, venous thrombotic event, and revision. The study population consisted of 53.2% male and 46.8% female subjects. The mean age at time of conversion was 52 years (range 36-65 years), the mean time until follow-up was 9.2 years (range 2.5-17.3), and the mean duration of arthrodesis was 27.7 years (range 11-40.2). As measured by Harris Hip Score, overall clinical outcomes improved from 58.1 points (range 42.4-70 points) pre-operatively to 80.0 (range 62-93.5) post-operatively. The specific complication rates were 5.3% (range 0-43.6%) for infection, 2.6% (range 0-15.4%) for instability, 6.2% (range 0-17.2%) for loosening, 4.7% (range 0-13%) for nerve-related complications, 13.1% (range 0-87%) for abductor-related complications, and 1.2% (range 0-13%) for venous thrombotic events. The revision rate was 12.0% (range 0-43.6%). Takedown of a fused-hip can be a challenging procedure. Although patients can benefit functionally, both patients and surgeons need to be aware of the complications and increased risk of further revision procedures, which should be an important

  20. Rapid Geriatric Assessment of Hip Fracture.

    Science.gov (United States)

    Zanker, Jesse; Duque, Gustavo

    2017-08-01

    A comprehensive geriatric assessment, combined with a battery of imaging and blood tests, should be able to identify those hip fracture patients who are at higher risk of short- and long-term complications. This comprehensive assessment should be followed by the implementation of a comprehensive multidimensional care plan aimed to prevent negative outcomes in the postoperative period (short and long term), thus assuring a safe and prompt functional recovery while also preventing future falls and fractures. Copyright © 2017 Elsevier Inc. All rights reserved.