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Sample records for hip joint contact

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2009-06-19

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

  3. Hip joint contact forces in normal subjects and subjects with total hip prostheses: walking and stair and ramp negotiation.

    Science.gov (United States)

    Stansfield, B W; Nicol, A C

    2002-02-01

    To calculate the hip joint contact force in normal subjects and subjects with total hip replacements. An observational study of age matched normal subjects and subjects with hip joint replacements. Hip joint contact forces have been calculated using musculo-skeletal models and measured in vivo using instrumented hip prostheses. There are few examples of studies performed on subjects in the 40-60 year age range. This study characterises the forces in both normal subjects and subjects with hip joint replacements for these 'young' subjects. Motion analysis and force plate data were used as input to a three-dimensional model of the leg. Five male and six female normal subjects and five male subjects with hip prostheses were studied. Each subject was observed walking and negotiating stairs and a ramp. Hip joint contact forces in both thigh and pelvic-based co-ordinate systems are presented. Subjects cadence, speed and stride length are given. In general subjects with hip replacements exhibited lower hip joint contact forces than age matched normal subjects. It is suggested that this was the results of the lower speeds, stride lengths and cadences adopted by the subjects with hip replacements. The characterisation of hip joint contact forces provides essential information for prosthetic joint design and testing. The comparison of hip joint contact forces in normal subjects with those in subjects with prosthetic joints provides evidence of, not only actual use of joints, but also of possible levels of force that might be applied to hip prostheses if subjects returned to normal use.

  4. Hip joint contact loads in older adults during recovery from forward loss of balance by stepping.

    Science.gov (United States)

    Graham, David F; Modenese, Luca; Trewartha, Grant; Carty, Christopher P; Constantinou, Maria; Lloyd, David G; Barrett, Rod S

    2016-09-06

    Hip joint contact loads during activities of daily living are not generally considered high enough to cause acute bone or joint injury. However there is some evidence that hip joint loads may be higher in stumble recovery from loss of balance. A common laboratory method used to evaluate balance recovery performance involves suddenly releasing participants from various static forward lean magnitudes (perturbation intensities). Prior studies have shown that when released from the same perturbation intensity, some older adults are able to recover with a single step, whereas others require multiple steps. The main purpose of this study was to use a musculoskeletal model to determine the effect of three balance perturbation intensities and the use of single versus multiple recovery steps on hip joint contact loads during recovery from forward loss of balance in community dwelling older adults (n=76). We also evaluated the association of peak hip contact loads with perturbation intensity, step length and trunk flexion angle at foot contact at each participant׳s maximum recoverable lean angle (MRLA). Peak hip joint contact loads were computed using muscle force estimates obtained using Static Optimisation and increased as lean magnitude was increased and were on average 32% higher for Single Steppers compared to Multiple Steppers. At the MRLA, peak hip contact loads ranged from 4.3 to 12.7 body weights and multiple linear stepwise regression further revealed that initial lean angle, step length and trunk angle at foot contact together explained 27% of the total variance in hip joint contact load. Overall findings indicated that older adults experience peak hip joint contact loads during maximal balance recovery by stepping that in some cases exceeded loads reported to cause mechanical failure of cadaver femurs. While step length and trunk flexion angle are strong predictors of step recovery performance they are at best moderate predictors of peak hip joint loading.

  5. Soft-tissue balance evaluation system for total hip arthroplasty by intraoperative contact pressure measurement at the hip joint.

    Science.gov (United States)

    Otake, Yoshito; Suzuki, Naoki; Hattori, Asaki; Hayashibe, Mitsuhiro; Miki, Hidenobu; Yamamura, Mitsuyoshi; Sugano, Nobuhiko; Yonenobu, Kazuo; Ochi, Takahiro

    2006-01-01

    We developed a system for measurement of contact pressure at the hip joint surfaces that enables checking of the artificial hip joint condition during surgery. First, we constructed the pressure sensor that forms the artificial joint. We installed eight small pressure sensors to the spherical head component, a part of the ball-socket joint. Next, we developed software for recording and visualizing the detected pressures that were recorded every 1 ms. The pressure distribution was displayed with the 3D computer graphics in real-time. The system enabled intuitive recognition of pressure direction 3-dimensions. Next, using the system, we conducted measurements during total hip arthroplasty. Although it requires some improvements in its measurement accuracy, the system allows real-time acquisition of information on the artificial hip joint in real-time. Further improvements of the calibration method should enable more accurate measurements. As a complete system, it will be a useful tool for selecting an appropriate implant that fits a patient's hip joint or for estimating the risk of complications after surgery.

  6. 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

    . The healthy bone in the femoral head of the Perthes’ hip carries additional loads as indicated by the increase of stress levels around the necrotic-healthy bone interface. Identifying the biomechanical changes, such as the location of stress and contact pressure concentrations, is a prerequisite......Perthes’ disease is a destructive hip joint disorder characterized by malformation of the femoral head in young children. While the morphological changes have been widely studied, the biomechanical effects of these changes still need to be further elucidated. The objective of this 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...

  7. Coupling of dynamics and contact mechanics of artificial hip joints in a pendulum model.

    Science.gov (United States)

    Liu, H; Ellison, P J; Xu, H; Jin, Z

    2010-01-01

    To date, fully coupled dynamics and contact mechanics analysis is still limited by expensive computational cost and long computing time and has not been addressed comprehensively, particularly in the hip joint. To understand the influence of different parameters on the biomechanics of the total hip replacement (THR) and improve its design, two numerical approaches were developed and implemented in finite element models to investigate the coupling between the dynamics response and the contact mechanics for three different THR configurations, metal-on-polyethylene (MOP), metal-on-metal (MOM), and ceramic-on-ceramic (COC). The dynamic force and the contact pressure distribution at the bearing surfaces from the two methods were predicted and compared. The influences of various parameters (motion angle, load applied in the pendulum, friction coefficient, geometry, and material properties) were subsequently investigated. From the comparisons, the decoupled method, based on the rigid-body dynamics and the quasi-static elastic contact mechanics, was adequate to predict the performance of the THRs efficiently. The load had the greatest influence on the dynamics/contact mechanics among other factors.

  8. Fluid load support and contact mechanics of hemiarthroplasty in the natural hip joint.

    Science.gov (United States)

    Pawaskar, Sainath Shrikant; Ingham, Eileen; Fisher, John; Jin, Zhongmin

    2011-01-01

    The articular cartilage covering the ends of the bones of diarthrodial synovial joints is thought to have evolved so that the loads are transferred under different and complex conditions, with a very high degree of efficiency and without compromising the structural integrity of the tissue for the life of an individual. These loading conditions stem from different activities such as walking, and standing. The integrity of cartilage may however become compromised due to congenital disease, arthritis or trauma. Hemiarthroplasty is a potentially conservative treatment when only the femoral cartilage is affected as in case of femoral neck fractures. In hemiarthroplasty, a metallic femoral prosthesis is used to articulate against the natural acetabular cartilage. It has also been hypothesized that biphasic lubrication is the predominant mechanism protecting the cartilage through a very high fluid load support which lowers friction. This may be altered due to hemiarthroplasty and have a direct effect on the frictional shear stresses and potentially cartilage degradation and wear. This study modelled nine activities of daily living and investigated the contact mechanics of a hip joint with a hemiarthroplasty, focussing particularly on the role of the fluid phase. It was shown that in most of the activities studied the peak contact stresses and peak fluid pressures were in the superior dome or lateral roof of the acetabulum. Total fluid load support was very high (~90%) in most of the activities which would shield the solid phase from being subjected to very high contact stresses. This was dependent not only on the load magnitude but also the direction and hence on the location of the contact area with respect to the cartilage coverage. Lower fluid load support was found when the contact area was nearer the edges where the fluid drained easily.

  9. Nonarthritic hip joint pain.

    Science.gov (United States)

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

    2014-06-01

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

  10. Effect of an edge at cup rim on contact stress during micro-separation in ceramic-on-ceramic hip joints.

    Science.gov (United States)

    Liu, Feng; Fisher, John

    2017-09-01

    Alumina ceramic total hip joint bearings have shown superior wear properties. The joint bearing may undergo adverse conditions such as micro-separation causing head contact on the cup rim. As a transition, an edge is formed between the cup bearing and the rim. The aim of this study was to predict the effect of the edge on contact stresses in order to better understand the mechanisms of wear. A finite element contact model was developed under the conditions of the head displacements 0.5-2 mm and vertical loads 0.5-3 kN. The edge contact produced the most severe stresses capable of causing elevated wear and damage to ceramic bearings. The study shows that the bearing design should be considered in association with clinical conditions to eliminate severe stress.

  11. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2016-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18-6...

  12. 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

  13. Surgical treatment for young adult hip dysplasia: joint-preserving options

    National Research Council Canada - National Science Library

    Chen, Min; Shang, Xi-Fu

    2016-01-01

    Developmental dysplasia of the hip (DDH) is a spectrum of disorders that results in anatomic abnormalities leading to increased contact stress in the joint and, eventually, secondary osteoarthritis...

  14. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

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

    2014-11-01

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

  15. IMAGING OF HIP JOINT PATHOLOGIES

    Directory of Open Access Journals (Sweden)

    Parul Dutta

    2016-08-01

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

  16. 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.

  17. Ankle and hip postural strategies defined by joint torques

    Science.gov (United States)

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

    1999-01-01

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

  18. Ankle and hip postural strategies defined by joint torques

    Science.gov (United States)

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

    1999-01-01

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

  19. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

    Directory of Open Access Journals (Sweden)

    Maya S. Krastanova

    2015-09-01

    Full Text Available Introduction: In relation to the study reporting the effects of applying phased complex rehabilitation in patients with total hip arthroplasty, it has been concluded that the everyday clinical practice in Bulgaria does not apply complex examination, giving an objective picture about the extent of functional status of patients with trauma and diseases of the hip. Aim: The main goal of this report is to present a test which incorporates all known and routine research and in which the total number of points determines the functional status of patients with trauma and diseases of the hip. Material and Methods: Based on the Hip dysfunction and Osteoarthritis Outcome Score, the Harris Hip Score modified test, scale D’Aubigne and Postel and Iowa’s test for complex functional evaluation of the hip joint, we have developed a test including information about the degree of pain; goniometry and manual muscle testing of the hip; locomotor test – type of gait and adjuvants; test for Daily Activities of Life. The test has been developed on the basis of expert assessment by doctors and physiotherapists of the proposed indicators for evaluation and determination of the weighting factors’ contribution to the general condition of the patient. Conclusion: The developed and tested method of complex functional assessment of the hip joint enables our colleagues, dealing with trauma and diseases of the hip, to use it in various research and scientific projects, as well as in general medical practice.

  20. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Wei YANG; Can-jun YANG‡; Ting XU

    2016-01-01

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

  3. 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

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

    Science.gov (United States)

    2010-04-01

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

  5. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  6. [Immune competence of human tissue lymphocytes in contact with loosened hip joint prostheses. On the topic of cellular or humoral rejection reaction as the mechanism of loosening].

    Science.gov (United States)

    Peters, K M; Löer, F; Hofstädter, F; Casser, H R

    1991-05-01

    In several investigations rejections were accused of being a possible cause for the loosening of hip endoprostheses. Using immunocytochemical techniques we studied the number and type of lymphocytes in the tissue adjacent to loosened hip endoprostheses. Tissue samples were taken from 18 patients being reoperated for a loosened endoprostheses. Impressive lymphocyte infiltrates were found in 4 of 18 patients (22%). These infiltrates only consisted of T-cells. In the other samples only few lymphocytes were detected belonging to T- and B-lymphocyte population, respectively. In our patients T-cell mediated rejections were of minor importance for the loosening of total hip replacement. B-cell accumulations were detected in none of the samples.

  7. Iliacus pyomyositis mimicking septic arthritis of the hip joint.

    Science.gov (United States)

    Chen W-S; Wan Y-L

    1996-01-01

    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  8. 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....

  9. Evaluation of the magnitude of hip joint deformation in subjects with avascular necrosis of the hip joint during walking with and without Scottish Rite orthosis.

    Science.gov (United States)

    Karimi, Mohammad Taghi; Mohammadi, Ali; Ebrahimi, Mohammad Hossein; McGarry, Anthony

    2017-02-01

    The femoral head in subjects with leg calve perthes disease (LCPD) is generally considerably deformed. It is debatable whether this deformation is due to an increase in applied loads, a decrease in bone mineral density or a change in containment of articular surfaces. The aim of this study was to determine the influence of these factors on deformation of the femoral head. Two subjects with LCPD participated in this study. Subject motion and the forces applied on the affected leg were recorded using a motion analysis system (Qualsis(TM)) and a Kistler force plate. OpenSim software was used to determine joint contact force of the hip joint whilst walking with and without a Scottish Rite orthosis. 3D Models of hip joints of both subjects were produced by Mimics software. The deformation of femoral bone was determined by Abaqus. Mean values of the force applied on the leg increased while walking with the orthosis. There was no difference between bone mineral density (BMD) of the femoral bone of normal and LCPD sides (p-value>0.05) and no difference between hip joint contact force of normal and LCPD sides. Hip joint containment appeared to decrease follow the use of the orthosis. It can be concluded that the deformation of femoral head in LCPD may not be due to change in BMD or applied load. Although the Scottish Rite orthosis is used mostly to increase hip joint containment, it appears to reduce hip joint contact area. It is recommended that a similar study is conducted using a higher number of subjects.

  10. Finite element analysis of sliding distance and contact mechanics of hip implant under dynamic walking conditions.

    Science.gov (United States)

    Gao, Yongchang; Jin, Zhongmin; Wang, Ling; Wang, Manyi

    2015-06-01

    An explicit finite element method was developed to predict the dynamic behavior of the contact mechanics for a hip implant under normal walking conditions. Two key parameters of mesh sensitivity and time steps were examined to balance the accuracy and computational cost. Both the maximum contact pressure and accumulated sliding distance showed good agreement with those in the previous studies using the implicit finite element analysis and analytical methods. Therefore, the explicit finite element method could be used to predict the contact pressure and accumulated sliding distance for an artificial hip joint simultaneously in dynamic manner.

  11. Metal-on-metal hip joint tribology.

    Science.gov (United States)

    Dowson, D; Jin, Z M

    2006-02-01

    The basic tribological features of metal-on-metal total hip replacements have been reviewed to facilitate an understanding of the engineering science underpinning the renaissance of these hard-on-hard joints. Metal-on-polymer hip replacements operate in the boundary lubrication regime, thus leading to the design guidance to reduce the femoral head diameter as much as is feasible to minimize frictional torque and volumetric wear. This explains why the gold-standard implant of this form from the past half-century had a diameter of only 22.225 mm (7/8 in). Metal-on-metal implants can operate in the mild mixed lubrication regime in which much of the applied load is supported by elastohydrodynamic films. Correct tribological design leads to remarkably low steady state wear rates. Promotion of the most effective elastohydrodynamic films calls for the largest possible head diameters and the smallest clearances that can reasonably be adopted, consistent with fine surface finishes, good sphericity and minimal structural elastic deformation of the cup on its foundations. This guidance, which is opposite in form to that developed for metal-on-polymer joints, is equally valid for solid (monolithic) metallic heads on metallic femoral stems and surface replacement femoral shells. Laboratory measurements of friction and wear in metal-on-metal joints have confirmed their potential to achieve a very mild form of mixed lubrication. The key lies in the generation of effective elastohydrodynamic lubricating films of adequate thickness compared with the composite roughness of the head and cup. The calculation of the film thickness is by no means easy, but the full procedure is outlined and the use of an empirical formula that displays good agreement with calculations based upon the full numerical solutions is explained. The representation of the lambda ratio, lambda, embracing both film thickness and composite roughness, is described.

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

    OpenAIRE

    2014-01-01

    Backgrounds Non-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future? Methods Material included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children ...

  13. Biomechanical Aspects of Shoulder and Hip Articulations: A Comparison of Two Ball and Socket Joints

    Directory of Open Access Journals (Sweden)

    Mustafa Qusay Ismael

    2006-01-01

    Full Text Available The shoulder and hip joints though essentially both are ball and socket joints, show structural variability to serve functional needs.study aims at revealing some of the structural and functional properties of each of the two joints regarding the factors that contribute to the stability of any joint in the body, namely: bone, ligament, and muscleTwenty dried scapula, hip, humerus, and femur were used. The area of the articular surfaces was estimated by molding a sheet of dental wax. Using special graphics software, a novel procedure was described to calculate the area under the curve, which was postulated to indicate the degree of curvature. Tension test was applied using a testometric machine, which was locally modified to suit biological specimens. A finite element analysis was designed to study the articulating bones under different loading conditionsIn the hip joint, the area of the articular surface of the head of the femur and that of the lunate showed no significant statistical difference. For the shoulder joint, the articular areas of the head of the humerus and the glenoid were statistically different. No statistical significance was observed regarding curvature of the articular surfaces within both the hip and shoulder joints; however, the values were significantly different between the hip and shoulder. In the tension test, the site of rupture of the capsule of the shoulder joint was found to be at its anteroinferior part. The more contact between the area of the cup and ball, as was demonstrated in the hip joint, the more stable the joint. On the contrary, the shoulder articular surfaces have less area of contact, which makes it more mobile and decreases stability. The insignificant difference in curvature within both joints indicates a good congruity and thus more stability especially during joint movement. The curvature difference between the head of femur and the head of humerus indicates that the range of motion is quite

  14. Differential diagnosis of pain around the hip joint.

    Science.gov (United States)

    Tibor, Lisa M; Sekiya, Jon K

    2008-12-01

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

  15. Finite element analysis of mechanical behavior of human dysplastic hip joints: a systematic review.

    Science.gov (United States)

    Vafaeian, B; Zonoobi, D; Mabee, M; Hareendranathan, A R; El-Rich, M; Adeeb, S; Jaremko, J L

    2016-11-09

    Developmental dysplasia of the hip (DDH) is a common condition predisposing to osteoarthritis (OA). Especially since DDH is best identified and treated in infancy before bones ossify, there is surprisingly a near-complete absence of literature examining mechanical behavior of infant dysplastic hips. We sought to identify current practice in finite element modeling (FEM) of DDH, to inform future modeling of infant dysplastic hips. We performed multi-database systematic review using PRISMA criteria. Abstracts (n = 126) fulfilling inclusion criteria were screened for methodological quality, and results were analyzed and summarized for eligible articles (n = 12). The majority of the studies modeled human adult dysplastic hips. Two studies focused on etiology of DDH through simulating mechanobiological growth of prenatal hips; we found no FEM-based studies in infants or children. Finite element models used either patient-specific geometry or idealized average geometry. Diversities in choice of material properties, boundary conditions, and loading scenarios were found in the finite-element models. FEM of adult dysplastic hips demonstrated generally smaller cartilage contact area in dysplastic hips than in normal joints. Contact pressure (CP) may be higher or lower in dysplastic hips depending on joint geometry and mechanical contribution of labrum (Lb). FEM of mechanobiological growth of prenatal hip joints revealed evidence for effects of the joint mechanical environment on formation of coxa valga, asymmetrically shallow acetabulum and malformed femoral head associated with DDH. Future modeling informed by the results of this review may yield valuable insights into optimal treatment of DDH, and into how and why OA develops early in DDH.

  16. 21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... metal/polyacetal cemented prosthesis. 888.3380 Section 888.3380 Food and Drugs FOOD AND DRUG... Devices § 888.3380 Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis is a...

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

    Science.gov (United States)

    2010-04-01

    ... cemented or uncemented prosthesis. 888.3390 Section 888.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 888.3390 Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis is a...

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

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2014-12-01

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

  19. Magnetic suspension hip joint: an ideal design of an artificial joint

    Institute of Scientific and Technical Information of China (English)

    DAI Min; NIE Tao

    2010-01-01

    Background Artificial joints present certain problems such as osteal absorption and lysis induced by wear debris which leads to loosening of the prosthesis over a period of time. Here we propose a design of an artificial magnetic suspension joint that was prepared by integrating the medical theories of modern material science, magnetism, and medical physics.Methods According to clinical characteristic of biological and mechanical for hip joint, we designed the appearance and dimensions of magnetic suspension joint and placed neodymium-iron-boron permanent magnets in the prosthesis.As the same time, we performed mechanical and biological experiments using artificial magnetic suspension hip joints models.Results By simulated the human hip structure and the external load, we discovered the artificial magnetic suspension hip joints models had much lesser amount and size of wear debris than the ceramic/ceramic artificial hip joint prosthesis in friction wear tests. The force between the artificial joints with magnetic materials that we have calculated is feasible for application of artificial joint. The design of artificial magnetic suspension hip joints models was plausible technically and safe biologically.Conclusion Artificial magnetic suspension hip joints may effectively reduce the incidence of the loosening of prosthesis over a period of time.

  20. Bone dynamic study. Evaluation for factor analysis of hip joint

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kotaro; Toyama, Hinako; Ishikawa, Nobuyoshi; Hatakeyama, Rokuro; Akisada, Masayoshi; Miyagawa, Shunpei

    1989-02-01

    Factor analysis was applied to dynamic study of Tc-99m MDP for the evaluation of hip joint disorders. Fifteen patients were examined; eight were normal, six was osteoarthritis in which one accompanied synovitis was included, and one was aseptic necrosis on the head of the femur. In normals, according to the Tc-99m MDP kinetics, three factor images and time-activity curves were obtained which were named as blood vessel, soft tissue, and bone factor images and curves. In the patient with osteoarthritis, increased accumulation of the hip joint was shown in bone factor image only. But in one patient, who took osteoarthritis with synovitis, marked accumulations of the Tc-99m MDP appeared not only on the bone factor image but also on the soft tissue. Operation revealed thickening synovial tissue around the hip joint, caused by inflammatory process. In follow-up studies of the patient with aseptic necrosis on the head of the left femur, exessive accumulations, which were seemed in his left hip joint on both bone and soft tissue factor images at first, were decreased respondently to the treatment of this lesion. In conclusion, the factor analysis was useful for differential diagnosis of the hip joint disorders and observation of the clinical course of the hip joint disorders.

  1. Radiographic parameters of the hip joint from birth to adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Than, P.; Kranicz, J.; Bellyei, A. [Dept. of Orthopaedics, Univ. of Pecs, Medical Faculty, Ifjusag utja (Hungary); Sillinger, T. [Dept. of Orthopaedics, Szt Gyorgy County Hospital, Szekesfehervar (Hungary)

    2004-03-01

    Background: Various qualitative and quantitative radiological geometrical parameters can be of great help when assessing dysplasia of the hip joint and in understanding developmental processes of the infant hip. There are few data on the normal values of the hip joint at different ages. Objective: To perform radiographic measurements on hip joints considered to be anatomically normal and to provide data for each age group, thus describing features of the radiographic development of the hip. Materials and methods: Radiographs were examined from 355 children (age 0-16 years) undergoing examination for scoliosis (long film), urography or plain abdominal radiography. Qualitative and quantitative signs were observed and measured, focusing on the Hilgenreiner, Wiberg and Idelberger angles and the decentric distance. Results: Before the age of 9 years measurable data from neighbouring age groups differed significantly, indicating typical radiological changes of the joint. For the same age range, qualitative changes could also be observed. After 9 years of age, radiological development of the normal hip joint during childhood is much slower. (orig.)

  2. [Real-time sonography of the infant hip joint in the early diagnosis of congenital hip dysplasia].

    Science.gov (United States)

    Casser, H R; Forst, R

    1985-01-01

    The ultrasonic examination of infant hip joint means a great advantage in early diagnosis of congenital hip dysplasia. The sonographic type classification by Graf enables the experienced examiner to make up a differentiated diagnostic-therapeutic concept as early as possible. Therapeutic omissions just as well as exaggerated therapeutic measures can be avoided. Consequently the prognosis of hip joint dysplasia is considerably improved by ultrasonic examination of new-born hip joints.

  3. MRI of the hip joint; MRT des Hueftgelenks

    Energy Technology Data Exchange (ETDEWEB)

    Czerny, C.; Noebauer-Huhmann, I.M.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, Medizinische Univ. Wien (Austria)

    2005-12-01

    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.)

  4. Joint space width in dysplasia of the hip

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K

    2005-01-01

    In a longitudinal case-control study, we followed 81 subjects with dysplasia of the hip and 136 control subjects without dysplasia for ten years assessing radiological evidence of degeneration of the hip at admission and follow-up. There were no cases of subluxation in the group with dysplasia....... Neither subjects with dysplasia nor controls had radiological signs of ongoing degenerative disease at admission. The primary radiological discriminator of degeneration of the hip was a change in the minimum joint space width over time. There were no significant differences between these with dysplasia...... and controls in regard to age, body mass index or occupational exposure to daily repeated lifting at admission.We found no significant differences in the reduction of the joint space width at follow-up between subjects with dysplasia and the control subjects nor in self-reported pain in the hip...

  5. Generation of physiological parameter sets for hip joint motions and loads during daily life activities for application in wear simulators of the artificial hip joint.

    Science.gov (United States)

    Fabry, Christian; Herrmann, Sven; Kaehler, Michael; Klinkenberg, Ernst-Dieter; Woernle, Christoph; Bader, Rainer

    2013-01-01

    At present, wear investigations of total hip replacements are performed in accordance with the ISO standard 14242, which is based on simplified kinematic and force data of the gait cycle. The aim of this analytical study was to generate parameter sets of daily life activities in order to replicate more realistic joint load situations in wear testing. Hence, published in vivo motion and force data of daily life activities were evaluated and adjusted using analytical techniques. The created kinematically and dynamically consistent parameter sets comprised time trajectories of three Cardan angles to describe the motion of the femur with respect to the pelvis and time trajectories of three force components, representing the hip joint contact force. The parameter sets include the activities of walking, knee bending, stair climbing and a combined load case of sitting down and standing up. Additionally, a motion sequence following the frequency of daily life activities was presented. Differences of the evaluated angular motions and joint contact forces in comparison to the ISO standard 14242-1 were pointed out. The results of this study offer the possibility to extend the kinematics and dynamics of the ISO standard test protocol and to support the loading conditions of hip wear simulators with a comprehensive set of motions and loads close to reality.

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

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2014-01-01

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

  7. Chromium Content in the Human Hip Joint Tissues

    Institute of Scientific and Technical Information of China (English)

    Barbara Brodziak-Dopiera; Jerzy Kwapuliski; Krzysztof Sobczyk; Danuta Wiechua

    2015-01-01

    Objective Chromium has many important functions in the human body. For the osseous tissue, its role has not been clearly defined. This study was aimed at determining chromium content in hip joint tissues. Methods A total of 91 hip joint samples were taken in this study, including 66 from females and 25 from males. The sample tissues were separated according to their anatomical parts. The chromium content was determined by the AAS method. The statistical analysis was performed with U Mann-Whitney's non-parametric test, P≤0.05. Results The overall chromium content in tissues of the hip joint in the study subjects was as follows:5.73 µg/g in the articular cartilage, 5.33 µg/g in the cortical bone, 17.86 µg/g in the cancellous bone, 5.95 µg/g in the fragment of the cancellous bone from the intertrochanteric region, and 1.28 µg/g in the joint capsule. The chromium contents were observed in 2 group patients, it was 7.04 µg/g in people with osteoarthritis and 12.59 µg/g in people with fractures. Conclusion The observed chromium content was highest in the cancellous bone and the lowest in the joint capsule. Chromium content was significantly different between the people with hip joint osteoarthritis and the people with femoral neck fractures.

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

    Science.gov (United States)

    Sudula, S N

    2016-05-01

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

  9. Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

    Science.gov (United States)

    Kutzner, Ines; Richter, Anja; Gordt, Katharina; Dymke, Jörn; Damm, Philipp; Duda, Georg N; Günzl, Reiner; Bergmann, Georg

    2017-01-01

    Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee) in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW). Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated individually in the

  10. Radiographic findings in restrained hip joints associated with ACL rupture.

    Science.gov (United States)

    Ellera Gomes, João L; Palma, Humberto Moreira; Becker, Ricardo

    2010-11-01

    Although decreased hip range of motion has been detected in many soccer players with noncontact anterior cruciate ligament (ACL), it is not clear whether it is associated with bone spurs, capsular soft tissue stiffness or both. Our aim was to investigate abnormal radiographic findings in soccer players with limited hip range of motion and noncontact ACL injury. Fifty consecutive male soccer players with restricted hip range of motion and noncontact ACL injury were subjected to radiographic examination to identify bone changes that could be associated with decreased hip range of motion. Of 50 patients, 56% revealed abnormal radiographic findings: pericapsular calcifications or acetabular rim osteophytes (24%), femoral neck deformity (10%), femoral neck and acetabular rim disorders (18%), neck groove caused by impingement (4%). Radiographic evaluation of those individuals showed a high number of bone abnormalities around the hip joint. This was considered to be an important finding to guide a decision-making process between three different approaches: changing the type of sports practiced, undergoing a more restrictive surgery (such as a double-bundle intra-articular reconstruction or an intra plus extra technique) or the onset of a hip-stretching program in addition to the conventional ACL rehabilitation protocol. In this last option, ACL-operated patients without radiographic hip abnormalities may have better outcomes for their decreased hip range of motion when submitted to a stretching program targeting the prevention of rotational overload on the reconstructed intra-articular grafts. The decision-making process concerning soccer players with ACL ruptures should take into consideration the amount of motion-limiting abnormalities around the hip joint.

  11. Synovial hemangioma of the hip joint in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Demertzis, Jennifer L.; Loomans, Rachel; Wessell, Daniel E. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, St. Louis, MO (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopedic Surgery, St. Louis, MO (United States)

    2014-01-15

    Hemangiomas of the articular synovium are rare and commonly associated with recurrent joint swelling and painful limitation of motion. The knee joint is the most commonly involved site, with most patients diagnosed in the second to third decade of life [1]. Although over 200 cases have been reported in the English-language medical literature, only three have originated within the hip joint, all of which were in adult patients reported in the surgical literature [2-4]. We describe a histologically proven synovial hemangioma of the hip joint in a pediatric patient that invaded the femur, acetabulum, and adjacent soft tissues, with a detailed discussion of the differential diagnosis based on the radiographic and magnetic resonance imaging (MRI) findings. (orig.)

  12. Management of acute calcific tendinitis around the hip joint.

    Science.gov (United States)

    Park, Sang-Min; Baek, Ji-Hoon; Ko, Young-Bong; Lee, Han-Jun; Park, Ki Jeong; Ha, Yong-Chan

    2014-11-01

    Although the natural history of calcific tendinitis within the rotator cuff of the shoulder is established, the natural history of calcific tendinitis around the hip joint remains unknown. To examine the duration of symptoms including pain, the location of calcific tendinitis around the hip joint, the radiologic course of calcium phosphate crystals, and the proportion of patients who required surgical treatment. Case series; Level of evidence, 4. Thirty hips (29 patients) with acute calcific tendinitis were treated between January 2010 and December 2012. Level of subjective hip pain using the visual analog scale pain score, radiologic type, and the location and size of calcium deposits were measured during a follow-up period of 12 to 32 months. The 29 patients included 7 men (24%) and 22 women (76%) with a mean age of 51.5 years (range, 28-78 years). All visual analog scale pain scores significantly improved from a mean of 7.1 to 0.8 at the latest follow-up (P 3 months) of severe pain, solid type, and large size (range, 96-416 mm(2)) were treated with arthroscopic excision. Nonoperative treatment in patients with acute calcific tendinitis of the hip joint might be successful in most patients. Surgical treatment is of value for patients experiencing prolonged severe pain, solid type, and large size. © 2014 The Author(s).

  13. Contact areas of the tibiotalar joint.

    Science.gov (United States)

    Windisch, Gunther; Odehnal, Boris; Reimann, Reinhold; Anderhuber, Friedrich; Stachel, Hellmuth

    2007-11-01

    The contact areas between the articular surfaces of the talus and tibia are essential for understanding the mobility of the ankle joint. The purpose of our study was to reveal the contact area among the superior articular surface of the trochlea tali (target surface T) and the inferior articular surface of the tibia (query surface Q) under non-weight-bearing conditions in plantar flexion and dorsiflexion. Twenty cadaveric foot specimens were dissected and scanned by a three-dimensional (3D) laser scanner to obtain data point sets. These point sets were triangulated and a registration procedure performed to avoid any intersection of the two joint surfaces. For all points of the query surface Q, the closest distance to T was measured. In 11 of the 20 ankle joints, the contact area was larger in plantar flexion, in 5 it was nearly of equal size, and in 4 the two surfaces were found in a better congruence in dorsiflexion. The two articular surfaces can be in point or line contact and cause different motions while T is gliding on Q, so the original geometry of ligaments must be carefully reconstructed after injury or during total ankle replacement.

  14. Morphometric analysis of the hip joint in fetuses and neonates.

    Science.gov (United States)

    Kossakowski, Dariusz; Popko, Janusz

    2003-12-30

    Background. Information's about prenatal development of hip joint are necessary for full understanding of it's neonatal abnormalities. Material and methods. Our research was carried out during autopsies on 43 cadavers of 20-40 week old fetuses and 7 cadavers of newborns which died before twelfth week. Observation of development of hip in the second half of the prenatal growth and the neonatal period was based on morphometric analysis. Results and Conclusions. In the hips of 20 to 40 weeks old fetuses, 3 cases of dysplasia were found. Morphometric analysis of hips in this age group, showed very complex developmental processes. The most important of them seems to be the decreasing overlay of acetabulum over femoral head in the last few weeks before the birth. This physiological process is an result of the relative decrease in acetabulum depth and simultaneous faster increase of femoral head diameter in two last weeks of prenatal development.

  15. Bioceramics for Hip Joints: The Physical Chemistry Viewpoint.

    Science.gov (United States)

    Pezzotti, Giuseppe

    2014-06-11

    Which intrinsic biomaterial parameter governs and, if quantitatively monitored, could reveal to us the actual lifetime potential of advanced hip joint bearing materials? An answer to this crucial question is searched for in this paper, which identifies ceramic bearings as the most innovative biomaterials in hip arthroplasty. It is shown that, if in vivo exposures comparable to human lifetimes are actually searched for, then fundamental issues should lie in the physical chemistry aspects of biomaterial surfaces. Besides searching for improvements in the phenomenological response of biomaterials to engineering protocols, hip joint components should also be designed to satisfy precise stability requirements in the stoichiometric behavior of their surfaces when exposed to extreme chemical and micromechanical conditions. New spectroscopic protocols have enabled us to visualize surface stoichiometry at the molecular scale, which is shown to be the key for assessing bioceramics with elongated lifetimes with respect to the primitive alumina biomaterials used in the past.

  16. Bioceramics for Hip Joints: The Physical Chemistry Viewpoint

    Directory of Open Access Journals (Sweden)

    Giuseppe Pezzotti

    2014-06-01

    Full Text Available Which intrinsic biomaterial parameter governs and, if quantitatively monitored, could reveal to us the actual lifetime potential of advanced hip joint bearing materials? An answer to this crucial question is searched for in this paper, which identifies ceramic bearings as the most innovative biomaterials in hip arthroplasty. It is shown that, if in vivo exposures comparable to human lifetimes are actually searched for, then fundamental issues should lie in the physical chemistry aspects of biomaterial surfaces. Besides searching for improvements in the phenomenological response of biomaterials to engineering protocols, hip joint components should also be designed to satisfy precise stability requirements in the stoichiometric behavior of their surfaces when exposed to extreme chemical and micromechanical conditions. New spectroscopic protocols have enabled us to visualize surface stoichiometry at the molecular scale, which is shown to be the key for assessing bioceramics with elongated lifetimes with respect to the primitive alumina biomaterials used in the past.

  17. Hip-spine syndrome: A cadaveric analysis between osteoarthritis of the lumbar spine and hip joints.

    Science.gov (United States)

    Weinberg, D S; Gebhart, J J; Liu, R W

    2017-09-01

    Authors have recently proposed the concept of "hip-spine syndrome", however there exists limited evidence available to differentiate whether these concomitant arthritides are due to anatomic/structural causes, or systemic/metabolic effects. Exploring this relationship has important implications during the evaluation and treatment of both spine and hip disorders-a common clinical presentation of many patients. The purpose of this experiment was to investigate the individual contribution of hip arthritis towards the development of spine arthritis, with knee arthritis also being analyzed as a negative (systemic) control. Hip and spine arthritis are caused by both metabolic and anatomic causes. A large, well-organized osteological database was queried, and osteoarthritis of the spine, hip, and knee joints was quantified using a validated scoring criteria. Six hundred and twenty-five specimens were chosen for analysis. Multivariate linear regression models were created to quantify the independent contributions of age, gender, race, height, and arthritis of the spine and hip joints. Age was the strongest predictor of arthritis at each site (standardized betas>0.281, P<0.001 for all). Hip arthritis was a stronger predictor of spine arthritis than was knee arthritis (standardized betas 0.215 and 0.155, respectively, P<0.001 for both). Spine arthritis was also a stronger predictor of hip arthritis than was knee arthritis (standardized betas 0.232 and 0.173, P<0.001 for both). Anatomic/structural influences about the lumbosacral-pelvic junction contribute towards the development of arthritis that is separate from any systemic/metabolic effects. Surgeons performing total hip arthroplasty should remain aware of these relationships, although future research is necessary regarding optimal surgical treatment of these patients. N/A (cadaveric study). Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. The prevalence of predisposing deformity in osteoarthritic hip joints

    DEFF Research Database (Denmark)

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

    2011-01-01

    It is becoming increasingly evident that hip joint deformities may be major contributors to the development of osteoarthritis, and the term 'idiopathic osteoarthritis' may be inappropriate in many cases. Our study cohort was derived from the Copenhagen Osteoarthritis Sub-study, a cross sectional ...

  19. Reconstruction of the hip joint in children after septic coxitis

    Directory of Open Access Journals (Sweden)

    Михаил Павлович Тепленький

    2016-06-01

    Full Text Available Background.Surgical treatment of destructive dislocations is problematic, and controversial. Treatment options range from active monitoring to complex multistage reconstruction protocols.Materials and methods.The results of treatment of 17 children with disruptive dislocation of the hip (class IV according to the Choi classification are presented. The mean age at which treatment was started was 6.3 ± 0.5 years (range: 3-9 years. Treatment strategies included formation of the weight-bearing contact of the proximal femur and acetabulum and ilium osteotomy using an Ilizarov frame. The follow-up period lasted from 2 to 11 years. Clinical results were assessed using Colton’s criteria. Assessment of the radiology findings included the anatomy relations and congruence of the articular surfaces. The patients were divided into two groups, according to age, for data analysis.Results.The majority (88% of the children had positive anatomical and functional outcomes. The functional results were good (12-15 points, satisfactory (9-11 points, and unsatisfactory (8 points for 3, 5, and 1, respectively, among 3-6 year olds and 2, 6, and 0, respectively, among 7-9 year olds. The distribution of joint congruence types I, III, and IV was 2, 4, and 3, respectively, in the younger group and 1, 6, and 1, respectively, in the older group.Conclusion.The use of reconstructive surgery using the Ilizarov apparatus in children with a defect of the proximal femur creates conditions for the adaptation of incongruent articular components without causing decompensation of the joint.

  20. 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) p...

  1. the Hip Joint Affected by Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Anetta Zioła-Frankowska

    2015-01-01

    Full Text Available The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers, alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol, and gender (higher Cu, Zn, and Ni concentrations in men. The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb. There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity.

  2. The ligaments of the canine hip joint revisited.

    Science.gov (United States)

    Casteleyn, C; den Ouden, I; Coopman, F; Verhoeven, G; Van Cruchten, S; Van Ginneken, C; Van Ryssen, B; Simoens, P

    2015-12-01

    Numerous conventional anatomical textbooks describe the canine hip joint, but many contradictions, in particular regarding the ligament of the femoral head, are present. This paper presents a brief overview of the different literature descriptions. These are compared with own observations that have resulted in a revised description of the anatomy of the ligament of the femoral head in the dog. To this purpose, the hip joints of 41 dogs, euthanized for reasons not related to this study and devoid of lesions related to hip joint pathology, were examined. It was observed that the ligament of the femoral head is not a single structure that attaches only to the acetabular fossa, as generally accepted, but it also connects to the transverse acetabular ligament and is complemented by a strong accessory ligament that courses in caudal direction to attach in the elongation of the acetabular notch that extends on the cranioventral surface of the body of the ischium. The description of this accessory ligament in conventional anatomical handbooks is incomplete. This description of the accessory ligament of the femoral head could support the research unravelling the etiopathogenesis of hip instability.

  3. Prediction of hip joint load and translation using musculoskeletal modelling with force-dependent kinematics and experimental validation.

    Science.gov (United States)

    Zhang, Xuan; Chen, Zhenxian; Wang, Ling; Yang, Wenjian; Li, Dichen; Jin, Zhongmin

    2015-07-01

    Musculoskeletal lower limb models are widely used to predict the resultant contact force in the hip joint as a non-invasive alternative to instrumented implants. Previous musculoskeletal models based on rigid body assumptions treated the hip joint as an ideal sphere with only three rotational degrees of freedom. An musculoskeletal model that considered force-dependent kinematics with three additional translational degrees of freedom was developed and validated in this study by comparing it with a previous experimental measurement. A 32-mm femoral head against a polyethylene cup was considered in the musculoskeletal model for calculating the contact forces. The changes in the main modelling parameters were found to have little influence on the hip joint forces (relative deviation of peak value kinematics approach underestimated the maximum hip contact force by a mean value of 6.68 ± 1.75% BW compared with the experimental measurements. The predicted maximum translations of the hip joint centres were 0.125 ± 0.03 mm in level walking and 0.123 ± 0.005 mm in climbing stairs.

  4. Risk factors for renal dysfunction after total hip joint replacement

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Sahlström, Arne; Dessau, Ram Benny Christian

    2015-01-01

    BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surgery......, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum...... creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors....

  5. Accelerated Degenerative Joint Disease After Staged Hip Arthroscopy and Periacetabular Osteotomy in a Patient with Hip Dysplasia.

    Science.gov (United States)

    Guss, Michael; Youm, Thomas

    2017-05-01

    Hip dysplasia, when significant, is effectively treated with periacetabular osteotomy. There have been good results reported with hip arthroscopy when dysplasia is mild. However, when dysplasia is significant, hip arthroscopy with labral repair alone has led to poor results and even rapid decline to end stage arthritis. Staged hip arthroscopy and periacetabular osteotomy would potentially treat the labral lesion and correct the underlying bony abnormality that resulted in the labral pathology. Such a staged treatment plan should help prevent progression to degenerative joint disease. We report a case of a 33-year-old woman who presented with left hip pain and was diagnosed with mild hip dysplasia and a labral tear. She underwent staged hip arthroscopy and labral repair followed by periacetabular osteotomy 2 weeks later. Three and a half months after surgery she developed constant pain and began limping at 5 months. Radiographs showed progression to severe degenerative joint disease. The patient was indicated for total hip arthroplasty.

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

    Science.gov (United States)

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

    2016-05-01

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

  7. Calculation of wear (f.i. wear modulus) in the plastic cup of a hip joint prosthesis

    NARCIS (Netherlands)

    Ligterink, D.J.

    1975-01-01

    The wear equation is applied to the wear process in a hip joint prosthesis and a wear modulus is defined. The sliding distance, wear modulus, wear volume, wear area, contact angle and the maximum normal stress were calculated and the theoretical calculations applied to test results. During the wear

  8. Increasing risk of prosthetic joint infection after total hip arthroplasty

    DEFF Research Database (Denmark)

    Dale, Håvard; Fenstad, Anne M; Hallan, Geir;

    2012-01-01

    Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA....

  9. Stereographic processing of CT figures in the hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Tomihara, Mitsuo (Kinki Univ., Osakasayama, Osaka (Japan). School of Medicine)

    1990-12-01

    CT scan is widely used in orthopedic examinations. By three-dimentional display of the form of bone and joint, the change of form can be identified and the lesion can be located. CT figures were stereographically processed using a personal computer to display the images of the hip joints. The outlines of the bone seen on the CT film were directly traced with a digitizer, then the A/D converted coordinate data were obtained. The data for each slice were input to the personal computer. After conversion to normal coordinate and magnification, the data were filed on the floppy disc. These data were regained from the disk and made affin transformation to display the stereographic images of the hip joints. In a case of solitary bone cyst of the coxal bone, this method helped us to decide the appropriated surgical approach. For the congenital dysplasia of the hip, acetabular coverage was examined three-dimensionally and postoperative changes were assessed in the cases of shelf operation and intertrochanteric extension osteotomy. In the cases of aseptic necrosis of the femoral head, location and size of the necrotic area were clearly visualized and the appropriate surgical procedure could be decided. Moreover, it was useful to decide the degree of rotation of the femoral head in rotational osteotomy. (author) 61 refs.

  10. 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.)

  11. 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.

  12. In Vivo Verification of Different Hip Joint Center Estimation Methods in Gait Analysis For Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Abdollah YOUSEFI

    2015-01-01

    Full Text Available Hip joint is one of the most stable joints in human body. It has intrinsic stability provided by its relatively rigid ball and socket configuration. The hip joint also has a wide range of motion, which allows normal locomotion and daily activities. Location of hip joint center (HJC is an important parameter in gait analysis, biomechanical and clinical research laboratories to calculate human lower extremity kinematics and kinetics. Inaccuracies in estimation of hip joint center are shown to propagate errors in kinematic and kinetic calculations of lower extremities

  13. The role of MRI in early ankylosing spondylitis: emphasis on the sacroiliac and hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Min; Kang, Moo Song; Kim, Chang Soo; Chung, Chun Phil [Maryknoll Hospital, Busan (Korea, Republic of)

    1995-05-15

    In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. Authors evaluated 11 cases (36 joints; SIJ 14 hip 22) confirmed as ankylosing spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its signal intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts, osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement of pannus. MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip 9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases.

  14. Hip and knee joint kinematics during a diagonal jump landing in anterior cruciate ligament reconstructed females.

    Science.gov (United States)

    Delahunt, Eamonn; Prendiville, Anna; Sweeney, Lauren; Chawke, Mark; Kelleher, Judy; Patterson, Matt; Murphy, Katie

    2012-08-01

    Anterior cruciate ligament (ACL) injury is a common injury encountered by sport medicine clinicians. Surgical reconstruction is the recommended treatment of choice for those athletes wishing to return to full-contact sports participation and for sports requiring multi-directional movement patterns. The aim of ACL reconstruction is to restore knee joint mechanical stability such that the athlete can return to sporting participation. However, knowledge regarding the extent to which lower limb kinematic profiles are restored following ACL reconstruction is limited. In the present study the hip and knee joint kinematic profiles of 13 ACL reconstructed (ACL-R) and 16 non-injured control subjects were investigated during the performance of a diagonal jump landing task. The ACL-R group exhibited significantly less peak knee joint flexion (P=0.01). Significant between group differences were noted for time averaged hip joint sagittal plane (Pjoint frontal plane (Phip and knee joint kinematic profiles are present following ACL reconstruction, which could influence future injury risk.

  15. Regional material properties of the human hip joint capsule ligaments.

    Science.gov (United States)

    Hewitt, J; Guilak, F; Glisson, R; Vail, T P

    2001-05-01

    The hip joint capsule functions to constrain translation between the femur and acetabulum while allowing rotational and planar movements. Despite the crucial role it plays in the pathogenesis of hip instability, little is known about its biomechanical properties. The goal of this study was to determine the regional material properties of the iliofemoral and ischiofemoral ligaments of the capsule. Ten human cadaveric specimens of each ligament were tested to failure in tension. The stress at failure, strain at failure, strain energy density at failure, toe- and linear-region elastic moduli, and the Poisson's ratio were measured for each ligament. The strain to failure was greatest in the ischiofemoral ligament, while no significant difference was noted in failure stress by region or ligament. The Young's moduli of elasticity ranged from 76.1 to 285.8 MPa among the different ligaments, and were generally consistent with properties previously reported for the shoulder capsule. The elastic moduli and strain energy density at failure differed by region. No significant differences in Poisson's ratio were found by region or ligament. The average Poisson's ratio was approximately 1.4, consistent with anisotropic behavior of ligamentous tissues. Understanding the material properties of the hip capsule may help the orthopaedic surgeon better understand normal ligament function, and thereby choose a surgical approach or strategy of repair. Furthermore, knowledge of the normal mechanical function of the hip capsule ligaments could assist in the evaluation of the success of a repair.

  16. Rapidly destructive osteoarthritis of the hip joint: a case series

    Directory of Open Access Journals (Sweden)

    McMurtrie A

    2008-01-01

    Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.

  17. Giant rheumatoid synovial cyst of the hip joint: diagnosed by MRI.

    Directory of Open Access Journals (Sweden)

    Patkar D

    1999-10-01

    Full Text Available Synovial cysts are commonly found in the knee joint. Hip Joint is an infrequent site for formation of synovial cysts. The features of a large, synovial cyst on magnetic resonance imaging, occurring in the hip joint, are described.

  18. [Minimally invasive approaches to hip and knee joints for total joint replacement].

    Science.gov (United States)

    Rittmeister, M; König, D P; Eysel, P; Kerschbaumer, F

    2004-11-01

    The manuscript features the different minimally invasive approaches to the hip for joint replacement. These include medial, anterior, anterolateral, and posterior approaches. The concept of minimally invasive hip arthroplasty makes sense if it is an integral part of a larger concept to lower postoperative morbidity. Besides minimal soft tissue trauma, this concept involves preoperative patient education, preemptive analgesia, and postoperative physiotherapy. It is our belief that minimal incision techniques for the hip are not suited for all patients and all surgeons. The different minimally invasive approaches to the knee joint for implantation of a knee arthroplasty are described and discussed. There have been no studies published yet that fulfill EBM criteria. The data so far show that minimally invasive approaches and implantation techniques for total knee replacements lead to quicker rehabilitation of patients.

  19. Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

    NARCIS (Netherlands)

    Stolk, J.; Verdonschot, N.J.J.; Huiskes, R.

    2001-01-01

    Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-cl

  20. STRUCTURAL ANALYSIS OF ARTICULAR CARTILAGE OF THE HIP JOINT USING FINITE ELEMENT METHOD

    Directory of Open Access Journals (Sweden)

    Robert Karpiński

    2016-09-01

    Full Text Available The paper presents the results of a preliminary study on the structural analysis of the hip joint, taking into account changes in the mechanical properties of the articular cartilage of the joint. Studies have been made due to the need to determine the tension distribution occurring in the cartilage of the human hip. These distribution are the starting point for designing custom made human hip prosthesis. Basic anatomy, biomechanical analysis of the hip joint and articular cartilage are introduced. The mechanical analysis of the hip joint model is conducted. Final results of analysis are presented. Main conclusions of the study are: the capability of absorbing loads by articular cartilage of the hip joint is preliminary determined as decreasing with increasing degenerations of the cartilage and with age of a patient. Without further information on changes of cartilage’s mechanical parameters in time it is hard to determine the nature of relation between mentioned capability and these parameters.

  1. Friction in total hip joint prosthesis measured in vivo during walking.

    Directory of Open Access Journals (Sweden)

    Philipp Damm

    Full Text Available Friction-induced moments and subsequent cup loosening can be the reason for total hip joint replacement failure. The aim of this study was to measure the in vivo contact forces and friction moments during walking. Instrumented hip implants with Al2O3 ceramic head and an XPE inlay were used. In vivo measurements were taken 3 months post operatively in 8 subjects. The coefficient of friction was calculated in 3D throughout the whole gait cycle, and average values of the friction-induced power dissipation in the joint were determined. On average, peak contact forces of 248% of the bodyweight and peak friction moments of 0.26% bodyweight times meter were determined. However, contact forces and friction moments varied greatly between individuals. The friction moment increased during the extension phase of the joint. The average coefficient of friction also increased during this period, from 0.04 (0.03 to 0.06 at contralateral toe off to 0.06 (0.04 to 0.08 at contralateral heel strike. During the flexion phase, the coefficient of friction increased further to 0.14 (0.09 to 0.23 at toe off. The average friction-induced power throughout the whole gait cycle was 2.3 W (1.4 W to 3.8 W. Although more parameters than only the synovia determine the friction, the wide ranges of friction coefficients and power dissipation indicate that the lubricating properties of synovia are individually very different. However, such differences may also exist in natural joints and may influence the progression of arthrosis. Furthermore, subjects with very high power dissipation may be at risk of thermally induced implant loosening. The large increase of the friction coefficient during each step could be caused by the synovia being squeezed out under load.

  2. [Surgical access routes to the hip joint in the elderly].

    Science.gov (United States)

    Nogler, M; Thaler, M

    2017-01-01

    There are a large number of different approaches to the hip joint. Several conventional and minimally invasive portals exist and numerous technical variations with different instrument sets are available. All approaches can be regarded as standard and can be utilized lege artis. The main differences between approaches are their potential to preserve muscles and avoid damage which would slow down rehabilitation and mobilization. In the elderly the preservation of abductor function is, in the authors' opinion, of utmost importance. A well-functioning gluteal system provides a limp-free gait, supports joint stability and reduces the probability of dislocations. The direct anterior approach has some advantages; however, minimally invasive approaches should be used with care. Surgical experience, experience with a specific approach and the availability of specialized instruments as well as sufficient training are mandatory for a successful performance. A surgeon should always choose the approach with which he has most experience.

  3. Steroid-associated hip joint collapse in bipedal emus.

    Directory of Open Access Journals (Sweden)

    Li-Zhen Zheng

    Full Text Available In this study we established a bipedal animal model of steroid-associated hip joint collapse in emus for testing potential treatment protocols to be developed for prevention of steroid-associated joint collapse in preclinical settings. Five adult male emus were treated with a steroid-associated osteonecrosis (SAON induction protocol using combination of pulsed lipopolysaccharide (LPS and methylprednisolone (MPS. Additional three emus were used as normal control. Post-induction, emu gait was observed, magnetic resonance imaging (MRI was performed, and blood was collected for routine examination, including testing blood coagulation and lipid metabolism. Emus were sacrificed at week 24 post-induction, bilateral femora were collected for micro-computed tomography (micro-CT and histological analysis. Asymmetric limping gait and abnormal MRI signals were found in steroid-treated emus. SAON was found in all emus with a joint collapse incidence of 70%. The percentage of neutrophils (Neut % and parameters on lipid metabolism significantly increased after induction. Micro-CT revealed structure deterioration of subchondral trabecular bone. Histomorphometry showed larger fat cell fraction and size, thinning of subchondral plate and cartilage layer, smaller osteoblast perimeter percentage and less blood vessels distributed at collapsed region in SAON group as compared with the normal controls. Scanning electron microscope (SEM showed poor mineral matrix and more osteo-lacunae outline in the collapsed region in SAON group. The combination of pulsed LPS and MPS developed in the current study was safe and effective to induce SAON and deterioration of subchondral bone in bipedal emus with subsequent femoral head collapse, a typical clinical feature observed in patients under pulsed steroid treatment. In conclusion, bipedal emus could be used as an effective preclinical experimental model to evaluate potential treatment protocols to be developed for prevention of

  4. Multidrug resistant Acinetobacter baumannii reaches a new frontier: prosthetic hip joint infection.

    Science.gov (United States)

    Hischebeth, G T R; Wimmer, M D; Molitor, E; Seifert, H; Gravius, S; Bekeredjian-Ding, I

    2015-02-01

    Acinetobacter baumannii is an emerging nosocomial pathogen primarily in countries with a high prevalence of multidrug resistance. Here we report the detection of a bla OXA23 carbapenemase-producing A. baumannii strain in a German patient with prosthetic hip joint infection following several hip joint surgeries but no history of foreign travel.

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

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3350 Section 888.3350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a hip joint. The device...

  6. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3300 Section 888.3300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal constrained cemented or uncemented prosthesis is a device intended to be implanted to replace a hip joint. The...

  7. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3340 Section 888.3340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/composite semi-constrained cemented prosthesis is a two-part device intended to be implanted to replace...

  8. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3310 Section 888.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted...

  9. Is there a risk of permanent renal dysfunction after primary total hip and knee joint replacements?

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Dessau, Ram Benny; Sahlström, Arne

    2016-01-01

    primary total hip and knee joint replacements. METHODS: Long-term postoperative renal dysfunction was analyzed in a retrospective study of 1301 consecutive primary total hip and knee joint replacements performed between January 2009 and December 2013. According to the RIFLE criteria, increased serum...

  10. In Vivo Measurement of Glenohumeral Joint Contact Patterns

    Science.gov (United States)

    Bey, Michael J.; Kline, Stephanie K.; Zauel, Roger; Kolowich, Patricia A.; Lock, Terrence R.

    2009-12-01

    The objectives of this study were to describe a technique for measuring in-vivo glenohumeral joint contact patterns during dynamic activities and to demonstrate application of this technique. The experimental technique calculated joint contact patterns by combining CT-based 3D bone models with joint motion data that were accurately measured from biplane x-ray images. Joint contact patterns were calculated for the repaired and contralateral shoulders of 20 patients who had undergone rotator cuff repair. Significant differences in joint contact patterns were detected due to abduction angle and shoulder condition (i.e., repaired versus contralateral). Abduction angle had a significant effect on the superior/inferior contact center position, with the average joint contact center of the repaired shoulder 12.1% higher on the glenoid than the contralateral shoulder. This technique provides clinically relevant information by calculating in-vivo joint contact patterns during dynamic conditions and overcomes many limitations associated with conventional techniques for quantifying joint mechanics.

  11. In Vivo Measurement of Glenohumeral Joint Contact Patterns

    Directory of Open Access Journals (Sweden)

    Bey MichaelJ

    2010-01-01

    Full Text Available The objectives of this study were to describe a technique for measuring in-vivo glenohumeral joint contact patterns during dynamic activities and to demonstrate application of this technique. The experimental technique calculated joint contact patterns by combining CT-based 3D bone models with joint motion data that were accurately measured from biplane x-ray images. Joint contact patterns were calculated for the repaired and contralateral shoulders of 20 patients who had undergone rotator cuff repair. Significant differences in joint contact patterns were detected due to abduction angle and shoulder condition (i.e., repaired versus contralateral. Abduction angle had a significant effect on the superior/inferior contact center position, with the average joint contact center of the repaired shoulder 12.1% higher on the glenoid than the contralateral shoulder. This technique provides clinically relevant information by calculating in-vivo joint contact patterns during dynamic conditions and overcomes many limitations associated with conventional techniques for quantifying joint mechanics.

  12. Effect of progressive wear on the contact mechanics of hip replacements--does the realistic surface profile matter?

    Science.gov (United States)

    Wang, Ling; Yang, Wenjian; Peng, Xifeng; Li, Dichen; Dong, Shuangpeng; Zhang, Shu; Zhu, Jinyu; Jin, Zhongmin

    2015-04-13

    The contact mechanics of artificial metal-on-polyethylene hip joints are believed to affect the lubrication, wear and friction of the articulating surfaces and may lead to the joint loosening. Finite element analysis has been widely used for contact mechanics studies and good agreements have been achieved with current experimental data; however, most studies were carried out with idealist spherical geometries of the hip prostheses rather than the realistic worn surfaces, either for simplification reason or lacking of worn surface profile. In this study, the worn surfaces of the samples from various stages of hip simulator testing (0 to 5 million cycles) were reconstructed as solid models and were applied in the contact mechanics study. The simulator testing results suggested that the center of the head has various departure value from that of the cup and the value of the departure varies with progressively increased wear. This finding was adopted into the finite element study for better evaluation accuracy. Results indicated that the realistic model provided different evaluation from that of the ideal spherical model. Moreover, with the progressively increased wear, large increase of the contact pressure (from 12 to 31 MPa) was predicted on the articulating surface, and the predicted maximum von Mises stress was increased from 7.47 to 13.26 MPa, indicating the marked effect of the worn surface profiles on the contact mechanics of the joint. This study seeks to emphasize the importance of realistic worn surface profile of the acetabular cup especially following large wear volume. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Joint awareness in osteoarthritis of the hip and knee evaluated with the 'Forgotten Joint' Score before and after joint replacement.

    Science.gov (United States)

    Thienpont, E; Vanden Berghe, A; Schwab, P E; Forthomme, J P; Cornu, O

    2016-10-01

    To utilize the 'Forgotten Joint' Score (FJS), a 12-item questionnaire analysing the ability to forget the joint, for comparing preoperative status in osteoarthritic patients scheduled for total hip arthroplasty (THA) or total knee arthroplasty (TKA). Higher scores represent a better result with a maximum of 100. The hypothesis of this study was that a preoperative difference in favour of hip arthritis could eventually explain why THA is cited more often as a forgotten joint than TKA. A prospective cohort study was conducted in 150 patients with either tricompartmental knee (n = 75) or hip osteoarthritis (n = 75). Patients completed FJS-12 scores preoperatively and 1 year postoperatively. A similar preoperative FJS-12 was observed for hip (22 (15)) and knee osteoarthritis (24 (17)) (n.s.). The postoperative FJS-12 score was significantly higher for THA (80 (24)) than for TKA (70 (27)) (p forgotten'. The preoperative FJS-12 Score is a powerful tool to provide patients with clearer insights into their positive evolution after surgery. The use of the FJS-12 in THA is a topic for further research, as this study found that floor and ceiling effects limit its usefulness in studies evaluating clinical outcome in this area. II.

  14. Validity of summing painful joint sites to assess joint-pain comorbidity in hip or knee osteoarthritis

    NARCIS (Netherlands)

    Siemons, Liseth; Klooster, ten Peter M.; Laar, van de Mart A.F.J.; Ende, van den Cornelia H.M.; Hoogeboom, Thomas J.

    2013-01-01

    BACKGROUND: Previous studies in patients with hip and knee osteoarthritis (OA) have advocated the relevance of assessing the number of painful joint sites, other than the primary affected joint, in both research and clinical practice. However, it is unclear whether joint-pain comorbidities can simpl

  15. Surrogate Modeling of Deformable Joint Contact using Artificial Neural Networks

    Science.gov (United States)

    Eskinazi, Ilan; Fregly, Benjamin J.

    2016-01-01

    Deformable joint contact models can be used to estimate loading conditions for cartilage-cartilage, implant-implant, human-orthotic, and foot-ground interactions. However, contact evaluations are often so expensive computationally that they can be prohibitive for simulations or optimizations requiring thousands or even millions of contact evaluations. To overcome this limitation, we developed a novel surrogate contact modeling method based on artificial neural networks (ANNs). The method uses special sampling techniques to gather input-output data points from an original (slow) contact model in multiple domains of input space, where each domain represents a different physical situation likely to be encountered. For each contact force and torque output by the original contact model, a multi-layer feed-forward ANN is defined, trained, and incorporated into a surrogate contact model. As an evaluation problem, we created an ANN-based surrogate contact model of an artificial tibiofemoral joint using over 75,000 evaluations of a fine-grid elastic foundation (EF) contact model. The surrogate contact model computed contact forces and torques about 1000 times faster than a less accurate coarse grid EF contact model. Furthermore, the surrogate contact model was seven times more accurate than the coarse grid EF contact model within the input domain of a walking motion. For larger input domains, the surrogate contact model showed the expected trend of increasing error with increasing domain size. In addition, the surrogate contact model was able to identify out-of-contact situations with high accuracy. Computational contact models created using our proposed ANN approach may remove an important computational bottleneck from musculoskeletal simulations or optimizations incorporating deformable joint contact models. PMID:26220591

  16. Rotational abnormalities of the hip joint; Rotationsfehler des Hueftgelenks

    Energy Technology Data Exchange (ETDEWEB)

    Tschauner, C.; Hofmann, S. [Orthopaedische Abteilung des Allgemeinen und Orthopaedischen, Landeskrankenhauses, Stolzalpe (Austria); Fock, C.M. [Abt. Radiologie, Landeskrankenhaus Wagna (Austria); Raith, J. [Universitaetsklinik fuer Radiologie und Zentralroentgeninstitut, Graz (Austria)

    2002-06-01

    Changes or limitations of the rotational range of motion of the hip are a non-specific clinical sign. There is a big variety of underlying morphological pathologies resulting in a symptomatic alteration of hip rotation. They need to be assessed by imaging techniques: based on plain radiographs (including specialized projections), often CT or MRI are necessary to visualize the underlying changes of shape, rotation and offset of the articulating surfaces, which might result in a painful ''femoroacetabular impingement'' as a trigger of secondary osteoarthritis. Highly sophisticated MR-arthrography-protocols are able to visualize conventionally ''obscure'' but biomechanically relevant morphological changes, that might be individually normalized by joint-preserving corrective surgery. (orig.) [German] Der Rotationsfehler des Hueftgelenks ist ein klinisches Symptom. Dieses klinische Symptom ist vieldeutig, denn es koennen ihm die vielfaeltigsten pathomorphologischen Veraenderungen, sei es einzeln, sei es in Kombination, zugrunde liegen. Wenn die klinische Symptomatik Schmerzen und/oder Veraenderungen der Rotationsfaehigkeit aufweist, muss eine eingehende bildgebende Analyse der zugrundeliegenden Formveraenderungen durchgefuehrt werden. Beginnend mit dem Nativroentgen (einschliesslich spezieller Projektionen) als Basisdiagnostik kann heute neben der CT und der konventionellen MRT insbesondere die Magnetresonanzarthrographie in differenzierter Technik versteckte Baufehler sichtbar und damit einer gelenkerhaltend-korrektiven orthopaedisch-chirurgischen Therapie zugaenglich machen. (orig.)

  17. Chicano Hip-Hop as Interethnic Contact Zone

    Science.gov (United States)

    McFarland, Pancho

    2008-01-01

    The critical study of rap music and hip-hop culture has the potential to expand Americans understanding of race and culture in the United States. Hip-hop culture as a multiracial, multiethnic phenomenon reveals the ways in which race relations over the past thirty years have become increasingly complex. The theories and concepts that they use to…

  18. [Development of the normal infantile hip joints assessed by MRI].

    Science.gov (United States)

    Wierusz-Kozłowska, M; Ziemiański, A; Kruczyński, J; Borkowski, W

    2000-01-01

    The paper provides an overview of the time of appearance of the secondary ossification centers and closure of the growth plates of the acetabulum and proximal epiphysis of the femur: the triradiate cartilage, the acetabular roof growth cartilage, the subcapital growth cartilage, the growth cartilage of the major trochanter, the growth cartilage of the minor trochanter. The study is based upon 62 MRI scans of healthy hips in 45 patients aged 3-21. The examined hips showed no pathologic traits--neither in the MRI scan nor in X-ray investigation. In Spin Echo and Turbo Spin Echo sequential imaging all obtained slices were used, on GRADIENT ECHO: FISP 3D, FLASH 2D, and FLASH 3D FAT SAT only chosen slices were included in the study. This way the following results were obtained: the ossification center of the major trochanter appears at the age of 3 in girls and at the age of 6 in boys, while the ossification center of the minor trochanter appears at the age of 6 in both sexes. The times of complete ossification of following growth cartilages were observed: for the triradiate cartilage ossification was observed at age 12-15 in girls and 15-16 in boys; for the cartilage of the acetabular roof ossification was noted at age 12-15 in girls and 15-18 in boys; ossification in the subcapital growth cartilage occurred at age 15-17 in girls and 16-18 in boys; the major trochanter growth cartilage ossifies at age 15-16 in girls and 16-18 in boys; for the minor trochanter ossification of the growth cartilage occurs at age 14-16 in girls and at age 16-18 in boys. The secondary ossification center of the pubic bone appears at age 9-11 in girls and 13-16 in boys and the secondary ossification center of the acetabular roof appears at age 13-17 in girls and boys. This study expand our knowledge on the development of the hip joint and facilitate the assessment of hip pathology.

  19. Traumatic Posterior Urethral Fistula to the Hip Joint Following Gunshot Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Ghasemi-Rad

    2010-05-01

    Full Text Available Introduction: Fistula of the Urinary system to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury."nCase Presentation: A 37-year-old man was shot with firearm to the superior part of the right pelvis. He underwent delayed reconstruction surgery for urethral rupture. After 10 months of initial injury, he presented with inability to urinate, and history of progressive pain in the right hip joint accompanied by low-grade fever, which started two months after the initial injury. In retrograde urethrography and antegrade cystography, a 5 cm-long stricture and a fistula tract to the right hip joint were detected. Hip x-ray showed evidence of acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty."nConclusion: Hip joint contamination with urine following urethro-acetabular fistula may lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should have these fistulas in mind as a complication of penetrating urethral injury; every attempt should be made for their early diagnosis and prompt treatment should be performed to prevent further complications."nKeywords: Urethral Fistula, Hip Joint, Gunshot Injury, Urethro-Acetabular Fistula, Trauma    

  20. Differences in hip-knee joint coupling during gait after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Gribbin, Timothy C; Slater, Lindsay V; Herb, C Collin; Hart, Joseph M; Chapman, Ryan M; Hertel, Jay; Kuenze, Christopher M

    2016-02-01

    After anterior cruciate ligament injury, patients have increased risk for developing degenerative osteoarthritis, potentially due to the kinematic changes that persist after surgical reconstruction. Current research only describes single joint kinematic differences rather than the way in which two joints behave concurrently, termed joint coupling. The purpose of this study was to compare knee motion relative to hip motion in anterior cruciate ligament reconstructed and healthy limbs during walking and jogging. Thirty-seven recreationally active volunteers (22 reconstructed, 15 healthy) walked and jogged at 4.83 km/h and 9.66 km/h respectively. Vector coding methods were used to calculate stride-to-stride variability, magnitude, and vector angle of 6 joint couples during walking and jogging: hip frontal-knee frontal planes, hip frontal-knee sagittal, hip frontal-knee transverse, hip sagittal-knee frontal, hip sagittal-knee transverse, and hip transverse-knee frontal planes. The hip sagittal-knee frontal and hip sagittal-knee transverse joint couples had decreased variability during mid-stance, and all other couples had increased variability during the stance phase in the reconstructed group. The reconstructed group had decreased magnitude of joint excursion in the hip frontal-knee sagittal couple during all phases of gait during walking. Vector angles of the hip frontal-knee transverse couple increased in the reconstructed group during the loading, middle, and terminal stance phases, and swing phase of gait during walking. The increased variability and decreased magnitude of joint excursion indicate that movement patterns were less consistent during walking gait despite employing a more constrained system during movement in the reconstructed limb compared to healthy controls. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Wear and deformation of ceramic-on-polyethylene total hip replacements with joint laxity and swing phase microseparation.

    Science.gov (United States)

    Williams, S; Butterfield, M; Stewart, T; Ingham, E; Stone, M; Fisher, J

    2003-01-01

    Wear of polyethylene and the resulting wear debris-induced osteolysis remains a major cause of long-term failure in artificial hip joints. There is interest in understanding engineering and clinical conditions that influence wear rates. Fluoroscopic studies have shown separation of the head and the cup during the swing phase of walking due to joint laxity. In ceramic-on-ceramic hips, joint laxity and microseparation, which leads to contact of the head on the superior rim of the cup, has led to localized damage and increased wear in vivo and in vitro. The aim of this study was to investigate the influence of joint laxity and microseparation on the wear of ceramic on polyethylene artificial hip joints in an in vitro simulator. Microseparation during the swing phase of the walking cycle produced contact of the ceramic head on the rim of the polyethylene acetabular cup that deformed the softer polyethylene cup. No damage to the alumina ceramic femoral head was found. Under standard simulator conditions the volume change of the moderately crosslinked polyethylene cups was 25.6 +/- 5.3 mm3/million cycles and this reduced to 5.6 +/- 4.2 mm3/million cycles under microseparation conditions. Testing under microseparation conditions caused the rim of the polyethylene cup to deform locally, possibly due to creep, and the volume change of the polyethylene cup when the head relocated was substantially reduced, possibly due to improved lubrication. Joint laxity may be caused by poor soft tissue tension or migration and subsidence of components. In ceramic-on-polyethylene acetabular cups wear was decreased with a small degree of joint laxity, while in contrast in hard-on-hard alumina bearings, microseparation accelerated wear. These findings may have significant implications for the choice of fixation systems to be used for different types of bearing couples.

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

    Science.gov (United States)

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

    2016-07-01

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

  3. Clarification on Mechanical Characteristic in State of Stress of Osteoarthritis of the Hip Joint Using Stress Freezing Method

    Science.gov (United States)

    Maezaki, Nobutaka; Ezumi, Tsutomu; Hachiya, Masashi

    In this research, the Osteoarthritis of Hip Joint was pick up, the 3-dimensional stress freezing method of photoelastic method was applied, and the state of the stress in the normality hip joint and the transformable hip joint was examined. The direction and the singular point of principal stress and stress distribution were experimentally examined. At result, The Osteoarthritis of Hip Joint touches by 2 points, Osteoarthritis of Hip Joint occurrence of the new singular point with flat of the femoral head, They change the direction of the principal stress line in an existing singular point is cause.

  4. Effects of hip joint position and intra-capsular volume on hip joint intra-capsular pressure: a human cadaveric model

    Directory of Open Access Journals (Sweden)

    Tse Paul

    2009-04-01

    Full Text Available Abstract Background Increase in hip intra-capsular pressure has been implicated in various hip pathologies, such as avascular necrosis complicating undisplaced femoral neck fracture. Our study aimed at documenting the relationship between intra-capsular volume and pressure in various hip positions. Methods Fifty-two cadaveric hips were studied. An electronic pressure-monitoring catheter recorded the intra-capsular hip pressure after each instillation of 2 ml of normal saline and in six hip positions. Results In neutral hip position, the control position for investigation, intra-capsular pressure remained unchanged when its content was below 10 ml. Thereafter, it increased exponentially. When the intra-capsular volume was 12 ml, full abduction produced a 2.1-fold increase (p = 0.028 of the intra-capsular hip joint pressure; full external rotation and full internal rotation increased the pressure by at least 4-fold (p Conclusion Intra-capsular pressure increases with its volume, but with a wide variation with different positions. It would be appropriate to recommend that hips with haemarthrosis or effusion should be positioned in 45-degree flexion.

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

    Science.gov (United States)

    Tateuchi, Hiroshige; Shiratori, Sakiko; Ichihashi, Noriaki

    2015-02-01

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

  6. [Short- and medium-term effectivenesses of stemless hip arthroplasty for treating hip joint disease in young and middle-aged patients].

    Science.gov (United States)

    Chen, Qingzhen; Liu, Wuyang; Gao, Hui; Shi, Mingxiang; Lian, Yucai

    2014-09-01

    To summarize the short- and medium-term effectivenesses of stemless hip arthroplasty for treating hip joint disease in young and middle-aged patients. Between June 2005 and December 2010, 25 cases (27 hips) of hip joint disease were treated with stemless hip arthroplasty. There were 17 males (19 hips) and 8 females (8 hips) with an average age of 45.6 years (range, 30-57 years), including 13 left hips, 10 right hips, and 2 bilateral hips. The causes included avascular necrosis of the femoral head (ANFH) secondary to femoral neck fracture in 5 cases (5 hips), ANFH in 15 cases (16 hips), osteoarthritis of the hip joint caused by ankylosing spondylitis in 2 cases (3 hips), osteoarthritis of the hip joint caused by dysplasia of acetabular in 2 cases (2 hips), and rheumatoid arthritis in 1 case (1 hip). The disease duration was 1-17 years (mean, 6.1 years). Before operation, the Harris score was 47.6 ± 14.2. The incision healed by first intention in all patients, and no complications occurred, such as infection, periprosthetic fracture, and deep vein thrombosis of lower extremity. Twenty-five patients (27 hips) were followed up 36-96 months (mean, 51 months). One case (1 hip) had sciatic nerve injury after operation, which was relieved by symptomatic treatment. One case (1 hip) had prosthesis loosening, which was relieved after revision. The survival rate of prosthesis was 96.3% (26/27). At last follow-up, the Harris score was 92.1 ± 3.6, which was significantly better than preoperative score (t = 18.241, P = 0.000). The excellent and good rate was 88.9% (excellent in 19 hips, good in 5 hips, fair in 2 hips, and poor in 1 hip). The X-ray films showed good location of prosthesis, and no evidence of dislocation, bone resorption, osteolysis, and heterotopic ossification. Because of reserving femoral neck, biomechanics conduction and distribute of the proximal femur achieve natural biomechanics state of the human body. The short- and medium-term effectivenesses of

  7. Cartilage contact pressure elevations in dysplastic hips: a chronic overload model

    Directory of Open Access Journals (Sweden)

    Grosland Nicole M

    2006-10-01

    Full Text Available Abstract Background Developmental dysplasia of the hip (DDH is a condition in which bone growth irregularities subject articular cartilage to higher mechanical stresses, increase susceptibility to subluxation, and elevate the risk of early osteoarthritis. Study objectives were to calculate three-dimensional cartilage contact stresses and to examine increases of accumulated pressure exposure over a gait cycle that may initiate the osteoarthritic process in the human hip, in the absence of trauma or surgical intervention. Methods Patient-specific, non-linear, contact finite element models, constructed from computed tomography arthrograms using a custom-built meshing program, were subjected to normal gait cycle loads. Results Peak contact pressures for dysplastic and asymptomatic hips ranged from 3.56 – 9.88 MPa. Spatially discriminatory cumulative contact pressures ranged from 2.45 – 6.62 MPa per gait cycle. Chronic over-pressure doses, for 2 million cycles per year over 20 years, ranged from 0.463 – 5.85 MPa-years using a 2-MPa damage threshold. Conclusion There were significant differences between the normal control and the asymptomatic hips, and a trend towards significance between the asymptomatic and symptomatic hips of patients afflicted with developmental dysplasia of the hip. The magnitudes of peak cumulative contact pressure differed between apposed articular surfaces. Bone irregularities caused localized pressure elevations and an upward trend between chronic over-pressure exposure and increasing Severin classification.

  8. Manubriosternal joint dislocation in contact sport.

    Science.gov (United States)

    Smith, M; Lenehan, B; O'Keefe, D; Martin, A

    2001-11-01

    A 17 year old man developed chest pain and shortness of breath immediately after a scrummage while playing rugby football. A lateral chest radiograph showed a dislocated manubriosternal joint, with no associated injuries. This has not been previously reported in a sporting setting. This injury should be considered in flexion-compression injury of the thorax.

  9. [Geometry of the hip joint: methodology and guidelines].

    Science.gov (United States)

    Gaspar, Drago; Crnković, Tomislav

    2013-03-01

    An hip fracture is an significant personal, family and health issue of people older than 65 years. In the first year of the fracture up to 30% of the injured die and about 50% of them never regain their formal degree of independence in fulfilling day-to-day activities. Estimations are that throughout 30 years in the world there will be around 6 million hip fractures per year which is about four times the todays amount. Todays predictions of hip fractures based on the hip geometry have shown us that the hip geometry is an independent variable of the bone mineral density. The hip geometry is more resistant to the effect of various factors than the bone mineral density and the changes throu life are a lot slower. The uniqueness and the sensitivity of the hip geometry in predicting a fracture is high and acceptable in research results of most authors. In this review we present the previous relevant knowledge about the measures and factors which determines the hip geometry and the accepted amount of pictorial methods of hip display. We have compared the methodology and the patients of eleven randomly picked writings on predicting hip fracture based on the hip geometry. We highlight the need of further refinement of the methodology and the more balanced selection of patients for a greater conformity in future writings. The hip geometry has shown it self as an useful diagnostical instrument but there is still more room for its improvement.

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

    Directory of Open Access Journals (Sweden)

    K C Geoffrey Ng

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

  11. Kinematic relationship between rotation of lumbar spine and hip joints during golf swing in professional golfers.

    Science.gov (United States)

    Mun, Frederick; Suh, Seung Woo; Park, Hyun-Joon; Choi, Ahnryul

    2015-05-14

    Understanding the kinematics of the lumbar spine and hip joints during a golf swing is a basic step for identifying swing-specific factors associated with low back pain. The objective of this study was to examine the kinematic relationship between rotational movement of the lumbar spine and hip joints during a golf swing. Fifteen professional golfers participated in this study with employment of six infrared cameras to record their golf swings. Anatomical reference system of the upper torso, pelvis and thigh segments, and the location of each hip and knee joint were defined by the protocols of the kinematic model of previous studies. Lumbar spine and hip joint rotational angle was calculated utilizing the Euler angle method. Cross-correlation and angle-angle plot was used to examine the degree of kinematic relationship between joints. A fairly strong coupling relationship was shown between the lumbar spine and hip rotational movements with an average correlation of 0.81. Leading hip contribution to overall rotation was markedly high in the early stage of the downswing, while the lumbar spine contributed greater towards the end of the downswing; however, the relative contributions of the trailing hip and lumbar spine were nearly equal during the entire downswing. Most of the professional golfers participated in this study used a similar coordination strategy when moving their hips and lumbar spine during golf swings. The rotation of hips was observed to be more efficient in producing the overall rotation during the downswing when compared to the backswing. These results provide quantitative information to better understand the lumbar spine and hip joint kinematic characteristics of professional golfers. This study will have great potential to be used as a normal control data for the comparison with kinematic information among golfers with low back pain and for further investigation of golf swing-specific factors associated with injury.

  12. Validation of the diagnosis 'prosthetic joint infection' in the Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Pedersen, A B; Schønheyder, HC;

    2016-01-01

    AIMS: The purpose of this study was to validate the diagnosis of periprosthetic joint infection (PJI) in the Danish Hip Arthroplasty Register (DHR). PATIENTS AND METHODS: We identified a cohort of patients from the DHR who had undergone primary total hip arthroplasty (THA) since 1 January 2005 an...

  13. The morphology and functions of the muscles around the hip joint after a unilateral transfemoral amputation

    NARCIS (Netherlands)

    Jaegers, Sonja Maria Héléne José

    1993-01-01

    This dissertation is concerned with the consequences of a transfemoral amputation for the morphology and functions of the muscles around the hip joint. Knowledge about and insight into the changes appearing in the morphology and functions of the hip muscles of transfemoral amputees are important to

  14. The morphology and functions of the muscles around the hip joint after a unilateral transfemoral amputation

    NARCIS (Netherlands)

    Jaegers, Sonja Maria Héléne José

    1993-01-01

    This dissertation is concerned with the consequences of a transfemoral amputation for the morphology and functions of the muscles around the hip joint. Knowledge about and insight into the changes appearing in the morphology and functions of the hip muscles of transfemoral amputees are important to

  15. Acute bursitis calcarea trochanterica in an infant, with perforation into the hip joint demonstrated by arthrogram.

    Science.gov (United States)

    Stenström, R; Gripenberg, L

    1978-04-10

    A case of bursitis calcarea trochanterica acuta is reported in a boy aged four months. The calcification was amorphous, and arthrography revealed extension into the hip joint. The lesion was treated surgically.

  16. What happens at the adjacent knee joint after total hip arthroplasty of Crowe type III and IV dysplastic hips?

    Science.gov (United States)

    Kilicarslan, Kasim; Yalcin, Nadir; Cicek, Hakan; Cila, Erdal; Yildirim, Hasan

    2012-02-01

    We prospectively evaluated 30 hips of 22 patients who had normal knees with a mean age of 53.4 years (range, 38-72 years). In the early postoperative period, genu valgum deformity was observed in all knees. Of 22 patients, 17 complained of severe pain owing to strain in the medial collateral ligament and iliotibial tract. Postoperatively, the ipsilateral extremities of the patients were extended by a mean of 16.5 mm (8-25 mm). Q angles of the patients increased by a mean of 4.4° ± 2.5° (P hip scores were improved (40.7-87.8 points), postoperative Lysholm-Gillquist knee scores were significantly reduced (92-76 points, P hips into the anatomical hip center and lengthening the extremity despite shortening procedure may lead to strain at the knee joint iatrogenically, particularly with the mechanical effect of tensor fascia lata, which results with changes in the knee biomechanics.

  17. Reverse engineering of pelvic bone for hip joint replacement.

    Science.gov (United States)

    Popov, I; Onuh, S O

    2009-01-01

    Research into fabrication of hip joint replacements combines knowledge from distinct domains, such as engineering, materials and medical fields. Recent computer assisted technologies have played an important role in the medical field. Unlike the modelling of most of the human bones, the creation of an accurate 3D model of a pelvic bone has been a challenging task. The main source of difficulties in this case has proven to be the complexity of the structure of the pelvis, having basically a free-form shape with a hole in the middle constituting some over-shadowed areas (undercuts), various cavities, areas with high form curvature, variable wall thickness with some very thin sections and inside layers with different mechanical properties. In this research work, a pelvic bone is generated using reverse engineering, rapid prototyping and rapid tooling techniques. The geometric data obtained from reverse engineering through laser scanning are used and manipulated to create accurate 3D CAD representations of these devices. These CAD models can be used for various virtual tests and simulations, as well as for reproduction through rapid manufacturing processes and then used as prototypes in tooling, physical tests and planning of surgical operations.

  18. Medial Translation of the Hip Joint Center Associated with the Bernese Periacetabular Osteotomy

    Science.gov (United States)

    Clohisy, John C; Barrett, Susan E; Gordon, J Eric; Delgado, Eliana D; Schoenecker, Perry L

    2004-01-01

    This study assessed medial translation of the hip joint achieved by the Bernese periacetabular osteotomy (PAO) in correcting residual acetabular dysplasia deformities. 86 hips in 75 patients with an average age of 25 years (range, 12-50) were treated for symptomatic acetabular dysplasia with a periacetabular osteotomy. Radiographic analysis was performed to assess correction of the acetabular deformity with specific attention to the horizontal position of the hip joint center. All hips were followed until bony union of the iliac osteotomy and the average follow-up was 28 months. The lateral center edge angle improved an average 31.6° (-0.4° preoperative, 31.2° at follow-up). Anterior center edge angle improved 39.3° (-4.5° to 34.8°). The acetabular roof obliquity improved an average 21.8° (25.1° to 3.3°). Preoperatively, the average distance from the medial aspect of the femoral head to the ilioischial line was 17.6 mm. This distance was decreased to an average 7.8 mm postoperatively. This change resulted in an average medial translation of the hip joint center of 9.8 mm, (range -6 to 31mm). Overall, some degree of medial translation of the hip joint center was obtained in 79 (92%) of the hips. 4 (5%) were maintained in the same horizontal position, and 3 (3%) had slight lateral repositioning. For the hips translated medially, the average change was 10.0 mm, and 72% of all hips had an optimal correction with the distance between the medial aspect of the femoral head and the ilioischial line being between 0 and 10 mm. This study demonstrates that in addition to optimizing femoral head coverage, a major and distinct advantage of the periacetabular osteotomy is reproducible and consistent medial translation of the hip joint center. PMID:15296205

  19. Changes of the hip joints associated with chronic subluxation and dislocation: CT and plain radiography analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ik; Ryu, Kyung Nam; Lee, Sun Wha; Choi, Woo Suk; Lee, Eil Seong [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1993-05-15

    Secondary osteoarthritis of the hip joint is a common disease and is frequently followed by chronic subluxation and dislocation. Twenty four cases of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the osteoarthritis and calcification of the acetabular labrum, 2) the thickness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.

  20. System for intraoperative evaluation of soft-tissue-generated forces during total hip arthroplasty by measurement of the pressure distribution in artificial joints.

    Science.gov (United States)

    Otake, Yoshito; Suzuki, Naoki; Hattori, Asaki; Miki, Hidenobu; Yamamura, Mitsuyoshi; Yonenobu, Kazuo; Ochi, Takahiro; Sugano, Nobuhiko

    2007-01-01

    A system for evaluating the soft-tissue-generated forces at the hip joint was developed. The system enabled measurement of contact pressure distribution at hip joint surfaces, as well as evaluation of the artificial hip joint condition during total hip arthroplasty (THA). First, a pressure sensor module that forms part of the artificial joint was constructed. Eight small pressure sensors were installed in the spherical head component of the ball-and-socket joint. Next, software for recording and visualizing the detected pressures at 1-millisecond intervals was developed. The pressure distribution was displayed in real time via 3D computer graphics on a monitor. The system enabled intuitive recognition of the direction of soft-tissue-generated forces and pressure distribution in three dimensions. Accuracy tests were conducted using a high-accuracy 6-degree-of-freedom positioning device and digital force gauge. The error between the applied loads and measured forces was 3.42 +/- 3.26 N (mean +/- standard deviation) for each coordinate in 10 trials involving load application from 10 different directions. Next, a clinical evaluation was conducted during THA. The relative positions of the cup and stem component were measured using a surgical navigation system simultaneously with the pressure measurement. The system allowed real-time acquisition of information regarding the artificial hip joint, as well as comparison of the differences in the hip condition when several types of neck were used. Further improvements to the calibration method should enable more accurate measurements. We believe this system will be a useful tool for selecting an appropriate implant that fits a patient's hip joint or for estimating the risk of complications following surgery.

  1. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph; Krauspe, Ruediger; Bittersohl, Bernd [University of Duesseldorf, Medical Faculty, Department of Orthopedic Surgery, Duesseldorf (Germany); Tiderius, Carl Johann [Lund University Hospital, Department of Orthopedic Surgery, Lund (Sweden)

    2015-08-15

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms ''cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC'', considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. (orig.)

  2. Muscle Strength Imbalance in the Hip Joint Caused by Fast Movements

    Science.gov (United States)

    Pontaga, I.

    2003-07-01

    Eleven male sportsmen at the age of 24.3 ± 4.5 were examined. Their hip joint flexors and extensors were tested by an "REV-9000" Technogym dynamometer system during isokinetic movements at angular velocities of 100 (low) and 200 (high) °/s. The range of hip joint movements was from 30 (in flexion) to 130° (in extension). Torque values and their ratios for hip flexors and extensors at different angular positions were obtained and compared. It is shown that, at high speeds, the flexion movement significantly raises ( p muscles at fast movements.

  3. Accumulation velocity of /sup 99m/Tc-HMDP in hip joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Torizumi, Kazutami; Aibata, Hirofumi; Kiji, Shigeyuki; Ueyoshi, Akitaka; Kiura, Yoshifumi; Okamoto, Yukiharu; Tuda, Tadaaki; Ota, Kiichiro

    1988-07-01

    The accumulation rate and velocity of /sup 99m/Tc-hydroxymethylene diphosphonate (/sup 99m/Tc-HMDP) in hip joints were determined within four minutes after a bolus of injection of /sup 99m/Tc-HMDP in the patients with hip joint disorders. There exist a significant relationship between accumulation velocity of /sup 99m/Tc-HMDP in the affected joint and serum osteocalcin in the patients with eight cases of degenerative osteoarthropathy and six cases of femoral necrosis. This result indicates that the accumulation velocithy of /sup 99m/Tc-HMDP in the affected joint is likely to become a marker of bone turnover in hip joint disorder.

  4. Experimentally reduced hip abductor function during walking: Implications for knee joint loads

    DEFF Research Database (Denmark)

    Henriksen, Marius; Aaboe, Jens; Simonsen, Erik B;

    2009-01-01

    muscle was significantly reduced by pain (-39.6%). All other muscles were unaffected. Peaks in the frontal plane hip and knee joint moments were significantly reduced during pain (-6.4% and -4.2%, respectively). Lateral trunk lean angles and midstance hip joint adduction and knee joint extension angles......-dimensional trunk and lower extremity joint kinematics and kinetics. Surface electromyography (EMG) of the glutei, quadriceps, and hamstring muscles were also measured. The peak GM EMG activity had temporal concurrence with peaks in frontal plane moments at both hip and knee joints. The EMG activity in the GM...... were reduced by 1 degrees . Thus, the gait changes were primarily caused by reduced GM function. Walking with impaired GM muscle function due to pain significantly reduced the external knee adduction moment. This study challenge the notion that reduced GM function due to pain would lead to increased...

  5. A Biomimetic Hip Joint Simulator and its Application in in vitro Study of the Integrity of Replacement Cemented Hip

    Institute of Scientific and Technical Information of China (English)

    Liu Chao-zong; S.M.Green; N.D.Watkins; A.W.McCaskie

    2005-01-01

    A biomimetic hip joint simulator that can be used to evaluate the outcome of the cemented total hip replacement has been designed, manufactured and evaluated. The simulator produces motion in the extension/flexion plane, with a socket to rotate internal/externally. At the same time a dynamic loading cycle is applied. A validation test was performed on a cemented femoral stem within a novel composite femur. The bone quality has a strong effect on the stem migration and on the integrity of the interfaces. The migration of the stem is a combination of 3-D translation and rotation of the stem. Under the same loading conditions, weak bone allows more stem migration than strong bone. There is a great decrease in the strength of the stem-cement interface after the dynamic test, and the weak bone composite exhibited a greater reduction in interfacial strength than the strong bone composite. The decrease of the interfacial strength indicates that the primary bonding between the stem and the cement mantle had deteriorated and the integrity of stem-cement interface was damaged.The study demonstrates the value of using a hip joint simulator to investigate stem migration and interface integrity within the cemented hip replacement, suggesting that method can be used for in vitro evaluation of the biomaterials used in the cemented hip replacements.

  6. The effect of resistance exercise direction for hip joint stabilization on lateral abdominal muscle thickness

    Science.gov (United States)

    Jung, Ju-Hyeon; Lee, Sang-Yeol

    2016-01-01

    The aim of this study was to determine the effects of resistance direction in hip joint stabilization exercise on change in lateral abdominal muscle thickness in healthy adults. Twenty-six healthy adults were randomly allocated to either a hip stabilization exercise by hip straight resistance group (n=12) or a hip diagonal resistance group (n=14). The outcome measures included contraction thickness ratio in transversus abdominis (TrA), internal oblique (IO) and external oblique, and TrA lateral slide were assessed during the abdominal drawing-in maneuver by b-mode ultrasound. The researcher measured the abdominal muscle thickness of each participant before the therapist began the intervention and at the moment intervention was applied. There was a significant difference in lateral abdominal muscle thickness between the straight resistance exercise of hip joint group and the diagonal resistance exercise of hip joint group. Significant differences were found between the two groups in the percentage of change of muscle thickness of the TrA (P=0.018) and in the thickness ratio of the TrA (P=0.018). Stability exercise accompanied by diagonal resistance on the hip joint that was applied in this study can induce automatic contraction of the IO and TrA, which provides stability to the lumbar spine. PMID:27807520

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Boniatis, I; Costaridou, L; Panayiotakis, G [University of Patras, School of Medicine, Department of Medical Physics, 265 00 Patras (Greece); Panagiotopoulos, E [University of Patras, School of Medicine, Department of Orthopaedics, 265 00 Patras (Greece)], E-mail: panayiot@upatras.gr

    2009-08-15

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

  9. Explanations pertaining to the hip joint flexor moment during the stance phase of human walking.

    Science.gov (United States)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild ί; Larsen, Peter K; Alkjær, Tine; Dyhre-Poulsen, Poul

    2012-11-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different positions: normal, inclined and reclined. Net joint moments were calculated about the hip, knee and ankle joint. The peak hip joint flexor moment during late stance was significantly lower during inclined walking than in the two other conditions. During normal walking the iliacus muscle showed no or very weak activity and first at the transition from stance to swing. When walking reclined, a clear but rather low activity level of the iliacus muscle was seen in the first half of the stance phase, which could contribute to the hip moment. In the inclined condition the iliacus showed much increased activity but only in the swing phase. It is concluded that the hip flexor moment in question is largely generated by passive structures in the form of ligaments resisting hip joint extension.

  10. [A review of diagnosis and causes of synovial cyst of the hip joint].

    Science.gov (United States)

    Wang, Li-Feng; Xu, San-Zhong; Lin, Xiang-Jin

    2010-04-01

    To analyze the clinical and radiological characteristics of hip joint synovial cyst, and to study the main causes and the early economical effective ways for diagnosis. Twenty-five patients with hip joint synovial cyst were studied in this research, including 16 males and 9 females aged from 14 to 76 with an average age of 52.8 years old (4 cases from clinical treatment from 1999 to 2007; 1 case searched with keyword "synovial cyst" and "hip" on CNKI form 1978 to 2002, 20 cases searched with keyword synovial cyst and hip on the Medline. The clinical manifestation of 25 cases were painless mass at medial of groin middle point and lower limb venous insufficiency. Synovial cysts of the hip joint were diagnosed by ultrasonography, computer tomography (CT) or nuclear magnetic resonance (MRI). All cases were analyzed retrospectively on the cause of a diseace, clinical features and radiological examinations. The possible causes of this disease included rheumatoid arthritis in 8 cases, osteoarthritis in 1, total hip replacement in 3, hip tramatic in 3, femoral head necrosis in 2 and unknown origin in 9. The main clinical features included painless groin mass in 9 cases; compression of the common femoral and external iliac veins (lead to outflow obstruction and leg swelling) in 7 cases; inguinal swelling in 5 cases; deep vein thrombosis (DVT) in 3 cases; compression of artery in 1 case. The correct preoperative diagnosis were made by ultrasonography or combined with colour duplex Doppler ultrasonography (CDDS) in 13 cases; CDDS combined with CT in 8 cases; CDDS combined with CT and MRI in 2 cases; articular cavity visualization in 1 case; puncture herniography in 1 case. The hip joint synovial cyst is mainly caused by the chronic inflammation of the hip joint. As the disease is extremely rare and asymptomatically, precise diagnoses are difficult and and often delayed. More attentions should be paid because of its severe complications. CDDS is an economical effective way for

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

    Science.gov (United States)

    Ali, Murat; Mao, Ken

    2014-01-01

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

  12. Joint space width in dysplasia of the hip

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K;

    2005-01-01

    In a longitudinal case-control study, we followed 81 subjects with dysplasia of the hip and 136 control subjects without dysplasia for ten years assessing radiological evidence of degeneration of the hip at admission and follow-up. There were no cases of subluxation in the group with dysplasia. N...

  13. Using a surrogate contact pair to evaluate polyethylene wear in prosthetic knee joints.

    Science.gov (United States)

    Sanders, Anthony P; Lockard, Carly A; Weisenburger, Joel N; Haider, Hani; Raeymaekers, Bart

    2016-01-01

    With recent improvements to the properties of ultra-high molecular weight polyethylene (UHMWPE) used in joint replacements, prosthetic knee and hip longevity may extend beyond two decades. However, it is difficult and costly to replicate such a long in vivo lifetime using clinically relevant in vitro wear testing approaches such as walking gait joint simulators. We advance a wear test intermediate in complexity between pin-on-disk and knee joint simulator tests. The test uses a surrogate contact pair, consisting of a surrogate femoral and tibial specimen that replicate the contact mechanics of any full-scale knee condyle contact pair. The method is implemented in a standard multi-directional pin-on-disk wear test machine, and we demonstrate its application via a two-million-cycle wear test of three different UHMWPE formulations. Further, we demonstrate the use of digital photography and image processing to accurately quantify fatigue damage based on the reduced transmission of light through a damage area in a UHMWPE specimen. The surrogate contact pairs replicate the knee condyle contact areas within -3% to +12%. The gravimetric wear test results reflect the dose of crosslinking radiation applied to the UHMWPE: 35 kGy yielded a wear rate of 7.4 mg/Mcycles, 55 kGy yielded 1.0 mg/Mcycles, and 75 kGy (applied to a 0.1% vitamin E stabilized UHMWPE) yielded 1.5 mg/Mcycles. A precursor to spalling fatigue is observed and precisely measured in the radiation-sterilized (35 kGy) and aged UHMWPE specimen. The presented techniques can be used to evaluate the high-cycle fatigue performance of arbitrary knee condyle contact pairs under design-specific contact stresses, using existing wear test machines. This makes the techniques more economical and well-suited to standardized comparative testing.

  14. Range of joint motion and disability in patients with osteoarthritis of the knee or hip.

    NARCIS (Netherlands)

    Steultjens, M.P.M.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    2000-01-01

    OBJECTIVE: To establish the relationships between the range of joint motion (ROM) and disability in patients with osteoarthritis (OA) of the knee or hip. Two related issues were addressed: (1) the inter-relationships between ROMs of joint actions, and (2) the relationship between ROM and disability.

  15. Estimation of Human Hip and Knee Multi-Joint Dynamics Using the LOPES Gait Trainer

    NARCIS (Netherlands)

    Koopman, Hubertus F.J.M.; van Asseldonk, Edwin H.F.; van der Kooij, Herman

    2016-01-01

    In this study, we present and evaluate a novel method to estimate multi-joint leg impedance, using a robotic gait training device. The method is based on multi-input–multi-output system identification techniques and is designed for continuous torque perturbations at the hip and knee joint

  16. Effect of Ti interlayer on the bonding quality of W and steel HIP joint

    Science.gov (United States)

    Wang, Ji-Chao; Wang, Wanjing; Wei, Ran; Wang, Xingli; Sun, Zhaoxuan; Xie, Chunyi; Li, Qiang; Luo, Guang-Nan

    2017-03-01

    Tungsten (W) and steel bonding is one of the key technologies for blanket First Wall (FW) manufacture in thermal fusion reactor. The W/Steel joints are prone to fail without interlayer for the different thermo physical properties. To study the effect of titanium (Ti) interlayer on the bonding quality of W and steel joints, W/Steel Hot Isostatic Pressing (HIP) experiments with Ti interlayer were conducted under 930 °C, 100 MPa for 2 h. Intermetallics caused by atom interdiffusion would affect the bonding quality of W/Ti/Steel HIP joints, the bonding quality was evaluated by microstructure analysis and mechanical tests. All the HIP joints were well bonded and results showed no intermetallics occurred between W/Ti interfaces, meanwhile multiply phases were found between Ti/Steel interfaces. Shear tests indicated when Ti thickness was 100-500 μm, the maximum shear strength of W/Ti/Steel HIP joints would be up to around 151 MPa. Charpy impact tests showed the W/Ti/Steel HIP joints all broke in a brittle manner and the maximum Charpy impact energy was ∼0.192 J. Nano-indentation tests demonstrated W/Ti interfaces could be enhanced by solid solution hardening and formation of brittle phases has conducted high hardness across the Ti/Steel interfaces.

  17. Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis.

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A; Gustafson, Jonathan A; Fitzgerald, G Kelley; Tashman, Scott

    2016-01-01

    The objective of this exploratory study was to evaluate tibiofemoral joint contact point excursions and velocities during downhill gait and assess the relationship between tibiofemoral joint contact mechanics with frontal-plane knee joint motion and lower extremity muscle weakness in patients with knee osteoarthritis (OA). Dynamic stereo X-ray was used to quantify tibiofemoral joint contact mechanics and frontal-plane motion during the loading response phase of downhill gait in 11 patients with knee OA and 11 control volunteers. Quantitative testing of the quadriceps and the hip abductor muscles was also performed. Patients with knee OA demonstrated larger medial/lateral joint contact point excursions (p < 0.02) and greater heel-strike joint contact point velocities (p < 0.05) for the medial and lateral compartments compared to the control group. The peak medial/lateral joint contact point velocity of the medial compartment was also greater for patients with knee OA compared to their control counterparts (p = 0.02). Additionally, patients with knee OA demonstrated significantly increased frontal-plane varus motion excursions (p < 0.01) and greater quadriceps and hip abductor muscle weakness (p = 0.03). In general, increased joint contact point excursions and velocities in patients with knee OA were linearly associated with greater frontal-plane varus motion excursions (p < 0.04) but not with quadriceps or hip abductor strength. Altered contact mechanics in patients with knee OA may be related to compromised frontal-plane joint stability but not with deficits in muscle strength.

  18. Finite element study of contact pressure distribution on inner and outer liner in the bipolar hip prosthesis

    NARCIS (Netherlands)

    Saputra, E.; Anwar, I.B.; Ismail, R.; Jamari, J.; Heide, E. van der

    2016-01-01

    Wear in the hip prosthesis due to sliding contact as a product of human activity is a phenomenon which cannot be avoided. In general, there are two modelof hip prostheses which are widely used in total hip replacement, i.e. unipolar and bipolar models. Wear in the bipolar model is more complex than

  19. Measurement of pelvic motion is a prerequisite for accurate estimation of hip joint work in maximum height squat jumping.

    Science.gov (United States)

    Blache, Yoann; Bobbert, Maarten; Argaud, Sebastien; Pairot de Fontenay, Benoit; Monteil, Karine M

    2013-08-01

    In experiments investigating vertical squat jumping, the HAT segment is typically defined as a line drawn from the hip to some point proximally on the upper body (eg, the neck, the acromion), and the hip joint as the angle between this line and the upper legs (θUL-HAT). In reality, the hip joint is the angle between the pelvis and the upper legs (θUL-pelvis). This study aimed to estimate to what extent hip joint definition affects hip joint work in maximal squat jumping. Moreover, the initial pelvic tilt was manipulated to maximize the difference in hip joint work as a function of hip joint definition. Twenty-two male athletes performed maximum effort squat jumps in three different initial pelvic tilt conditions: backward (pelvisB), neutral (pelvisN), and forward (pelvisF). Hip joint work was calculated by integrating the hip net joint torque with respect to θUL-HAT (WUL-HAT) or with respect to θUL-pelvis (WUL-pelvis). θUL-HAT was greater than θUL-pelvis in all conditions. WUL-HAT overestimated WULpelvis by 33%, 39%, and 49% in conditions pelvisF, pelvisN, and pelvisB, respectively. It was concluded that θUL-pelvis should be measured when the mechanical output of hip extensor muscles is estimated.

  20. Computer-aided grading and quantification of hip osteoarthritis severity employing shape descriptors of radiographic hip joint space.

    Science.gov (United States)

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

    2007-12-01

    A computer-based system was designed for the grading and quantification of hip osteoarthritis (OA) severity. Employing an active-contours segmentation model, 64 hip joint space (HJS) images (18 normal, 46 osteoarthritic) were obtained from the digitized radiographs of 32 unilateral and bilateral OA-patients. Shape features, generated from the HJS-images, and a hierarchical decision tree structure was used for the grading of OA. A shape features based regression model quantified the OA-severity. The system accomplished high accuracies in characterizing hips as "Normal" (100%), of "mild/moderate"-OA (93.8%) or "severe"-OA (96.7%). OA-severity values, as expressed by HJS-narrowing, correlated highly (r=0.9,p<0.001) with the values predicted by the regression model. The system may contribute to OA-patient management.

  1. Synovial cyst of the hip joint as a rare cause of unlateral leg edema; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hun; Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Park, Hyung Kyu; Kim, Wan Seop; Lee, Hui Jin; Kim, Na Ra; Moon, Sung Gyu [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    A synovial cyst of the hip joint is a rare cause of unilateral leg edema, and it is usually associated with arthropathies such as rheumatoid arthritis and osteoarthritis. An asymptomatic synovial cyst of the hip joint that is not associated with an arthritic condition occurs infrequently. In this paper, we described the case of a 52-year-old woman who presented with unilateral right leg edema caused by a synovial cyst of the hip joint.

  2. Sound side joint contact forces in below knee amputee gait with an ESAR prosthetic foot.

    Science.gov (United States)

    Karimi, Mohammad Taghi; Salami, Firooz; Esrafilian, Amir; Heitzmann, Daniel W W; Alimusaj, Merkur; Putz, Cornelia; Wolf, Sebastian I

    2017-08-08

    The incidence of knee and hip joint osteoarthritis in subjects with below knee amputation (BK) appears significantly higher compared to unimpaired subjects, especially in the intact side. However, it is controversial if constant higher loads on the sound side are one of the major factors for an increased osteoarthritis (OA) incidence in subjects with BK, beside other risk factors, e.g. with respect to metabolism. The aim wasto investigate joint contact forces (JCF) calculated by a musculoskeletal model in the intact side and to compare it with those of unimpaired subjects and to further elucidate in how far increased knee JCF are associated with increased frontal plane knee moments. A group of seven subjects with BK amputation and a group of ten unimpaired subjects were recruited for this study. Gait data were measured by 3D motion capture and force plates. OpenSim software was applied to calculate JCF. Maximum joint angles, ground reaction forces, and moments as well as time distance parameters were determined and compared between groups showing no significant differences, with some JCF components of knee and hip even being slightly smaller in subjects with BK compared to the reference group. This positive finding may be due to the selected ESAR foot. However, other beneficial factors may also have influenced this positive result such as the general good health status of the subjects or the thorough and proper fitting and alignment of the prosthesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The contact mechanics and occurrence of edge loading in modular metal-on-polyethylene total hip replacement during daily activities.

    Science.gov (United States)

    Hua, Xijin; Li, Junyan; Jin, Zhongmin; Fisher, John

    2016-06-01

    The occurrence of edge loading in hip joint replacement has been associated with many factors such as prosthetic design, component malposition and activities of daily living. The present study aimed to quantify the occurrence of edge loading/contact at the articulating surface and to evaluate the effect of cup angles and edge loading on the contact mechanics of a modular metal-on-polyethylene (MoP) total hip replacement (THR) during different daily activities. A three-dimensional finite element model was developed based on a modular MoP bearing system. Different cup inclination and anteversion angles were modelled and six daily activities were considered. The results showed that edge loading was predicted during normal walking, ascending and descending stairs activities under steep cup inclination conditions (≥55°) while no edge loading was observed during standing up, sitting down and knee bending activities. The duration of edge loading increased with increased cup inclination angles and was affected by the cup anteversion angles. Edge loading caused elevated contact pressure at the articulating surface and substantially increased equivalent plastic strain of the polyethylene liner. The present study suggested that correct positioning the component to avoid edge loading that may occur during daily activities is important for MoP THR in clinical practice.

  4. A technique for determining prosthetic joint contact areas.

    Science.gov (United States)

    Martin, S M; Moran, J M; Stahurski, T M; Cepulo, A J

    1984-01-01

    A technique to determine the contact areas of total joint replacements has been developed. A thin film of petroleum jelly is deposited by the metallic component on the plastic component when load is applied. Fingerprint powder is then used to highlight the petroleum jelly coated area. Experimental data produced using this technique was found to be in good agreement with theoretical predictions.

  5. Measuring functional outcome after total hip replacement with subject-specific hip joint loading

    NARCIS (Netherlands)

    Weber, Tim; Dendorfer, Sebastian; Dullien, Silvia; Grifka, Joachim; Verkerke, Gijsbertus Jacob; Renkawitz, Tobias

    2012-01-01

    Total hip replacement is an often-performed orthopedic surgical procedure; the amount of procedures undertaken will increase since our life expectancy is growing. In order to optimize function, hip biomechanics should be restored to as near normal as possible. The goal of this pilot study was to

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

    African Journals Online (AJOL)

    further attention needs to be paid to the problem of aseptic loosening of the hips. Subjects: ... affecting young adults and is peculiar ... sugar. Beer and a lightly fermented brew called amahewu are prepared from ... of school children in the area.

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

    Science.gov (United States)

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

    2016-10-01

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

  8. Synovial desmoplastic fibroblastoma of hip joint with bone erosion

    Energy Technology Data Exchange (ETDEWEB)

    Beggs, I. [Department of Clinical Radiology, Royal Infirmary, Edinburgh (United Kingdom); Salter, D.S. [Department of Pathology, University of Edinburgh, Edinburgh (United Kingdom); Dorfman, H.D. [Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (United States)

    1999-07-01

    A 78-year-old woman presented with pain at the left hip. Initial radiographs showed minimal age-related changes. Over the next 2 years she developed large erosions in the left femoral neck and proceeded to hip replacement. Histological examination showed bland spindle cells in a loose and hyalinised collagenous stroma considered to represent a desmoplastic fibroblastoma (collagenous fibroma). This is the first reported case of synovial desmoplastic fibroblastoma. (orig.) With 7 figs., 33 refs.

  9. Volume of the ligamentum capitis femoris in osteoarthritic hip joints of adult dogs.

    Science.gov (United States)

    Mande, J D; Mbithi, P M F; Mbugua, S W; Buoro, I B J; Gathumbi, P K

    2003-03-01

    Ventrodorsal pelvic radiographs were made of 32 adult dogs under general anaesthesia. The hip joints were evaluated according to the severity of osteoarthritic changes graded as 0, 1, 2 or 3. The dogs were euthanased, the hip joints opened and the ligamentum capitis femoris dissected out in toto. The volume of each ligament was determined using a water displacement technique and the mean volume compared to the four radiographic grades of osteoarthritis. There was an inverse correlation (r = -0.75) between the mean volume of the ligamentum capitis femoris and the increasing severity of osteoarthritis as assessed by radiography. The results confirmed the crucial role of radiography in the clinical evaluation of hip dysplasia and osteoarthritis in the adult dog. Assessment of the volume of the ligamentum capitis femoris revealed that it is an important tool for research in canine hip dysplasia and osteoarthritis.

  10. Volume of the ligamentum capitis femoris in osteoarthritic hip joints of adult dogs

    Directory of Open Access Journals (Sweden)

    J.D. Mande

    2003-06-01

    Full Text Available Ventrodorsal pelvic radiographs were made of 32 adult dogs under general anaesthesia. The hip joints were evaluated according to the severity of osteoarthritic changes graded as 0, 1, 2 or 3. The dogs were euthanased, the hip joints opened and the ligamentum capitis femoris dissected out in toto. The volume of each ligament was determined using a water displacement technique and the mean volume compared to the four radiographic grades of osteoarthritis. There was an inverse correlation (r = -0.75 between the mean volume of the ligamentum capitis femoris and the increasing severity of osteoarthritis as assessed by radiography. The results confirmed the crucial role of radiography in the clinical evaluation of hip dysplasia and osteoarthritis in the adult dog. Assessment of the volume of the ligamentum capitis femoris revealed that it is an important tool for research in canine hip dysplasia and osteoarthritis.

  11. Epilepsia partialis continua present with shoulder joint-trunk-hip joint rhythmic clonic seizure: a case report

    Directory of Open Access Journals (Sweden)

    Lv YD

    2016-09-01

    Full Text Available Yudan Lv, Zan Wang, Fengna Chu, Chang Liu, Hongmei Meng Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, ChangChun, People’s Republic of China Abstract: Epilepsia partialis continua (EPC is a particular type of epilepsy which is distinguished from “common epilepsy” by its characteristic semiological features. However, unusual manifestations should be described in order to give awareness at clinical diagnosis. In this case report we describe a rare EPC case not previously reported, in which left shoulder joint-trunk-hip joint jerk was present for 1 week. Abnormal electroencephalogram and cerebrospinal fluid results supported a diagnosis of viral encephalitis. Antiepileptic treatment seemed effective. Our report emphasizes that a detailed functional anatomical analysis and synchronized electroencephalogram discharge should be done to avoid misdiagnosis in patients with synchronic shoulder-trunk-hip jerk symptoms. Keywords: EPC, shoulder-trunk-hip, EEG, clonic seizure, virus encephalitis

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

    Science.gov (United States)

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

    2006-12-01

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

  13. Normal radiological unossified hip joint space and femoral head size development during growth in 675 children and adolescents.

    Science.gov (United States)

    Wegener, Veronika; Jorysz, Gabriele; Arnoldi, Andreas; Utzschneider, Sandra; Wegener, Bernd; Jansson, Volkmar; Heimkes, Bernhard

    2017-03-01

    Evaluation of hip joint space width during child growth is important to aid in the early diagnosis of hip pathology in children. We established reference values for hip joint space and femoral head size for each age. Hip joint space development during growth was retrospectively investigated medial and cranial in 1350 hip joints of children using standard anteroposterior supine plain pelvic radiographs. Maximum capital femoral epiphysis diameter and femoral radii were further more investigated. Hip joint space values show a slow decline during growth. Joint space was statistically significantly (p < 0.006) larger in boys than girls. Our hip joint space measurements on supine subjects seem slightly larger than those reported by Hughes on standing subjects. Evaluation of the femoral head diameter and the radii showed a size curve quite parallel to the known body growth charts. Radii medial and perpendicular to the physis are not statistically significantly different. We recommend to compare measurements of hip joint space at two locations to age dependent charts using the same imaging technique. During growth, a divergence in femoral head size from the expected values or loss of the spherical shape should raise the question of hip disorder. Clin. Anat. 30:267-275, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

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

    OpenAIRE

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

    2014-01-01

    Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur) leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS), triple pelvic osteotomy (TPO)...

  15. Prediction of elbow joint contact mechanics in the multibody framework.

    Science.gov (United States)

    Rahman, Munsur; Cil, Akin; Stylianou, Antonis P

    2016-03-01

    Computational multibody musculoskeletal models of the elbow joint that are capable of simultaneous and accurate predictions of muscle and ligament forces, along with cartilage contact mechanics can be immensely useful in clinical practice. As a step towards producing a musculoskeletal model that includes the interaction between cartilage and muscle loading, the goal of this study was to develop subject-specific multibody models of the elbow joint with discretized humerus cartilage representation interacting with the radius and ulna cartilages through deformable contacts. The contact parameters for the compliant contact law were derived using simplified elastic foundation contact theory. The models were then validated by placing the model in a virtual mechanical tester for flexion-extension motion similar to a cadaver experiment, and the resulting kinematics were compared. Two cadaveric upper limbs were used in this study. The humeral heads were subjected to axial motion in a mechanical tester and the resulting kinematics from three bones were recorded for model validation. The maximum RMS error between the predicted and measured kinematics during the complete testing cycle was 2.7 mm medial-lateral translation and 9.7° varus-valgus rotation of radius relative to humerus (for elbow 2). After model validation, a lateral ulnar collateral ligament (LUCL) deficient condition was simulated and, contact pressures and kinematics were compared to the intact elbow model. A noticeable difference in kinematics, contact area, and contact pressure were observed for LUCL deficient condition. LUCL deficiency induced higher internal rotations for both the radius and ulna during flexion and an associated medial shift of the articular contact area.

  16. Analysis on Image Processing of Human Hip Joints during Lifting Using MAT Lab and ANSYS

    Directory of Open Access Journals (Sweden)

    N. Sundaram

    2013-08-01

    Full Text Available Human Joint paints exhibit abnormal motion and vise versa during movements. Most of the patients were suffering from joint paints. This joint paints like Hip joints, Knee joints, Foot joints, Shoulder joints Elbow joints, and Wrist joints. Patients suffering from joint disorders visit a therapist. The therapist must correlate all these information sources regarding joint Problems. Most probable one third of all jobs in industry involve Manual Material Handling (MMH. This Manual Material Handling of human poses risk to many and cause back pain, joint pains and other problems like Knee joints, wrist joints, Shoulder joints, etc. A finite element model is used to study about the stress of human joints. Image processing techniques using soft computing like MAT Lab and ANSYS are used. A Biomedical model has been used for optimizing the lifting posture for minimum efforts. This model is also used to predict the lifting material in every individual human being. This study can be extended for loading of muscles.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

    Tsai, Henry P; Holliday, Casey M

    2015-06-01

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

  19. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats (Center for Medical Imaging and Physiology, Skaane University Hospital, Lund University, Lund (Sweden)), Email: mats@geijer.info; Dunker, Dennis; Collin, David; Goethlin, Jan H. (Department of Radiology, Sahlgrenska University Hospital, Moelndal (Sweden))

    2012-03-15

    Background. A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. Purpose. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. Material and Methods. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. Results. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Conclusion. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign

  20. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture.

    Science.gov (United States)

    Geijer, Mats; Dunker, Dennis; Collin, David; Göthlin, Jan H

    2012-03-01

    A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign.

  1. Dysfunction in the hip joints in children with Charcot-Marie-Tooth syndrome (literature review

    Directory of Open Access Journals (Sweden)

    Иван Юрьевич Поздникин

    2015-09-01

    Full Text Available A review of the literature on the treatment of children with dysfunction in the hip joints in motor-sensory neuropathy Charcot-Marie-Tooth is presented. Peculiarities of disease diagnosis and the approach used in the treatment of patients are described. The Charcot-Marie-Tooth syndrome is a hereditary neuromuscular disease characterized by progressive atrophy of the distal muscle group of the lower limbs. According to international authors, the incidence of hip joint dysfunction in this condition is at least 10%, ranking second only to foot deformities. In the Russian literature, the problem has not been adequately interpreted. Early diagnosis of dysfunction in the hip joints during Charcot-Marie-Tooth syndrome is complicated by the child's age and is characterized by progression. Conflicting clinical signs and trivial symptoms of the disease also confuse diagnosis, until it becomes clearer in adolescence or the second or third decade of life. Surgical reconstructive operations on the hip joint often occur too late, and they are accompanied by a greater frequency of neurological complications. Practitioner awareness coupled with an early diagnosis of hip subluxation and decentration and complex orthopedic and neurological examinations of children with the disease of Charcot-Marie-Tooth should result in more favorable outcomes.

  2. [SOMATOTYPE JOINT MOBILITY AND RANGES OF HIP AND KNEE OF COLLEGE STUDENTS].

    Science.gov (United States)

    Godoy-Cumillaf, Andrés; Valdés-Badilla, Pablo; García Sandoval, Alan; Grandón Fuentes, Monica; Lagos Del Canto, Loreto; Aravena Turra, Raúl; Herrera-Valenzuela, Tomás; Bruneau Chavez, José; Durán Agüero, Samuel

    2015-12-01

    several studies indicate a consistency between the physical inactivity and low levels of mobility in hip and knee joint. to determine the differences in the motion range of the hip and knee joint between the different classifications of somatotype in students of Pedagogy in Physical Education of the Universidad Autónoma de Chile, campus Temuco. the sample included 102 physical education students (31.3% female), somatotype was obtained through the protocol of the International Society for the Advancement of Kinanthropometry (ISAK) and the motion range of the hip and knee joint (ROM) using a universal goniometer. the mean somatotype was endo-mesomorphic (4.8 - 3.4 - 2) for the women and meso-endomorphic (3.5 - 5.7 - 2) for the males, while the ROM evaluation indicated that the 50% of the students presented mobility values of joint lower than the normal ones. Furthermore, the endo-mesomorphic women showed lower ROM values of medial rotation of the right hip (45.5 ° ± 10.2 °; P = 0.0125, t = 2.732) and left hip side rotation (41.7 ° ± 10.3 °; P = 0.0256; p = 2.402) than the women meso-endomorphic. the results shows a relationship between the somatotype and hip ROM in the women, showing that in the women the most favorable results of joint mobility are related with a greater muscle mass. In contrasts, no significant differences were observed in men. It is important to encourage the development of joint mobility exercises according to the specific needs of each sex. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. Direct hip joint distraction during acetabular fracture surgery using the AO universal manipulator.

    Science.gov (United States)

    Calafi, L Afshin; Routt, M L Chip

    2010-02-01

    Certain acetabular fractures may necessitate distraction of the hip joint for removal of intra-articular debris and assessment of reduction. Distraction can be accomplished by manual traction, using a traction table or an AO universal manipulator (UM). The UM is a relatively simple and an inexpensive device that can provide focal distraction in a controlled manner without the risks associated with the use of a traction table. We describe a technique using the UM for hip joint distraction during acetabular fracture surgery through a Kocher-Langenbeck surgical exposure.

  4. Bicentric bipolar hip prosthesis: A radiological study of movement at the interprosthetic joint

    Directory of Open Access Journals (Sweden)

    Anil Kumar Rai

    2011-01-01

    Full Text Available Background: The bipolar hip prostheses after some time functions as a unipolar device. There is a need to change the design of bipolar hip prostheses to make it function as a bipolar device over a prolonged period of time. A bicentric bipolar hip prosthesis was used as an implant for various conditions of the hip. We evaluated the movement of this newly developed prosthesis at the interprosthetic joint radiologically at periodic intervals. Materials and Methods: Fifty two cases were operarted with the Bicentric bipolar prosthesis for indications like fracture neck of femur and various other diseases of the hip and were followed up with serial radiographs at periodic intervals to evaluate, what fraction of the total abduction at the hip was occurring at the interprosthetic joint. Results: In cases of intracapsular fracture neck of femur, the percentage of total abduction occurring at the interprosthetic joint at 3 months follow-up was 33.74% (mean value of all the patients, which fell to 25.66% at 1.5 years. In indications for bipolar hemireplacement other than fracture neck of femur, the percentage of total abduction occurring at the interprosthetic joint at 3 months follow-up was 71.71% (mean value and at 1.5 years it was 67.52%. Conclusion: This study shows the relative preservation of inner bearing movement in the bipolar hip prosthesis with time probably due its refined design. Further refinements are needed to make the prosthesis work better in patients of intracapsular fracture neck femur.

  5. Effects of hip joint center location and femoral offset on abductor muscle strength after total hip arthroplasty.

    Science.gov (United States)

    Tezuka, Taro; Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Kubota, So; Kawamura, Masaki; Saito, Tomoyuki

    2015-07-01

    The purposes of this study were 1) to examine the changes in the hip joint center (HJC) position and the femoral offset (FO) after total hip arthroplasty (THA) and 2) to investigate the effects of the HJC and FO on isometric abductor muscle strength. We evaluated 51 patients who underwent unilateral primary THA. The FO, and horizontal and vertical distances from the HJC to the tip of the teardrop were measured and isometric hip abductor muscle strength was measured. The HJC of the affected side moved medially postoperatively compared with that of the unaffected side (p < 0.05), and the FO was reconstructed similarly to the unaffected side. There were significant negative correlations between the changes in the horizontal distance from the HJC and FO to the tip of the teardrop. An increase in the FO and infero-medial cup position optimized hip abductor muscle strength. The HJC was reconstructed medially and superiorly, and the change in the FO after THA was influenced by the change in the horizontal distance of the HJC. Multiple regression analysis revealed that the medial and inferior HJC and increase in the FO constitute an effective procedure for restoring abductor strength.

  6. Knee and hip joint biomechanics are gender-specific in runners with high running mileage.

    Science.gov (United States)

    Gehring, D; Mornieux, G; Fleischmann, J; Gollhofer, A

    2014-02-01

    Female runners are reported to be more prone to develop specific knee joint injuries than males. It has been suggested that increased frontal plane joint loading might be related to the incidence of these knee injuries in running. The purpose of this study was to evaluate if frontal plane knee and hip joint kinematics and kinetics are gender-specific in runners with high mileage. 3D-kinematics and kinetics were recorded from 16 female and 16 male runners at a speed of 3 m/s, 4 m/s, and 5 m/s. Frontal plane joint angles and joint moments were ascertained and compared between genders among speed conditions. Across all speed conditions, females showed increased hip adduction and reduced knee adduction angles compared to males (p running speed (p = 0.07). Hip and knee frontal plane joint kinematics are gender-specific. In addition, there are indications that frontal plane joint loading is increased in female runners. Future research should focus on the relationship of these observations regarding overuse running injuries.

  7. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

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

    Science.gov (United States)

    2010-04-01

    ... cemented or nonporous uncemented prosthesis. 888.3353 Section 888.3353 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis is a device intended to be implanted to replace a hip joint. This device...

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

    Science.gov (United States)

    2010-04-01

    ... porous-coated uncemented prosthesis. 888.3358 Section 888.3358 Food and Drugs FOOD AND DRUG... Devices § 888.3358 Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis. (a) Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a...

  10. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

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

  11. Bearing Stresses in Bolted Composite Joints with Different Contact Interactions.

    Directory of Open Access Journals (Sweden)

    Hilton Ahmad

    2016-04-01

    Full Text Available In a bolted joint, it has been shown to be better to model the real contact between bolt and hole than to fix the boundary of the hole edge, a practice used by most previous researchers. Master-slave interaction was implemented in ABAQUS to simulate full contact conditions. Stress distributions were plotted along net-tension plane and hole boundary. Due to geometric non-linearity, the clearance and friction coefficients used substantially effected the maximum stress on hole boundary as shown using the benchmarking work of Eriksson. A physically-based constitutive model used is based on state-of-the art fracture mechanics was used for bolted joint strength prediction. Idealized models from Hollmann were remodelled both by fixing the hole boundary (following the original author and by implementing full contact condition using CZM and XFEM. The physically-based constitutive law used independently measured of unnotched strength and fracture energy parameter for crack opening, which is calibrated from available literatures (known as apparent fracture energy. Good correlation with experimental results was found when using the real contact condition.

  12. An index for diagnosing infant hip dysplasia using 3-D ultrasound: the acetabular contact angle.

    Science.gov (United States)

    Mabee, Myles G; Hareendranathan, Abhilash Rakkunedeth; Thompson, Richard B; Dulai, Sukhdeep; Jaremko, Jacob L

    2016-06-01

    Developmental dysplasia of the hip (DDH) is a common condition that is highly treatable in infancy but can lead to the lifelong morbidity of premature osteoarthritis if left untreated. Current diagnostic methods lack reliability, which may be improved by using 3-D ultrasound. Conventional 2-D US assessment of DDH has limitations, including high inter-scan variability. We quantified DDH on 3-D US using the acetabular contact angle (ACA), a property of the 3-D acetabular shape. We assessed ACA reliability and diagnostic utility. We prospectively collected data from January 2013 to December 2014, including 114 hips in 85 children divided into three clinical diagnostic groups: (1) normal, (2) initially borderline but ultimately normal without treatment and (3) dysplastic requiring treatment. Using custom software, two observers each traced acetabula twice on two 3-D US scans of each hip, enabling automated generation of 3-D surface models and ACA calculation. We computed inter-observer and inter-scan variability of repeatability coefficients and generated receiver operating characteristic (ROC) curves. The 3-D US acetabular contact angle was reproduced 95% of the time within 6° in the same scan and within 9° in different scans of the same hip, vs. 9° and 14° for the 2-D US alpha angle (P dysplasia of the hip were 0.954 for ACA and 0.927 for alpha angle. The 3-D US ACA was significantly more reliable than 2-D US alpha angle, and the 3-D US measurement predicted the presence of DDH with slightly higher accuracy. The ACA therefore shows promising initial diagnostic utility. Our findings call for further study of 3-D US in the diagnosis and longer-term follow-up of infant hip dysplasia.

  13. Bone mineral density in patients with destructive arthrosis of the hip joint.

    Science.gov (United States)

    Okano, Kunihiko; Aoyagi, Kiyoshi; Enomoto, Hiroshi; Osaki, Makoto; Chiba, Ko; Yamaguchi, Kazumasa

    2014-05-01

    Recent reports have shown the existence of subchondral insufficiency fracture in rapidly destructive arthrosis of the hip joint (RDA), and the findings suggest that osteopenia is related to the pathogenesis of the rapid progression of this disease. Therefore, we measured bone mineral density (BMD) in RDA patients. We measured BMD of the lumbar spine, radius, and calcaneus using dual-energy X-ray absorptiometry in 19 patients with RDA and 75 with osteoarthritis of the hip (OA) and compared BMD at different skeletal sites between RDA and OA patients. No significant differences were observed in BMD of the lumbar spine, ultradistal radius, mid-radius, and calcaneous between the RDA and OA groups. Our data suggest that RDA is not accompanied by generalized osteoporosis. Factors other than generalized bone status, for example, BMD around the affected hip joint before destruction, need to be analyzed to elucidate the pathophysiological mechanism of RDA.

  14. MR imaging of transient osteoporosis of the hip: an update on 155 hip joints.

    Science.gov (United States)

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

    2015-03-01

    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. 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. 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. 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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Use of Tranexamic Acid during Total Endoprosthetic Replacement of the Hip Joint

    Directory of Open Access Journals (Sweden)

    D. D. Selivanov

    2010-01-01

    Full Text Available Objective: to evaluate the blood-saving activity, efficacy, and safety of tranexamic acid. Subjects and methods. Thirty-seven patients allocated into two groups were enrolled in the study of the efficacy of tranexamic acid as an agent in reducing blood loss during hip joint replacement. Group 2 patients were injected tranexamic acid, 10 mg/kg body weight, 20—30 minutes before and 3 hours after surgery in the same dosage. This resulted in a significant (48.5% reduction in total blood loss (from 1089.6 to 560.8 ml (p<0.05. No tranexamic acid-induced complications were found. The administration of tranexamic acid during total endoprosthetic replacement of the hip joint could reduce blood loss by 35 and 59.4% in the intraoperative and postoperative periods, respectively, and total blood loss by 48.4%. The use of tranexamic acid allows one to refuse transfusion of blood components during total endoprosthetic replacement of the hip joint. Key words: hip joint replacement, blood loss, tranexamic acid.

  16. Bilateral rapidly destructive arthrosis of the hip joint resulting from subchondral fracture with superimposed secondary osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan); Schneider, Robert [Hospital for Special Surgery, Department of Radiology, New York (United States); Bullough, Peter G. [Hospital for Special Surgery, Department of Laboratory Medicine, New York, NY (United States)

    2010-02-15

    A 57-year-old woman suffered rapid destruction of both hip joints over a 10 months period. At the first visit, her radiographs demonstrated slight joint space narrowing and acetabular cyst formation in both hips. Five months later, joint space narrowing had further progressed, and intra-articular injection of steroid was given in both hips. However, the hip pain gradually became worse. Five months later, both joint spaces had totally disappeared and both femoral heads had undergone massive collapse. At gross examination, both resected femoral heads showed extensive opaque yellow areas consistent with osteonecrosis. Microscopic examination of these areas revealed evidence of both extensive fracture and callus formation, as well as necrosis throughout, indicating that the osteonecrosis observed in this case was a secondary phenomenon superimposed on pre-existing osteoarthritis and subchondral fracture. There were many pseudogranulomatous lesions in the marrow space and necrotic area, where tiny fragments of bone and articular cartilage, surrounded by histiocytes and giant cells, were embedded, such as are typically seen in rapidly destructive arthrosis. No radiologic or morphologic evidence of primary osteonecrosis was noted. This case indicates that at least some cases of rapidly destructive arthritis are the result of subchondral fracture with superimposed secondary osteonecrosis. (orig.)

  17. 3D Finite Element Analysis of a Man Hip Joint Femur under Impact Loads

    Institute of Scientific and Technical Information of China (English)

    YU Xue-zhong; GUO Yi-mu; LI Jun; ZHANG Yun-qiu; HE Rong-xin

    2007-01-01

    The biomechanical characters of the bone fracture of the man femoral hip joint under impact loads are explored. Methods: A biosystem model of the man femoral hip joint by using the GE ( General Electric) lightspeed multi-lay spiral CT is conducted. A 3D finite element model is established by employing the finite element software ANSYS. The FE analysis mainly concentrates on the effects of the impact directions arising from intense movements and the parenchyma on the femoral hip joint on the stress distributions of the proximal femur. Results:The parenchyma on the hip joint has relatively large relaxation effect on the impact loads. Conclusion:Effects of the angle δ of the impact load to the anterior direction and the angle γ of the impact load to the femur shaft on the bone fracture are given;δ has larger effect on the stress and strain distributions than the angle γ, which mainly represents the fracture of the upper femur including the femoral neck fracture when the posterolateral femur is impacted, consistent with the clinical results.

  18. [Adhesive (retractile) capsulitis of the hip joint in diabetes mellitus. An x-ray histomorphological synopsis].

    Science.gov (United States)

    Dihlmann, W; Höpker, W W

    1992-09-01

    Adhesive (retractile) capsulitis of the hip joint is a rare complication (association) of (juvenile) diabetes mellitus. The clinical features, plain radiographic and CT findings and histomorphological appearances of this condition are described and attention is drawn to changes in the elastic tissue in the fibrosed capsule. Three diagnostic radiological features have been defined; in their presence, arthrography or diagnostic arthroscopy need not be performed.

  19. Explanations pertaining to the Hip Joint Flexor Moment During the Stance Phase of Human Walking

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild;

    2012-01-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different...

  20. Clinical examination and physical assessment of hip joint-related pain in athletes

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian

    2014-01-01

    UNLABELLED: Evidence-based clinical examination and assessment of the athlete with hip joint related pain is complex. It requires a systematic approach to properly differentially diagnose competing potential causes of athletic pain generation. An approach with an initial broad focus (and hence use...

  1. Conversion coefficients for determining organ doses in paediatric pelvis and hip joint radiography

    Energy Technology Data Exchange (ETDEWEB)

    Seidenbusch, Michael C.; Schneider, Karl [Ludwig-Maximilians-University of Munich, Institute of Clinical Radiology, Paediatric Radiology (Germany)

    2014-09-15

    Knowledge of organ and effective doses achieved during paediatric X-ray examinations is an important prerequisite for assessment of radiation burden to the patient. Conversion coefficients for reconstruction of organ and effective doses from entrance doses for pelvis and hip joint radiographs of 0-, 1-, 5-, 10-, 15- and 30-year-old patients are provided regarding the Guidelines of Good Radiographic Technique of the European Commission. Using the personal computer program PCXMC developed by the Finnish Centre for Radiation and Nuclear Safety (Saeteilyturvakeskus STUK), conversion coefficients for conventional pelvis and hip joint radiographs were calculated by performing Monte Carlo simulations in mathematical hermaphrodite phantom models representing patients of different ages. The clinical variation of radiation field settings was taken into consideration by defining optimal and suboptimal standard field settings. Conversion coefficients for the reconstruction of organ doses in about 40 organs and tissues from measured entrance doses during pelvis and hip joint radiographs of 0-, 1-, 5-, 10-, 15- and 30-year-old patients were calculated for the standard sagittal beam projection and the standard focus detector distance of 115 cm. The conversion coefficients presented can be used for organ dose assessments from entrance doses measured during pelvis and hip joint radiographs of children and young adults with all field settings within the optimal and suboptimal standard field settings. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Magerkurth, Olaf [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); University Children' s Hospital, Department of Radiology, Basel (Switzerland); Jacobson, Jon A.; Girish, Gandikota; Kalume Brigido, Monica; Fessell, David [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Bedi, Asheesh [University of Michigan, Department of Orthopedic Surgery, Ann Arbor, MI (United States)

    2012-10-15

    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.)

  3. 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.

  4. Hip motion analysis using multi phase (virtual and physical) simulation of the patient-specific hip joint dynamics.

    Science.gov (United States)

    Otake, Yoshito; Suzuki, Naoki; Hattori, Asaki; Miki, Hidenobu; Yamamura, Mitsuyoshi; Yonenobu, Kazuo; Ochi, Takahiro; Sugano, Nobuhiko

    2008-01-01

    In total hip arthroplasty (THA), the patient-specific bone geometry or the characteristics of the skeletal movement should be considered during treatment in order to prevent complications. In this paper, we propose a novel approach for the analysis of joints which combines the patient-specific virtual and physical simulation. The patient-specific anatomical structure and hip motion was obtained from CT and optical motion capture. The virtual simulation was conducted by integrating these data using virtual reality technique. The physical simulation was achieved by using plaster models of the patient's pelvis and femur and robotic manipulator. The plaster models were driven by two robotic manipulators to reproduce the hip motion. The accuracy of the robot movement was 0.245 mm over the working area according to the validation by an optical tracking system. By combining this system with linear actuators that reproduce the muscle functions, patient-specific muscle function can be simulated, thereby helping clinicians to diagnose and make a treatment plan.

  5. Features of radiological and anatomical changes in bone of the hip joint due to injuries

    OpenAIRE

    2015-01-01

    Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typical changes in acetabulum (A) and proximal femur (F) in patients with the consequences of injuries in the area of the hip joint.Methods: We analyzed radiographs and CT scans in 106 patients. Patients were divided into groups: I — false joint of F neck, II – false joint at the level of per-, inter- and subtrochanteric area of F, III — post-traumatic avascular necrosis of F head, IV — posttraumatic co...

  6. [Clinical examination of the hip joint in adults].

    Science.gov (United States)

    Grifka, J; Keshmiri, A; Maderbacher, G; Craiovan, B

    2014-12-01

    Complaints in the region of the hips and pelvis are often difficult to classify. This is due to the fact that pain projection and overlapping can occur; therefore, the complete region of the lumbar spine, pelvis and hips must be considered as a single entity in which alterations can result in radiation throughout the whole region. There are many different anatomical structures within the pelvic region so that the function of various muscle components can be impaired and cause pathological alterations to positional relationships of bony structures or even alterations to other soft tissues, such as ligaments, tendons and labra. In terms of differential diagnostics the groin must be seen as the weak point of the peritoneum and vascular system and taken into consideration. Therefore, a detailed and targeted medical history, functional testing and specific examinations and tests are necessary to narrow down the pathology in question and reach a definitive diagnosis. Orthopedic surgeons must know which conspicuous features can lead to which problems and which anatomical structures are likely to be affected by irritation. The results of the clinical examination are the basis for targeted imaging diagnostics and subsequent therapy.

  7. Design parameters dependences on contact stress distribution in gait and jogging phases after total hip arthroplasty.

    Science.gov (United States)

    Rixrath, E; Wendling-Mansuy, S; Flecher, X; Chabrand, P; Argenson, J N

    2008-01-01

    We have developed a mathematical model to calculate the contact stress distribution in total hip arthroplasty (THA) prosthesis between the articulating surfaces. The model uses the clearance between bearing surfaces as well as the inclination and thickness of the Ultra High Molecular Weight Poly-Ethylene (UHMWPE) cup to achieve this. We have used this mathematical model to contrast the maximal force during normal gait and during jogging. This is based on the assumption that the contact stress is proportional to the radial deformation of the cup. The results show that the magnitude of the maximal contact stress remains constant for inclination values in the range of [0-35 degrees ] and increase significantly with the cup clearance and liner thickness for inclination values in the range of [35-65 degrees ]. A major use for this model would be the calculation of spatial contact stress distribution during normal gait or jogging for different couples of bearing surfaces.

  8. Biofeedback for Gait Retraining Based on Real-Time Estimation of Tibiofemoral Joint Contact Forces.

    Science.gov (United States)

    Pizzolato, Claudio; Reggiani, Monica; Saxby, David J; Ceseracciu, Elena; Modenese, Luca; Lloyd, David G

    2017-09-01

    Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this paper, we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints. Full-body inverse kinematics, inverse dynamics, and musculotendon kinematics were solved in real-time from motion capture and force plate data to estimate the knee medial tibiofemoral contact force (MTFF). We analyzed five healthy subjects while they were walking on an instrumented treadmill with visual biofeedback of their MTFF. Each subject was asked to modify their gait in order to vary the magnitude of their MTFF. All subjects were able to increase their MTFF, whereas only three subjects could decrease it, and only after receiving verbal suggestions about possible gait modification strategies. Results indicate the important role of knee muscle activation patterns in modulating the MTFF. While this paper focused on the knee, the technology can be extended to examine the musculoskeletal tissue loads at different sites of the human body.

  9. The compliance contact model of cylindrical joints with clearances

    Institute of Scientific and Technical Information of China (English)

    Caishan Liu; Ke Zhang; Lei Yang; Keren Wang

    2005-01-01

    This paper is concerned with the determination of the normal force-displacement (NFD) relation for the contact problem of cylindrical joints with clearance. A simple formulation for this contact problem is developed by modeling the pin as a rigid wedge and the elastic plate as a simple Winkler elastic foundation. The numerical results show that the normal displacement relation based on Hertz theory is only valid for the case of large clearance with a small normal load, and the NFD relation based on Persson theory is only effective in the case of very small clearance. The proposed approximate model in this paper gives better results than Hertz theory and Persson theory in a large range of clearances as seen from the comparison with the results of FEM.

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

    Directory of Open Access Journals (Sweden)

    Jacek Białecki

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  12. Validation of a standardized mapping system of the hip joint for radial MRA sequencing

    Energy Technology Data Exchange (ETDEWEB)

    Klenke, Frank M.; Hoffmann, Daniel B.; Cross, Brian J.; Siebenrock, Klaus A. [Bern University Hospital, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland)

    2014-10-14

    Intraarticular gadolinium-enhanced magnetic resonance arthrography (MRA) is commonly applied to characterize morphological disorders of the hip. However, the reproducibility of retrieving anatomic landmarks on MRA scans and their correlation with intraarticular pathologies is unknown. A precise mapping system for the exact localization of hip pathomorphologies with radial MRA sequences is lacking. Therefore, the purpose of the study was the establishment and validation of a reproducible mapping system for radial sequences of hip MRA. Sixty-nine consecutive intraarticular gadolinium-enhanced hip MRAs were evaluated. Radial sequencing consisted of 14 cuts orientated along the axis of the femoral neck. Three orthopedic surgeons read the radial sequences independently. Each MRI was read twice with a minimum interval of 7 days from the first reading. The intra- and inter-observer reliability of the mapping procedure was determined. A clockwise system for hip MRA was established. The teardrop figure served to determine the 6 o'clock position of the acetabulum; the center of the greater trochanter served to determine the 12 o'clock position of the femoral head-neck junction. The intra- and inter-observer ICCs to retrieve the correct 6/12 o'clock positions were 0.906-0.996 and 0.978-0.988, respectively. The established mapping system for radial sequences of hip joint MRA is reproducible and easy to perform. (orig.)

  13. Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient".

    Science.gov (United States)

    Rieker, C B

    2006-01-01

    The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

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

    Science.gov (United States)

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

    2015-02-01

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

  15. Finite element study of contact pressure distribution on inner and outer liner in the bipolar hip prosthesis

    Science.gov (United States)

    Saputra, Eko; Anwar, Iwan Budiwan; Ismail, Rifky; Jamari, J.; van der Heide, Emile

    2016-04-01

    Wear in the hip prosthesis due to sliding contact as a product of human activity is a phenomenon which cannot be avoided. In general, there are two modelof hip prostheses which are widely used in total hip replacement, i.e. unipolar and bipolar models. Wear in the bipolar model is more complex than the unipolar model due to its contact motion. The bipolar model has two contact mechanisms while the unipolar model has only one contact mechanism. It means that the bipolar model has two wear positions, i.e. wear on inner and outer liner surface. Fortunately, wear phenomena in the hip prosthesis can be predicted by analytical or numerical method. Wear on the inner and outer liner surface in the bipolar model itself can be early predicted by contact pressure distribution that is obtained from contact mechanic analysis.The contact pressure distribution itself is an essential variable in wear equations. This paper is aimed to studythe difference of the contact pressure distribution on the inner and outer liner surface in the bipolar model. To obtain the contact pressure distribution at each surface, contact mechanic analysis on the inner and outer liner surface by analytical and numerical method were performed. Results showedthat there was significant difference of the contact pressure distribution on the inner and outer liner surface in the bipolar model. Therefore, it is expected that there is significant wear difference on the inner and outer liner in the bipolar model.

  16. Outcome of pelvic support osteotomy with the Ilizarov method in the treatment of the unstable hip joint.

    Science.gov (United States)

    El-Mowafi, Hani

    2005-12-01

    Instability of the hip joint in the young adult is a difficult problem. Patients with an unstable hip secondary to any aetiology usually have loss of bone from the proximal femur or shortening of the limb or both. In this study we report our results in the treatment of the unstable hip joint in young adults by pelvic support osteotomy using the Ilizarov method. From 1997 to 2004, 25 patients (17 females and 8 males) with an unstable hip joint were treated in the Orthopaedic department of Mansoura University Hospital, Egypt. Their mean age was 22.4 years (range: 19 to 35). The main complaints were pain, leg length discrepancy, limping, and limited abduction of the hip. All patients underwent valgus extension osteotomy in the proximal femur and distal femoral osteotomy for lengthening. The average follow-up ranged from 2 to 7 years. All hips were pain free at follow-up. The Trendelenburg sign became negative in 20 patients. There was no limb length discrepancy and alignments of the extremity were re-established. Five patients had a lurch gait. Valgus extension osteotomy has provided stability of the hip joint and maintained some motion of the hip joint. By using the Ilizarov technique, we could prevent the valgus effects created by the valgus extension osteotomy while achieving lengthening of the femur through the distal osteotomy in the femur.

  17. Difficulty of diagnosing the origin of lower leg pain in patients with both lumbar spinal stenosis and hip joint osteoarthritis.

    Science.gov (United States)

    Saito, Junya; Ohtori, Seiji; Kishida, Shunji; Nakamura, Junichi; Takeshita, Munenori; Shigemura, Tomonori; Takazawa, Makoto; Eguchi, Yawara; Inoue, Gen; Orita, Sumihisa; Takaso, Masashi; Ochiai, Nobuyasu; Kuniyoshi, Kazuki; Aoki, Yasuchika; Ishikawa, Tetsuhiro; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Kubota, Gou; Inage, Kazuhide; Sainoh, Takeshi; Yamauchi, Kazuyo; Toyone, Tomoaki; Takahashi, Kazuhisa

    2012-12-01

    Case series. To present the difficulty of diagnosing the origin of lower leg pain in patients with lumbar spinal stenosis and hip joint arthritis. Pain arising from a degenerated hip joint is sometimes localized to the lower leg. Patients with lumbar spinal disease may also show radicular pain corresponding to the lower leg area. If patients present with both conditions and only pain at the lower leg, it is difficult to determine the origin of the pain. We reviewed 420 patients who had leg pain with lumbar spinal stenosis diagnosed by myelography, computed tomography after myelography, or magnetic resonance imaging. Pain only at the ipsilateral lateral aspect of the lower leg but slight low back pain or pain around the hip joint was shown in 4 patients who had lumbar spinal stenosis and hip osteoarthritis. The symptoms resolved after L5 spinal nerve block, but remained after lidocaine infiltration into the hip joint. We performed decompression and posterolateral fusion surgery for these 4 patients. Leg pain did not resolve after lumbar surgery in all patients. Conservative treatment was not effective from 6 to 12 months, so ultimately we performed ipsilateral total hip replacement for all patients and they became symptom-free. It is difficult to determine the origin of lower leg pain by spinal nerve block and hip joint block in patients with lumbar spinal stenosis and hip osteoarthritis. We take this into consideration before surgery.

  18. Hip joint biomechanics during gait in people with and without symptomatic femoroacetabular impingement.

    Science.gov (United States)

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

    2016-01-01

    Femoroacetabular impingement (FAI) is a morphological hip condition that can cause hip/groin pain and impaired function in younger active adults, and may lead to stiffness, muscle weakness, structural damage, and hip osteoarthritis. Understanding the impairments associated with FAI is crucial to guide treatment and rehabilitation strategies. Evidence is limited and conflicting about whether hip biomechanics are impaired during walking in people with symptomatic FAI. The objective of this study was to determine whether kinematics and kinetics during gait differ between people with symptomatic FAI and control participants. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery and 14 age-, and sex-matched disease-free controls underwent three-dimensional gait analysis. Tri-planar hip kinematics and kinetics were compared between the two groups. There were limited significant between-group differences with respect to spatiotemporal variables. Participants with FAI walked with less range of motion in the sagittal plane during a gait cycle, but did not exhibit any significant kinematic differences in the frontal or transverse planes. There were no systematic differences in kinetics between the groups in any plane. Findings suggest that individuals with symptomatic FAI have minimal impairments in gait biomechanics. Although these individuals demonstrate reduced hip joint motion in the sagittal plane, the size of the difference is small and its significance for symptoms and function is unclear. More pronounced deficits in hip kinetics and kinematics may be evident during functional tasks that challenge the hip towards the position of impingement.

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

    Science.gov (United States)

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

    2017-01-01

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

  20. Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-09-01

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

  1. A comparison of effectiveness of fascial relaxation and classic model of patients rehabilitation after hip joint endoprosthetics.

    Science.gov (United States)

    Wójcik, Beata; Jabłoński, Mirosław; Gębala, Edyta; Drelich, Małgorzata

    2012-01-01

    Degenerative joint disease usually leads to functional failure and pain in the affected parts of the musculoskeletal system. The aim of this study was to evaluate the effectiveness of fascial relaxation for tense muscles in the affected hip joint by comparing this method and classic physiotherapeutic rehabilitation in patients after hip arthroplasty with regard to the range of motion, presence of pain and quality of life. The study involved 35 females qualified for hip arthroplasty. A control group consisted of 10 patients aged 47 to 77 years who received classic kinesiotherapy, including antithrombotic prophylaxis and isometric muscle exercises for the operated lower limb followed by active exercises for supported flexion in the hip and knee joints, active decompression exercises, assuming the upright position, and gait training. The experimental group consisted of 25 women aged 45 to 75 years who, along with conventional therapeutic exercises, were treated by fascial relaxation of the affected hip joint. The arthroplasty procedure was carried out from a posterior approach in all patients, in accordance with the technique recommended by Swanson. The results indicate that the group of patients who additionally received fascial relaxation demonstrated a significantly increased range of motion in the operated hip joint. The experimental group also reported considerable pain reduction and improved daily activity in comparison to the control group. The techniques of fascial relaxation significantly reduced recovery time and liminated muscle tensing in the operated hip joint, thus contributing to improving the range of motion.

  2. Sexual dimorphism of the hip joint in Greeks.

    Science.gov (United States)

    Papaloucas, Christos; Fiska, Aliki; Demetriou, Thespis

    2008-07-18

    The objective of the present study was to report our measurements of hip bones within the Greek population and review the possible implications of these differences in their health as well as in social life. For this purpose the remains of 100 male and 100 female pelvic and femoral bones were studied. The distance from the pubic tubercle to the anterior rim of the acetabulum, the acetabulum diameter between its rims, their ratio, the depth of the acetabulum, the diameter of the femoral head and the ratio between the femoral head and the diameter of the acetabulum were measured. It was found that in males, in comparison to the females, the distance from the pubic tubercle to the anterior rim of the acetabulum was smaller while the acetabulum diameter and its depth, the diameter of the femoral head and the ratio between femoral head and the acetabulum diameter were larger. The above differences reached strong statistical significance. Of the two ratios used only the first one reached statistical significance. Using this ratio alone offered the best discrimination rate of up to 99% and should be the preferred choice when available.

  3. Effect of arm swinging on lumbar spine and hip joint forces.

    Science.gov (United States)

    Angelini, Lorenza; Damm, Philipp; Zander, Thomas; Arshad, Rizwan; Di Puccio, Francesca; Schmidt, Hendrik

    2017-09-14

    During level walking, arm swing plays a key role in improving dynamic stability. In vivo investigations with a telemeterized vertebral body replacement showed that spinal loads can be affected by differences in arm positions during sitting and standing. However, little is known about how arm swing could influence the lumbar spine and hip joint forces and motions during walking. The present study aims to provide better understanding of the contribution of the upper limbs to human gait, investigating ranges of motion and joint reaction forces. A three-dimensional motion analysis was carried out via a motion capturing system on six healthy males and five patients with hip instrumented implant. Each subject performed walking with different arm swing amplitudes (small, normal, and large) and arm positions (bound to the body, and folded across the chest). The motion data were imported in a commercial musculoskeletal analysis software for kinematic and inverse dynamic investigation. The range of motion of the thorax with respect to the pelvis and of the pelvis with respect to the ground in the transversal plane were significantly associated with arm position and swing amplitude during gait. The hip external-internal rotation range of motion statistically varied only for non-dominant limb. Unlike hip joint reaction forces, predicted peak spinal loads at T12-L1 and L5-S1 showed significant differences at approximately the time of contralateral toe off and contralateral heel strike. Therefore, arm position and swing amplitude have a relevant effect on kinematic variables and spinal loads, but not on hip loads during walking. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Wierzcholski, Krzysztof

    2014-01-01

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

  5. Wear tests in a hip joint simulator of different CoCrMo counterfaces on UHMWPE

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez-Mora, V.A.; Hoffmann, M.; Stroosnijder, R. [Institute for Health and Consumer Protection, Joint Research Centre, European Commission, Ispra (Italy); Gil, F.J. [CREB, Dept. Ciencia de Materiales e Ingenieria Metalurgica, ETSEIB, Universidad Politecnica de Cataluna, Av. Diagonal 647, 08028-Barcelona (Spain)], E-mail: francesc.xavier.gil@upc.edu

    2009-01-01

    The objective in this work was to study the effect of different material counterfaces on the Ultra High Molecular Weight Polyethylene (UHMWPE) wear behavior. The materials used as counterfaces were based on CoCrMo: forged with hand polished and mass finished, CoCrMo coating applied on the forged CoCrMo alloy obtained by Physical Vapour Deposition (PVD). A hip joint simulator was designed and built for these studies. The worn surfaces were observed by optical and scanning electron microscopy. The results showed that the hand polished CoCrMo alloy caused the higher UHMWPE wear of the acetabular cups. The CoCrMo coating caused the least UHMWPE wear, while the mass finished CoCrMo alloy caused an intermediate UHMWPE wear. It is shown that the wear rates obtained in this work are closer to clinical studies than to similar hip joints simulator studies.

  6. Preparation for femur prosthesis of ceramic-metal combination artificial hip joint

    Institute of Scientific and Technical Information of China (English)

    王欣宇; 李世普; 陈晓明; 贺建华

    2002-01-01

    Al2O3 material was synthesized by using high purity alumina micro-powder and Mg-Zr-Y composite additives at temperature of 1600℃, which had good mechanics property of 416MPa bending strength and 5.46MPa*m1/2 fracture toughness. Femur head prosthesis of hip joint was prepared by using this material; Ti alloy femur handle was sprayed bioactive hydroxyapatite (HA) by plasma on surface, which improves the chemistry stability and biocompatibility of Ti alloy; ceramic-metal combination artificial hip joint femur prosthesis was made by combining Al2O3 femur head with Ti alloy femur handle, so the manufacturing process is improved and the property and application flexibility are advanced.

  7. THE USE OF THE SADDLE PROSTHESIS FOR RECONSTRUCTION OF THE HIP-JOINT AFTER TUMOR RESECTION OF THE PELVIS

    NARCIS (Netherlands)

    VANDERLEI, B; HOEKSTRA, HJ; VETH, RPH; HAM, SJ; OLDHOFF, J; KOOPS, HS

    1992-01-01

    Reconstruction of the hip joint by a saddle prosthesis after excision of a malignant pelvic tumor is a relatively new method, which thus far has been mainly used for revision of infected hip arthroplasties. One patient with a metastatic cystosarcoma phyllodes and one patient with a chondrosarcoma of

  8. Arthroscopic validation of radiographic minimum joint space width associated with the subchondral bone exposure in symptomatic hip dysplasia.

    Science.gov (United States)

    Nakashima, Yasuharu; Fujii, Masanori; Noguchi, Yasuo; Suenaga, Kenya; Yamamoto, Takuaki; Fukushi, Jun-Ichi; Motomura, Goro; Hamai, Satoshi; Hara, Daisuke; Iwamoto, Yukihide

    2017-05-01

    The purpose of this study was to clarify the minimum joint space width (MJSW) that leads to subchondral bone exposure (SBE) in patients with hip dysplasia. We included 82 subjects (86 hips) who had hip dysplasia with center-edge angle less than 20° and who underwent periacetabular osteotomy combined with hip arthroscopy. The acetabular and femoral cartilages were divided into three regions: anterosuperior, superior, and posterosuperior; for each region, we analyzed the correlation between the incidence of SBE and the MJSW measured on plain radiographs. The disease stage was defined according to the Kellgren and Lawrence grades (KL grade). SBE was found in 51 hips (59.3%) in total, involved the acetabulum in 49 hips (57.0%), and involved the femoral head in 26 hips (30.2%). SBE was more frequent in the acetabulum, with the highest incidence in the anterosuperior region, followed by the superior region. SBE was present in six hips (22.2%), 17 hips (56.7%), and 28 hips (96.5%), at KL-1, KL-2, and KL-3, respectively. MJSW of hips with SBE was significantly smaller than those without SBE (2.3 vs 4.0 mm, p hip dysplasia.

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

    Energy Technology Data Exchange (ETDEWEB)

    Boniatis, Ioannis [Department of Medical Physics, University of Patras, School of Medicine, 265 00 Patras (Greece); Costaridou, Lena [Department of Medical Physics, University of Patras, School of Medicine, 265 00 Patras (Greece); Cavouras, Dionisis [Department of Medical Instrumentation Technology, Technological Educational Institute of Athens, 122 10 Athens (Greece); Panagiotopoulos, Elias [Department of Orthopaedics, School of Medicine, University of Patras, 265 00 Patras (Greece); Panayiotakis, George [Department of Medical Physics, University of Patras, School of Medicine, 265 00 Patras (Greece)]. E-mail: panayiot@upatras.gr

    2006-12-20

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

  10. Hip Joint Osteochondroma: Systematic Review of the Literature and Report of Three Further Cases

    Directory of Open Access Journals (Sweden)

    Asim M. Makhdom

    2014-01-01

    Full Text Available The aim of this study is to systematically review the literature with regards to surgical treatment of patients with hip joint osteochondromas, and to report our surgical management of three paediatric patients who had femoral neck or acetabular osteochondromas in association with acetabular dysplasia. We performed a systematic review using PubMed and Embase databases for all studies that reported surgical treatments for patients with peritrochanteric or acetabular osteochondroma with or without acetabular dysplasia. We also retrospectively reviewed three patients who were diagnosed with a hip osteochondroma in association with actetabular dysplasia. These patients were known to have hereditary multiple exostoses (HME. The systematic review revealed 21 studies that met our inclusion criteria. All studies were case reports and retrospective in nature and failed to conclude a uniform treatment plan. The three reported cases illustrate successful excision of hip osteochondromas and treatment of acetabular dysplasia. Early excision of hip osteochondromas might prevent acetabular dysplasia in HME patients. Routine radiographic pelvic survey at the time of diagnosis of HME is recommended for early detection of hip osteochondromas and acetabular dysplasia in these children.

  11. The tribological behaviour of different clearance MOM hip joints with lubricants of physiological viscosities.

    Science.gov (United States)

    Hu, X Q; Wood, R J K; Taylor, A; Tuke, M A

    2011-11-01

    Clearance is one of the most influential parameters on the tribological performance of metal-on-metal (MOM) hip joints and its selection is a subject of considerable debate. The objective of this paper is to study the lubrication behaviour of different clearances for MOM hip joints within the range of human physiological and pathological fluid viscosities. The frictional torques developed by MOM hip joints with a 50 mm diameter were measured for both virgin surfaces and during a wear simulator test. Joints were manufactured with three different diametral clearances: 20, 100, and 200 microm. The fluid used for the friction measurements which contained different ratios of 25 percent newborn calf serum and carboxymethyl cellulose (CMC) with the obtained viscosities values ranging from 0.001 to 0.71 Pa s. The obtained results indicate that the frictional torque for the 20 microm clearance joint remains high over the whole range of the viscosity values. The frictional torque of the 100 microm clearance joint was low for the very low viscosity (0.001 Pa s) lubricant, but increased with increasing viscosity value. The frictional torque of the 200 microm clearance joint was high at very low viscosity levels, however, it reduced with increasing viscosity. It is concluded that a smaller clearance level can enhance the formation of an elastohydrodynamic lubrication (EHL) film, but this is at the cost of preventing fluid recovery between the bearing surfaces during the unloaded phase of walking. Larger clearance bearings allow a better recovery of lubricant during the unloaded phase, which is necessary for higher viscosity lubricants. The selection of the clearance value should therefore consider both the formation of the EHL film and the fluid recovery as a function of the physiological viscosity in order to get an optimal tribological performance for MOM hip joints. The application of either 25 per cent bovine serum or water in existing in vitro tribological study should

  12. [Strength of muscles surrounding the hip joint and gait in patients following implantation of a cementless hip endoprosthesis].

    Science.gov (United States)

    Horstmann, T; Martini, F; Mayer, F; Sell, S; Knak, J; Zacher, J

    1995-01-01

    There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprotheses. The aim of this study was to examine the pre- and postoperative course of strength deficits in this musculature compared to clinical parameters and the uninvolved side. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip protheses were implanted were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strength of abductors, flexors, and rotator muscles as well as maximum isokinetic strength of the extensors and flexor musculature at 60% and 120%/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months (90-124%). By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 6 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of capsule pattern.

  13. A 3D mathematical model to predict spinal joint and hip joint force for trans-tibial amputees with different SACH foot pylon adjustments.

    Science.gov (United States)

    Yu, Chung-huang; Hung, Yu-Cheng; Lin, Yang-Hua; Chen, Guan-Xun; Wei, Shun-Hwa; Huang, Chang-Hung; Chen, Chen-Sheng

    2014-09-01

    A solid-ankle cushioned heel (SACH) foot is a non-joint foot without natural ankle function. Trans-tibial amputees may occur toe scuffing in the late swing phase due to a lack of active dorsiflexion. To address this problem, clinical guidelines suggests shortening the pylon to produce a smooth gait. However, this causes a leg length discrepancy, induces asymmetry in the hip joint, and causes an overload of L5/S1 joint force. Therefore, this study aimed to investigate the influence of different prosthesis pylons on the hip joint and L5/S1 joint forces. Ten subjects were recruited using leg length for normalisation. Four different pylon reductions (0%, 1%, 2%, and 3%) were used for gait analysis. A Vicon system and force plates were used to collect kinematic data and ground reaction force, respectively. The software package MATLAB was used to create a mathematical model for evaluating the symmetry and force of the hip joint and the low back force of the L5/S1 joint. The model was validated by the correlation coefficient (CC=0.947) and root mean square (RMS=0.028 BW). The model estimated that the 1% group had a symmetrical hip joint force and a lower L5/S1 joint force in the vertical direction. This study indicates that a 1% pylon shortening on a SACH prosthesis is appropriate for a trans-tibial amputee.

  14. Knee joint strength ratios and effects of hip position in rugby players.

    Science.gov (United States)

    Deighan, Martine A; Serpell, Benjamin G; Bitcon, Mark J; De Ste Croix, Mark

    2012-07-01

    Measures of knee joint function, although useful in predicting injury, can be misleading because hip position in traditional seated isokinetic tests is dissimilar to when injuries occur. This study aimed to determine the differences between seated and supine peak torques and strength ratios and examine the interaction of position with joint velocity. This was a cross-sectional, repeated measures study. Isokinetic knee extensor and flexor concentric and eccentric peak torque was measured seated and supine (10° hip flexion) at 1.04 and 3.14 rad·s(-1) in 11 Rugby players. Repeated measures analysis of variance and paired t-tests were used to analyze peak torques and strength ratios. Bonferroni post hoc, limits of agreement, and Pearson's correlation were applied. Seated peak torque was typically greater than that for supine for muscle actions and velocities. The values ranged from 109 ± 18 N·m (mean ± σ) for supine hamstring concentric peak torque at 1.04 rad·s(-1) to 330 ± 71 for seated quadriceps eccentric peak torque at 1.04 rad·s(-1). There was a significant position × muscle action interaction; eccentric peak torque was reduced more than concentric in the supine position. Knee joint strength ratios ranged from 0.47 ± 0.06 to 0.86 ± 0.23, with a significant difference in means between supine and seated positions for functional ratio at 3.14 rad·s(-1) observed; for seated it was 0.86 ± 0.23; and for supine, it was 0.68 ± 0.15 (p torques and knee joint strength ratios. Therefore, the hip angle should be nearer 10° when measuring knee joint function because this is more ecologically valid. Using similar protocols, sports practitioners can screen for injury and affect training to minimize injury.

  15. The Development and Clinical Application of Acoustical Technique in Hip Joint

    Institute of Scientific and Technical Information of China (English)

    黄晓琳; 邝适存; 郑振耀

    2002-01-01

    Summary: A non-invasive acoustical system was developed for the measurement of transmissionproperties of acoustic waves in the hip joints. The instrumentation consisted of three sub-systems.An excitation system employed a vibratory force at the sacrum of the test subjects. A transductionsystem included a pair of identical microphones installed in the tubes of two stethoscopes, whichwere placed at the greater trochanters on both sides for picking up the acoustical signals transmit-ted across the hip joints. The data acquisition and analysis system was a portable signal analyzerwith a program of dual channel digital filter for measuring the power of acoustical signal in 1/3-oc-tave frequency bands. 27 normal adults, 20 normal pre-school children and 40 normal neonateswere randomly selected for testing. Coherence function (CF) and discrepancy(D) was measuredduring the testing. Results from the three groups showed that there was a high coherence of thesignals (CF>0. 9) and a small discrepancy (D<3 dB) between bilateral hips in the frequencyrange of 200-315 Hz. For normal neonates, there was a wider frequency range of 160-315 Hz inwhich the acoustical signals maintained a high coherence (CF>0. 93) and a smaller discrepancy (D<2 dB) was observed. This study showed that the development of the acoustical technique pro-vided a practical method with objective parameters. The results obtained in this study can offer abaseline for further investigation of hip disorders particularly those related to structural abnormali-ties of the hip.

  16. Reliability of the acetabular reconstruction technique using autogenous bone graft from resected femoral head in hip dysplasia: Influence of the change of hip joint center on clinical outcome.

    Science.gov (United States)

    Song, Joo Ho; Ahn, Tae Soo; Yoon, Pil Whan; Chang, Jae Suk

    2017-12-01

    The previous studies have not reached on consensus as to the outcome of acetabular reconstruction with autogenous bone graft for dysplastic hips, especially in severe cases such as Crowe type IV. The current study aimed to determine the survivorship of the arthroplasty and the grafts as well as the change of hip joint center averagely 9.8 years (range, 5-19) after cementless total hip arthroplasty. We reviewed 52 cases including 19 cases of complete hip dislocation of which acetabular defects were augmented with autogenous bone grafts taken from the resected femoral heads. For radiographic evaluation, in addition to checking failures of THA, acetabular coverages of the grafts as well as lateral center-edge angles were measured and compared between two time points, immediately postoperative and the final evaluations. Those outcomes were also analyzed according to the degree of hip dysplasia, grouping the subjects by Crowe classification. Translations of the reconstructed hip joint center after THA were measured and checked if they affected clinical outcomes or caused any complications. To assess clinically, Harris hip score and visualized analogue pain scale were reviewed. Mean coverage ratio of the sockets with the grafts was 28.4% immediately after the surgery (range, 11.1%-65.0%) and 27.2% at the final follow-up (range, 11.1%-63.6%). When comparing high grade dysplasia (Crowe type III, IV) to low grade dysplasia (Crowe type I, II), there was no significant difference of the above outcomes (p = 0.476). As to the location of hip joint center, 14 outliers were located distally within the normal horizontal range especially in cases with Crowe type IV. Those outliers showed no difference on clinical outcome. The mean HHS was 52.2 (range, 19-87) and VAS was 7.2 (range, 5-9) preoperatively, each of which was improved to 92.9 (range, 63-100) and 1.4 (range, 0-4) postoperatively. No failures were experienced during the study period. Acetabular augmentation using

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

    Science.gov (United States)

    Nozawa, Takashi; Noh, Sanghoon; Tanigawa, Hiroyasu

    2012-08-01

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

  18. Three-dimensional helical CT imaging of bone and joint diseases in the trunk and the hip joints. Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Gong Hohghan [Jangxi Medical Coll. (China). First Affiliated Hospital; Hiraishi, Kumiko; Doi, Miwako; Matsui, Ritsuo; Simizu, Tadafumi; Sueyoshi, Kouzou; Narabayashi, Isamu

    1997-12-01

    To confirm the utility of CT scan images for orthopedic surgeons managing patients with complex disorders, we have produced and studied three-dimensional images from helical CT scans of 28 patients with various bone and joint disorders in the trunk and the hip joint. The CT scanner employed was a Toshiba X-force, and the 3D-CT images were constructed on an X-link50. The 3D images obtained could be observed from various projections. Congenital vertebral malformations, spondylosis, OPLL, osteonecrosis, fractures, and bone tumors were examined, and the 3D helical CT images brought useful information to bear on the spatial location and extent of the lesions. Therefore, 3D helical CT should become an indispensable tool for both preoperative examination and post-operative follow-up studies in orthopedic surgery. (author)

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

    Science.gov (United States)

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

    1992-01-01

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

  20. Use of dimensionality reduction for structural mapping of hip joint osteoarthritis data

    Science.gov (United States)

    Theoharatos, C.; Boniatis, I.; Panagiotopoulos, E.; Panayiotakis, G.; Fotopoulos, S.

    2009-10-01

    A visualization-based, computer-oriented, classification scheme is proposed for assessing the severity of hip osteoarthritis (OA) using dimensionality reduction techniques. The introduced methodology tries to cope with the confined ability of physicians to structurally organize the entire available set of medical data into semantically similar categories and provide the capability to make visual observations among the ensemble of data using low-dimensional biplots. In this work, 18 pelvic radiographs of patients with verified unilateral hip OA are evaluated by experienced physicians and assessed into Normal, Mild and Severe following the Kellgren and Lawrence scale. Two regions of interest corresponding to radiographic hip joint spaces are determined and representative features are extracted using a typical texture analysis technique. The structural organization of all hip OA data is accomplished using distance and topology preservation-based dimensionality reduction techniques. The resulting map is a low-dimensional biplot that reflects the intrinsic organization of the ensemble of available data and which can be directly accessed by the physician. The conceivable visualization scheme can potentially reveal critical data similarities and help the operator to visually estimate their initial diagnosis. In addition, it can be used to detect putative clustering tendencies, examine the presence of data similarities and indicate the existence of possible false alarms in the initial perceptual evaluation.

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

    Science.gov (United States)

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

    1992-01-01

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

  2. CT evaluation of chronic hip joint diseases: avascular necrosis vs. osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myeong Jin; Suh, Jin Seok; Lee, Jong Doo; Park, Chang Yoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    Computed tomography (CT) of the hip was done on 37 patients those who have been suffered from chronic hip joint pain. There were 18 patients of avascular necrosis of hip (AVN), 67% of whom were affected bilaterally, 15 patients of degenerative arthritis (DA), 33% bilaterally; one patient of tuberculous arthritis, rheumatoid arthritis and traumatic arthritis respectively. Comparison of the staging by means of the CT and plain film showed good correlation between the two methods. The CT findings of the AVN and OA were also compared; crescent sign or fissure, loss of congruity, and loss or change of normal asterisk sign were more commonly seen in AVN. Acetabular change especially associated cystic appearance, osteophytes formation and joint narrowing were more frequent in OA. CT showed primary and secondary change of AVN and OA more clearly without confusion than plain film. We think that CT can be helpful in evaluation and understanding of each disease process and differentiation of the two lesions in difficult case000.

  3. Tribology and total hip joint replacement: current concepts in mechanical simulation.

    Science.gov (United States)

    Affatato, S; Spinelli, M; Zavalloni, M; Mazzega-Fabbro, C; Viceconti, M

    2008-12-01

    Interest in the rheology and effects of interacting surfaces is as ancient as man. This subject can be represented by a recently coined word: tribology. This term is derived from the Greek word "tribos" and means the "science of rubbing". Friction, lubrication, and wear mechanism in the common English language means the precise field of interest of tribology. Wear of total hip prosthesis is a significant clinical problem that involves, nowadays, a too high a number of patients. In order to acquire further knowledge on the tribological phenomena that involve hip prosthesis wear tests are conducted on employed materials to extend lifetime of orthopaedic implants. The most basic type of test device is the material wear machine, however, a more advanced one may more accurately reproduce some of the in vivo conditions. Typically, these apparatus are called simulators, and, while there is no absolute definition of a joint simulator, its description as a mechanical rig used to test a joint replacement, under conditions approximating those occurring in the human body, is acceptable. Simulator tests, moreover, can be used to conduct accelerated protocols that replicate/simulate particularly extreme conditions, thus establishing the limits of performance for the material. Simulators vary in their level of sophistication and the international literature reveals many interpretations of the design of machines used for joint replacement testing. This paper aims to review the current state of the art of the hip joint simulators worldwide. This is specified through a schematic overview by describing, in particular, constructive solutions adopted to reproduce in vivo conditions. An exhaustive commentary on the evolution and actually existing simulation standards is proposed by the authors. The need of a shared protocol among research laboratories all over the world could lead to a consensus conference.

  4. Three-Dimensional Analysis of the Contact Pattern between the Cortical Bone and Femoral Prosthesis after Cementless Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Hiroshi Wada

    2016-01-01

    Full Text Available The cementless stem Excia (B. Braun, Melsungen, Germany implant has a rectangular cross-sectional shape with back-and-forth flanges and a plasma-sprayed, dicalcium phosphate dihydrate coating from the middle to proximal portion to increase initial fixation and early bone formation. Here, the conformity of the Excia stem to the femoral canal morphology was three-dimensionally assessed using computed tomography. Forty-three patients (45 hips were examined after primary total hip arthroplasty with a mean follow-up of 27 ± 3 months (range: 24–36 months. Spot welds occurred at zone 2 in 16 hips and at zone 6 in 24 hips, with 83% (20/24 hips of those occurring within 3 months after surgery. First- (n=12 hips, second- (n=32, and third- (n=1 degree stress shielding were observed. The stem was typically in contact with the cortical bone in the anterolateral mid-portion (100% and posteromedial distal portions (85%. Stress shielding did not progress, even in cases where the stems were in contact with the distal portions. The anterior flange was in contact with the bone in all cases. The stability of the mid-lateral portion with the dicalcium phosphate dihydrate coating and the anterior flange may have inhibited the progression of stress shielding beyond the second degree.

  5. The relationship of hip joint space to self reported hip pain. A survey of 4.151 subjects of the Copenhagen City Heart Study: the Osteoarthritis Substudy

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, Kjeld;

    2004-01-01

    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......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...

  6. The relationship of hip joint space to self reported hip pain. A survey of 4.151 subjects of the Copenhagen City Heart Study: the Osteoarthritis Substudy

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, Kjeld;

    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 inv...

  7. Rapidly destructive arthrosis of the hip joint in a young adult with systemic lupus erythematosus.

    Science.gov (United States)

    Lee, Yongseung; Motomura, Goro; Yamamoto, Takuaki; Nakashima, Yasuharu; Ohishi, Masanobu; Hamai, Satoshi; Iura, Kunio; Iwamoto, Yukihide

    2015-10-01

    A 37-year-old female had been treated with corticosteroids for systemic lupus erythematosus clinically diagnosed at age 10. She suddenly had right hip pain without any antecedent trauma. Four months after the onset of pain, she visited her primary care physician. On magnetic resonance imaging, joint space narrowing at the weight-bearing area was already seen with bone marrow edematous lesions in both the femoral head and acetabulum. She was treated non-operatively; however, her pain continued to worsen in severity. Thirteen months after the onset of pain, she was referred to our hospital. A plain radiograph showed subluxation of the collapsed femoral head accompanied by destruction of the acetabular rim. Because of her severe intractable pain, she underwent total hip arthroplasty 1 month after her first visit. Histological examination of the resected femoral head revealed pseudogranulomatous lesions along with prominent callus formation, suggesting rapid destruction of the femoral head.

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

    Directory of Open Access Journals (Sweden)

    Rajiv Gandhi

    2015-01-01

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

  9. Assessment of a New Axis of Radiation in Hip Joint Radiographies

    Directory of Open Access Journals (Sweden)

    "A. Esmaeelzadeh

    2005-08-01

    Full Text Available Introduction & Background: The harmful effects of x-rays on sensitive cells such as those of sex gonads are a well-established fact. Therefore, special care should be taken in hip radiographies to protect the gonads. According to the most recent references, to locate the head of femur and its joint in hip radiographies, a line should be drawn from the ASIS to symphysis pubis. To locate the head of the joint, we had to move 2.5cm inferior and laterally from the middle of the men-tioned line. The outer end of this new line indicates the position of the femur head. However, due to the lack of accurate instruments in wards and the variety of diseases and also to avoid repetitive hip radiogra-phies, we decided to apply an experimental method. Patients & Methods: In this study, hip radiographies with FFD=100 were done for 50 patients of both sex with different ages. In all instances the distances be-tween symphysis pubis and the greater trocanter, the base of the lesser trocanter, and upper edge of acetabulum, and symphysis pubis and the center of femur, were measured on the radiographs by means of a standard ruler. The findings were then statisti-cally analyzed. The radiography apparatus was Phil-lips 500MA model D7. Results: In this study, it was shown that in 27 cases, the distance between symphysis pubis and the center of the head of femur was equal to the distance be-tween the base of the lesser trocanter and the upper edge of acetabulum. There was also a difference of 0.5, 1, and 2.5 centimeters in 14, 10, and 3 cases re-spectively. Conclusion: These findings were statistically signifi-cant and new. This is notable with regard to the ease of locating the hip joint in small radiographs. In addi-tion it has the advantage of a small degree of gonadal protection.

  10. Analysis of Relative Motion between Femoral Head and Acetabular Cup and Advances in Computation of the Wear Factor for the Prosthetic Hip Joint

    Directory of Open Access Journals (Sweden)

    O. Calonius

    2003-01-01

    Full Text Available The amount and type of wear produced in the prosthetic hip joint depends on the type of relative motion between the femoral head and the acetabular cup. Wear particles removed from the bearing surfaces of the joint can cause adverse tissue reactions resulting in osteolysis and ultimately in loosening of the fixation of the implant. When designing a simulator for evaluation of prospective materials for artificial hip joints it is important to verify that the type of relative motion at the articulation is similar to that produced in walking, involving continually changing direction of sliding. This paper is an overview of recent research done at Helsinki University of Technology on the analysis of the relationship between relative motion and wear in the prosthetic hip joint.To analyze the relative motion, software for computing tracks, referred to as slide tracks, drawn on the counterface by marker points on the bearing surface was developed and experimentally verified. The overall relative motion of the joint was illustrated by a slide track pattern, produced by many points. The patterns resulting from walking motion and from motion produced in ten contemporary hip simulator types were compared. The slide track computations were not limited to illustrational purposes but offered a basis for computing variations of sliding distances, sliding speeds and direction of sliding during a cycle. This was done for the slide track termed the force track, drawn by the resultant contact force. In addition, the product of the instantaneous load and increment of sliding distance was numerically integrated over a cycle. This track integral of load had so far not been determined for the majority of contemporary hip simulators. The track integral can be used in determining the wear factor, making it possible to compare clinical wear rates with those produced by hip simulators. The computation of the wear factor was subsequently improved by replacing the track

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

    Directory of Open Access Journals (Sweden)

    Philipp Damm

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

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

    Directory of Open Access Journals (Sweden)

    Griffin Damian R

    2010-01-01

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

  13. Variable Amount of Reaction Time and H-Reflex on Position Changes of the Hip Joint

    OpenAIRE

    笠井, 達哉

    1981-01-01

    Postural changes and the difference of attitudes influence the reaction time of a limb muscle. The present study is a modification and extension of previous studies on influence of the position changes in the hip joint on the electromyographic reaction time (EMG-RT) and on the H-reflex of the soleus muscle in normal human subjects. Primarily, the aim of this study was to explore the relevant neurophysiological mechanisms which control reaction time. In experiment I (Exp. I), the EMG-RT fr...

  14. In-vivo degradation mechanism of Ti-6Al-4V hip joints

    DEFF Research Database (Denmark)

    Lomholt, Trine Colding; Pantleon, Karen; Somers, Marcel A. J.

    2011-01-01

    In-vivo exposed Ti-6Al-4V implants were investigated to determine the degradation mechanism occurring during the articulating movements of the hip joint in the human body. Failed implants were compared to Ti-6Al-4V samples, which were tested in the laboratory for their tribocorrosion performance....... was concluded to be of combined mechanical and chemical nature. Wear debris is formed and accumulated in large flakes (>100μm). Upon further sliding the flakes are pressed into the surface and ultimately crushed into small, brittle particulate debris (...

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

    Science.gov (United States)

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

    2007-07-01

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

  16. Lubrication of metal-on-metal hip joints: the effect of protein content and load on film formation and wear.

    Science.gov (United States)

    Myant, C; Underwood, R; Fan, J; Cann, P M

    2012-02-01

    Lubricant films were measured for a series of bovine serum and protein containing (albumin, globulin) saline solutions for CoCrMo femoral component sliding against a glass disc. Central film thickness was measured by optical interferometry as a function of time (constant mean speed: 0 and 10 mm/s) and variable mean speed (0-50 mm/s). The effect of load (5-20 N) on film thickness was also studied. The development of the wear scar on the CoCrMo surface was monitored by measuring the width of the contact zone during the film thickness tests. The results showed film thickness increased with time for both the static and sliding tests. Films formed in the static, loaded test were typically in the range of 3-40 nm. The globulin containing solutions formed the thickest films. In the sliding tests a wear scar rapidly formed on the implant component for the bovine serum and albumin fluids, negligible wear was observed for the globulin solutions. Film thickness increased with sliding time for all test solutions and was much greater than predicted by isoviscous EHL models. The film increase was found to correlate with increasing wear scar size and thus decreasing contact pressure. A new lubricating mechanism is proposed whereby during sliding the fluid undergoes bulk phase separation rheology, so that an elevated protein phase forms in the inlet zone. This protein phase is a high-viscosity biphasic matrix, which is periodically entrained into the contact forming a thick protective hydro-gel film. One of the main findings of this study is that film thickness was very sensitive to load; to a much greater extent than predicted by EHL models. Thus film formation in MoM hip joints is very susceptible to high contact pressures which might be due to implant misalignment and edge-loading.

  17. Quantification of the Contact Area at the Head-Stem Taper Interface of Modular Hip Prostheses.

    Directory of Open Access Journals (Sweden)

    Florian Witt

    Full Text Available Corrosion of modular taper junctions of hip implants may be associated with clinical failure. Taper design parameters, as well as the intraoperatively applied assembly forces, have been proposed to affect corrosion. Fretting corrosion is related to relative interface shear motion and fluid ingress, which may vary with contact force and area. It was hypothesised in this study that assembly forces modify the extent and distribution of the surface contact area at the taper interface between a cobalt chrome head and titanium stem taper with a standard threaded surface profile. Local abrasion of a thin gold coating applied to the stem taper prior to assembly was used to determine the contact area after disassembly. Profilometry was then used to assess permanent deformation of the stem taper surface profile. With increasing assembly force (500 N, 2000 N, 4000 N and 8000 N the number of stem taper surface profile ridges in contact with the head taper was found to increase (9.2±9.3%, 65.4±10.8%, 92.8±6.0% and 100% and the overall taper area in contact was also found to increase (0.6±0.7%, 5.5±1.0%, 9.9±1.1% and 16.1±0.9%. Contact was inconsistently distributed over the length of the taper. An increase in plastic radial deformation of the surface ridges (-0.05±0.14 μm, 0.1±0.14 μm, 0.21±0.22 μm and 0.96±0.25 μm was also observed with increasing assembly force. The limited contact of the taper surface ridges at lower assembly forces may influence corrosion rates, suggesting that the magnitude of the assembly force may affect clinical outcome. The method presented provides a simple and practical assessment of the contact area at the taper interface.

  18. [The causes of arthrosis of the hip-joint. A radiologic study (author's transl)].

    Science.gov (United States)

    Mutter, K; Schlegel, K F

    1975-06-01

    It is often possible to establish the origin of an arthosis of the hip joint radiologically. Only in 17 out of 445 patients were we unable to arrive at a classification because the arthrosis was already too advanced. Data relating to the history are of limited value -- only 21% of our patients knew of earlier disorders of the joint --, so definition of causes an radiographs is important. The high percentage of arthroses the origin of which is known, makes it likely that the concept of "primary arthrosis" is unnecessary, since behind it there hide those cases of apparently ill-defined arhtroses which -- as shown in our results -- can be further differentiated. This radiologically based classification will serve to increase the possibilities of progressing from symptomatic to prophylactic treatment.

  19. Flanged joints with contact outside the bolt circle: ASME Part B design rules

    Energy Technology Data Exchange (ETDEWEB)

    Rodabaugh, E. C.; Moore, S. E.

    1976-05-01

    The ASME Boiler and Pressure Vessel Code, Section VIII, Division 1, gives rules which are subdivided into ''Part A'' and ''Part B''. Part A covers flanged joints where contact between flanges occurs through a gasket located inside the bolt holes. Part B covers flanged joints with contact outside the bolt holes. This report (a) summarizes the theory for Part B flanged joints, (b) presents examples which show the significant differences between Part A flanged joints and Part B flanged joints, (c) presents the available test data relevant to the characteristics of Part B flanged joints, (d) gives listings of two computer programs which can be used to evaluate the characteristics of Part B flanged joints, and (e) gives recommendations for Code revisions and other aspects of Part B flanged-joint design.

  20. Subsurface changes of a MoM hip implant below different contact zones.

    Science.gov (United States)

    Pourzal, Robin; Theissmann, Ralf; Williams, Sophie; Gleising, Birgit; Fisher, John; Fischer, Alfons

    2009-04-01

    Metal-on-metal hip arthroplasties undergo distinct release of toxic metal particles and ions. Thus, it is necessary to minimize this. In order to evaluate the wear behaviour of metal-on-metal hip replacements it is essential to understand the micro-structural changes in the sub-surface region. Previous studies revealed that cobalt chromium metal-on-metal implants are able to alter their mechanical behaviour by adjusting the microstructure to load. The reason for this is the so-called mechanical mixing. This means that a nano-crystal layer is formed by rotating clusters of atoms that incorporate denatured proteins from the interfacial medium. This is followed by a layer of rhombic shaped nano-crystals in between sheared epsilon-martensite lathes, twins, and stacking faults. Although the primary wear zone has been well characterized, the sub-surface structure of the stripe wear and the non-contact zone of the hip ball have yet to be analysed. For this study a 28-mm cobalt base alloy femoral head and acetabular cup were analysed. The implant was simulator tested for 5 million cycles with the application of micro-separation resulting in a clearly visible stripe wear appearance. The TEM micrograph of the primary wear zone of the ball confirmed the presence of a sub-surface layer of nano-crystals. The thickness of this layer was approximately 200 nm and the average grain diameter ranged from 35 to 40 nm. Within the stripe wear zone the micrographs also revealed a nano-crystal layer but with a thickness of only 50 nm and an average grain diameter from 15 to 20 nm. The carbon and oxygen content was highest closest to the surface which proves the occurrence of mechanical mixing. The non-contact zone of the ball was analysed as well. When compared to the primary wear zone a nano-crystal layer with similar thickness but with an average grain diameter smaller than 15 nm was observed.

  1. Low bone mineral density is associated with reduced hip joint space width in women: results from the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Trine W; Bach-Mortensen, Pernille

    2007-01-01

    inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs...... was calculated. Minimum hip JSW was assessed on standardized pelvic radiographs. RESULTS: Digital x-ray radiogrammetry BMD decreased in both men and women after the age of 45 years, progressively more so in women. Although minimum hip JSW in men remained relatively unaltered throughout life, a marked decline...

  2. MR findings associated with positive distraction of the hip joint achieved by axial traction

    Energy Technology Data Exchange (ETDEWEB)

    Suter, Aline; Dietrich, Tobias J.; Maier, Matthias; Pfirrmann, Christian W.A. [Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Dora, Claudio [Orthopedic University Hospital Balgrist, Orthopedic Surgery, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2015-06-01

    To determine which MR-arthrography findings are associated with positive hip joint distraction. One hundred patients with MR arthrography of the hip using axial traction were included. Traction was applied during the MR examination with an 8 kg (females) or 10 kg (males) water bag, attached to the ankle over a deflection pulley. Fifty patients showing joint space distraction were compared to an age- and gender-matched control group of 50 patients that did not show a joint distraction under axial traction. Two radiologists assessed the neck-shaft angle, lateral and anterior center-edge (CE) angles, CE angles in the transverse plane, extrusion index of the femoral head, acetabular depth, alpha angle, acetabular version, ligamentum teres, joint capsule and ligaments, iliopsoas tendon and the labrum. Mean joint space distraction in the study group was 0.9 ± 0.6 mm. Patients with positive joint space distraction had significantly higher neck-shaft angles (control group 131.6 ± 5.4 /study group 134.1 ± 6.1 , p < 0.05), smaller lateral CE angles (38.1 ± 5.9 /34.6 ± 7.2 , p < 0.05), smaller overall transverse CE angles (161.4 ± 9.9 /153.6 ± 9.6 , p < 0.001), smaller acetabular depth (4.1 ± 2.4 mm/5.8 ± 2.5 mm, p < 0.01), higher alpha angles (53.5 ± 7.8 /59.2 ± 10.1 , p < 0.01) and a thicker ligamentum teres (4.7 ± 1.4 mm/5.4 ± 1.8 mm, p < 0.05). The other parameters revealed no significant differences. ICC values for interobserver agreement were 0.71-0.95 and kappa values 0.43-0.92. Increased neck-shaft angles, small CE angles, small acetabular depth, higher alpha angles and a thick ligamentum teres are associated with positive joint distraction. (orig.)

  3. Influence of the contralateral hip state after total hip arthroplasty on patient-reported outcomes measured with the Forgotten Joint Score-12.

    Science.gov (United States)

    Matsumoto, Mikio; Baba, Tomonori; Ochi, Hironori; Ozaki, Yu; Watari, Taiji; Homma, Yasuhiro; Kaneko, Kazuo

    2017-04-25

    The purpose of this study was to examine the influence of the contralateral hip state on postoperative assessment using the Forgotten Joint Score-12 (FJS-12) in comparison with the McMaster Universities Osteoarthritis Index (WOMAC) and the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). One hundred and thirty-four hips underwent total hip arthroplasty (THA) between 2014 and 2015. Of these, the subjects were 106 hips with degenerative hip arthrosis as a primary disease for whom initial THA was performed on the affected side. The WOMAC and JHEQ were investigated before surgery and 1 month, 6 months, and 1 year after surgery. The FJS-12 was examined 1 month, 6 months, and 1 year after surgery. We divided the subjects into three groups based on the state of the contralateral hip, which was not surgically treated in this study: healthy (n = 43), THA (n = 31), and OA (n = 31) groups. One year after surgery, the mean FJS-12 scores in the healthy, THA, and OA groups were 69.1, 52.8, and 68.0 points, respectively. In the THA group, the score was significantly lower than in the healthy and OA group. There were no significant differences in WOMAC and JHEQ scores among the three groups. The FJS-12 score in the presence of an arthroplasty on the contralateral side was more markedly influenced by the contralateral hip state compared with that in the presence of contralateral painful OA. This result suggests that it is necessary to understand the characteristics of PROs and utilize them for post-THA assessment.

  4. Fatigue behaviour of fine-grained alumina hip-joint heads under normal walking conditions

    Indian Academy of Sciences (India)

    D Basu

    2003-06-01

    In prosthetic applications, the reliability of implant materials over a period of thirty years is absolutely essential. Calculation of the lifetimes of alumina ceramic heads is generally made on the basis of experimental fatigue and slow crack growth tests using finite element analysis. This investigation is aimed at understanding the fatigue behaviour of fine-grained alumina heads of hip joints. The service conditions of cyclic stress experienced by hip joints during walking are used in evaluating the fatigue behaviour of alumina femoral heads. These femoral heads have successfully withstood 107 cycles at a maximum walking stress of 17.2 kN, which is equivalent to a body weight of 400 kg. The femoral heads did not exhibit any sub-critical crack growth at the maximum walking load of 10 kN, indicating the quasi-infinite performance life in patients up to a body weight of 250 kg. The details of proof testing designed for evaluating the performance of femoral heads over 40 years are also presented.

  5. Focused shape models for hip joint segmentation in 3D magnetic resonance images.

    Science.gov (United States)

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

    2014-04-01

    Deformable models incorporating shape priors have proved to be a successful approach in segmenting anatomical regions and specific structures in medical images. This paper introduces weighted shape priors for deformable models in the context of 3D magnetic resonance (MR) image segmentation of the bony elements of the human hip joint. The fully automated approach allows the focusing of the shape model energy to a priori selected anatomical structures or regions of clinical interest by preferentially ordering the shape representation (or eigen-modes) within this type of model to the highly weighted areas. This focused shape model improves accuracy of the shape constraints in those regions compared to standard approaches. The proposed method achieved femoral head and acetabular bone segmentation mean absolute surface distance errors of 0.55±0.18mm and 0.75±0.20mm respectively in 35 3D unilateral MR datasets from 25 subjects acquired at 3T with different limited field of views for individual bony components of the hip joint.

  6. MRI for examination of hip joint disorders. Kernspintomographische Untersuchungen bei Hueftgelenkserkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Schedel, H. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Freie Univ. Berlin (Germany)); Wicht, L. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Freie Univ. Berlin (Germany)); Kern, A. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Freie Univ. Berlin (Germany)); Vogl, T. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Freie Univ. Berlin (Germany))

    1993-07-01

    152 patients with pathological manifestations in one or both hip joints were examined with MRI. The cases where it was possible to reliably assess vascularisation or vitality only after i.v. injection of Gd-DTPA were the early stages of femoral head necrosis (n = 5), post-operative follow-up after chip grafting (n = 22), Perthes disease (n = 20), and transitory osteoporosis (n = 21). MRI also had to be supplemented by Gd-DTPA contrast enhancement in order to achieve differential diagnosis of inflammatory processes (n = 20). Lesions due to Paget's disease (n = 5) or traumatic fractures (n = 3) could be fully evaluated by conventional spin-echo sequences without contrast enhancement. The results obtained for post-operative femoral head necroses revealed a distinct correlation between signal intensity upon contrast enhancement with Gd-DTPA and clinical symptoms: strong enhancement and moderate pains up to six months after surgery went together, while low enhancement was correlated with extensive pains. Injection of Gd-DTPA also was important for differential diagnosis of pathological processes in the hip joint and for follow-up examinations after chip grafting. (orig.)

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

    Science.gov (United States)

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

    2015-09-01

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

  8. Vacuum-assisted closure in the treatment of early hip joint infections

    Directory of Open Access Journals (Sweden)

    Jens Kelm, Eduard Schmitt, Konstantinos Anagnostakos

    2009-01-01

    Full Text Available The aim of the present study was to evaluate the efficacy of the vacuum-assisted closure (V.A.C. system in the treatment of early hip joint infections. 28 patients (11 m / 17 f; mean age 71 y. [43-84] with early hip joint infections have been treated by means of the V.A.C.-therapy. At least one surgical revision [1-7] has been unsuccessfully performed for infection treatment prior to V.A.C. - application. Pathogen organisms could have been isolated in 22/28 wounds. During revision, cup inlay and prosthesis head have been exchanged and 1-3 polyvinylalcohol sponges inserted into the wound cavity/ periprosthetically at an initial continuous pressure of 200 mm Hg. Postoperatively, a systemic antibiosis was given according to antibiogram. 48-72 h after surgery an alteration from haemorrhagic to serous fluid was observed in the V.A.C.-canister. Afterwards, the pressure was decreased to 150 mm Hg and remained at this level till sponge removal. After a mean period of 9 [3-16] days the inflammation parameters have been retrogressive and the sponges were removed. An infection eradication could be achieved in 26/28 cases. In the two remaining cases the infected prosthesis had to be explanted and a gentamicin-vancomycin-loaded spacer has been implanted, respectively. At a total mean follow-up of 36 [12-87] months no reinfection or infection persistence was observed. The V.A.C.-system can be a valuable contribution in the treatment of early joint infections when properly used. Indications should be early infections with well-maintained soft-tissues for retention of the negative atmospheric pressure.

  9. A quantitative assessment of the insertional footprints of the hip joint capsular ligaments and their spanning fibers for reconstruction.

    Science.gov (United States)

    Telleria, Jessica J M; Lindsey, Derek P; Giori, Nicholas J; Safran, Marc R

    2014-04-01

    Quantitative descriptions of the hip joint capsular ligament insertional footprints have been reported. Using a three-dimensional digitizing system, and computer modeling, the area, and dimensions of the three main hip capsular ligaments and their insertional footprints were quantified in eight cadaveric hips. The iliofemoral ligament (ILFL) attaches proximally to the anterolateral supra-acetabular region (mean area = 4.2 cm(2)). The mean areas of the ILFL lateral and medial arm insertional footprints are 4.8 and 3.1 cm(2), respectively. The pubofemoral ligament (proximal footprint mean area = 1.4 cm(2)) blends with the medial ILFL anteriorly and the proximal ischiofemoral ligament (ISFL) distally without a distal bony insertion. The proximal and distal ISFL footprint mean areas are 6.4 and 1.2 cm(2), respectively. The hip joint capsular ligaments have consistent anatomic and insertional patterns. Quantification of the ligaments and their attachment sites may aid in improving anatomic repairs and reconstructions of the hip joint capsule using open and/or arthroscopic techniques.

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

    Science.gov (United States)

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

    2012-06-01

    To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P therapy was beneficial to ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.

  11. Wear Debris Characterization and Corresponding Biological Response: Artificial Hip and Knee Joints

    Directory of Open Access Journals (Sweden)

    Md J. Nine

    2014-02-01

    Full Text Available Wear debris, of deferent sizes, shapes and quantities, generated in artificial hip and knees is largely confined to the bone and joint interface. This debris interacts with periprosthetic tissue and may cause aseptic loosening. The purpose of this review is to summarize and collate findings of the recent demonstrations on debris characterization and their biological response that influences the occurrence in implant migration. A systematic review of peer-reviewed literature is performed, based on inclusion and exclusion criteria addressing mainly debris isolation, characterization, and biologic responses. Results show that debris characterization largely depends on their appropriate and accurate isolation protocol. The particles are found to be non-uniform in size and non-homogeneously distributed into the periprosthetic tissues. In addition, the sizes, shapes, and volumes of the particles are influenced by the types of joints, bearing geometry, material combination, and lubricant. Phagocytosis of wear debris is size dependent; high doses of submicron-sized particles induce significant level of secretion of bone resorbing factors. However, articles on wear debris from engineered surfaces (patterned and coated are lacking. The findings suggest considering debris morphology as an important parameter to evaluate joint simulator and newly developed implant materials.

  12. A 3D lower limb musculoskeletal model for simultaneous estimation of musculo-tendon, joint contact, ligament and bone forces during gait.

    Science.gov (United States)

    Moissenet, Florent; Chèze, Laurence; Dumas, Raphaël

    2014-01-03

    Musculo-tendon forces and joint reaction forces are typically estimated using a two-step method, computing first the musculo-tendon forces by a static optimization procedure and then deducing the joint reaction forces from the force equilibrium. However, this method does not allow studying the interactions between musculo-tendon forces and joint reaction forces in establishing this equilibrium and the joint reaction forces are usually overestimated. This study introduces a new 3D lower limb musculoskeletal model based on a one-step static optimization procedure allowing simultaneous musculo-tendon, joint contact, ligament and bone forces estimation during gait. It is postulated that this approach, by giving access to the forces transmitted by these musculoskeletal structures at hip, tibiofemoral, patellofemoral and ankle joints, modeled using anatomically consistent kinematic models, should ease the validation of the model using joint contact forces measured with instrumented prostheses. A blinded validation based on four datasets was made under two different minimization conditions (i.e., C1 - only musculo-tendon forces are minimized, and C2 - musculo-tendon, joint contact, ligament and bone forces are minimized while focusing more specifically on tibiofemoral joint contacts). The results show that the model is able to estimate in most cases the correct timing of musculo-tendon forces during normal gait (i.e., the mean coefficient of active/inactive state concordance between estimated musculo-tendon force and measured EMG envelopes was C1: 65.87% and C2: 60.46%). The results also showed that the model is potentially able to well estimate joint contact, ligament and bone forces and more specifically medial (i.e., the mean RMSE between estimated joint contact force and in vivo measurement was C1: 1.14BW and C2: 0.39BW) and lateral (i.e., C1: 0.65BW and C2: 0.28BW) tibiofemoral contact forces during normal gait. However, the results remain highly influenced by the

  13. The management of hip fracture in the older population. Joint position statement by Gruppo Italiano Ortogeriatria (GIOG).

    Science.gov (United States)

    Pioli, Giulio; Barone, A; Mussi, C; Tafaro, L; Bellelli, G; Falaschi, P; Trabucchi, M; Paolisso, G

    2014-10-01

    This document is a Joint Position Statement by Gruppo Italiano di OrtoGeriatria (GIOG) supported by Società Italiana di Gerontologia e Geriatria (SIGG), and Associazione Italiana Psicogeriatria (AIP) on management of hip fracture older patients. Orthogeriatric care is at present the best model of care to improve results in older patients after hip fracture. The implementation of orthogeriatric model of care, based on the collaboration between orthopaedic surgeons and geriatricians, must take into account the local availability of resources and facilities and should be integrated into the local context. At the same time the programme must be based on the best available evidences and planned following accepted quality standards that ensure the efficacy of the intervention. The position paper focused on eight quality standards for the management of hip fracture older patients in orthogeriatric model of care. The GIOG promotes the development of a clinic database with the aim of obtaining a qualitative improvement in the management of hip fracture.

  14. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  15. The "true" incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl;

    2015-01-01

    BACKGROUND AND PURPOSE: It has been suggested that the risk of prosthetic joint infection (PJI) in patients with total hip arthroplasty (THA) may be underestimated if based only on arthroplasty registry data. We therefore wanted to estimate the "true" incidence of PJI in THA using several data...

  16. Contact mechanics and elastohydrodynamic lubrication in a novel metal-on-metal hip implant with an aspherical bearing surface.

    Science.gov (United States)

    Meng, Qingen; Gao, Leiming; Liu, Feng; Yang, Peiran; Fisher, John; Jin, Zhongmin

    2010-03-22

    Diameter and diametral clearance of the bearing surfaces of metal-on-metal hip implants and structural supports have been recognised as key factors to reduce the dry contact and hydrodynamic pressures and improve lubrication performance. On the other hand, application of aspherical bearing surfaces can also significantly affect the contact mechanics and lubrication performance by changing the radius of the curvature of a bearing surface and consequently improving the conformity between the head and the cup. In this study, a novel metal-on-metal hip implant employing a specific aspherical bearing surface, Alpharabola, as the acetabular surface was investigated for both contact mechanics and elastohydrodynamic lubrication under steady-state conditions. When compared with conventional spherical bearing surfaces, a more uniform pressure distribution and a thicker lubricant film thickness within the loaded conjunction were predicted for this novel Alpharabola hip implant. The effects of the geometric parameters of this novel acetabular surface on the pressure distribution and lubricant thickness were investigated. A significant increase in the predicted lubricant film thickness and a significant decrease in the dry contact and hydrodynamic pressures were found with appropriate combinations of these geometric parameters, compared with the spherical bearing surface.

  17. A TETRACYCLINE LABELING STUDY OF SUBCHONDRAL BONE TISSUES IN OSTEOARTHRITIC HIP JOINT

    Institute of Scientific and Technical Information of China (English)

    徐荣辉; 柴本甫

    1992-01-01

    Seven female patients (mean age of 56 years) with advanced hip joint osteoarthritis underwent total hip replacement. Four days before operation they were given oral tetracycline for two days. During operation specimens were taken from the white articular cartilage, the yellowish articular cartilage and the ivory bone together with their subchondral bone tissues. The undecalcified specimens were cut into 10 μm sections and observed under the fluorescence microscope. In all the specimens the following findings could be observed. 1. The osteoarthritic articular cartilage became thinner, with uneven surface and fissures. 2. The superficial and deep surfaces and the central part of the subchondral bone plate showed bright golden yellow fluorescence. It reflected extensive new bone formation. 3. The subchondral bone trabeculae also revealed bright golden yellow fluorescence on their peripheral borders, so trabeculae turned thicker obviously. 4. The marrow tissues between the bone trabeculae exhibited particulate or spherical bright golden yellow fluorescence, reflecting new bone formation in the marrow. The particulate and spherical bright golden yellow fluorescent materials might aggregate, enlarge and merge into large piece of new bone and they also fused with the neighbouring bone trabeculae. The aforementioned changes in the structure of the subchondral bone tissues increased greatly the mass in the osteoarthritic femoral head.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-05-01

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

  19. ANALYSIS AND RESEARCH OF COMPUTER-AIDED MODEL OF HIP JOINT BASED ON REVERSE ENGINEERING

    Institute of Scientific and Technical Information of China (English)

    Hu Xin; Xi Juntong; Jin Ye; Gu Dongyun; Dai Kerong

    2003-01-01

    Former research work about the modeling of hip joint focus on the upper segment of femoral, and assumes the acetabulum cup is sphere concave, and the acetabulum prostheses is semisphere. A method of acquiring the point data on the surface of the hipbone using the reverse engineering technology is presented. After analyzing the acetabulum surface fitting error, a rotation ellipsoid CAD model is applied to fit the acetabulum surface, and then optimization technique is used to find the geometric parameters of the model. The fitting error between the sphere and rotation ellipsoid is compared and gets the result that the fitting error of rotation ellipsoid is smaller than sphere, and the rotation ellipsoid can describe the shape of the acetabulum better.

  20. Lower Urinary Tract Infection and Periprosthetic Joint Infection after Elective Primary Total Hip Arthroplasty

    Science.gov (United States)

    Park, Chan Ho; Lee, Young-Kyun

    2017-01-01

    Purpose Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a grave complication. Urinary tract infection (UTI) as a source for PJI is controversial. Our purposes were, (1) to evaluate the incidence of PJI after elective primary THA and (2) to determine whether UTI was associated with a risk of PJI after elective primary THA. Materials and Methods We retrospectively reviewed the medical records of 527 patients who underwent elective primary THA by using universal aseptic technique from May 2003 to October 2007. UTI group (13 patients) was defined as patients who underwent THA in status of having an UTI, and the remaining patients were defined as control group (514 patients). We compared the incidence of PJI in both groups. Results During the study period, the incidence of PJI was 0%, regardless of existence (or presence) of UTI. Conclusion There was no significant association between UTI and PJI, when cautiously performed THA. PMID:28316960

  1. Hip joint centre position estimation using a dual unscented Kalman filter for computer-assisted orthopaedic surgery.

    Science.gov (United States)

    Beretta, Elisa; De Momi, Elena; Camomilla, Valentina; Cereatti, Andrea; Cappozzo, Aurelio; Ferrigno, Giancarlo

    2014-09-01

    In computer-assisted knee surgery, the accuracy of the localization of the femur centre of rotation relative to the hip-bone (hip joint centre) is affected by the unavoidable and untracked pelvic movements because only the femoral pose is acquired during passive pivoting manoeuvres. We present a dual unscented Kalman filter algorithm that allows the estimation of the hip joint centre also using as input the position of a pelvic reference point that can be acquired with a skin marker placed on the hip, without increasing the invasiveness of the surgical procedure. A comparative assessment of the algorithm was carried out using data provided by in vitro experiments mimicking in vivo surgical conditions. Soft tissue artefacts were simulated and superimposed onto the position of a pelvic landmark. Femoral pivoting made of a sequence of star-like quasi-planar movements followed by a circumduction was performed. The dual unscented Kalman filter method proved to be less sensitive to pelvic displacements, which were shown to be larger during the manoeuvres in which the femur was more adducted. Comparable accuracy between all the analysed methods resulted for hip joint centre displacements smaller than 1 mm (error: 2.2 ± [0.2; 0.3] mm, median ± [inter-quartile range 25%; inter-quartile range 75%]) and between 1 and 6 mm (error: 4.8 ± [0.5; 0.8] mm) during planar movements. When the hip joint centre displacement exceeded 6 mm, the dual unscented Kalman filter proved to be more accurate than the other methods by 30% during multi-planar movements (error: 5.2 ± [1.2; 1] mm).

  2. CT image analysis from hip joint shelf morphology of 62 normal healthy Japanese

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hiroshi [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    In the present study we measured and analyzed CT imaging of acetabulum in the hip joint of the normal Japanese who were judged normal by simple X-ray, and examined the age difference, sex difference and individual difference among the measurements. We carried out CT imaging and X-ray measurement of 124 hip joints from 62 normal adults (21 men and 41 women). The age ranged from 17 to 76 years (mean 46.2 year). We measured 7 items, which were the pelvic inclination angle, acetabular anterior index, acetabular lateral index, acetabular anteversion angle (AV), anterior acetabular sector angle (AASA), posterior acetabular sector angle, horizontal acetabular sector angle (HASA), and added the correction of pelvic inclination. We also measured Sharp angle, CE angle, and acetabular head index (AHI) which were conventionally used as the measurement values of the simple X-ray normal imaging. From the separate measurement values of men and women, we calculated the mean and the standard deviation, and examined the correlation between the values. In women, AV and Sharp angles were significantly large and AASA was significantly small. These were thought to be unique features for women. It is also suggested that the present results may be reflected that many Japanese women suffer from the luxatio coxae congenita. We found that there is a correlation between age and the measurement value reflecting the state of the sector except AASA, and that the aged subjects have the larger sector. We also found the correlation between the values from CT measurement reflecting the state of sector and that from the simple X-ray measurement, and could obtain the direction and the degree of the sector by combining these two values. (K.H.)

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

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Christensen, Finn Kjær; Pedersen, Niels Wisbech;

    2012-01-01

    for the girls. At the time of skeletal maturity, the centre-edge angle was decreased and the acetabular index angle increased in the affected hip and the nonaffected hip in Stulberg class III/IV/V hips compared with the control group. Initially radiographic changes only occur on the affected hip. At skeletal...

  4. Obesity and increased burden of hip and knee joint disease in Australia: Results from a national survey

    Directory of Open Access Journals (Sweden)

    Ackerman Ilana N

    2012-12-01

    Full Text Available Abstract Background Research involving more representative samples is needed to extend our understanding of the broader impact of obesity in hip or knee joint disease (arthritis and OA beyond clinical settings. Although population-based research has been conducted in the United States, how these findings translate to other countries is unclear. Using a national approach, this study explored associations between obesity and the burden of hip and knee joint disease in Australia (in terms of prevalence, pain, stiffness, function, Health-Related Quality of Life (HRQoL and disease severity. Methods A random sample of 5000 Australians (≥39 years from the federal electoral roll was invited to complete a mailed questionnaire to identify doctor-diagnosed hip arthritis, hip OA, knee arthritis and knee OA and evaluate the burden of these conditions. Validated questionnaires included the WOMAC Index, Assessment of Quality of Life instrument and Multi-Attribute Prioritisation Tool. Body Mass Index (BMI was classified into underweight/normal weight (≤24.99 kg/m2, overweight (25–29.99 or obese (≥30. Multiple logistic regression was used to estimate odds of arthritis and OA, with demographic and socioeconomic variables included in the models. Associations between BMI and other variables were investigated using analysis of covariance, with adjustment for age and sex. Results Data were available from 1,157 participants (23%. Overweight participants had increased odds of knee arthritis (adjusted OR (AOR 1.87, 95%CI 1.14-3.07 and knee OA (AOR 2.11, 95%CI 1.07-4.15. Obesity was associated with higher prevalence of hip arthritis (AOR 2.18, 95%CI 1.17-4.06, knee arthritis (AOR 5.47, 95%CI 3.35-8.95 and knee OA (AOR 7.35, 95%CI 3.85-14.02. Of those with arthritis or OA, obese individuals reported more pain (for hip arthritis, hip OA and knee OA, greater stiffness (for hip arthritis, knee arthritis and knee OA, worse function (all diagnoses, lower HRQoL (for hip

  5. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    Science.gov (United States)

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  6. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces.

    Science.gov (United States)

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F; Fregly, Benjamin J; Delp, Scott L; Banks, Scott A; Pandy, Marcus G; D'Lima, Darryl D; Lloyd, David G

    2013-11-15

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.

  7. THA following deformities due to congenital dislocation of the hip joint.

    Science.gov (United States)

    Macheras, George A; Koutsostathis, Stefanos D; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Galanakos, Spyridon; Papadakis, Stamatios A

    2014-10-02

    Total hip replacement is the treatment of choice for the patient suffering from end-stage hip osteoarthritis. Excellent long-term results have been published. In the presence of deformities due to congenital hip dislocation, total hip replacement is, in most of the cases, a difficult task, since the technique of performing such an operation is demanding and the results could vary. This paper presents our experience and preferred strategies focusing on challenges and surgical techniques associated with reconstructing the dysplastic hip.

  8. Transcriptome-Wide High-Density Microarray Analysis Reveals Differential Gene Transcription in Periprosthetic Tissue From Hips With Chronic Periprosthetic Joint Infection vs Aseptic Loosening.

    Science.gov (United States)

    Omar, Mohamed; Klawonn, Frank; Brand, Stephan; Stiesch, Meike; Krettek, Christian; Eberhard, Jörg

    2017-01-01

    Differentiating between periprosthetic hip infection and aseptic hip prosthesis loosening can be challenging, especially in patients with chronic infections. This study used whole-genome microarray analysis to investigate the transcriptomes of periprosthetic hip tissues to identify genes that are differentially transcripted between chronic periprosthetic hip infection and aseptic hip prosthesis loosening. In this pilot study, a total of 24 patients with either chronic periprosthetic hip infection (n = 12) or aseptic hip prosthesis loosening (n = 12) were analyzed. Periprosthetic hip infection was diagnosed based on modified criteria of the Musculoskeletal Infection Society. To evaluate differences in gene transcription, whole-genome microarray analysis was performed on the mRNA of periprosthetic tissue. Microarray analysis revealed differential gene transcription in periprosthetic hip tissue affected by chronic hip infection vs aseptic hip prosthesis loosening. A total of 39 genes had area under the curve values greater than 0.9 for diagnosing chronic periprosthetic hip infection; 5 genes had annotations relevant to infection and metabolism. The 39 genes also included 7 genes that were differentially transcribed but that have no apparent connection to immune response processes plus 27 genes with unknown function. Differences in gene transcription profiles might represent novel diagnostic targets that can be used to differentiate between chronic periprosthetic hip infections and aseptic hip prosthesis loosening. Secondary metabolites of differentially transcripted genes might serve as easily accessible markers for detecting chronic periprosthetic joint infection in future. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Altered Tibiofemoral Joint Contact Mechanics and Kinematics in Patients with Knee Osteoarthritis and Episodic Complaints of Joint Instability

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A.; Klatt, Brian A.; Gustafson, Jonathan A.; Tashman, Scott; Fitzgerald, G. Kelley

    2014-01-01

    Background To evaluate knee joint contact mechanics and kinematics during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. Methods Forty-three subjects, 11 with medial compartment knee osteoarthritis and self-reported instability (unstable), 7 with medial compartment knee osteoarthritis but no reports of instability (stable), and 25 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a downhill gait task on a treadmill. Findings The medial compartment contact point excursions were longer in the unstable group compared to the stable (p=0.046) and the control groups (p=0.016). The peak medial compartment contact point velocity was also greater for the unstable group compared to the stable (p=0.047) and control groups (p=0.022). Additionally, the unstable group demonstrated a coupled movement pattern of knee extension and external rotation after heel contact which was different than the coupled motion of knee flexion and internal rotation demonstrated by stable and control groups. Interpretation Our findings suggest that knee joint contact mechanics and kinematics are altered during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. The observed longer medial compartment contact point excursions and higher velocities represent objective signs of mechanical instability that may place the arthritic knee joint at increased risk for disease progression. Further research is indicated to explore the clinical relevance of altered contact mechanics and kinematics during other common daily activities and to assess the efficacy of rehabilitation programs to improve altered joint biomechanics in knee osteoarthritis patients with self-reported instability. PMID:24856791

  10. The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises

    OpenAIRE

    Lee, Su-Kyoung; Park, Du-Jin

    2013-01-01

    [Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0...

  11. Concentric joint space narrowing of the hip associated with hemosiderotic synovitis (HS) including pigmented villonodular synovitis (PVNS)

    Energy Technology Data Exchange (ETDEWEB)

    Abrahams, T.G.; Pavlov, H.; Bansal, M.; Bullough, P.

    1988-01-01

    Concentric joint space narrowing of the hip is an expected radiographic finding in cases of inflammatory arthritis such as rheumatoid arthritis or sepsis. However, similar joint space narrowing is associated with chronic hemorrhagic conditions that produce hemosiderotic synovitis. Hemosiderotic synovitis results from chronic intraarticular bleeding such as occurs in pigmented villonodular synovitis, generalized bleeding diathesis, synovial hemangioma, and chronic trauma. Five hips in five patients with concentric joint space narrowing not associated with inflammatory arthritis or with hemophilia were reviewed clinically, radiographically, and pathologically. All patients had a hemosiderotic synovitis. The definitive diagnosis of pigmented villonodular synovitis was made pathologically in two cases that demonstrated nodular areas of giant cell proliferation, collagen production, and lipid-laden histiocytes on histologic samples. (orig.)

  12. The effectiveness of massage in therapy for obturator nerve dysfunction as complication of hip joint alloplasty-case report.

    Science.gov (United States)

    Kassolik, Krzysztof; Kurpas, Donata; Wilk, Iwona; Uchmanowicz, Izabella; Hyży, Jacek; Andrzejewski, Waldemar

    2014-01-01

    The purpose of our case presentation was to reveal effectiveness of medical massage in the therapy for obturator nerve dysfunction as a complication of hip joint alloplasty. Medical massage was carried out in a 58-year-old man after hip joint alloplasty. The aim was to normalize tension of muscle-ligament-fascia apparatus within pelvic girdle and reconstruct correct structural conditions in the course of obturator nerve. The methodology included correct positioning and medical massage with individually designed procedures. Full normalization of muscular tone and subsidence of pain complaints were obtained. Massage has a positive influence on subsidence of pain complaints; however, effectiveness of the procedure depends on an appropriate methodology. The presented massage procedure is an effective therapy in obturator nerve dysfunction as complication after alloplasty and it can be one of elements of complex improvement after surgical joint procedures within the scope of nursing rehabilitation. © 2013 Association of Rehabilitation Nurses.

  13. The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Gosvig, K.K.; Jacobsen, S.; Sonne-Holm, S.

    2008-01-01

    . The relationships between cam malformation and self-reported hip pain were evaluated, and the relative importance of known risk factors for cam malformation estimated. RESULTS: We found a pronounced sex-related difference in cam-deformity distribution. The overall prevalence of cam deformity was approximately 17......% in men and 4% in women. The distribution of cam deformity was unaltered in subjects with normal joint-space width or other features of hip-joint degeneration. We found no significant association with self-reported hip pain, nor did we find any relative importance of possible risk factors for hip...

  14. Clinical experience with a new hip-knee-ankle-foot orthotic system using a medial single hip joint for paraplegic standing and walking.

    Science.gov (United States)

    Saitoh, E; Suzuki, T; Sonoda, S; Fujitani, J; Tomita, Y; Chino, N

    1996-01-01

    The Walkabout is a new hip-knee-ankle-foot orthotic (HKAFO) system with a medial single hip joint (MSH-KAFO) invented by S. McKay in 1992. Compared with other HKAFO systems, the hip joint part is compact and removable, so it has distinguishable, real merits: ease in donning and doffing the device, compatibility with a wheelchair, and cosmesis. We clinically tested five patients, paraplegic because of spinal cord injury, using the MSH-KAFO system. All were males, aged 26-36 yr old. Their functional levels were L-1 (2 cases), T-10 (2 cases), and T-5 (1 case). All patients could stand stably without crutches and walk in parallel bars immediately the first time they wore the braces. After a few hours of crutch-walking exercises, all could walk independently with Lofstrand crutches. Their walking velocities ranged from 10 to 37.5 (mean, 19.9) m/min at the follow-up points (mean, 7.1 mo). With four cases, we measured oxygen uptake for predictions of energy consumption. At comfortable walking, predicted energy consumptions were from 1.31 to 3.89 (mean, 2.75) METs. Compared with the data in literature, these seemed to be at the same level with normal walking and lower than the KAFOs walking level. Our results suggest that MSH-KAFO is a very convenient standing and walking device for paraplegics and is compatible with wheelchair use.

  15. Sample size for prospective studies of hip joint space width narrowing in osteoarthritis by the use of radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Sipola, Petri [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, Faculty of Health Sciences, Kuopio (Finland); Niemitukia, Lea H. [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); Hyttinen, Mika M. [University of Eastern Finland, Institute of Biomedicine, Anatomy, Kuopio (Finland); Arokoski, Jari P.A. [Kuopio University Hospital, Department of Physical and Rehabilitation Medicine, Kuopio (Finland)

    2011-04-15

    To determine the number of participants required in controlled clinical trials investigating the progression of osteoarthritis (OA) of the hip as evaluated by the joint space width (JSW) on radiographs and to evaluate the reproducibility of the JSW measurement methods. Anteroposterior radiographs of hip were taken from 13 healthy volunteers and from 18 subjects with radiographic hip OA. The reproducibility of the JSW was determined from four segments using digital caliper measurements performed on film radiographs and using semiautomatic computerized image analysis of digitized images. Pearson correlation coefficient, coefficient of variability [CV (%)], and sample size values were calculated. It was found that 20 was a typical number of patients for a sufficiently powered study. The highest sample size was found in subjects with OA in the lateral segment. The reproducibility of the semiautomatic computerized method was not significantly better than the digital caliper method. The number of study subjects required to detect a significant joint space narrowing in follow-up studies is influenced by the baseline hip joint OA severity. The JSW measurements with computerized image analysis did not improve the reproducibility and thus performing JSW measurements with a digital caliper is acceptable. (orig.)

  16. Three-dimensional knee joint contact forces during walking in unilateral transtibial amputees.

    Science.gov (United States)

    Silverman, Anne K; Neptune, Richard R

    2014-08-22

    Individuals with unilateral transtibial amputations have greater prevalence of osteoarthritis in the intact knee joint relative to the residual leg and non-amputees, but the cause of this greater prevalence is unclear. The purpose of this study was to compare knee joint contact forces and the muscles contributing to these forces between amputees and non-amputees during walking using forward dynamics simulations. We predicted that the intact knee contact forces would be higher than those of the residual leg and non-amputees. In the axial and mediolateral directions, the intact and non-amputee legs had greater peak tibio-femoral contact forces and impulses relative to the residual leg. The peak axial contact force was greater in the intact leg relative to the non-amputee leg, but the stance phase impulse was greater in the non-amputee leg. The vasti and hamstrings muscles in early stance and gastrocnemius in late stance were the largest contributors to the joint contact forces in the non-amputee and intact legs. Through dynamic coupling, the soleus and gluteus medius also had large contributions, even though they do not span the knee joint. In the residual leg, the prosthesis had large contributions to the joint forces, similar to the soleus in the intact and non-amputee legs. These results identify the muscles that contribute to knee joint contact forces during transtibial amputee walking and suggest that the peak knee contact forces may be more important than the knee contact impulses in explaining the high prevalence of intact leg osteoarthritis.

  17. Application of a falsification strategy to a musculoskeletal model of the lower limb and accuracy of the predicted hip contact force vector.

    Science.gov (United States)

    Modenese, L; Gopalakrishnan, A; Phillips, A T M

    2013-04-05

    In the literature, lower limb musculoskeletal models validated against in vivo measured hip contact forces (HCFs) exhibit a tendency to overestimate the HCFs magnitude and predict inaccurate components of the HCF vector in the transverse plane. In order to investigate this issue, a musculoskeletal model was forced to produce HCFs identical to those measured and the resulting joint equilibrium equations were studied through both a general approach and a static optimization framework. In the former case, the existence of solutions to the equilibrium equations was investigated and the effect of varying the intersegmental moments and the muscle tetanic stress assessed: for a value of 100 N/cm(2) and moments calculated from an inverse dynamics analysis on average only 62% of analyzed frames were solvable for level walking and 70% for stair climbing. In the static optimization study, the model could reproduce the experimental HCFs but the recruited muscles were unable to simultaneously equilibrate the hip intersegmental moments without the contribution of reserve moment actuators. Without constraints imposed on the HCFs, the predicted HCF vectors presented maximum angle deviations up to 22° for level walking and 33° for stair climbing during the gait stance phase. The influence of the medio-lateral HCF component on the solvability of the equilibrium equations and the muscle recruitment alteration when the model was forced to produce the experimental HCFs suggest that a more accurate geometrical representation of the gluteal muscles is mandatory to improve predictions of the HCF vector yielded by the static optimization technique.

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

    Directory of Open Access Journals (Sweden)

    Kalacı Aydıner

    2009-01-01

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

  19. Modern radiological postoperative diagnostics of the hip joint in children and adults; Moderne radiologische postoperative Diagnostik des Hueftgelenks im Kindes- und Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Weber, M.A.; Thierjung, H.; Kloth, J.K. [Heidelberg University Hospital (Germany). Diagnostic and Interventional Radiology; Egermann, M. [Heidelberg University Hospital (Germany). Center for Orthopedics

    2015-07-15

    The assessment of bone healing and loosening of endoprosthesis material was long the primary indication for postoperative projection radiography and CT imaging of the hip joint following trauma and endoprosthesis implantation. With the increasing number of joint-preserving surgery, e. g. of surgical hip luxation and hip arthroscopy for the treatment of femoroacetabular impingement (FAI), high-resolution imaging of intra-articular pathologies before and after surgery has become increasingly important. In this review article, diagnostic imaging of the hip joint is presented following common trauma surgery and orthopedic surgery interventions. The imaging modalities of projection radiography, CT and MRI including direct MR-arthrography are discussed with regard to their diagnostic capability in the postoperative assessment of the hip joint. Among others topics, imaging is discussed following hip arthroplasty, following surgical hip luxation and arthroscopic interventions for the treatment of FAI, as well as following core decompression for avascular necrosis of the femoral head. Moreover, orthopedic interventions of the hip joint in children and adolescents are presented and the dedicated reporting of postoperative imaging is outlined.

  20. Meaningful changes for the Oxford hip and knee scores after joint replacement surgery.

    Science.gov (United States)

    Beard, David J; Harris, Kristina; Dawson, Jill; Doll, Helen; Murray, David W; Carr, Andrew J; Price, Andrew J

    2015-01-01

    To present estimates of clinically meaningful or minimal important changes for the Oxford Hip Score (OHS) and the Oxford Knee Score (OKS) after joint replacement surgery. Secondary data analysis of the NHS patient-reported outcome measures data set that included 82,415 patients listed for hip replacement surgery and 94,015 patients listed for knee replacement surgery was performed. Anchor-based methods revealed that meaningful change indices at the group level [minimal important change (MIC)], for example in cohort studies, were ∼ 11 points for the OHS and ∼ 9 points for the OKS. For assessment of individual patients, receiver operating characteristic analysis produced MICs of 8 and 7 points for OHS and OKS, respectively. Additionally, the between group minimal important difference (MID), which allows the estimation of a clinically relevant difference in change scores from baseline when comparing two groups, that is, for clinical trials, was estimated to be ∼ 5 points for both the OKS and the OHS. The distribution-based minimal detectable change (MDC90) estimates for the OKS and OHS were 4 and 5 points, respectively. This study has produced and discussed estimates of minimal important change/difference for the OKS/OHS. These estimates should be used in the power calculations and the interpretation of studies using the OKS and OHS. The MDC90 (∼ 4 points OKS and ∼ 5 points OHS) represents the smallest possible detectable change for each of these instruments, thus indicating that any lower value would fall within measurement error. Copyright © 2015 University of Oxford. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Affatato, Saverio; Freccero, Nadia; Taddei, Paola

    2016-01-01

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

  2. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Directory of Open Access Journals (Sweden)

    Sen Ramesh Kumar

    2011-06-01

    Full Text Available 【Abstract】This paper discussed the injury mecha- nism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture- dislocations of the left hip (Pipkin’s type IV and knee (Moore II joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin’s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabi- lized with lateral buttress plate and a transarticular span- ning fixator. The open fracture on the other leg was de- brided and fixed with an external fixator. There was no insta- bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appro- priate intervention can provide good functional outcome to the patient in this situation. Key words: Hip dislocation; Knee dislocation; Fractures, bone

  3. Reliability of sagittal plane hip, knee, and ankle joint angles from a single frame of video data using the GAITRite camera system.

    Science.gov (United States)

    Ross, Sandy A; Rice, Clinton; Von Behren, Kristyn; Meyer, April; Alexander, Rachel; Murfin, Scott

    2015-01-01

    The purpose of this study was to establish intra-rater, intra-session, and inter-rater, reliability of sagittal plane hip, knee, and ankle angles with and without reflective markers using the GAITRite walkway and single video camera between student physical therapists and an experienced physical therapist. This study included thirty-two healthy participants age 20-59, stratified by age and gender. Participants performed three successful walks with and without markers applied to anatomical landmarks. GAITRite software was used to digitize sagittal hip, knee, and ankle angles at two phases of gait: (1) initial contact; and (2) mid-stance. Intra-rater reliability was more consistent for the experienced physical therapist, regardless of joint or phase of gait. Intra-session reliability was variable, the experienced physical therapist showed moderate to high reliability (intra-class correlation coefficient (ICC) = 0.50-0.89) and the student physical therapist showed very poor to high reliability (ICC = 0.07-0.85). Inter-rater reliability was highest during mid-stance at the knee with markers (ICC = 0.86) and lowest during mid-stance at the hip without markers (ICC = 0.25). Reliability of a single camera system, especially at the knee joint shows promise. Depending on the specific type of reliability, error can be attributed to the testers (e.g. lack of digitization practice and marker placement), participants (e.g. loose fitting clothing) and camera systems (e.g. frame rate and resolution). However, until the camera technology can be upgraded to a higher frame rate and resolution, and the software can be linked to the GAITRite walkway, the clinical utility for pre/post measures is limited.

  4. The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises.

    Science.gov (United States)

    Lee, Su-Kyoung; Park, Du-Jin

    2013-07-01

    [Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0, 5, 10, and 15°. [Result] The changes in the knee joint angle and the hip abduction angle exhibited statistically significant effects on the cervical erector spinae, adductor magnus, and gluteus medius muscles. The abduction angles did not result in statistically significant effects on the upper trapezium, erector spinae, external oblique, and rectus abdominis muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. [Conclusion] When patients with both cervical and back pain do a bridging exercise, widening the knee joint angle would reduce cervical and shoulder muscle activity through minimal levels of abduction, permitting trunk muscle strengthening with reduced cervical muscle activity. This method would be helpful for strengthening trunk muscles in a selective manner.

  5. Leg length equalization for total hip joint replacement patients%人工全髋关节置换术中肢体长度的平衡

    Institute of Scientific and Technical Information of China (English)

    马保安; 范清宇; 周勇; 张勇; 杨彤涛; 陈军

    2002-01-01

    Objective To investigate the methods to maintain leg equalization for patients undergoing primary total hip joint replacement. Methods 40 patients,45 hips with various diseases were treated by total hip joint replacement from Jan 2000 to Sep 2001.Before operation, the perpendicular length from center of femoral head to the summit of great tuberosity and the tip of less tuberosity to the line of bilateral ischial tuberosity were measured; the length from anterior superior iliac spine to medial malleolus were measured at same time.Leg length was decided and corrected according to these lines. Results Before operation, shortening of limbs were presented in 39 hips, 1 to 4 cm, average 2.4 cm.After operation, discrepancy of both legs was 0~ 0.8 cm.Apparent limps were not observed in all patients. Conclusion This measurement is a useful method to maintain and recover leg length in total hip joint replacement.

  6. Low bone mineral density is associated with reduced hip joint space width in women: results from the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Trine W; Bach-Mortensen, Pernille

    2007-01-01

    OBJECTIVE: Since estrogen receptors (ER-alpha/ER-beta) were identified in human chondrocytes, animal and experimental studies have demonstrated the importance of continued estrogen production for the integrity of articular cartilage. However, human epidemiological support of the hypothesis has been...... inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs...... was calculated. Minimum hip JSW was assessed on standardized pelvic radiographs. RESULTS: Digital x-ray radiogrammetry BMD decreased in both men and women after the age of 45 years, progressively more so in women. Although minimum hip JSW in men remained relatively unaltered throughout life, a marked decline...

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

    Science.gov (United States)

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

    2015-03-01

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

  8. Changes in gene expression profiles of the hip joint ligament of patients with ankylosing spondylitis revealed by DNA chip.

    Science.gov (United States)

    Xu, Ling; Sun, Qingwen; Jiang, Songmin; Li, Jia; He, Chongru; Xu, Weidong

    2012-10-01

    To investigate the pathogenesis of abnormal ossification of the hip ligament in patients with ankylosing spondylitis (AS) by comparing gene expression profiles of the hip ligament in patients with AS to those in normal persons using DNA microarray technology, we studied 18 patients with AS (case group) who underwent total hip arthroplasty in our department from March 1, 2009 to January 31, 2010 and compared them with 6 patients with femoral neck fracture (control group) who underwent total hip replacement. We screened the first five patients in each group with the HumanWG-6 v3.0 Expression BeadChip. Compared to the control group, 519 genes in the case group showed statistically significant differences. Among these, there were 238 upregulated genes and 196 downregulated genes. Gene Ontology (GO) classification showed that differential genes in the hip joint ligaments of patients with AS were involved in immunity, cell adhesion, membrane transport, sugar metabolism, polysaccharide synthesis and metabolism, and cell motility. The Kyoto Encyclopedia of Genes and Genomes classification showed that these differential genes were involved in B cell receptor signaling pathways, adherens junction, protein export, fructose and mannose metabolism, T cell receptor signaling pathways, keratin sulfate biosynthesis, N-glycan biosynthesis, and regulation of the actin cytoskeleton. We tested 2 genes from the screened differential genes in 18 case patients and 6 control cases using real-time polymerase chain reaction. The results demonstrated that the expression of the B4GALT3 gene in the case group was 15.32 times higher than that in the control group (P hip joint ligament ossification.

  9. Serum levels of BMP-2, 4, 7 and AHSG in patients with degenerative joint disease requiring total arthroplasty of the hip and temporomandibular joints.

    Science.gov (United States)

    Albilia, Jonathan B; Tenenbaum, Howard C; Clokie, Cameron M L; Walt, David R; Baker, Gerald I; Psutka, David J; Backstein, David; Peel, Sean A F

    2013-01-01

    To date, there is no objective or reliable means of assessing the severity of degenerative joint disease (DJD) and need for joint replacement surgery. Hence, it is difficult to know when an individual with DJD has reached a point where total arthroplasty is indicated. The purpose of the present study is to determine whether serum levels of Alpha-2 HS-glycoprotein (AHSG) as well as bone morphogenetic proteins (BMP-2, 4, 7) can be used to predict the presence of severe DJD of the hip and/or temporomandibular joint (TMJ) (specifically: joints that require replacement). A total of 30 patients scheduled for arthroplasty (diseased) (15 HIP, 15 TMJ) and 120 age-matched controls (healthy/non-diseased) were included. Blood samples were collected from all patients ≥8 weeks after the last arthroplasty. Concentrations of serum analytes were measured using enzyme-linked immunosorbent assays, and these were compared between the Diseased and Healthy groups, utilizing the Mann-Whitney U-test. Patients with disease had significantly higher levels of BMP-2 and BMP-4 and lower levels of AHSG in serum compared to non-diseased humans (p < 0.01). Higher levels of BMP-2, 4 and reduced levels of AHSG appear to characterize patients who have DJD that is severe enough to require total joint replacement. Perhaps measurements of these proteins can be used to make objective decisions regarding the need for total arthroplasty as opposed to the current subjective approaches.

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

    Science.gov (United States)

    Dumas, R; Cheze, L

    2008-08-01

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

  11. An investigation of the association between grip strength and hip and knee joint moments in older adults.

    Science.gov (United States)

    Samuel, Dinesh; Rowe, Philip

    2012-01-01

    Grip strength is a predictor of health outcomes but with differing rates of age-related decline in muscle strength, it is unclear whether handgrip is a reliable indicator of lower limb moments. This study investigated the relationship between grip strength and lower extremity moments in community-dwelling older adults. Eighty-two healthy volunteers aged 60-82 years (mean age 73.2 years) performed maximal voluntary contractions of knee and hip extensors and flexors at three positions and at neutral position for hip abductors and adductors using a custom-built dynamometer. Grip strength was measured using an electronic Jamar dynamometer. The relative reduction in muscle strength of 80s age category compared to 60-year-olds ranged from 14% for grip strength to 27% for hip abductors. Peak torque of flexors and extensors of the knee and hip joints were significantly correlated with grip strength and Pearson's correlation coefficients ranged from 0.56 to 0.78 with the highest correlations observed between knee moments and grip strength. "Good" correlation was found but only 31-60% of the variation in grip strength could be related to changes in joint torques. Hence the assumption that grip strength is an indicator of strength in the lower limb would seem unjustified in the healthy older adult.

  12. Digital correction of magnification in pelvic x rays for preoperative planning of hip joint replacements : Theoretical development and clinical results of a new protocol

    NARCIS (Netherlands)

    The, B; Diercks, RL; Stewart, RE; van Ooijen, PMA; van Horn, [No Value; van Horn, J.R.

    2005-01-01

    The introduction of digital radiological facilities leads to the necessity of digital preoperative planning, which is an essential part of joint, replacement surgery. To avoid errors in the preparation and execution of hip surgery, reliable correction of the Magnification of the projected hip is a p

  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. Mechanical and physiological factors in knee joint contact mechanics

    DEFF Research Database (Denmark)

    Mølgaard, Carsten

    Numerous biomechanical studies have provided evidence that laterally wedged insoles reduce the knee adduction moment during walking in healthy controls as well as patients with knee osteoarthritis potentially reducing the contact stress of medial tibial and femoral condyles. The knee adduction...... conservative treatment modalities also increases. The aim of this thesis was to 1) identify relationships between footwear and laterally wedged insoles in a healthy group, 2) to evaluate the mechanical and physiological factors of experimental pain when introducing a laterally wedged insoles to otherwise...... healthy subjects, and 3) to identify the acute effect of laterally wedged insoles on biomechanical markers in patients after an medial arthroscopic partial meniscectomy. The results showed that shoe design and lateral wedges are equally important factors for changing the knee adduction moment...

  15. Acute changes of hip joint range of motion using selected clinical stretching procedures: A randomized crossover study.

    Science.gov (United States)

    Hammer, Adam M; Hammer, Roger L; Lomond, Karen V; O'Connor, Paul

    2017-09-01

    Hip adductor flexibility and strength is an important component of athletic performance and many activities of daily living. Little research has been done on the acute effects of a single session of stretching on hip abduction range of motion (ROM). The aim of this study was to compare 3 clinical stretching procedures against passive static stretching and control on ROM and peak isometric maximal voluntary contraction (MVC). Using a randomized crossover study design, a total of 40 participants (20 male and 20 female) who had reduced hip adductor muscle length attended a familiarization session and 5 testing sessions on non-consecutive days. Following the warm-up and pre-intervention measures of ROM and MVC, participants were randomly assigned 1 of 3 clinical stretching procedures (modified lunge, multidirectional, and joint mobilization) or a static stretch or control condition. Post-intervention measures of ROM and MVC were taken immediately following completion of the assigned condition. An ANOVA using a repeated measure design with the change score was conducted. All interventions resulted in small but statistically significant (p stretching was greater than control (p = 0.031). These data suggest that a single session of stretching has only a minimal effect on acute changes of hip abduction ROM. Although hip abduction is a frontal plane motion, to effectively increase the extensibility of the structures that limit abduction, integrating multi-planar stretches may be indicated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. [Development of the ceramic sandwich cup used for the hip joint prosthesis.].

    Science.gov (United States)

    Konvicková, S; Cech, O

    1995-01-01

    The abrasion of the polyethylene seems to be the most important factor participating on the endoprosthesis loosening. From this reason, the ceramics (AI2O3) was introduced for the both parts of the prosthesis, i. e. the head and the cup. It appears that the friction resistance is an important factor for the comparison of the hitherto applied endoprosthesis designs with the new developed type. The frictional resistance in the hip joint total prosthesis was measured by means of a testing device which allowed a swinging motion of the ceramic ball in the tested cup in the range of +/-25 degrees . This measurement was carried out at the loading levels being 0; 500; 1000; 1500 and 2000 N. For the comparison of the frictional resistance of single measured couples "cup-head", the energy consumed was ascertained which was necessary for including a swinging motion over the time interval of 35 sec. Ceramic cups manufactured by a. s. DIAS Turnov were used for the measurement. Altogether eight couples "ceramics-ceramics" having the diameter differences ranging from 0,022 mm to 0,137 mm and one friction couple "polyethylene cup-ceramics ball" were measured. The research of influence of different lubricants was also done. Key words: sandwich cup, total prosthesis, ceramics--ceramics, bioceramics, frictional resistance.

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

    Science.gov (United States)

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

    2010-11-01

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

  18. Development of optimized epoxy graphite implant for the total hip joint.

    Science.gov (United States)

    Iyer, L S; Jayasekaran, T; Blunck, C F; Selvam, R P

    1984-01-01

    Various metal implants are available for total hip joint replacements. There are problems associated with the micromovement of the implants with bone and/or with bone cement and about ten percent failure cases are reported. The mechanical properties of the metal implants do not match with that of human bone in the femur resulting in a stress distribution in the femur different from one without implant. Many researchers are working with different materials like alloy materials with lower modulus of elasticity, ceramic, etc. The study conducted at S.D.S.M. & T. biomechanics laboratory investigates the feasibility of using epoxy graphite as an implant material. The mechanical properties of the implant material are being optimized using experimental and analytical methods. The reflection polariscope method (photo stress method) was used to determine the micromovement of the implant and the bone, and stress distribution in the femur subjected to cyclic loading. A finite element method was used to optimize the mechanical properties of the implant to obtain a stress distribution closer to the one without implant. An epoxy graphite implant with optimized mechanical properties is being manufactured and tests are in progress.

  19. Use of Autoplasma in the Prevention of Venous Thromboses during Endoprosthetic Replacement of the Hip Joint

    Directory of Open Access Journals (Sweden)

    S. A. Kravtsov

    2009-01-01

    Full Text Available Hip joint endoprosthetic replacement (HJER leads to hemodynamic disorders and massive intraoperative hemorrhage and presents a high risk (30—55% of cases for postoperative deep vein thrombosis in the lower extremity, at the same time the possibility (12—22% of massive pulmonary thromboembolism (PTE is ruled out. So the choice of infusion-transfusion therapy is of paramount importance in these patients. The authors studied the efficiency of normovolemic hemodilution with the autoplasma (patented in the Russian Federation in treating massive perioperative hemorrhage in patients undergoing HJER and in reducing postoperative thrombotic events. It was compared with infusion therapy comprising hydroxyethyl starch (130/0.4. All the patients had spinal anesthesia and standard postoperative analgesia in an intensive care unit. The administration of autologous fresh frozen plasma resulted in a 15% reduction in intraoperative blood loss, by increasing the coagulation potential and platelet aggregability. Postoperatively, there was an overall increase in the hypercoagulation potential, both the plasma link and platelet aggregability, in both groups. The use of autologous plasma by elevating the concentration of natural anticoagulants (AT III by 9% could prevent 35 and 75% rises in soluble fibrin monomer complexes and D-dimer. In two patients from the comparative group, the postoperative period was complicated by the development of occlusive thrombosis of the femoral vein. Key words: intraoperative hemodilution, auto-plasma, vein thromboses.

  20. 先天性髋关节脱位术后康复训练38例体会%Experience of postoperative rehabilitation training on 38 cases of congenital dislocation of hip joint

    Institute of Scientific and Technical Information of China (English)

    闫庆荣; 丁新友

    2003-01-01

    @@ BACKGROUND: Postoperative long-tern immobilization ofdislocation of hip joint may lead to degradation of ligament structure, decreasing of intensity and decline of stress ability. Besides tissue proliferation, organization and adhesion in the course of repairing will lead to dysfunction of hip jolt even stiffness. So planned rehabilitation training on hip joint is very necessary.

  1. Validation of a Finite Element Humeroradial Joint Model of Contact Pressure Using Fuji Pressure Sensitive Film.

    Science.gov (United States)

    Kim, Sunghwan; Carl Miller, Mark

    2016-01-01

    A finite element (FE) elbow model was developed to predict the contact stress and contact area of the native humeroradial joint. The model was validated using Fuji pressure sensitive film with cadaveric elbows for which axial loads of 50, 100, and 200 N were applied through the radial head. Maximum contact stresses ranged from 1.7 to 4.32 MPa by FE predictions and from 1.34 to 3.84 MPa by pressure sensitive film measurement while contact areas extended from 39.33 to 77.86 mm2 and 29.73 to 83.34 mm2 by FE prediction and experimental measurement, respectively. Measurements from cadaveric testing and FE predictions showed the same patterns in both the maximum contact stress and contact area, as another demonstration of agreement. While measured contact pressures and contact areas validated the FE predictions, computed maximum stresses and contact area tended to overestimate the maximum contact stress and contact area.

  2. Microscopic analysis of the iliofemoral and ischiofemoral ligaments in the hip joint: collagen fiber direction and crimp distribution.

    Science.gov (United States)

    Sato, Kaori; Uchiyama, Eiichi; Katayose, Masaki; Fujimiya, Mineko

    2012-03-01

    Since no previous studies have described the functional significance of the iliofemoral and ischiofemoral ligaments on the basis of microscopic analyses, we examined the direction of collagen fiber alignment and crimp distribution of the collagen fibers in sections cut in different directions. Polarized microscopic images of sections along the longitudinal (L) and transverse (T) planes of each ligament were obtained from 20 cadavers (8 males and 12 females, age at death 81.7 ± 9.4 years old). Results showed that the microscopic direction of collagen fibers in the iliofemoral ligament was parallel to the macroscopic direction, suggesting that this ligament may play a part in restricting extension of the hip joint. In contrast, the microscopic direction of collagen fibers in the ischiofemoral ligament was not parallel to the macroscopic direction, suggesting that this ligament may contribute not only to the restriction of medial rotation but also retstriction of flexion of the hip joint. From the low density of the crimp distribution in the L plane, the iliofemoral ligament may contribute to stability of the hip joint in the standing position in the living body. In conclusion, the microscopic observations of the direction of collagen fibers as well as the crimp distribution shown in the present study provide a better understanding of the functional significance of the iliofemoral and ischiofemoral ligaments.

  3. Dynamic loading of the knee and hip joint and compensatory strategies in children and adolescents with varus malalignment.

    Science.gov (United States)

    Stief, Felix; Böhm, Harald; Schwirtz, Ansgar; Dussa, Chakravarthy Ugandhar; Döderlein, Leonhard

    2011-03-01

    Three-dimensional gait analysis is a diagnostic tool that can be used to gain a better understanding of the relationship between joint loading and the onset or progression of articular cartilage degeneration in subjects with varus malalignment. The purpose of the present study was to investigate knee and hip joint angles and moments in children and adolescents with pathological varus alignment of the knee without signs of knee osteoarthritis (OA). Moreover, we wanted to know if compensatory mechanisms are present in this young patient group. Fourteen, otherwise healthy patients with varus malalignment of the knee and 15 healthy control subjects were analysed. Patients showed a reduced knee extension and a significantly lower maximum knee extension moment in terminal stance compared to controls. The maximum knee adduction moment in mid and terminal stance and the maximum hip abduction moment in loading response were significantly higher in the patient group. In the transverse plane, abnormally increased knee internal rotation and hip external rotation moments were present in patients with varus malalignment. These findings imply that varus malalignment is not an isolated problem in the frontal plane. In contrast to adult patients with established medial knee OA, the young patients assessed in the present study did not show typical compensatory mechanisms such as increased foot progression angle or reduced walking speed. This suggests that children and adolescents with varus malalignment of the knee probably do not need to alter their spatio-temporal gait parameters in order to decrease knee joint loading.

  4. Groin and hip quandaries

    African Journals Online (AJOL)

    specialist opinions and four different surgical procedures. One needs sound ... of pain. The two joints in the pelvis should be emphasised – the hip joint and the pubic .... intervention aimed at improving hip kinematics would be effective in.

  5. Comparative Analysis of Radiographic Hip Joint Geometry Using Measurement Tools on Picture Archiving and Communication System: A Prospective Study of 100 Pelvic Radiographs of Koreans.

    Science.gov (United States)

    Kim, Seung-Chan; Lim, Young-Wook; Kwon, Soon-Yong; Lee, Jun-Ku; Park, Il-Kyu; Kim, Yong-Sik

    2016-11-01

    A contralateral normal hip joint has been often used as a reference standard in preoperative planning and intraoperative assessment of hip arthroplasty, with the assumption that bilateral hip joint geometries have no significant differences. However, one previous study using analog measurements on hardcopy films reported significant bilateral variation in hip joint geometry. We therefore investigated the level of agreement between the right and left hips for each measurement and determined index values and the range of normal bilateral variations. We assessed 100 standard anteroposterior radiographs of the pelvis in this study. Two independent observers measured the actual value of femoral head diameter, location of the femoral head center, acetabular offset, femoral offset, hip offset, greater trochanteric height, neck-shaft angle, medullary canal diameter, and proximal femoral diameter. Intraclass correlation coefficients (ICCs) and values of mean difference were calculated for each measurement. The results demonstrated perfect agreement (ICC >0.8) between the right and left hips for most parameters and substantial agreement for greater trochanteric height (ICC = 0.735) and femoral offset (ICC = 0.773). The mean difference and standard deviation in the measurement between the right and left hips for the location of the femoral head center and the acetabular offset were 0.60 ± 0.48 mm and 0.42 ± 0.30 mm, respectively. Hip joint geometry is not influenced by side. In hip arthroplasty, a contralateral normal hip can be reliably used as a guide for preoperative planning using measurement tools on a picture archiving and communication system. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Institute of Scientific and Technical Information of China (English)

    Ramesh Kumar Sen; Sujit Kumar Tripathy; Vibhu Krishnan; Tarun Goyal; Vanyambadi Jagadeesh

    2011-01-01

    This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture.A 32-year-old man presented with ipsilateral fracturedislocations of the left hip (Pipkin's type Ⅳ) and knee (Moore Ⅱ)joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints.Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

  7. 正常步态下髋臼底接触面积与压力分布的三维有限元分析%Three-dimensional finite analysis of hip contact area and contact pressure during normal walking

    Institute of Scientific and Technical Information of China (English)

    汪光晔; 张春才; 许硕贵

    2011-01-01

    BACKGROUND: Estimation of the hip joint contact area and pressure distribution during activities of daily living is important in predicting joint degeneration mechanism, prosthetic implant wear, providing biomechanical rationales for preoperative planning and postoperative rehabilitation.OBJECTIVE: To explore the hip joint contact area and pressure distribution during different trait phases, which is important in predicting joint degeneration mechanism.METHODS: CT scanning and computer image processing system were used to establish the model to simulate the situation of acetabulum for 32 phases during the trait. A finite element solves was used to calculate stress and contact area. RESULTS AND CONCLUSION: Stress distribution within the acetabular cartilage was obtained and regions with elevated stress at 32 phases were located. The stress distributions of 32 phases were significantly different. The stress demonstrated the bimodal shape of a pronounced phush-off often seen in trial gait cycle (4.2 MPa). The regions of elevated stress and contact area of acetabulum both occurred during stance phases of a gait cycle. Persistent stress-transfer located on medial roof, while on anterior and posterior horn there is always no stress-transfer. The elevated stress located roof during stance phases and medial acetabular cartilage during swing-phases respectively. These results can be used to rationalize rehabilitation protocols, functional restrictions after complex acetabular reconstructions, the renions of elevated stress and contact area of acetabulum are important, which provide an insight into the factors contribution to the arthritis.%背景:认识髋关节的正常压力分布特点,将有助于进一步了解正常髋关节的力学机制与异常载荷下关节软骨的病理学行为.目的:运用三维有限元的方法,分析正常步态过程中头臼间接触面积和应力分布情况.方法:应用CT扫描技术和计算机图像处理系统,建立髋臼的

  8. Moberg Osteotomy Shifts Contact Pressure Plantarly in the First Metatarsophalangeal Joint in a Biomechanical Model.

    Science.gov (United States)

    Kim, Paul Hyon-Uk; Chen, Xiang; Hillstrom, Howard; Ellis, Scott J; Baxter, Josh R; Deland, Jonathan T

    2016-01-01

    A proximal phalangeal dorsiflexion osteotomy (Moberg osteotomy) is commonly used to treat hallux rigidus, but the mechanical explanation for its effectiveness is unclear. The purpose of our study was to test the effect of a Moberg osteotomy on first metatarsophalangeal joint contact mechanics. Ten cadaveric first ray specimens were dissected, with the medial band of the plantar aponeurosis preserved at its origin, and placed in a custom testing apparatus. Forefoot loads during mid-stance with the first metatarsal positioned at 10 degrees were simulated using a custom-made loading jig while contact mechanics were acquired with a thin pressure-sensitive sensor. A Moberg osteotomy was performed starting 9 mm distal to the proximal phalanx with excision of a 3-mm wedge of bone and fixated with a 2-mm Kirschner wire. The effect of the Moberg osteotomy was tested by reapplying the forefoot loads and acquiring the joint pressures. The center of pressure, peak pressure, and contact area were calculated. Paired t tests were performed to determine if the Moberg osteotomy affected joint contact mechanics. The Moberg osteotomy shifted the center of contact pressure on the proximal phalanx surface more plantarly (P osteotomy did not affect the peak pressure (P = .62) or the joint contact area (P = .96). There were no differences in peak pressure or first MTPJ contact area, but a plantar shift in the center of pressure occurred after the Moberg osteotomy. The plantar cartilage, which is often spared from arthritic changes, may be preferentially loaded and the potential edge loading following cheilectomy may be avoided with the Moberg osteotomy secondary to the plantar shift of center of pressure. © The Author(s) 2015.

  9. Grafting of poly(2-methacryloyloxyethyl phosphorylcholine) on polyethylene liner in artificial hip joints reduces production of wear particles.

    Science.gov (United States)

    Moro, Toru; Kyomoto, Masayuki; Ishihara, Kazuhiko; Saiga, Kenichi; Hashimoto, Masami; Tanaka, Sakae; Ito, Hideya; Tanaka, Takeyuki; Oshima, Hirofumi; Kawaguchi, Hiroshi; Takatori, Yoshio

    2014-03-01

    Despite improvements in the techniques, materials, and fixation of total hip arthroplasty, periprosthetic osteolysis, a complication that arises from this clinical procedure and causes aseptic loosening, is considered to be a major clinical problem associated with total hip arthroplasty. With the objective of reducing the production of wear particles and eliminating periprosthetic osteolysis, we prepared a novel hip polyethylene (PE) liner whose surface graft was made of a biocompatible phospholipid polymer-poly(2-methacryloyloxyethyl phosphorylcholine (MPC)). This study investigated the wear resistance of the poly(MPC)-grafted cross-linked PE (CLPE; MPC-CLPE) liner during 15×10(6) cycles of loading in a hip joint simulator. The gravimetric analysis showed that the wear of the acetabular liner was dramatically suppressed in the MPC-CLPE liner, as compared to that in the non-treated CLPE liner. Analyses of the MPC-CLPE liner surface revealed that it suffered from no or very little wear even after the simulator test, whereas the CLPE liners suffered from substantial wears. The scanning electron microscope (SEM) analysis of the wear particles isolated from the lubricants showed that poly(MPC) grafting dramatically decreased the total number, area, and volume of the wear particles. However, there was no significant difference in the particle size distributions, and, in particular, from the SEM image, it was observed that particles with diameters less than 0.50μm were present in the range of the highest frequency. In addition, there were no significant differences in the particle size descriptors and particle shape descriptors. The results obtained in this study show that poly(MPC) grafting markedly reduces the production of wear particles from CLPE liners, without affecting the size of the particles. These results suggest that poly(MPC) grafting is a promising technique for increasing the longevity of artificial hip joints. Copyright © 2013 Elsevier Ltd. All rights

  10. Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities.

    Science.gov (United States)

    Lau, E C; Cooper, C; Lam, D; Chan, V N; Tsang, K K; Sham, A

    2000-11-01

    In 1998, a case-control study was conducted in Hong Kong on hospital patients with osteoarthritis of the hip (n = 138) and osteoarthritis of the knee (n = 658). Age- and sex-matched controls were recruited consecutively from general practice clinics in the same region. The following three risk factors were found to be associated with osteoarthritis of both the hip and the knee: first, a history of joint injury: for osteoarthritis of the hip, the odds ratio = 25.1 (95% confidence interval (CI): 3.5, 181) in men and 43.3 (95% CI: 11.7, 161) in women; for osteoarthritis of the knee, the odds ratio = 12.1 (95% CI: 3.4, 42.5) in men and 7.6 (95% CI: 3.8, 15.2) in women; second, climbing stairs frequently: for osteoarthritis of the hip, the odds ratio = 12.5 (95% CI: 1.5, 104.3) in men and 2.3 (95% CI: 0.6, 8.1) in women; for osteoarthritis of the knee, the odds ratio = 2.5 (95% CI: 1.0, 6.4) in men and 5.1 (95% CI: 2.5, 10.2) in women; third, lifting heavy weight frequently: for osteoarthritis of the hip, the odds ratio = 3.1 (95% CI: 0.7, 14.3) in men and 2.4 (95% CI: 1.1, 5.3) in women; for osteoarthritis of the knee, the odds ratio = 5.4 (95% CI: 2.4, 12.4) in men and 2.0 (95% CI: 1.2, 3.1) in women. In addition, subjects whose height and weight were in the highest quartile were at increased risk of osteoarthritis of the hip and knee, respectively (p < 0.05).

  11. Predicting sagittal plane biomechanics that minimize the axial knee joint contact force during walking.

    Science.gov (United States)

    Miller, Ross H; Brandon, Scott C E; Deluzio, Kevin J

    2013-01-01

    Both development and progression of knee osteoarthritis have been associated with the loading of the knee joint during walking. We are, therefore, interested in developing strategies for changing walking biomechanics to offload the knee joint without resorting to surgery. In this study, simulations of human walking were performed using a 2D bipedal forward dynamics model. A simulation generated by minimizing the metabolic cost of transport (CoT) resembled data measured from normal human walking. Three simulations targeted at minimizing the peak axial knee joint contact force instead of the CoT reduced the peak force by 12-25% and increased the CoT by 11-14%. The strategies used by the simulations were (1) reduction in gastrocnemius muscle force, (2) avoidance of knee flexion during stance, and (3) reduced stride length. Reduced gastrocnemius force resulted from a combination of changes in activation and changes in the gastrocnemius contractile component kinematics. The simulations that reduced the peak contact force avoided flexing the knee during stance when knee motion was unrestricted and adopted a shorter stride length when the simulated knee motion was penalized if it deviated from the measured human knee motion. A higher metabolic cost in an offloading gait would be detrimental for covering a long distance without fatigue but beneficial for exercise and weight loss. The predicted changes in the peak axial knee joint contact force from the simulations were consistent with estimates of the joint contact force in a human subject who emulated the predicted kinematics. The results demonstrate the potential of using muscle-actuated forward dynamics simulations to predict novel joint offloading interventions.

  12. Validation of radiocarpal joint contact models based on images from a clinical MRI scanner.

    Science.gov (United States)

    Johnson, Joshua E; McIff, Terence E; Lee, Phil; Toby, E Bruce; Fischer, Kenneth J

    2014-01-01

    This study was undertaken to assess magnetic resonance imaging (MRI)-based radiocarpal surface contact models of functional loading in a clinical MRI scanner for future in vivo studies, by comparison with experimental measures from three cadaver forearm specimens. Experimental data were acquired using a Tekscan sensor during simulated light grasp. Magnetic resonance (MR) images were used to obtain model geometry and kinematics (image registration). Peak contact pressures (PPs) and average contact pressures (APs), contact forces and contact areas were determined in the radiolunate and radioscaphoid joints. Contact area was also measured directly from MR images acquired with load and compared with model data. Based on the validation criteria (within 25% of experimental data), out of the six articulations (three specimens with two articulations each), two met the criterion for AP (0%, 14%); one for peak pressure (20%); one for contact force (5%); four for contact area with respect to experiment (8%, 13%, 19% and 23%), and three contact areas met the criterion with respect to direct measurements (14%, 21% and 21%). Absolute differences between model and experimental PPs were reasonably low (within 2.5 MPa). Overall, the results indicate that MRI-based models generated from 3T clinical MR scanner appear sufficient to obtain clinically relevant data.

  13. The role of agonist and antagonist muscles in explaining isometric knee extension torque variation with hip joint angle.

    Science.gov (United States)

    Bampouras, Theodoros M; Reeves, Neil D; Baltzopoulos, Vasilios; Maganaris, Constantinos N

    2017-08-12

    The biarticular rectus femoris (RF), operating on the ascending limb of the force-length curve, produces more force at longer lengths. However, experimental studies consistently report higher knee extension torque when supine (longer RF length) compared to seated (shorter RF length). Incomplete activation in the supine position has been proposed as the reason for this discrepancy, but differences in antagonistic co-activation could also be responsible due to altered hamstrings length. We examined the role of agonist and antagonist muscles in explaining the isometric knee extension torque variation with changes in hip joint angle. Maximum voluntary isometric knee extension torque (joint MVC) was recorded in seated and supine positions from nine healthy males (30.2 ± 7.7 years). Antagonistic torque was estimated using EMG and added to the respective joint MVC (corrected MVC). Submaximal tetanic stimulation quadriceps torque was also recorded. Joint MVC was not different between supine (245 ± 71.8 Nm) and seated (241 ± 69.8 Nm) positions and neither was corrected MVC (257 ± 77.7 and 267 ± 87.0 Nm, respectively). Antagonistic torque was higher when seated (26 ± 20.4 Nm) than when supine (12 ± 7.4 Nm). Tetanic torque was higher when supine (111 ± 31.9 Nm) than when seated (99 ± 27.5 Nm). Antagonistic co-activation differences between hip positions do not account for the reduced MVC in the supine position. Rather, reduced voluntary knee extensor muscle activation in that position is the major reason for the lower MVC torque when RF is lengthened (hip extended). These findings can assist standardising muscle function assessment and improving musculoskeletal modelling applications.

  14. Does joint effusion influence the clinical response to a single Hylan GF-20 injection for hip osteoarthritis?

    Science.gov (United States)

    Rennesson-Rey, Bénédicte; Rat, Anne-Christine; Chary-Valckenaere, Isabelle; Bettembourg-Brault, Isabelle; Juge, Nadine; Dintinger, Hervé; Pourel, Jacques; Loeuille, Damien

    2008-03-01

    To evaluate the influence of a joint effusion on the clinical response to a single injection of Hylan GF-20 for hip osteoarthritis. We prospectively included patients scheduled for intraarticular Hylan GF-20 injection to treat hip osteoarthritis. Disease severity was assessed based on the Kellgren-Lawrence radiological grade. Ultrasonography was performed to look for a joint effusion. The pain score on a visual analog scale, Lequesne algofunctional index, and WOMAC scores were recorded at baseline and 1, 3, and 6 months postinjection. The proportions of patients who met OARSI response criteria and who achieved Patient Acceptable Symptom State (PASS) thresholds were determined in the overall population and in the groups with and without a joint effusion at baseline. Of 55 included patients, 24 (44%) had an effusion at baseline. The baseline Lequesne index was significantly higher in the group with an effusion (11.9+/-3.6 versus 8.4+/-4.5) (p=0.003). The proportions of OARSI responders in the overall population were 31.8%, 39.4%, and 14.8% after 1, 3, and 6 months, respectively. The proportions of patients who achieved the PASS for pain and function were 52.4% and 50.0% after 1 month, 67.7% and 54.5% after 3 months, and 60.0% and 50.0% after 6 months, respectively. Presence of an effusion at baseline had no effect on any of the clinical response parameters. Presence of a joint effusion is associated with worse pain and functional impairment at baseline but has no influence on the clinical response to Hylan GF-20 in patients with hip osteoarthritis.

  15. Discrete modeling of rock joints with a smooth-joint contact model

    Institute of Scientific and Technical Information of China (English)

    C. Lambert; C. Coll

    2014-01-01

    Structural defects such as joints or faults are inherent to almost any rock mass. In many situations those defects have a major impact on slope stability as they can control the possible failure mechanisms. Having a good estimate of their strength then becomes crucial. The roughness of a structure is a major contributor to its strength through two different aspects, i.e. the morphology of the surface (or the shape) and the strength of the asperities (related to the strength of the rock). In the current state of practice, roughness is assessed through idealized descriptions (Patton strength criterion) or through empirical parameters (Barton JRC). In both cases, the multi-dimensionality of the roughness is ignored. In this study, we propose to take advantage of the latest developments in numerical techniques. With 3D photogrammetry and/or laser mapping, practitioners have access to the real morphology of an exposed structure. The derived triangulated surface was introduced into the DEM (discrete element method) code PFC3D to create a synthetic rock joint. The interaction between particles on either side of the discontinuity was described by a smooth-joint model (SJM), hence suppressing the artificial roughness introduced by the particle dis-cretization. Shear tests were then performed on the synthetic rock joint. A good correspondence between strengths predicted by the model and strengths derived from well-established techniques was obtained for the first time. Amongst the benefits of the methodology is the possibility offered by the model to be used in a quantitative way for shear strength estimates, to reproduce the progressive degradation of the asperities upon shearing and to analyze structures of different scales without introducing any empirical relation.

  16. Discrete modeling of rock joints with a smooth-joint contact model

    Directory of Open Access Journals (Sweden)

    C. Lambert

    2014-02-01

    Full Text Available Structural defects such as joints or faults are inherent to almost any rock mass. In many situations those defects have a major impact on slope stability as they can control the possible failure mechanisms. Having a good estimate of their strength then becomes crucial. The roughness of a structure is a major contributor to its strength through two different aspects, i.e. the morphology of the surface (or the shape and the strength of the asperities (related to the strength of the rock. In the current state of practice, roughness is assessed through idealized descriptions (Patton strength criterion or through empirical parameters (Barton JRC. In both cases, the multi-dimensionality of the roughness is ignored. In this study, we propose to take advantage of the latest developments in numerical techniques. With 3D photogrammetry and/or laser mapping, practitioners have access to the real morphology of an exposed structure. The derived triangulated surface was introduced into the DEM (discrete element method code PFC3D to create a synthetic rock joint. The interaction between particles on either side of the discontinuity was described by a smooth-joint model (SJM, hence suppressing the artificial roughness introduced by the particle discretization. Shear tests were then performed on the synthetic rock joint. A good correspondence between strengths predicted by the model and strengths derived from well-established techniques was obtained for the first time. Amongst the benefits of the methodology is the possibility offered by the model to be used in a quantitative way for shear strength estimates, to reproduce the progressive degradation of the asperities upon shearing and to analyze structures of different scales without introducing any empirical relation.

  17. Retrospective analysis for genetic improvement of hip joints of cohort labrador retrievers in the United States: 1970-2007.

    Directory of Open Access Journals (Sweden)

    Yali Hou

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

  18. Long-term survival and risk factors for failure of the native hip joint after operatively treated displaced acetabular fractures.

    Science.gov (United States)

    Clarke-Jenssen, J; Røise, O; Storeggen, S A Ø; Madsen, J E

    2017-06-01

    Our aim in this study was to describe the long-term survival of the native hip joint after open reduction and internal fixation of a displaced fracture of the acetabulum. We also present long-term clinical outcomes and risk factors associated with a poor outcome. A total of 285 patients underwent surgery for a displaced acetabular fracture between 1993 and 2005. For the survival analysis 253 were included, there were 197 men and 56 women with a mean age of 42 years (12 to 78). The mean follow-up of 11 years (1 to 20) was identified from our pelvic fracture registry. There were 99 elementary and 154 associated fracture types. For the long-term clinical follow-up, 192 patients with complete data were included. Their mean age was 40 years (13 to 78) with a mean follow-up of 12 years (5 to 20). Injury to the femoral head and acetabular impaction were assessed with CT scans and patients with an ipsilateral fracture of the femoral head were excluded. A total of 36 patients underwent total hip arthroplasty (THA). The overall ten-year survival of the hip joint was 86% (95% confidence interval (CI) 81% to 90%) and the 20-year survival was 82% (95% CI 76% to 87%). Injury to the femoral head and acetabular impaction were the strongest predictors of failure, with the long-term survival rate falling towards 50% in these patients. The survival fell to 0% at three years when both these risk factors were present in patients aged > 60 years. The long-term survival of the native hip joint after acetabular fractures was good, but the presence of injury to the femoral head and acetabular impaction proved to be strong predictors of failure, especially in patients aged > 60 years. These patients may be better treated with a combination of open reduction and internal fixation and primary arthroplasty. Cite this article: Bone Joint J 2017;99-B:834-40. ©2017 The British Editorial Society of Bone & Joint Surgery.

  19. A distributed mechanical joint contact model with slip/slap coupling effects

    Science.gov (United States)

    Ahmadian, Hamid; Mohammadali, Mohsen

    2016-12-01

    This paper introduces a zero thickness interface model that considers hysteresis effects in both normal and shear directions of a contact. The model is rate independent and represents coupling effects between normal and shear displacements. Contact effects are included through a segment-to-segment contact model which considers stick, micro-slip, slide and slap behaviors at every point within the contact interface. The model has six parameters and three memory variables without the need for integration during response computations. Behavior of the model is validated using the available mechanical joint records in the literature and it is successfully employed for model identification and dynamic response prediction of an internally resonating test structure with frictional support.

  20. Development of steel head joints with fiberglass sucker rod on the base of contact stresses investigation

    Energy Technology Data Exchange (ETDEWEB)

    Kopey, B.V.; Kopey, L.B. [Ivano-Frankivsk State Technical Oil and Gas University (Ukraine); Maksymuk, A.V.; Shcherbyna, N.M. [National Ukrainian Academy of Sciences (Ukraine)

    1998-12-31

    The methods of calculation of contact stresses during cylinder shell tube - steel bandage interaction are presented. Tymoshenko`s generalized theory of shells serves as a basis for investigating steel head to fiberglass sucker rod joint strength. This theory allows to consider mechanical performance of composite materials. The problem is reduced to solving Fredholm integral equation of second degree. The numeric analysis is performed. Several joints of composite body with steel head are proposed. The full-size sucker rod fatigue tests are performed to determine the fatigue limit under the bending and axial cyclic loads in the medium of oil well fluids. (orig.)

  1. The Effect of a Complex (3-week Therapy on the Hip and Knee Joints in Obese Patients

    Directory of Open Access Journals (Sweden)

    Tóvári Anett

    2015-05-01

    Full Text Available Currently, overweight and obesity are the most widespread problems in life-style having a significant impact on everyday life, and thus, conduct of life. Further contributory problems may develop in patients with weight problems: deformities of the joints and skeleton (coxarthrosis and gonarthrosis, circulatory problems and arrhythmia. Overweight definitely has an effect on motion: some people are not involved in certain activities as it is impossible for them because of their weight problem. Thus, even more health problems are generated because of the overweight. The first question arising in discussing the actuality of this issue is what effect the applied therapy (massage, therapeutic exercises, electrotherapy and balneotherapy has on the knee and hip joints of patients with weight problems hospitalised in our Institute for a 3-week complex therapy. Based on my prior hypothesis, positive changes are detected in a minimum percentage in the condition of overweight or obese patients. My hypothesis was that the range of flexion and extension of the hip and knee joints would improve compared to other movements. Based on the results of the studied population (n=30, my hypothesis seems to be proven. After the 3-week complex therapy of obese patients, positive changes were found in the prearranged assessments and tests, thereby improving the general health, life-style, life quality and mental status of the patients. After the end of the complex therapy, patients were provided life-style counselling and exercise schemes to be performed in their home to maintain the achieved health status.

  2. Misalignment of total ankle components can induce high joint contact pressures.

    Science.gov (United States)

    Espinosa, N; Walti, M; Favre, P; Snedeker, J G

    2010-05-01

    A major cause of the limited longevity of total ankle replacements is premature polyethylene component wear, which can be induced by high joint contact pressures. We implemented a computational model to parametrically explore the hypothesis that intercomponent positioning deviating from the manufacturer's recommendations can result in pressure distributions that may predispose to wear of the polyethylene insert. We also investigated the hypothesis that a modern mobile-bearing design may be able to better compensate for imposed misalignments compared with an early two-component design. Two finite element models of total ankle replacement prostheses were built to quantify peak and average contact pressures on the polyethylene insert surfaces. Models were validated by biomechanical testing of the two implant designs with use of pressure-sensitive film. The validated models were configured to replicate three potential misalignments with the most version of the tibial component, version of the talar component, and relative component rotation of the two-component design. The misalignments were simulated with use of the computer model with physiologically relevant boundary loads. With use of the manufacturer's guidelines for positioning of the two-component design, the predicted average joint contact pressures exceeded the yield stress of polyethylene (18 to 20 MPa). Pressure magnitudes increased as implant alignment was systematically deviated from this reference position. The three-component design showed lower-magnitude contact pressures in the standard position (pressures than a less congruent design. Although the mobile-bearing implant reduced susceptibility to aberrant joint contact characteristics that were induced by misalignment, predicted average contact stresses reached the yield stress of polyethylene for imposed version misalignments of >5 degrees.

  3. The influence of metallic shell deformation on the contact mechanics of a ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Qiu, Changdong; Wang, Ling; Li, Dichen; Jin, Zhongmin

    2016-01-01

    Total hip arthroplasty of ceramic-on-ceramic bearing combinations is increasingly used clinically. The majority of these implants are used with cementless fixation that a metal-backing shell is press-fitted into the pelvic bone. This usually results in the deformation of the metallic shell, which may also influence the ceramic liner deformation and consequently the contact mechanics between the liner and the femoral head under loading. The explicit dynamic finite element method was applied to model the implantation of a cementless ceramic-on-ceramic with a titanium shell and subsequently to investigate the effect of the metallic shell deformation on the contact mechanics. A total of three impacts were found to be necessary to seat the titanium alloy shell into the pelvic bone cavity with a 1 mm diameter interference and a 1.3 kg impactor at 4500 mm s(-1) velocity. The maximum deformation of the metallic shell was found to be 160 µm in the antero-superior and postero-inferior direction and 97 µm in the antero-inferior and postero-superior direction after the press-fit. The corresponding values were slightly reduced to 67 and 45 µm after the ceramic liner was inserted and then modified to 74 and 43 µm under loading, respectively. The maximum deformation and the maximum principal stress of the ceramic liner were 31 µm and 144 MPa (tensile stress), respectively, after it was inserted into the shell and further increased to 52 µm and 245 MPa under loading. This research highlights the importance of the press-fit of the metallic shell on the contact mechanics of the ceramic liner for ceramic-on-ceramic total hip arthroplasties and potential clinical performances.

  4. Comparison of Biocompatibility of Cemented vs. Cementless Hip Joint Endoprostheses Based on Postoperative Evaluation of Proinflammatory Cytokine Levels

    Science.gov (United States)

    Szypuła, Jan; Cabak, Anna; Kiljański, Marek; Boguszewski, Dariusz; Tomaszewski, Wiesław

    2016-01-01

    Background The yearly increase in the number of procedures involving implantation of hip joint endoprostheses forces prosthetics manufacturers to search for biologically neutral implants. The goal of this study was to assess the concentration of Interleukin-6 (IL-6) and its correlation with C-reactive protein (CRP), depending on the type of hip joint endoprosthesis (cemented or cementless endoprosthesis) in order to determine implant biotolerance during the early postoperative period. Material/Methods The sample comprised 200 patients [mean age=64 (31–81) years] with coxarthrosis. All patients underwent hip joint arthroplasty using a cemented or cementless endoprosthesis. Blood samples were collected 3 times: before the procedure, on the first day after the procedure, and after 6 weeks. IL-6 and CRP levels were assayed using immunoenzymatic methods. The results were subjected to statistical analysis using the Shapiro-Wilk test. Results On the 1st day after the procedure, CRP and IL-6 concentration increased rapidly after implantation of both cemented and cementless endoprostheses. At 6 weeks postoperatively, the CRP value remained at a similar level in patients after cemented arthroplasty and was almost 2-fold lower in patients who underwent cementless arthroplasty. The IL-6 value returned to the baseline level in patients after cementless arthroplasty and showed an ongoing increasing tendency in patients after cemented arthroplasty. Conclusions 1. The measurement of C-reactive protein and Interleukin-6 is a high-sensitivity test, assessing implant biotolerance. 2. The implantation of a cemented endoprosthesis induces a higher increase in the level of proinflammatory cytokines as compared with a cementless endoprosthesis. 3. For a complete assessment of both early and later body responses to implantation and the related surgical procedure, further studies using available approaches and tools are recommended. PMID:27935873

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

    Science.gov (United States)

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

    2015-12-01

    The combined anteversion surgical technique has been proposed and used in clinical practice. To more objectively evaluate the feasibility of this surgical technique using combined anteversion concept for DDH patients, we studied 34 DDH patients (40 hips) in this research. Every patient underwent pelvic CT scans before and after surgery and the HHSs were recorded. Optimal range of joint motion was measured using a three-dimensional reconstruction technique and a dynamic measurement technique. The results revealed that joint function met the requirements of daily life and the range of motion was not over-limited by impingement between the prosthesis and the skeleton. Moreover, the combined anteversion was found to be the most critical parameter in this study. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Functional integrative analysis of the human hip joint: the three-dimensional orientation of the acetabulum and its relation with the orientation of the femoral neck.

    Science.gov (United States)

    Bonneau, Noémie; Baylac, Michel; Gagey, Olivier; Tardieu, Christine

    2014-04-01

    In humans, the hip joint occupies a central place in the locomotor system, as it plays an important role in body support and the transmission of the forces between the trunk and lower limbs. The study of the three-dimensional biomechanics of this joint has important implications for documenting the morphological changes associated with the acquisition of a habitual bipedal gait in humans. Functional integration at any joint has important implications in joint stability and performance. The aim of the study was to evaluate the functional integration at the human hip joint. Both the level of concordance between the three-dimensional axes of the acetabulum and the femoral neck in a bipedal posture, and patterns of covariation between these two axes were analysed. First, inter-individual variations were quantified and significant differences in the three-dimensional orientations of both the acetabulum and the femoral neck were detected. On a sample of 57 individuals, significant patterns of covariation were identified, however, the level of concordance between the axes of both the acetabulum and the femoral neck in a bipedal posture was lower than could be expected for a key joint such as the hip. Patterns of covariation were explored regarding the complex three-dimensional biomechanics of the full pelvic-femoral complex. Finally, we suggest that the lower degree of concordance observed at the human hip joint in a bipedal posture might be partly due to the phylogenetic history of the human species.

  7. Bilateral Asymmetric Dislocations of Hip Joints: An Unusual Mechanism of Injury

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Kanojia

    2013-01-01

    Full Text Available Asymmetric bilateral dislocations of the hips are rare injuries. Among the small number of reports in the literature, most have attributed the cause to high-velocity motor crashes. These dislocations are often seen to be associated with fractures of the proximal femur or the acetabulum. We present a case of a 45-year-old man with bilateral asymmetric dislocation of hips which were purely ligamentous in nature, without any fracture. He sustained his injuries due to a fall while getting on a moving bus. It was an unusual mechanism of injury as compared to the other cases of asymmetric hip dislocations reported in published studies. Both hips were reduced under general anaesthesia within three hours of the trauma. Skin traction and non-weight-bearing rehabilitation were continued for six weeks. After 35 months of followup, the patient remains asymptomatic. Early diagnosis and timely reduction of such dislocations under anaesthesia are necessary for prevention of complications.

  8. 生物型自锁式人工髋关节假体的改良设计%Modified design of biotype self-locking hip joint prosthesis

    Institute of Scientific and Technical Information of China (English)

    黄伟韬; 李彩华; 蒋托; 杨俊

    2016-01-01

    prosthesis needs to meet the good structural compatibility with femoral bone marrow cavity and the biomechanical properties of the original bone tissue. However, the difference of individual anatomical characteristics and the stress concentration in the local area after replacement directly affect postoperative combination of femoral prosthesis stem, force flow transfer and femoral reconstruction, and finaly result in aseptic loosening of hip joint in some patients. OBJECTIVE:To analyze the biomechanical characteristics of modified biotype self-locking hip prosthesis by the method of finite element analysis, and to provide the reference for the application of self-locking hip prosthesis in hip replacement. METHODS:Experimental design contained traditional biotype hip joint prosthesis group and self-locking hip joint prosthesis group. In accordance with the finite element models of self-locking hip prosthesis, 28 kinds of screw fixation were established. Three-dimensional models were generated in the Minics system. After the optimization of prosthesis, prosthesis was designed. In the Solidworks software, the femur was re-positioned and set for contacting set in Ansys to analyze the stress distribution and displacement distribution of the femoral-prosthesis-screw by Ansys. We compared the peak of stress and displacement of the femur and prosthesis, and analyzed the biomechanical stability of prosthesis. RESULTS AND CONCLUSION:(1) By using the Ansys finite element method, we analyzed the stress and displacement distribution of the femoral-prosthesis-screw. The minimum stress peak value of the femur was 15.698 MPa. The minimum stress peak value of prosthesis was 45.491 MPa. The minimum stress peak value of screw was 8.359 MPa. The minimum displacement peak value of femur was 1.125 3 mm. The minimum displacement peak value of prosthesis was 1.039 6 mm. The minimum displacement peak value of screw was 0.566 4 mm. (2) Compared with the traditional biotype hip joint prosthesis group

  9. Contact thermography, 99mTc-plasmin scintimetry and 99mTc-plasmin scintigraphy as screening methods for deep venous thrombosis following major hip surgery

    DEFF Research Database (Denmark)

    Christensen, S W; Wille-Jørgensen, P; Kjaer, L

    1987-01-01

    Fifty-six patients scheduled for total hip alloplasty were screened for deep venous thrombosis by means of 99mTc-plasmin scintimetry, 99mTc-plasmin scintigraphy and contact thermography. Investigations were performed on the seventh postoperative day, and a total of 112 legs were examined. Bilateral....... The nosographic sensitivity/specificity was 33%/75% for scintimetry, 50%/91% for scintigraphy and 33%/87% for contact thermography, respectively. It is concluded that all three tests are of no value as screening methods for deep venous thrombosis following major elective hip surgery....

  10. Comparing contemporary revision burden among hip and knee joint replacement registries

    Directory of Open Access Journals (Sweden)

    Brian J. McGrory, MD, MS

    2016-06-01

    Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

  11. PERIPROSTHETIC INFECTION AFTER ENDOPROSTHETIC REPLACEMENT OF THE HIP JOINT IN PATIENTS WITH RHEUMATOID DISEASES

    Directory of Open Access Journals (Sweden)

    Vadim Petrovich Pavlov

    2013-01-01

    Full Text Available Periprosthetic infection (PI in patients with rheumatoid diseases (RD after total hip joint endoprosthesis (THJE is a relevant problem of rheumoorphopedics that has not been solved yet. The relative assessment of PI incidence rate after THJE and treatment outcomes in patients with this complication is expected to be carried out. A total of 1201 THJE performed in 1069 patients with RD are considered. The female : male ratio was 3.6 : 1; the mean age was 49.6 years (range: 16 to 83 years. 323 patients had rheumatoid arthritis (RA; 124 patients had juvenile rheumatoid arthritis (JRA; 80 patients had ankylosing spondylitis (AS; 79 patients had systemic lupus erythematosus (SLE; 11 patients had systemic sclerodermatitis (SSD; 18 patients had psoriatic arthropathy (PsA; and 353 patients had osteoarthritis (OA. Other RD were revealed in 81 patients. PI were detected in 9 (0.84% of 1069 patients with RD, including 7 (2.17% of 323 patients with RA; 1 (0.8% of 124 patients with JRA; and 1 (0.28% of 353 patients with OA. No PI were detected in 81 patients who had other RD. An eightfold (in patients with RA and a threefold (in patients with JRA increase in PI compared to that in patients with OA attests to the high risk of this complication in patients with inflammatory as compared to the patients with degenerative RD. After integrated treatment (revision surgery, sanation, continuous irrigation with antibiotics/lavasept, the graft was preserved in OA patients; the complication was prevented in RA patients. Six patients will be subjected to repeated revision surgery; one patient died of diabetes complications after the graft had been removed. A significant increase in PI incidence rate after THJE in patients with RA and JRA as compared to that in OA patients allows one to regard inflammatory RD as risk factors of this complication. The low effectiveness of the procedure for integrated therapy for PI in RD patients indicates that it needs to

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint

    OpenAIRE

    Chlebečková, Helena

    2013-01-01

    Title: Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint Summary: This bachelor thesis deals with the problem of rheumatic disease ankylosing spondylitis and the effects of this disease. General part focuses on describing the theoretical knowledge of ankylosing spondylitis and possible methods for its treatment, and the implantation of hip replacement and subsequent rehabilitation. The special part p...

  14. A comparison of hip joint centre localisation techniques with 3-DUS for clinical gait analysis in children with cerebral palsy.

    Science.gov (United States)

    Peters, Alana; Baker, Richard; Morris, M E; Sangeux, Morgan

    2012-06-01

    Functional calibration techniques have been proposed as an alternative to regression equations for estimating the position of the hip within the pelvic co-ordinate system for clinical gait analysis. So far validation of such techniques has focussed on healthy adults. This study evaluated a range of techniques based on regression equations or functional calibration procedures techniques in 46 children representative of those attending a major clinical gait analysis service against previously validated 3-D ultrasound techniques for determining the hip joint centre. Best agreement with ultrasound for the position of the hip within the pelvic coordinate system was found for the Harrington equations (mean 14 mm, sd 8 mm). Sphere fitting (mean≈22 mm, sd 11 mm) performed better than transformational techniques applied locally (mean≈33 mm, sd 12 mm) or globally (mean=30 mm, sd 14 mm). The participants with cerebral palsy showed reduced range of movement compared with healthy adults. Differences between these results and studies modelling the effects of simulated noise on functional techniques can probably be attributed to differences between that noise and the soft tissue displacements that are actually occurring.

  15. Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime [Universidad de Barcelona, Department of Radiology, Hospital Clinic, Barcelona (Spain); Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep [Universidad de Barcelona, Department of Orthopaedics, Hospital Clinic, Barcelona (Spain); Soriano, Alex; Mensa, Josep [Universidad de Barcelona, Department of Infectious Diseases, Hospital Clinic, Barcelona (Spain); Rios, Jose [Statistical Unit de Suport a la Estadistica I Metodologia IDIBAPS, Barcelona (Spain); Almela, Manel [Universidad de Barcelona, Department of Microbiology, Hospital Clinic, Barcelona (Spain)

    2011-01-15

    To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

  16. Structural modifications induced by compressive plastic deformation in single-step and sequentially irradiated UHMWPE for hip joint components.

    Science.gov (United States)

    Puppulin, Leonardo; Sugano, Nobuhiko; Zhu, Wenliang; Pezzotti, Giuseppe

    2014-03-01

    Structural modifications were studied at the molecular scale in two highly crosslinked UHMWPE materials for hip-joint acetabular components, as induced upon application of (uniaxial) compressive strain to the as-manufactured microstructures. The two materials, quite different in their starting resins and belonging to different manufacturing generations, were a single-step irradiated and a sequentially irradiated polyethylene. The latter material represents the most recently launched gamma-ray-irradiated polyethylene material in the global hip implant market. Confocal/polarized Raman spectroscopy was systematically applied to characterize the initial microstructures and the microstructural response of the materials to plastic deformation. Crystallinity fractions and preferential orientation of molecular chains have been followed up during in vitro deformation tests on unused cups and correlated to plastic strain magnitude and to the recovery capacity of the material. Moreover, analyses of the in vivo deformation behavior of two short-term retrieved hip cups are also presented. Trends of preferential orientation of molecular chains as a function of residual strain were similar for both materials, but distinctly different in their extents. The sequentially irradiated material was more resistant to plastic deformation and, for the same magnitude of residual plastic strain, possessed a higher capacity of recovery as compared to the single-step irradiated one.

  17. Analysis and design of rolling-contact joints for evaluating bone plate performance.

    Science.gov (United States)

    Slocum, Alexander H; Cervantes, Thomas M; Seldin, Edward B; Varanasi, Kripa K

    2012-09-01

    An apparatus for testing maxillofacial bone plates has been designed using a rolling contact joint. First, a free-body representation of the fracture fixation techniques utilizing bone plates is used to illustrate how rolling contact joints accurately simulate in vivo biomechanics. Next, a deterministic description of machine functional requirements is given, and is then used to drive the subsequent selection and design of machine elements. Hertz contact stress and fatigue analysis for two elements are used to ensure that the machine will both withstand loads required to deform different plates, and maintain a high cycle lifetime for testing large numbers of plates. Additionally, clinically relevant deformations are presented to illustrate how stiffness is affected after a deformation is applied, and to highlight improvements made by the machine over current testing standards, which do not adequately re-create in vivo loading conditions. The machine performed as expected and allowed for analysis of bone plates in both deformed and un-deformed configurations to be conducted. Data for deformation experiments is presented to show that the rolling-contact testing machine leads to improved loading configurations, and thus a more accurate description of plate performance. A machine for evaluation of maxillofacial bone plates has been designed, manufactured, and used to accurately simulate in vivo loading conditions to more effectively evaluate the performance of both new and existing bone plates.

  18. Intra-Articular Knee Contact Force Estimation During Walking Using Force-Reaction Elements and Subject-Specific Joint Model.

    Science.gov (United States)

    Jung, Yihwan; Phan, Cong-Bo; Koo, Seungbum

    2016-02-01

    Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and -0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty.

  19. Iranian Joint Registry(Iranian National Hip and Knee Arthroplasty Registry

    Directory of Open Access Journals (Sweden)

    Hamidreza Aslani

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Low-level laser therapy of myofascial pain syndromes of patients with osteoarthritis of knee and hip joints

    Science.gov (United States)

    Gasparyan, Levon V.

    2001-04-01

    The purpose of the given research is the comparison of efficiency of conventional treatment of myofascial pain syndromes of patients with osteoarthritis (OA) of hip and knee joints and therapy with additional application of low level laser therapy (LLLT) under dynamic control of clinical picture, rheovasographic, electromyographic examinations, and parameters of peroxide lipid oxidation. The investigation was made on 143 patients with OA of hip and knee joints. Patients were randomized in 2 groups: basic group included 91 patients, receiving conventional therapy with a course of LLLT, control group included 52 patients, receiving conventional treatment only. Transcutaneous ((lambda) equals 890 nm, output peak power 5 W, frequency 80 - 3000 Hz) and intravenous ((lambda) equals 633 nm, output 2 mW in the vein) laser irradiation were used for LLLT. Studied showed, that clinical efficiency of LLLT in the complex with conventional treatment of myofascial pain syndromes at the patients with OA is connected with attenuation of pain syndrome, normalization of parameters of myofascial syndrome, normalization of the vascular tension and parameters of rheographic curves, as well as with activation of antioxidant protection system.

  2. sup 99m Tc-MDP abnormal uptake in the shaft of femur with hemi-lateral hip joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hidetoshi; Tanaka, Kouji (Gifu Prefectural Tajimi Hospital (Japan)); Sakuma, Sadayuki

    1990-08-01

    During the past 4 years, three-phase bone scintigraphy using {sup 99m}Tc-MDP has been studied in 68 patients suffering from hemi-lateral hip-joint disorders. We were impressed on abnormal uptake of the shaft of femur on the involved side. {sup 99m}Tc-MDP uptake in the shaft of femur was compared with between involved leg and normal leg of 68 patients with hemi-lateral hip-joint disorders (76 examinations). We excluded cases of osteomyelitis, cases of malignant tumor, and post-operative cases. In early images, the {sup 99m}Tc-MDP uptake was not always increased in involved side. But in delayed images, there were no patients whose normal side's {sup 99m}Tc-MDP uptake was increased. The {sup 99m}Tc-MDP uptake in early image was not related only with blood flow of the tigh but with the amount of soft tissue of the tigh. And the {sup 99m}Tc-MDP uptake in delayed image was related with disuse osteoporosis. (author).

  3. Changes in the activity of trunk and hip extensor muscles during bridge exercises with variations in unilateral knee joint angle

    Science.gov (United States)

    Kim, Juseung; Park, Minchul

    2016-01-01

    [Purpose] This study compared abdominal and hip extensor muscle activity during a bridge exercise with various knee joint angles. [Subjects and Methods] Twenty-two healthy male subjects performed a bridge exercise in which the knee joint angle was altered. While subjects performed the bridge exercise, external oblique, internal oblique, gluteus maximus, and semitendinosus muscle activity was measured using electromyography. [Results] The bilateral external and internal oblique muscle activity was significantly higher at 0° knee flexion compared to 120°, 90°, and 60°. The bilateral gluteus maximus muscle activity was significantly different at 0° of knee flexion compared to 120°, 90°, and 60°. The ipsilateral semitendinosus muscle activity was significantly increased at 90° and 60° of knee flexion compared to 120°, and significantly decreased at 0° knee flexion compared with 120°, 90°, and 60°. The contralateral semitendinosus muscle activity was significantly higher at 60° of knee flexion than at 120°, and significantly higher at 0° of knee flexion than at 120°, 90°, and 60°. [Conclusion] Bridge exercises performed with knee flexion less than 90° may be used to train the ipsilateral semitendinosus. Furthermore, bridge exercise performed with one leg may be used to train abdominal and hip extensor muscles. PMID:27799688

  4. Independent predictors of revision following metal-on-metal hip resurfacing: a retrospective cohort study using National Joint Registry data.

    Science.gov (United States)

    Jameson, S S; Baker, P N; Mason, J; Porter, M L; Deehan, D J; Reed, M R

    2012-06-01

    Modern metal-on-metal hip resurfacing has been widely performed in the United Kingdom for over a decade. However, the literature reports conflicting views of the benefits: excellent medium- to long-term results with some brands in specific subgroups, but high failure rates and local soft-tissue reactions in others. The National Joint Registry for England and Wales (NJR) has collected data on all hip resurfacings performed since 2003. This retrospective cohort study recorded survival time to revision from a resurfacing procedure, exploring risk factors independently associated with failure. All patients with a primary diagnosis of osteoarthritis who underwent resurfacing between 2003 and 2010 were included in the analyses. Cox's proportional hazard models were used to analyse the extent to which the risk of revision was related to patient, surgeon and implant covariates. A total of 27 971 hip resurfacings were performed during the study period, of which 1003 (3.59%) underwent revision surgery. In the final adjusted model, we found that women were at greater risk of revision than men (hazard ratio (HR) = 1.30, p = 0.007), but the risk of revision was independent of age. Of the implant-specific predictors, five brands had a significantly greater risk of revision than the Birmingham Hip Resurfacing (BHR) (ASR: HR = 2.82, p operations performed by low-volume surgeons (HR = 1.36, p < 0.001). Once these influences had been removed, in 4873 male patients < 60 years old undergoing resurfacing with a BHR, the five-year estimated risk of revision was 1.59%. In summary, after adjustment for a range of covariates we found that there were significant differences in the rate of failure between brands and component sizes. Younger male patients had good five-year implant survival when the BHR was used.

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

    Science.gov (United States)

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

    2014-07-01

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

  6. Isolated GH deficiency due to a GHRH receptor mutation causes hip joint problems and genu valgum, and reduces size but not density of trabecular and mixed bone.

    Science.gov (United States)

    Epitácio-Pereira, Carlos C; Silva, Gabriella M F; Salvatori, Roberto; Santana, João A M; Pereira, Francisco A; Gois-Junior, Miburge B; Britto, Allan V O; Oliveira, Carla R P; Souza, Anita H O; Santos, Elenilde G; Campos, Viviane C; Pereira, Rossana M C; Valença, Eugênia H O; Barbosa, Rita A A; Farias, Maria Isabel T; de Paula, Francisco J A; Ribeiro, Taisa V; Oliveira, Mario C P; Aguiar-Oliveira, Manuel H

    2013-11-01

    The GH/IGF-I axis is important for bone growth, but its effects on joint function are not completely understood. Adult-onset GH-deficient individuals have often reduced bone mineral density (BMD). However, there are limited data on BMD in adult patients with untreated congenital isolated GH-deficient (IGHD). We have shown that adult IGHD individuals from the Itabaianinha, homozygous for the c.57+1G>A GHRHR mutation, have reduced bone stiffness, but BMD and joint status in this cohort are unknown. The goal is to study BMD, joint function, and osteoarthritis score in previously untreated IGHD adults harboring the c.57+1G>A GHRHR mutation. This is a cross-sectional study. Areal BMD by dual-energy X-ray absorptiometry was measured in 25 IGHD and 23 controls (CO). Volumetric BMD (vBMD) was calculated at the lumbar spine and total hip. Joint function was assessed by goniometry of elbow, hips, and knees. X-rays were used to measure the anatomic axis of knee and the severity of osteoarthritis, using a classification for osteophytes (OP) and joint space narrowing (JSN). Genu valgum was more prevalent in IGHD than CO. The osteoarthritis knees OP score was similar in both groups, and knees JSN score showed a trend to be higher in IGHD. The hips OP score and JSN score were higher in IGHD. Areal BMD was lower in IGHD than CO, but vBMD was similar in the two groups. Range of motion was similar in elbow, knee, and hip in IGHD and CO. Untreated congenital IGHD due to a GHRHR mutation causes hip joint problems and genu valgum, without apparent clinical significance, reduces bone size, but does not reduce vBMD of the lumbar spine and hip.

  7. The influence of contact ratio and its location on the primary stability of cementless total hip arthroplasty: A finite element analysis.

    Science.gov (United States)

    Reimeringer, M; Nuño, N

    2016-05-03

    Cementless hip stems are fixed to the surrounding bone by means of press-fit. To ensure a good press-fit, current surgical technique specifies an under-reaming of the bone cavity using successively larger broaches. Nevertheless, this surgical technique is inaccurate. Several studies show that the contact ratio (percentage of stem interface in contact with bone) achieved after surgery can vary between 20% and 95%. Therefore, this study aimed to investigate the influence of the contact ratio and its location on the primary stability of a cementless total hip arthroplasty using finite element analysis. A straight tapered femoral stem implanted in a composite bone was subjected to stair climbing. Micromotion of 7600 nodes at the stem-bone interface was computed for different configurations of contact ratios between 2% and 98%) along the hip stem. Considering the 15 configurations evaluated, the average micromotion ranges between 27μm and 54μm. The percentage of the porous interface of the stem having micromotion below 40μm that allows bone ingrowth range between 25-57%. The present numerical study shows that full contact (100%) between stem and bone is not necessary to obtain a good primary stability. The stem primary stability is influenced by both the contact ratio and its location. Several configurations with contact ratio lower than 100% and involving either the proximal or the cortical contact provide better primary stability than the full contact configuration. However, with contact ratio lower than 40%, the stem should be in contact with cortical bone to ensure a good primary stability.

  8. Physical rehabilitation after endo-prosthetic appliance of hip-joint.

    Directory of Open Access Journals (Sweden)

    Skripnichenko Igor' Olegovich

    2009-02-01

    Full Text Available Dedicated to the question of raising the effectiveness of renewal of patient's ability to work with the hip-join injuries after its endo-prosthetic appliance made by the using of complex methods of physical rehabilitation. The peculiarities of the functional changes in the physical state of the patients with the injuries of the cervix of the hip-bone are studied. The complex of the therapeutic physical gymnastics, considering different periods of physical rehabilitation are developed. Complexes of physical exercises are developed with allowance for different periods of a physical rehabilitation.

  9. Changes in Joint Contact Mechanics in a Large Quadrupedal Animal Model After Partial Meniscectomy and a Focal Cartilage Injury.

    Science.gov (United States)

    Heckelsmiller, David J; James Rudert, M; Baer, Thomas E; Pedersen, Douglas R; Fredericks, Douglas C; Goetz, Jessica E

    2017-05-01

    Acute mechanical damage and the resulting joint contact abnormalities are central to the initiation and progression of post-traumatic osteoarthritis (PTOA). Study of PTOA is typically performed in vivo with replicate animals using artificially induced injury features. The goal of this work was to measure changes in a joint contact stress in the knee of a large quadruped after creation of a clinically realistic overload injury and a focal cartilage defect. Whole-joint overload was achieved by excising a 5-mm wedge of the anterior medial meniscus. Focal cartilage defects were created using a custom pneumatic impact gun specifically developed and mechanically characterized for this work. To evaluate the effect of these injuries on joint contact mechanics, Tekscan (Tekscan, Inc., South Boston, MA) measurements were obtained pre-operatively, postmeniscectomy, and postimpact (1.2-J) in a nonrandomized group of axially loaded cadaveric sheep knees. Postmeniscectomy, peak contact stress in the medial compartment is increased by 71% (p = 0.03) and contact area is decreased by 35% (p = 0.001); the center of pressure (CoP) shifted toward the cruciate ligaments in both the medial (p = 0.004) and lateral (p = 0.03) compartments. The creation of a cartilage defect did not significantly change any aspect of contact mechanics measured in the meniscectomized knee. This work characterizes the mechanical environment present in a quadrupedal animal knee joint after two methods to reproducibly induce joint injury features that lead to PTOA.

  10. Ultrasound: Infant Hip

    Science.gov (United States)

    ... ultrasound when they suspect a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can ... THIS TOPIC X-Ray Exam: Leg Length Developmental Dysplasia of the Hip X-Ray Exam: Hip Contact Us Print Resources ...

  11. [Biomechanical aspects of load-bearing capacity after total endoprosthesis replacement of the hip joint. An evaluation of current knowledge and review of the literature].

    Science.gov (United States)

    Wirtz, D C; Heller, K D; Niethard, F U

    1998-01-01

    Purpose of the study was to summarize the current scientific knowledge of the interaction between rehabilitative procedures and the periprosthetic bone remodeling processes in the early postoperative phase of total hip arthroplasties. In a comprehensive review of the international literature we analysed the interdependence between osseointegration, primary implant stability, relative micromotion of implant versus bone, and joint loading forces during mobilisation or physiotherapy. Accordingly, guidelines for the rehabilitation of cemented as well as cementless hip arthroplasties were established in order to eliminate factors disturbing prosthetic integration and hence provide for the best long-term stability of the implanted prosthesis possible. Osseointegration of cementless implants is impossible if relative micromotions exceed > 150 microns. Furthermore, torsional stresses (i.e. alternate climbing of stairs, rising from seated position without arm support) will destabilize uncemented femoral shaft implants. Cemented prostheses may be loaded with full body weight. Uncemented implants should be loaded only partially for at least 6 weeks. Loadings of the hip joint with more than twice the body-weight (i.e. walking without crutches, physical exercise against high resistances or long levers) are to be avoided for 3 months. The transition from the three-points walking to the two-points walking technique depends particularly on the conditions of the muscles stabilizing the hip joint. The rehabilitation of patients after total hip arthroplasty has to be brought into line with the changed biomechanical situation, the particulars of the implants and the individual requirements of the patients.

  12. Effects of medially wedged foot orthoses on knee and hip joint running mechanics in females with and without patellofemoral pain syndrome.

    Science.gov (United States)

    Boldt, Andrew R; Willson, John D; Barrios, Joaquin A; Kernozek, Thomas W

    2013-02-01

    We examined the effects of medially wedged foot orthoses on knee and hip joint mechanics during running in females with and without patellofemoral pain syndrome (PFPS). We also tested if these effects depend on standing calcaneal eversion angle. Twenty female runners with and without PFPS participated. Knee and hip joint transverse and frontal plane peak angle, excursion, and peak internal knee and hip abduction moment were calculated while running with and without a 6° full-length medially wedged foot orthoses. Separate 3-factor mixed ANOVAs (group [PFPS, control] x condition [medial wedge, no medial wedge] x standing calcaneal angle [everted, neutral, inverted]) were used to test the effect of medially wedged orthoses on each dependent variable. Knee abduction moment increased 3% (P = .03) and hip adduction excursion decreased 0.6° (P < .01) using medially wedged foot orthoses. No significant group x condition or calcaneal angle x condition effects were observed. The addition of medially wedged foot orthoses to standardized running shoes had minimal effect on knee and hip joint mechanics during running thought to be associated with the etiology or exacerbation of PFPS symptoms. These effects did not appear to depend on injury status or standing calcaneal posture.

  13. Evaluation of the wear performance of a polycarbonate-urethane acetabular component in a hip joint simulator and comparison with UHMWPE and cross-linked UHMWPE.

    Science.gov (United States)

    St John, Kenneth; Gupta, Minakshi

    2012-07-01

    Acetabular hip joint components manufactured from gamma-sterilized ultra high molecular weight polyethylene (UHMWPE), gamma cross-linked UHMWPE, or polycarbonate-urethane (PCU) polymers were evaluated in a hip joint simulator, using cobalt alloy femoral components, for at least 5 million cycles. The volume of material losses due to wear was calculated for each type of sample, based upon mass loss measurements, every 500,000 cycles. The loss of material for the conventional UHMWPE was much higher than for the cross-linked UHMWPE, showing about a 70% reduction in wear due to cross-linking. The material loss for the PCU samples appears to have been at least 24% lower than for the cross-linked UHMWPE. Based upon these results, the PCU material seems to have potential for use as an alternative bearing material to UHMWPE for total hip replacement surgeries.

  14. The clinical impact of hip joint centre regression equation error on kinematics and kinetics during paediatric gait.

    Science.gov (United States)

    Kiernan, D; Malone, A; O'Brien, T; Simms, C K

    2015-01-01

    Regression equations based on pelvic anatomy are routinely used to estimate the hip joint centre during gait analysis. While the associated errors have been well documented, the clinical significance of these errors has not been reported. This study investigated the clinical agreement of three commonly used regression equation sets (Bell et al., Davis et al. and Orthotrak software) against the equations of Harrington et al. Full 3-dimensional gait analysis was performed on 18 healthy paediatric subjects. Kinematic and kinetic data were calculated using each set of regression equations and compared to Harrington et al. In addition, the Gait Profile Score and GDI-Kinetic were used to assess clinical significance. Bell et al. was the best performing set with differences in Gait Profile Score (0.13°) and GDI-Kinetic (0.84 points) falling below the clinical significance threshold. Small deviations were present for the Orthotrak set for hip abduction moment (0.1 Nm/kg), however differences in Gait Profile Score (0.27°) and GDI-Kinetic (2.26 points) remained below the clinical threshold. Davis et al. showed least agreement with a clinically significant difference in GDI-Kinetic score (4.36 points). It is proposed that Harrington et al. or Bell et al. regression equation sets are used during gait analysis especially where inverse dynamic data are calculated. Orthotrak is a clinically acceptable alternative however clinicians must be aware of the effects of error on hip abduction moment. The Davis et al. set should be used with caution for inverse dynamic analysis as error could be considered clinically meaningful.

  15. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    DEFF Research Database (Denmark)

    Boesen, M.; Jensen, K.E.; Quistgaard, E.;

    2006-01-01

    PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58...

  16. ANNUAL EVALUATION OF HIP JOINTS AND HANDS FOR RADIOGRAPHIC SIGNS OF A-BETA(2)M-AMYLOIDOSIS IN LONG-TERM HEMODIALYSIS-PATIENTS

    NARCIS (Netherlands)

    KAMPHUIS, AGA; GEERLINGS, W; HAZENBERG, BPC; THIJN, CJP

    1994-01-01

    Radiographs of hand and hip joints of 15 hemodialysis patients taken annually over at least 15 years were evaluated in this retrospective study. We looked for signs of A beta(2),M-amyloidosis such as lucencies, erosions, and soft tissue swelling. The femoral head-soft tissue distance (FHSTD) was use

  17. Wear resistance of artificial hip joints with poly(2-methacryloyloxyethyl phosphorylcholine) grafted polyethylene: comparisons with the effect of polyethylene cross-linking and ceramic femoral heads.

    Science.gov (United States)

    Moro, Toru; Kawaguchi, Hiroshi; Ishihara, Kazuhiko; Kyomoto, Masayuki; Karita, Tatsuro; Ito, Hideya; Nakamura, Kozo; Takatori, Yoshio

    2009-06-01

    Aseptic loosening of artificial hip joints induced by wear particles from the polyethylene (PE) liner remains the ruinous problem limiting their longevity. We reported here that grafting with a polymer, poly(2-methacryloyloxyethyl phosphorylcholine (MPC)) (PMPC), on the PE liner surface dramatically decreased the wear production under a hip joint simulator condition. We examined that the effect of properties of both PE by cross-linking and femoral head by changing the materials on wearing properties of PE. The PMPC grafting on the liners increased hydrophilicity and decreased friction torque, regardless of the cross-linking of the PE liner or the difference in the femoral head materials. During the hip joint simulator experiments (5 x 10(6) cycles of loading), cross-linking caused a decrease of wear amount and a reduction of the particle size, while the femoral head materials did not affect it. The PMPC grafting abrogated the wear production, confirmed by almost no wear of the liner surface, independently of the liner cross-linking or the femoral head material. We concluded that the PMPC grafting on the PE liner surpasses the liner cross-linking or the change of femoral head materials for extending longevity of artificial hip joints.

  18. The correlation between movement of the center of mass and the kinematics of the spine, pelvis, and hip joints during body rotation.

    Science.gov (United States)

    Wada, Osamu; Tateuchi, Hiroshige; Ichihashi, Noriaki

    2014-01-01

    Body rotation is associated with many activities. The concomitant movement of the center of mass (COM) is essential for effective body rotation. This movement is considered to be influenced by kinematic changes in the spine, pelvis, and hip joints. However, there is no research on the association between COM movement and kinematic changes during body rotation. We aimed to investigate the association between COM movement and the kinematics of the spine, pelvis, and hip joints during body rotation in standing. Twenty-four healthy men were included in the study. COM movement during active body rotation in a standing position was measured. We evaluated pelvic shift and changes in the angles of the spine, pelvis, and hip joints. We calculated the Pearson correlation coefficients to analyze the relationship between COM movement and kinematic changes in the spine, pelvis, and hip joints. There were significant correlations between lateral COM movement to the rotational side and pelvic shift to the rotational side, and between posterior COM movement and pelvic shift to the posterior side. In addition, lateral COM movement to the rotational side showed significant and negative correlation with spinal flexion and was significantly and positively correlated with the change in anterior pelvic tilt. Clinicians need to take particular note of both spinal and pelvic motion in the sagittal plane, as well as the pelvic shift, to speculate COM movement during body rotation in standing. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. 全髋置换是否重建偏心距对髋关节功能的影响%Effects of femoral offset reconstruction or non-reconstruction on hip joint function in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    李永旺; 何荣丽; 白晓亮; 安明; 张谦; 马文海; 宋兴建; 孙俊英

    2014-01-01

    背景:股骨偏心距的重建对于恢复外展肌力和髋关节周围软组织张力平衡,维持关节稳定,恢复关节功能,减少置换后跛行,降低假体磨损、人工关节脱位等并发症的发生率具有重要意义。  目的:探讨全髋置换的重建偏心距对髋关节功能恢复的影响。  方法:对比分析采用组配式假体(S-ROM)行全髋置换20例20髋患者及采用普通假体(Corail)行全髋置换19例20髋患者的相关资料,通过临床(Harris评分)和X射线测量,对两组患者置换后髋关节功能和偏心距重建率进行对比研究。  结果与结论:纳入患者均无感染、骨折、脱位,无深静脉血栓及神经损伤等并发症。临床随访:在组配式假体和普通假体两组中,股骨偏心距重建组与未重建组置换前Harris评分差异无显著性意义(P>0.05);置换后12个月及末次随访偏心距重建患者Harris评分高于未重建者(P 0.05)。说明组配式假体和普通假体两组中股骨偏心距得到重建患者的髋关节功能和髋关节外展活动度优于未得到重建者,组配式假体偏心距重建率高。%BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation. OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty. METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied

  20. Reliability of functional and predictive methods to estimate the hip joint centre in human motion analysis in healthy adults.

    Science.gov (United States)

    Kainz, Hans; Hajek, Martin; Modenese, Luca; Saxby, David J; Lloyd, David G; Carty, Christopher P

    2017-03-01

    In human motion analysis predictive or functional methods are used to estimate the location of the hip joint centre (HJC). It has been shown that the Harrington regression equations (HRE) and geometric sphere fit (GSF) method are the most accurate predictive and functional methods, respectively. To date, the comparative reliability of both approaches has not been assessed. The aims of this study were to (1) compare the reliability of the HRE and the GSF methods, (2) analyse the impact of the number of thigh markers used in the GSF method on the reliability, (3) evaluate how alterations to the movements that comprise the functional trials impact HJC estimations using the GSF method, and (4) assess the influence of the initial guess in the GSF method on the HJC estimation. Fourteen healthy adults were tested on two occasions using a three-dimensional motion capturing system. Skin surface marker positions were acquired while participants performed quite stance, perturbed and non-perturbed functional trials, and walking trials. Results showed that the HRE were more reliable in locating the HJC than the GSF method. However, comparison of inter-session hip kinematics during gait did not show any significant difference between the approaches. Different initial guesses in the GSF method did not result in significant differences in the final HJC location. The GSF method was sensitive to the functional trial performance and therefore it is important to standardize the functional trial performance to ensure a repeatable estimate of the HJC when using the GSF method.

  1. Prevalence of modifiable surgical site infection risk factors in hip and knee joint arthroplasty patients at an urban academic hospital.

    Science.gov (United States)

    Pruzansky, Jason S; Bronson, Michael J; Grelsamer, Ronald P; Strauss, Elton; Moucha, Calin S

    2014-02-01

    Surgical site infections after hip and knee arthroplasty can be devastating if they lead to periprosthetic joint infection. We examined the prevalence of the modifiable risk factors for surgical site infection described by the American Academy of Orthopaedic Surgery Patient Safety Committee. Our study of 300 cases revealed that only 20% of all cases and 7% of revision cases for infection had no modifiable risk factors. The most common risk factors were obesity (46%), anemia (29%), malnutrition (26%), and diabetes (20%). Cases with obesity or diabetes were associated with all histories of remote orthopedic infection, 89% of urinary tract infections, and 72% of anemia cases. The high prevalence of several modifiable risk factors demonstrates that there are multiple opportunities for perioperative optimization of such comorbidities.

  2. Fluoroscopic bone fragment tracking for surgical navigation in femur fracture reduction by incorporating optical tracking of hip joint rotation center.

    Science.gov (United States)

    Nakajima, Yoshikazu; Tashiro, Takahito; Sugano, Nobuhiko; Yonenobu, Kazuo; Koyama, Tsuyoshi; Maeda, Yuki; Tamura, Yuichi; Saito, Masanobu; Tamura, Shin'ichi; Mitsuishi, Mamoru; Sugita, Naohiko; Sakuma, Ichiro; Ochi, Takahiro; Matsumoto, Yoichiro

    2007-09-01

    A new method for fluoroscopic tracking of a proximal bone fragment in femoral fracture reduction is presented. The proposed method combines 2-D and 3-D image registration from single-view fluoroscopy with tracking of the head center position of the proximal femoral fragment to improve the accuracy of fluoroscopic registration without the need for repeated manual adjustment of the C-arm as required in stereo-view registrations. Kinematic knowledge of the hip joint, which has a positional correspondence with the femoral head center and the pelvis acetabular center, allows the position of the femoral fragment to be determined from pelvis tracking. The stability of the proposed method with respect to fluoroscopic image noise and the desired continuity of the fracture reduction operation is demonstrated, and the accuracy of tracking is shown to be superior to that achievable by single-view image registration, particularly in depth translation.

  3. Finite element algorithm reproducing hip squeak measured in experiment

    Science.gov (United States)

    Kang, Jaeyoung

    2017-04-01

    In this study, the frequency spectrum of squeak noise in hip joint system is measured in experiment. The numerical reproduction of hip squeak signal involves the formulation of the finite element geometry, the analytical contact kinematics such as Hertz theory and Coulomb's law and the mode-discretization. For general approach, the contact kinematics are analytically modeled to easily adjust the contact location, the contact area, the rotation direction, the pressure distribution, the friction law, and so on. Furthermore the friction stress vectors act on the 3-dimensional spherical contact surfaces where they can be divided into the steady-sliding and its transverse slip directions. Numerical calculations for the various contact parameters are conducted to investigate the possibility of hip squeak occurrence and the nonlinear oscillations after the onset of squeak are also solved. In the transient analysis, the periodic limit cycle of hip squeaking is shown to be the stick-slip type oscillation. Then the numerical frequency spectrum is qualitatively compared with hip squeak signal measured in experiment. The stick-slip oscillation during hip squeaking and its contact behavior will be also discussed over the contact area within one period.

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

    Science.gov (United States)

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

    2009-01-01

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

  5. [Validity and Reliability of the German Version of the HSS Expectation Questionnaire on Hip Joint Replacement].

    Science.gov (United States)

    Balck, F; Kirschner, S; Jeszenszky, C; Lippmann, M; Günther, K-P

    2016-12-01

    Background: Total hip arthroplasty is one of the most successful operations in medicine. The clinical result after surgery and compliance during rehabilitation are influenced by the patient's expectations. There is a lack of a validated German instrument to record these expectations in a standardised manner. Patients: 193 patients from the Dresden Hip Register with osteoarthritis of the hip were surveyed with respect to their expectations before the operation. The study sample consists of 108 women and 85 men. The average age of the patients was 59.7 years, with a standard deviation of 12.2 years. Methods: The Hospital for Special Patient Expectations Survey was translated into German and culturally adapted. In addition, the RKI demographic core data set, the HADS-D, LOT-R and the SCL-(K-)9 were collected to validate the instrument. In the statistical analysis, four main factors could be distinguished. These were "everyday activities", "pain relief and improvement in function", "medication and social participation" and "gait improvement". Results: Patients were predominantly married. 20 % of the women were widowed. 20 % had received higher education. Almost half of the patients were retired, 30 % were employed, 15.1 % self-employed and 7.3 % were unemployed. For most of the items, patients expected major improvements up to normalisation of their health. There were many different answers to several items, such as the question on occupation. For sporting and sexual activities no high expectations were given. The average expectation of the whole sample shows major differences to individual expectations. Men showed higher expectations for medication, social participation and gait improvement than did women. There were lower expectations for everyday activities, medication and social participation and gait improvement for older patients. Summary: The German version of the HSS patients expectation survey was validated. The instrument is useful in the

  6. CAD - CAM Procedures Used for Rapid Prototyping of Prosthetic Hip Joint Bone

    Science.gov (United States)

    Popa, Luminita I.; Popa, Vasile N.

    2016-11-01

    The article addresses the issue of rapid prototyping CAD/ CAM procedures, based on CT imaging, for custom implants dedicated to hip arthroplasty and the correlation study to be achieved between femoral canal shape, valued by modern imaging methods, and the prosthesis form. A set of CT images is transformed into a digital model using one of several software packages available for conversion. The purpose of research is to obtain prosthesis with compatible characteristics as close to the physiological, with an optimal adjustment of the prosthesis to the bone in which it is implanted, allowing the recovery of the patient physically, mentally and socially.

  7. Development of high strength W/V/Au/ODS-Cu joint using HIP process

    Directory of Open Access Journals (Sweden)

    Hiroyuki Noto

    2016-12-01

    Full Text Available A new high strength bonding method between Tungsten (W and Oxide Dispersion Strengthening copper (ODS-Cu using vanadium (V and gold (Au inserts was investigated and the resulting joints were characterized with SEM, micro-hardness and four point bending test. For the joints using thick Au inserts (300µm, a hardened reaction layer was observed in the V/Au interface region. On the other hand, the joints using thin Au inserts (0.7µm exhibited a serrated interface layer having homogeneous hardness profiles. In this case, the observed behavior is a reflection of degradation of melting point by inter-diffusion between Au and Cu. Room temperature bending test of the joints with and without 0.7µm inserts at interface between V and ODS-Cu exhibited yielding behavior with the strength of approximately 300MPa which is close to that of ODS-Cu. The joint with the thin Au insert had a serrated interface which implies appearance of liquid phase by reaction between Au and Cu.

  8. Prediction of in vivo joint mechanics of an artificial knee implant using rigid multi-body dynamics with elastic contacts.

    Science.gov (United States)

    Chen, Zhenxian; Zhang, Xuan; Ardestani, Marzieh M; Wang, Ling; Liu, Yaxiong; Lian, Qin; He, Jiankang; Li, Dichen; Jin, Zhongmin

    2014-06-01

    Lower extremity musculoskeletal computational models play an important role in predicting joint forces and muscle activation simultaneously and are valuable for investigating functional outcomes of the implants. However, current computational musculoskeletal models of total knee replacement rarely consider the bearing surface geometry of the implant. Therefore, these models lack detailed information about the contact loading and joint motion which are important factors for evaluating clinical performances. This study extended a rigid multi-body dynamics simulation of a lower extremity musculoskeletal model to incorporate an artificial knee joint, based upon a novel force-dependent kinematics method, and to characterize the in vivo joint contact mechanics during gait. The developed musculoskeletal total knee replacement model integrated the rigid skeleton multi-body dynamics and the flexible contact mechanics of the tibiofemoral and patellofemoral joints. The predicted contact forces and muscle activations are compared against those in vivo measurements obtained from a single patient with good agreements for the medial contact force (root-mean-square error = 215 N, ρ = 0.96) and lateral contact force (root-mean-square error = 179 N, ρ = 0.75). Moreover, the developed model also predicted the motion of the tibiofemoral joint in all degrees of freedom. This new model provides an important step toward the development of a realistic dynamic musculoskeletal total knee replacement model to predict in vivo knee joint motion and loading simultaneously. This could offer a better opportunity to establish a robust virtual modeling platform for future pre-clinical assessment of knee prosthesis designs, surgical procedures and post-operation rehabilitation.

  9. Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction.

    Science.gov (United States)

    Kern, Andrew M; Anderson, Donald D

    2015-09-18

    Acute injury severity, altered joint kinematics, and joint incongruity are three important mechanical factors linked to post-traumatic osteoarthritis (PTOA). Finite element analysis (FEA) was previously used to assess the influence of increased contact stress due to joint incongruity on PTOA development. While promising agreement with PTOA development was seen, the inherent complexities of contact FEA limited the numbers of subjects that could be analyzed. Discrete element analysis (DEA) is a simplified methodology for contact stress computation, which idealizes contact surfaces as a bed of independent linear springs. In this study, DEA was explored as an expedited alternative to FEA contact stress exposure computation. DEA was compared to FEA using results from a previously completed validation study of two cadaveric human ankles, as well as a previous study of post-operative contact stress exposure in 11 patients with tibial plafond fracture. DEA-computed maximum contact stresses were within 19% of those experimentally measured, with 90% of the contact area having computed contact stress values within 1MPa of those measured. In the 11 fractured ankles, maximum contact stress and contact area differences between DEA and FEA were 0.85 ± 0.64 MPa and 22.5 ± 11.5mm(2). As a predictive measure for PTOA development, both DEA and FEA had 100% concordance with presence of OA (KL grade ≥ 2) and >95% concordance with KL grade at 2 years. These results support DEA as a reasonable alternative to FEA for computing contact stress exposures following surgical reduction of a tibial plafond fracture.

  10. [The infected endoprosthesis with the example of the hip joint endoprosthesis. An increasing danger to patient and society].

    Science.gov (United States)

    Cramer, J; Ekkernkamp, A; Ostermann, P A

    2001-04-01

    Because of demographic factors there is an increase in the numbers of total joint replacement operations each year. Deep infection after joint replacement remains one of the major complications in orthopedic surgery. The economic consequences for society are enormous. The treatment of such infections usually means a long and difficult course for the patient. In most cases multiple operations, including removal or exchange of the prosthesis are required. Concepts of treatment are very different and vary from debridement and keeping the prosthesis, resection arthroplasty to one- and second-stage exchange procedures. It is essential to know the special advantages and disadvantages of each concept to be able to choose the right strategy of treatment. Even getting the right diagnosis may be difficult since only about 2/3 of all cases go along with a positive microbiology. By the example of the infected hip prosthesis, the aim of the article is to give recommendations on the bases of current literature and our own experience. The strategy of treatment of infections used in our hospital is reported.

  11. Tensile properties of the hip joint ligaments are largely variable and age-dependent - An in-vitro analysis in an age range of 14-93 years.

    Science.gov (United States)

    Schleifenbaum, Stefan; Prietzel, Torsten; Hädrich, Carsten; Möbius, Robert; Sichting, Freddy; Hammer, Niels

    2016-10-03

    Hip joint stability is maintained by the surrounding ligaments, muscles, and the atmospheric pressure exerted via these structures. It is unclear whether the ligaments are capable of preventing dislocation solely due to their tensile properties, and to what extent they undergo age-related changes. This study aimed to obtain stress-strain data of the hip ligaments over a large age range. Stress-strain data of the iliofemoral (IL), ischiofemoral (IS) and pubofemoral ligament (PF) were obtained from cadavers ranging between 14 and 93 years using a highly standardized setting. Maximum strains were compared to the distances required for dislocation. Elastic modulus was 24.4 (IL), 22.4 (IS) and 24.9N/mm(2) (PF) respectively. Maximum strain was 84.5%, 86.1%, 72.4% and ultimate stress 10.0, 7.7 and 6.5N/mm(2) for the IL, IS and PF respectively. None of these values varied significantly between ligaments or sides. The IS' elastic modulus was higher and maximum strain lower in males. Lower elastic moduli of the PF and higher maximum strains for the IS and PF were revealed in the ≥55 compared to the <55 population. Maximum strain exceeded the dislocation distance of the IS without external hip joint rotation in females, and of the IS and cranial IL under external rotation in both genders. Tensile and failure load properties of the hip joint ligaments are largely variable. The IS and PF change age-dependently. Though the hip ligaments contribute to hip stability, the IS and cranial IL may not prevent dislocation due to their elasticity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Directory of Open Access Journals (Sweden)

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  13. Effects of hip joint centre mislocation on gait kinematics of children with cerebral palsy calculated using patient-specific direct and inverse kinematic models.

    Science.gov (United States)

    Kainz, Hans; Carty, Christopher P; Maine, Sheanna; Walsh, Henry P J; Lloyd, David G; Modenese, Luca

    2017-09-01

    Joint kinematics can be calculated by Direct Kinematics (DK), which is used in most clinical gait laboratories, or Inverse Kinematics (IK), which is mainly used for musculoskeletal research. In both approaches, joint centre locations are required to compute joint angles. The hip joint centre (HJC) in DK models can be estimated using predictive or functional methods, while in IK models can be obtained by scaling generic models. The aim of the current study was to systematically investigate the impact of HJC location errors on lower limb joint kinematics of a clinical population using DK and IK approaches. Subject-specific kinematic models of eight children with cerebral palsy were built from magnetic resonance images and used as reference models. HJC was then perturbed in 6mm steps within a 60mm cubic grid, and kinematic waveforms were calculated for the reference and perturbed models. HJC perturbations affected only hip and knee joint kinematics in a DK framework, but all joint angles were affected when using IK. In the DK model, joint constraints increased the sensitivity of joint range-of-motion to HJC location errors. Mean joint angle offsets larger than 5° were observed for both approaches (DK and IK), which were larger than previously reported for healthy adults. In the absence of medical images to identify the HJC, predictive or functional methods with small errors in anterior-posterior and medial-lateral directions and scaling procedures minimizing HJC location errors in the anterior-posterior direction should be chosen to minimize the impact on joint kinematics. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, M.; Jensen, K. E.; Qvistgaard, E.; Danneskiold-Samsoe, B.; Thomsen, C.; Oestergaard, M.; Bliddal, H. [Frederiksberg Hospital, Copenhagen (Denmark). Parker Inst.

    2006-07-15

    Purpose: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. Material and Methods: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. Results: Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images ( P <0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA ( P <0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. Conclusion: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.

  15. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    Directory of Open Access Journals (Sweden)

    Honda,Mitsugi

    2010-06-01

    Full Text Available Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH. The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

  16. Research Advances of the Normal Hip Joint Development%髋关节正常生长发育的研究进展

    Institute of Scientific and Technical Information of China (English)

    邱旭升

    2011-01-01

    The normal hip development is the result of a complicated halance of acetabulum , proximal femur, ligaments, vasculature , nerves ,and muscles. 'rhe program of hip development is controlled by complicated celluar events which are influenced by environmental and biologic factors. The systemic review is to show the following aspects of the normal hip development, the prenatal development , postnatal development , the arterial supply and innervation of the hip, and the cell signaling in intrauterine hip joint development. Understanding the sequential steps of the hip's development is critical to elucidate the pathobiologic mechanisms of hip disease and deformity,such as hip dysplasia.%髋关节的正常生长发育需要髋臼、股骨近端、关节周围韧带、血管、神经以及肌肉的协调生长共同完成.它由复杂的基因网络调控,同时受环境、生物因素的影响.现从出生前髋关节发育、出生后髋关节发育、髋关节的血管神经支配以及髋关节形成的分子机制等方面对髋关节的正常生长发育进行全面系统的回顾,为临床研究髋关节疾病,如发育性髋关节发育不良等提供理论基础.

  17. FIVE YEAR OUTCOMES OF CERAMIC-ОN-CERAMIC AND CERAMIC-ОN-POLYETHYLENE BEARINGS IN HIP JOINT REPLACEMENT

    Directory of Open Access Journals (Sweden)

    V. Yu. Murylev

    2017-01-01

    Full Text Available In view of the increasing number of hip joint replacement volume there remains the key issue of improving prosthesis survivorship which directly depends on the friction couple. Material and methods. The authors have analyzed five year outcomes of two bearing types (head and insert used in hip replacement: ceramic-on-ceramic (CoC in 324 patients and ceramic-on-polyethylene (CoP in 300 patients. Totally 550 patients were operated in the period starting 2010 till 2014, including 74 patients underwent bilateral hip replacement. The authors divided patients based on gender and also into three age groups: 20-40, 41-60 and 61-80 years old. The largest group comprised 156 women aged 41-60 years (28.4%. Additional grouping of patients was made based on gender, age and bearing diameter.36 mm diameter bearing was characterized of the most frequent use. Functional outcomes were assessed by Harris Hip Score. Statistical analysis was made with Statistica 10 software. Statistical significant was observed at p<0.05.Results.28 mm diameter bearing were rarely (19.5% applied and mainly in women which is related to need for use of smaller acetabulum components and inability to implant a larger insert.36 mm diameter bearing were used most frequently, CoC articulation of36 mm was used in men in 34% of cases and in women – in 18.12% of cases.40 mm articulations were implanted in women two times less than in men which is related to a smaller diameter of acetabulum in women. Generally, CoC bearings were implanted more often in men which can be explained by a bigger social demand as well as a higher anti-luxation stability of large diameter bearings. Dislocations of implants occurred in 5 (0.91% patients: in 4 patients with CoP bearingand in one patient with CoC articulation. Four revision procedures (0.64% were made due to deep periprosthetic infection: two surgeries in each group. Harris Hip Score evaluation in CoC group demonstrated excellent and good outcomes in

  18. Balance lower limb loads and 3D spine modifications after total hip joint replacement: effects of leg length discrepancy correction.

    Science.gov (United States)

    D'Amico, Moreno; Ciarrocca, Francesca; Liscio, Grazia; Serafini, Paolo; Tommasini, Maura; Vallasciani, Massimo

    2006-01-01

    Following total hip joint replacement (THJR), the durability of a prosthesis is limited by: wearing of frictional surfaces and loosening and migration of the prosthesis-cement-bone system. Literature review witnesses biomechanical studies focused mainly/only on hip functional state while none of them approached leg length discrepancy (LLD), posture unbalancing or spine related problems after THJR. Conversely, these latter could be critical elements for surgery and rehabilitation success, given the possible induction of asymmetric loading patterns. This study presents the results obtained by using a recently proposed methodology, to measure 3D subject posture balance and spine morphology and to evaluate its usefulness in individual therapy tuning/follow up. 3D subject's posture has been measured by means of 3D opto-electronic device, force platform and baropodography. 90 subjects after THJR have been included in this study. The subjects have been evaluated in two different epochs: 3 weeks after surgical intervention and after 3 months. 77/90 patients presented a LLD, pelvic obliquity and posture unbalancing. More than 90% of this group showed an overall postural re-balancing induced by the use of simple underfoot wedge. 70/77 patients needed wedge under the healthy side showing the surgical intervention produced a leg lengthening. 60/90 (52 LLD) patients underwent up to now to control and patients who wore the suggested wedge (63.4%) presented an improvement over all the considered quantitative parameters. Patients who wore a shorter than suggested wedge (23.1%), or that did not wear the suggested wedge (13.5%) presented a moderate or significant worsening of their postural balancing respectively.

  19. The Clinical Research of Total Hip Arthroplasty for Ankylosing Spondylitis Hip Joint Disease%全髋关节置换术治疗强直性脊柱炎髋关节病变

    Institute of Scientific and Technical Information of China (English)

    刘勇; 王业华; 蒋健; 柯明池; 徐峥

    2014-01-01

    目的:探讨全髋关节置换术治疗强直性脊柱炎髋关节病变的效果。方法对20例(27髋)强直性脊柱炎髋关节病变患者行人工全髋关节置换手术。置换前患者日常活动均明显受限,其中需要使用助行器7例,生活完全不能自理4例,8例(11髋)关节强直。比较手术前后髋关节 Harris 评分和关节活动度及术后并发症。1例患者后期行脊柱后凸矫形术。结果全部病例获得随访,平均随访时间4.2年(1.2~7.8年)。最后一次随访,23髋(85.2%)疼痛完全消失;仅有1例仍需双拐辅助行走,其余患者均可不扶拐行走,步态正常。术前 Harris 评分平均14.9分,髋关节活动度平均40°。术后 Harris 评分平均82.9分,其中优8髋,良10髋,可7髋,差2髋,优良率74.1%;髋关节活动度平均190.5°;髋关节 Harris 评分及关节活动度均显著高于置换前(P <0.05)。4髋(7.4%)出现异位骨化,分别为Brooker 分级Ⅰ、Ⅱ级。假体无菌性松动1例。结论全髋关节置换术是治疗强直性脊柱炎髋关节病变的有效手段,可以缓解关节疼痛,恢复关节功能,改善患者生活质量。%Objective To evaluate the clinical results of the total hip replacement in the patients with ankylosing spondy-litis. Methods A total of 20 ankylosing spondylitis patients(27 hip joints)underwent total hip replacement. All the patients had obvious restriction in daily life before operation:7 cases had to walk with the help of crutches,4 cases had to sit on wheel-chair,and 8 cases(11 hip joints)were stiff. The range of motion of the hip joint,the Harris score,and the postoperative compli-cations were compared and analysed in this study. Additional spinal operation for their kyphosis was required in 1 patient. Re-sults The patients were followed up for an average age of 4. 2 years(ranged from 1. 2 to 7. 8 years)in our department. The pain was completely released in 23 hips

  20. Analysis of the Effects of Normal Walking on Ankle Joint Contact Characteristics After Acute Inversion Ankle Sprain.

    Science.gov (United States)

    Bae, Ji Yong; Park, Kyung Soon; Seon, Jong Keun; Jeon, Insu

    2015-12-01

    To show the causal relationship between normal walking after various lateral ankle ligament (LAL) injuries caused by acute inversion ankle sprains and alterations in ankle joint contact characteristics, finite element simulations of normal walking were carried out using an intact ankle joint model and LAL injury models. A walking experiment using a volunteer with a normal ankle joint was performed to obtain the boundary conditions for the simulations and to support the appropriateness of the simulation results. Contact pressure and strain on the talus articular cartilage and anteroposterior and mediolateral translations of the talus were calculated. Ankles with ruptured anterior talofibular ligaments (ATFLs) had a higher likelihood of experiencing increased ankle joint contact pressures, strains and translations than ATFL-deficient ankles. In particular, ankles with ruptured ATFL + calcaneofibular ligaments and all ruptured ankles had a similar likelihood as the ATFL-ruptured ankles. The push off stance phase was the most likely situation for increased ankle joint contact pressures, strains and translations in LAL-injured ankles.

  1. A Systematic Review Investigating the Presence of Inflammatory Synovitis in Hip and Knee Joint Replacement Surgery

    Directory of Open Access Journals (Sweden)

    Sherif Hosny

    2015-01-01

    Full Text Available Synovial tissue can display an inflammatory response in the presence of OA. There is increasing interest to better understand the role of inflammation in OA, particularly with regard to those who require joint replacement. A systematic review of inflammatory synovitis in OA of literature databases was undertaken from their inception until October 14, 2014. Independent critical appraisal of each study was undertaken using the CASP appraisal tool. From a total of sixty-six identified citations, twenty-three studies were deemed eligible for review. The studies presented moderate to strong methodological quality. Strong correlation was identified between histological and imaging synovitis severity. Correlation was weaker between clinical symptoms and imaging and/or histological synovitis severity. There was little consensus, with regard to expressed cytokines and chemokines at the different stages of OA disease progression. Few studies investigated the influence of inflammatory synovitis on the outcome of major joint replacement. Research into inflammatory synovitis in OA is an emerging field. Longitudinal studies applying proven imaging modalities, histological analysis, and longer follow-up are required in order to further define our understanding of the role of synovitis in the pathogenesis of OA and its effects on outcomes following major joint replacement.

  2. 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.

  3. Modification and Actuator Minimization of the Hip Leg Joint in a Bipedal Robot: A Proposed Design

    Directory of Open Access Journals (Sweden)

    Nirmalya Tripathi

    2014-12-01

    Full Text Available In recent times, there have been numeric applications of Biped Robots. In this paper, a proposed upper leg hip design of a biped was developed taking cost reduction and optimization as factors for consideration. The proposed system introduces a novel method which consists of a vibration reduction (VR DC stepper motor, microcontroller, microprocessor and gearing arrangement. The program in the microprocessor is so designed that it gives a fixed number of cycles/steps to the VR DC stepper motor in clockwise and thereafter in anti-clockwise direction. This turning movement can then be transmitted to the gearing system which precisely moves one upper leg when the VR DC stepper motor moves in clockwise direction, while the other upper leg remains static, and vice-versa. It has been observed that this new proposed system may reduce the cost overhead, weight and the energy consumption incurred by working on a single VR DC stepper motor while conventionally two stepper motors are used to give the motion of the two upper legs in a biped.

  4. Reassessment of the usefulness of frozen section analysis for hip and knee joint revisions.

    Science.gov (United States)

    Kanner, William A; Saleh, Khaled J; Frierson, Henry F

    2008-09-01

    Intraoperative frozen section (FS) consultation is used in evaluating possible infection in cases of hip and knee revision arthroplasty, serving as an adjunct to preoperative and intraoperative studies. We examined our experience for more than 11 years to determine if FS examination had value when sections were sent nonselectively. We reviewed 244 cases, 132 with available culture results. The criterion for the presence of acute inflammation was more than 5 polymorphonuclear leukocytes per high-power field (hpf) in at least 5 separate hpfs, excluding surface inflammatory exudate and fibrin. Only 27 cases (11.1%) demonstrated positive FS or paraffin section results. In comparison with intraoperative culture, the sensitivity, specificity, positive predictive value, and negative predictive value for FS analysis alone (on review) were 29%, 95%, 40%, and 92%. As currently used, FS analysis has excellent specificity and negative predictive value but poor sensitivity and positive predictive value. We suggest that FS examination be used more selectively in conjunction with other studies, namely erythrocyte sedimentation rate and C-reactive protein.

  5. Behavior and Failure Modes of Sandwich T-Joint Using Cohesive Zone Material Model and Contact Elements

    Science.gov (United States)

    Khalili, S. M. R.; Ghaznavi, A.

    2013-02-01

    One of the significant concerns of sandwich panels is their joints. T-joint is one the most common joint in sandwich structures. This paper deals with the numerical study of triangle T-joint under static loading. The results of numerical solution obtained by ANSYS modeling are verified with the results of experimental tests obtained in the literature. In general, the results obtained for anticipated failure load by numerical solution with the results of experimental test is in good agreement. Contact elements and cohesive zone material model are used to model the adhesive layer, hence debonding and fracture of adhesive is observed by the numerical modeling. Also, by using a written macro code in the ANSYS software, the ability of damage is explained for the core of sandwich panels; thus both the modes in fracture of T-joints (core shear failure in base panel and debonding of adhesive) are modeled. Core materials consist of Divinycell H100, H160, H250, and HCP70 are used for modeling sandwich panels, so that the function of joint is studied under different conditions of the sandwich core material. Nine different geometrical models are created by changing the base angle of the core triangle. The absorbed energy associated with different segments of the T-joint are used to investigate the effect of joint geometry and core material on the load transfer and failure mode of the T-joint.

  6. Hip Replacement

    Science.gov (United States)

    ... The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven't helped, hip ...

  7. Chronic Periprosthetic Hip Joint Infection. A Retrospective, Observational Study on the Treatment Strategy and Prognosis in 130 Non-Selected Patients

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Søballe, Kjeld

    2016-01-01

    INTRODUCTION: Limited information is available regarding the treatment strategy and prognosis of non-selected patients treated for chronic periprosthetic hip joint infection. Such information is important as no head-to-head studies on treatment strategies are available. The purpose of this study...... is to report on the treatment strategy and prognosis of a non-selected, consecutive patient population. METHODS: We identified 130 patients in the National Patient Registry, consecutively treated for a chronic periprosthetic hip joint infection between 2003-2008 at 11 departments of orthopaedic surgery. We.......00001). After adjusting for selected confounders, the mortality risk was no longer significantly different. The 5-year re-infection rate after re-implantation was 14.6% (95%CI 8.0-23.1). Re-infections occurred mainly within 3 years of follow-up. The overall 1-year survival rate was 92% (95%CI 86...

  8. Lumbosacral transitional vertebrae, canine hip dysplasia, and sacroiliac joint degenerative changes on ventrodorsal radiographs of the pelvis in police working German shepherd dogs.

    Science.gov (United States)

    Komsta, Renata; Łojszczyk-Szczepaniak, Anna; Dębiak, Piotr

    2015-03-01

    Lumbosacral transitional vertebrae (LTV) frequently occur in German shepherd dogs. The aim of the study was to evaluate the prevalence and interdependence between LTV and canine hip dysplasia (CHD) as well as sacroiliac joint degenerative changes visualized on ventrodorsal radiographs of the pelvis in both working and companion German shepherd dogs. The presence of LTV was found in 12% of working dogs and in 33% of companion dogs. Similar incidence of hip dysplasia in both the groups was found. It has been shown that dogs with LTV have a higher frequency of severe CHD. A higher percentage of sacroiliac joint degenerative changes was observed in dogs with no signs of LTV and in working dogs.

  9. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  10. Importance of SPECT/CT for knee and hip joint prostheses; Stellenwert der SPECT/CT bei Knie- und Hueftgelenkprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Steurer-Dober, I.; Huellner, M.W.; Veit-Haibach, P.; Allgayer, B. [Luzerner Kantonsspital (Switzerland). Institut fuer Nuklearmedizin und Roentgendiagnostik

    2012-07-15

    Complications, such as loosening or infections are common problems after hip or knee arthroplasty. If conventional X-rays are equivocal bone scintigraphy is the classical second-line imaging modality. Single photon emission computed tomography/computed tomography (SPECT/CT) offers metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals. The SPECT/CT procedure is a promising method and is increasingly being used in daily routine to evaluate joint arthroplasty. The additional benefit compared with classical conventional bone scintigraphy has to be evaluated in further prospective studies. In our hospital SPECT/CT regularly gives important additional information regarding prosthetic joint complications. SPECT/CT is increasingly being used as the second step imaging standard modality if conventional X-rays are equivocal. (orig.) [German] Komplikationen wie Lockerung und Infekt stellen ein haeufiges Problem nach Hueft- und Kniegelenkprothesen dar. Wenn die konventionelle Roentgenaufnahme nicht zum Ziel fuehrt, ist die klassische konventionelle Skelettszintigraphie die am haeufigsten verwendete ''Second-line''-Bildgebung. Die ''single photon emission computed tomography''/CT (SPECT/CT) bietet metabolische und morphologische Informationen bzgl. Prothesenkomplikationen in einem Untersuchungsgang und ist zunehmend in groesseren Kliniken verfuegbar. Die SPECT/CT ist eine viel versprechende Methode und wird im klinischen Alltag bei der Evaluation von Gelenkprothesen zunehmend eingesetzt. Es sind noch mehr prospektive Studien noetig, um die Leistungsfaehigkeit und den Zusatznutzen gegenueber der klassischen Szintigraphie zu evaluieren. In unserer Klinik wird die Knochenszintigraphie bei der Abklaerung von Prothesenkomplikationen zumeist mit einer SPECT/CT kombiniert und liefert regelmaessig wichtige Zusatzinformationen. Die SPECT/CT entwickelt sich zunehmend zum Standard

  11. Wear rate evaluation of a novel polycarbonate-urethane cushion form bearing for artificial hip joints.

    Science.gov (United States)

    Elsner, Jonathan J; Mezape, Yoav; Hakshur, Keren; Shemesh, Maoz; Linder-Ganz, Eran; Shterling, Avi; Eliaz, Noam

    2010-12-01

    There is growing interest in the use of compliant materials as an alternative to hard bearing materials such as polyethylene, metal and ceramics in artificial joints. Cushion form bearings based on polycarbonate-urethane (PCU) mimic the natural synovial joint more closely by promoting fluid-film lubrication. In the current study, we used a physiological simulator to evaluate the wear characteristics of a compliant PCU acetabular buffer, coupled against a cobalt-chrome femoral head. The wear rate was evaluated over 8 million cycles gravimetrically, as well as by wear particle isolation using filtration and bio-ferrography (BF). The gravimetric and BF methods showed a wear rate of 9.9-12.5mg per million cycles, whereas filtration resulted in a lower wear rate of 5.8mg per million cycles. Bio-ferrography was proven to be an effective method for the determination of wear characteristics of the PCU acetabular buffer. Specifically, it was found to be more sensitive towards the detection of wear particles compared to the conventional filtration method, and less prone to environmental fluctuations than the gravimetric method. PCU demonstrated a low particle generation rate (1-5×10⁶ particles per million cycles), with the majority (96.6%) of wear particle mass lying above the biologically active range, 0.2-10μm. Thus, PCU offers a substantial advantage over traditional bearing materials, not only in its low wear rate, but also in its osteolytic potential.

  12. Dynamic input to determine hip joint moments, power and work on the prosthetic limb of transfemoral amputees: ground reaction vs knee reaction

    OpenAIRE

    FROSSARD, Laurent; Cheze, Laurence; Dumas, Raphaël

    2011-01-01

    Background: Calculation of lower limb kinetics is limited by floor-mounted force-plates. Objectives: Comparison of hip joint moments, power and mechanical work on the prosthetic limb of a transfemoral amputee calculated by inverse dynamics using either the ground reactions (force-plates) or knee reactions (transducer). Study design: Comparative analysis. Methods: Kinematics, ground reaction and knee reaction data were collected using a motion analysis system, two forceplates, and a multi-axia...

  13. The Hip Restoration Algorithm

    Science.gov (United States)

    Stubbs, Allston Julius; Atilla, Halis Atil

    2016-01-01

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

  14. Numerical simulation of the insertion process of an uncemented hip prosthesis in order to evaluate the influence of residual stress and contact distribution on the stem initial stability.

    Science.gov (United States)

    Monea, Aida Georgeta; Pastrav, Leonard Cezar; Mulier, Michiel; Van der Perre, Georges; Jaecques, Siegfried V

    2014-01-01

    The long-term success of a cementless total hip arthroplasty depends on the implant geometry and interface bonding characteristics (fit, coating and ingrowth) and on stem stiffness. This study evaluates the influence of stem geometry and fitting conditions on the evolution and distribution of the bone-stem contact, stress and strain during and after the hip stem insertion, by means of dynamic finite element techniques. Next, the influence of the mechanical state (bone-stem contact, stress and strain) resulted from the insertion process on the stem initial resistance to subsidence is investigated. In addition, a study on the influence of bone-stem interface conditions (friction) on the insertion process and on the initial stem stability under physiological loading is performed. The results indicate that for a stem with tapered shape the contact in the proximal part of the stem was improved, but contact in the calcar region was achieved only when extra press-fit conditions were considered. Changes in stem geometry towards a more tapered shape and extra press fit and variation in the bone-stem interface conditions (contact amount and high friction) led to a raise in the total insertion force. A direct positive relationship was found between the stem resistance to subsidence and stem geometry (tapering and press fit), bone-stem interface conditions (bone-stem contact and friction interface) and the mechanical status at the end of the insertion (residual stress and strain). Therefore, further studies on evaluating the initial performance of different stem types should consider the parameters describing the bone-stem interface conditions and the mechanical state resulted from the insertion process.

  15. Ceramic-on-ceramic bearing fractures in total hip arthroplasty: an analysis of data from the National Joint Registry.

    Science.gov (United States)

    Howard, D P; Wall, P D H; Fernandez, M A; Parsons, H; Howard, P W

    2017-08-01

    Ceramic-on-ceramic (CoC) bearings in total hip arthroplasty (THA) are commonly used, but concerns exist regarding ceramic fracture. This study aims to report the risk of revision for fracture of modern CoC bearings and identify factors that might influence this risk, using data from the National Joint Registry (NJR) for England, Wales, Northern Ireland and the Isle of Man. We analysed data on 223 362 bearings from 111 681 primary CoC THAs and 182 linked revisions for bearing fracture recorded in the NJR. We used implant codes to identify ceramic bearing composition and generated Kaplan-Meier estimates for implant survivorship. Logistic regression analyses were performed for implant size and patient specific variables to determine any associated risks for revision. A total of 222 852 bearings (99.8%) were CeramTec Biolox products. Revisions for fracture were linked to seven of 79 442 (0.009%) Biolox Delta heads, 38 of 31 982 (0.119%) Biolox Forte heads, 101 of 80 170 (0.126%) Biolox Delta liners and 35 of 31 258 (0.112%) Biolox Forte liners. Regression analysis of implant size revealed smaller heads had significantly higher odds of fracture (chi-squared 68.0, p ceramic type. Liner thickness was not predictive of fracture (p = 0.67). Body mass index (BMI) was independently associated with revision for both head fractures (odds ratio (OR) 1.09 per unit increase, p = 0.031) and liner fractures (OR 1.06 per unit increase, p = 0.006). We report the largest independent study of CoC bearing fractures to date. The risk of revision for CoC bearing fracture is very low but previous studies have underestimated this risk. There is good evidence that the latest generation of ceramic has greatly reduced the odds of head fracture but not of liner fracture. Small head size and high patient BMI are associated with an increased risk of ceramic bearing fracture. Cite this article: Bone Joint J 2017;99-B:1012-19. ©2017 The British Editorial Society of Bone & Joint Surgery.

  16. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

    Science.gov (United States)

    Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

    2017-12-01

    A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P  0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

  17. HIP JOINT OSTEOARTHRITIS IN LEGG-CALVÉ-PERTHES DISEASE - A LONG-TIME FOLLOW-UP CASE-CONTROL STUDY

    DEFF Research Database (Denmark)

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

    2009-01-01

    compared to one hip of 107 hips in the control group. One patient out of 41 in Stulberg class I/II had OA compared to three out of nine in Stulberg class III/IV/V. CONCLUSION LCP patients have a significant higher risk of having hip OA compared to a sex- and age-matched control group, p=0.04 [OR=8.5 (CI=0.......8-428.8)]. Patients in Stulberg class III, IV or V have a significantly increases risk of hip OA compared to patients in Stulberg class I or II, p=0.03 [OR=13.7 (CI 1.9-97.1)].......INTRODUCTION The purposes of this study are to investigate the inter-relationship between Stulberg class and radiographic hip osteoarthritis (OA) in patients with Legg-Calvé-Perthes disease (LCP) and to determine whether LCP patients develop hip OA more often than sex- and age-matched individuals...

  18. Residual hip dysplasia at 1 year after treatment for neonatal hip instability is not related to degenerative joint disease in young adulthood: a 21-year follow-up study including dGEMRIC.

    Science.gov (United States)

    Wenger, D; Siversson, C; Dahlberg, L E; Tiderius, C J

    2016-03-01

    Developmental dysplasia of the hip (DDH) is associated with an increased risk of early hip osteoarthritis (OA). We aimed to examine the outcome at the completion of growth in a cohort of children who had residual acetabular dysplasia at age 1 year following early treatment for neonatal instability of the hip (NIH). We examined 21 of 30 subjects who had been treated with the von Rosen splint neonatally for NIH and had residual acetabular dysplasia at age 1 year. Mean follow-up time was 21 years (range 17-24). Signs of OA and acetabular dysplasia were assessed by radiography. Cartilage quality was assessed by delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC), a tool for molecular imaging of cartilage quality, at 1.5 T. Patient reported outcome (PRO) was assessed by the 12-item WOMAC score. No study participant had radiographic OA (defined as Kellgren-Lawrence grade ≥2) or minimum joint space width (JSW) ≤2 mm. The mean dGEMRIC index was 630 ms (95% CI: 600-666, range: 516-825) suggesting good cartilage quality. The mean 12-item WOMAC score was 1.2. Two of three radiographic measurements of DDH correlated positively to the dGEMRIC index. Children treated neonatally for NIH have good hip function and no signs of cartilage degeneration at 21-year follow-up, despite residual dysplasia at age 1 year. Unexpectedly, radiographic signs of dysplasia were associated with better cartilage quality, as assessed with dGEMRIC. This may indicate cartilage adaptation to increased mechanical stress in mild hip dysplasia. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  19. Wear analysis of retrieved ceramic-on-ceramic articulations in total hip arthroplasty: Femoral head makes contact with the rim of the socket outside of the bearing surface.

    Science.gov (United States)

    Yamamoto, Tetsuya; Saito, Masanobu; Ueno, Masaru; Hananouchi, Takehito; Tokugawa, Yusuke; Yonenobu, Kazuo

    2005-05-01

    We investigated articular bearing surfaces retrieved from three patients with ceramic-on-ceramic total hip arthroplasties using high-quality alumina. The duration of implantation was 3.5, 3.0, and 2.5 years, respectively. Dislocation of the hip joint after implantation did not occur in any patients. The retrieved prostheses were examined by stereomicroscopy and scanning electron microscopy (SEM). In the main load-bearing area, no wear marks were seen in any sockets. However, in all three cases, stripe scars were observed at the rim of the alumina inlay under stereomicroscopy, despite the lack of indentation in the socket and the stem, which suggests impingement. Such scars were not observed on the load-bearing surface. Under SEM, the scars showed excessive wear, including material excavation, that has not been observed in conventional hip simulator experiments. These findings are similar to those of experiments in which a simulator was programmed to distract the femoral head from the socket. The present results suggest that the femoral head can separate from the socket without neck-socket impingement in vivo. (c) 2005 Wiley Periodicals, Inc.

  20. Analysis of wear of polyethylene hip joint cup related to its positioning in patient's body.

    Science.gov (United States)

    Rońda, Jacek; Wojnarowski, Paweł

    2013-01-01

    Polyethylene parts of endoprosthesis are the weakest parts of each medical implant. They can be worn out within several years. During this period, a patient can enjoy good physical efficiency until the wear of polyethylene part limits his/her mobility. Then the reoperation is necessary and positioning of all parts of endoprosthesis has an effect on future patient's mobility and durability of implant. Elements of endoprosthesis during exploitation are heavily loaded both by normal and tangential forces and moments. In this paper, the dependence of wear of polyethylene cup on its positioning in pelvis is the major problem. Wear of the cup is determined by two measures: the depth and volume of a material rubbed off from the contact surface. The sensitivity of the depth of rubbing off is evaluated relative to two angles of anteversion and abduction, and radii of the cup. Numerical results are obtained by using Abaqus FE system with data related to patient's activity identified on the basis of medical reports.

  1. Developmental Dysplasia of the Hip

    Science.gov (United States)

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

  2. A geometric approach to study the contact mechanisms in the patellofemoral joint of normal versus patellofemoral pain syndrome subjects.

    Science.gov (United States)

    Islam, Kamrul; Duke, Kajsa; Mustafy, Tanvir; Adeeb, Samer M; Ronsky, Janet L; El-Rich, Marwan

    2015-01-01

    The biomechanics of the patellofemoral (PF) joint is complex in nature, and the aetiology of such manifestations of PF instability as patellofemoral pain syndrome (PFPS) is still unclear. At this point, the particular factors affecting PFPS have not yet been determined. This study has two objectives: (1) The first is to develop an alternative geometric method using a three-dimensional (3D) registration technique and linear mapping to investigate the PF joint contact stress using an indirect measure: the depth of virtual penetration (PD) of the patellar cartilage surface into the femoral cartilage surface. (2) The second is to develop 3D PF joint models using the finite element analysis (FEA) to quantify in vivo cartilage contact stress and to compare the peak contact stress location obtained from the FE models with the location of the maximum PD. Magnetic resonance images of healthy and PFPS subjects at knee flexion angles of 15°, 30° and 45° during isometric loading have been used to develop the geometric models. The results obtained from both approaches demonstrated that the subjects with PFPS show higher PD and contact stresses than the normal subjects. Maximum stress and PD increase with flexion angle, and occur on the lateral side in healthy and on the medial side in PFPS subjects. It has been concluded that the alternative geometric method is reliable in addition to being computationally efficient compared with FEA, and has the potential to assess the mechanics of PFPS with an accuracy similar to the FEA.

  3. Accurate Evaluation of Balancing-side Contacts in Relation to Internal Derangements of the Temporomandibular Joint : Possible Roles of Balancing-side Protection

    OpenAIRE

    Minagi, Shogo; Watanabe, Hideyuki; Tsuru, Hiromichi

    1989-01-01

    Balancing-side contacts were precisely evaluated in relation to internal derangements of the temporomandibular joint. Balancing-side contacts were classified into the three following groups: 1) Severe balancing-side interference, 2) balancing-side interference and 3) balancing-side protective contacts. Balancing-side protective contacts were defined as balancing-side occlusal contacts on lower first and/or second molar in lateral excursive movements, which are observed only when clenching for...

  4. In the queue for total joint replacement: patients' perspectives on waiting times. Ontario Hip and Knee Replacement Project Team.

    Science.gov (United States)

    Llewellyn-Thomas, H A; Arshinoff, R; Bell, M; Williams, J I; Naylor, C D

    1998-02-01

    We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P = 0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z = 2.951; P = 0.004) and shorter times since their surgeon first advised them of the need for surgery (z = 3.014; P = 0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.

  5. Finite element lumbar spine facet contact parameter predictions are affected by the cartilage thickness distribution and initial joint gap size.

    Science.gov (United States)

    Woldtvedt, Daniel J; Womack, Wesley; Gadomski, Benjamin C; Schuldt, Dieter; Puttlitz, Christian M

    2011-06-01

    Current finite element modeling techniques utilize geometrically inaccurate cartilage distribution representations in the lumbar spine. We hypothesize that this shortcoming severely limits the predictive fidelity of these simulations. Specifically, it is unclear how these anatomically inaccurate cartilage representations alter range of motion and facet contact predictions. In the current study, cadaveric vertebrae were serially sectioned, and images were taken of each slice in order to identify the osteochondral interface and the articulating surface. A series of custom-written algorithms were utilized in order to quantify each facet joint's three-dimensional cartilage distribution using a previously developed methodology. These vertebrae-dependent thickness cartilage distributions were implemented on an L1 through L5 lumbar spine finite element model. Moments were applied in three principal planes of motion, and range of motion and facet contact predictions from the variable thickness and constant thickness distribution models were determined. Initial facet gap thickness dimensions were also parameterized. The data indicate that the mean and maximum cartilage thickness increased inferiorly from L1 to L5, with an overall mean thickness value of 0.57 mm. Cartilage distribution and initial facet joint gap thickness had little influence on the lumbar range of motion in any direction, whereas the mean contact pressure, total contact force, and total contact area predictions were altered considerably. The data indicate that range of motion predictions alone are insufficient to establish model validation intended to predict mechanical contact parameters. These data also emphasize the need for the careful consideration of the initial facet joint gap thickness with respect to the spinal condition being studied.

  6. Joint-bounded crescentic scars formed by subglacial clast-bed contact forces: Implications for bedrock failure beneath glaciers

    Science.gov (United States)

    Krabbendam, M.; Bradwell, T.; Everest, J. D.; Eyles, N.

    2017-08-01

    Glaciers and ice sheets are important agents of bedrock erosion, yet the precise processes of bedrock failure beneath glacier ice are incompletely known. Subglacially formed erosional crescentic markings (crescentic gouges, lunate fractures) on bedrock surfaces occur locally in glaciated areas and comprise a conchoidal fracture dipping down-ice and a steep fracture that faces up-ice. Here we report morphologically distinct crescentic scars that are closely associated with preexisting joints, termed here joint-bounded crescentic scars. These hitherto unreported features are ca. 50-200 mm deep and involve considerably more rock removal than previously described crescentic markings. The joint-bounded crescentic scars were found on abraded rhyolite surfaces recently exposed (ice produces a continuously migrating clast-bed contact force as it is dragged over the hard (bedrock) bed. As the ice-embedded boulder approaches a preexisting joint in the bedrock, stress concentrations build up in the bed that exceed the intact rock strength, resulting in conchoidal fracturing and detachment of a crescentic wedge-shaped rock fragment. Subsequent removal of the rock fragment probably involves further fracturing or crushing (comminution) under high contact forces. Formation of joint-bounded crescentic scars is favoured by large boulders at the base of the ice, high basal melting rates, and the presence of preexisting subvertical joints in the bedrock bed. We infer that the relative scarcity of crescentic markings in general on deglaciated surfaces shows that fracturing of intact bedrock below ice is difficult, but that preexisting weaknesses such as joints greatly facilitate rock failure. This implies that models of glacial erosion need to take fracture patterns of bedrock into account.

  7. 核素骨显像对骶髂关节、髋关节及 脊柱关节病的诊断%Bone scintigraphic imaging of sacroiliac joint, hip joint and spondyloarthritis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To establish normal reference value of radioactivity ratio of sacroiliac joint /soft tissue,sacroiliac joint/sacrum, hip joint/soft tissue and hip joint/thighbone in Chinese, and discuss its diagnostic value in spondyloarthritis (SpA). Methods 260 joints from 130 normal individuals were divided into 4 groups according to ages: 15~19 years, ~24 years, ~39 years and ≥40 years. They have exhibited no waist-leg symptom and a normal CT exam in sacroiliac joint. SPECT was performed on whole body skeleton as well as sacroiliac joint and hip joint to measure the radioactivity ratio in these joints respectively. In the same time, SPECT was also undertaken in 45 patients with SpA to calculate the radioactivity ratio of sacroiliac joint/soft tissue and sacroiliac joint/sacum. Results After statistical processing, a normal reference value of all radioactivity ratio in four groups was obtained. Analysis on the data in 4 groups showed that the variant coefficient of sacroiliac joint/sacrum is minimal, and thus to be used as a judgment for sacroiliac joint/sacrum osteometabolism. In 45 patients with SpA, 23 cases were undifferentiated spondyloarthritis. The radioactivity ratio of sacroiliac joint/sacrum increased in 20 cases (86.9%), while other joint disorders occurred in 21 cases. Conclusion The radioactivity ratio of sacroiliac joint/sacrum is of important value in early diagnosis for SpA.%目的 建立国人骶髂关节/软组织、骶髂关节/骶骨、髋关节/软组织、髋关节/股骨放射性比值的正常参考值,探讨其在脊柱关节病(SpA)中的诊断价值。方法 对无腰腿症状、CT检查骶髂关节正常的不同年龄者130例260组关节分为4组:15~19岁,~24岁,~39岁,≥40岁,进行全身骨骼及骶髂关节、髋关节周围结构的SPECT显像,取得4组不同部位放射性比值。同时对临床诊断为SpA的45例患者进行骨显像,计算其左右骶髂关节/软组织、骶髂关节/骶骨放射

  8. The diagnostic performance of radiography for detection of osteoarthritis-associated features compared with MRI in hip joints with chronic pain

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Li [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Beijing Jishuitan Hospital, Department of Radiology, Beijing (China); Hayashi, Daichi; Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Hunter, David J. [University of Sydney, Department of Medicine, Sydney (Australia); Li, Ling [New England Baptist Hospital, Division of Research, Boston, MA (United States); Winterstein, Anton; Bohndorf, Klaus [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Klinikum Augsburg, Department of Radiology, Augsburg (Germany); University of Erlangen, Department of Radiology, Erlangen (Germany)

    2013-10-15

    To evaluate the diagnostic performance of radiography for the detection of MRI-detected osteoarthritis-associated features in various articular subregions of the hip joint. Forty-four patients with chronic hip pain (mean age, 63.3 {+-} 9.5 years), who were part of the Hip Osteoarthritis MRI Scoring (HOAMS) cohort, underwent both weight-bearing anteroposterior pelvic radiography and 1.5 T MRI. The HOAMS study was a prospective observational study involving 52 subjects, conducted to develop a semiquantitative MRI scoring system for hip osteoarthritis features. In the present study, eight subjects were excluded because of a lack of radiographic assessment. On radiography, the presence of superior and medial joint space narrowing, superior and inferior acetabular/femoral osteophytes, acetabular subchondral cysts, and bone attrition of femoral head was noted. On MRI, cartilage, osteophytes, subchondral cysts, and bone attrition were evaluated in the corresponding locations. Diagnostic performance of radiography was compared with that of MRI, and the area under curve (AUC) was calculated for each pathological feature. Compared with MRI, radiography provided high specificity (0.76-0.90) but variable sensitivity (0.44-0.78) for diffuse cartilage damage (using JSN as an indirect marker), femoral osteophytes, acetabular subchondral cysts and bone attrition of the femoral head, and a low specificity (0.42 and 0.58) for acetabular osteophytes. The AUC of radiography for detecting overall diffuse cartilage damage, marginal osteophytes, subchondral cysts and bone attrition was 0.76, 0.78, 0.67, and 0.82, respectively. Diagnostic performance of radiography is good for bone attrition, fair for marginal osteophytes and cartilage damage, but poor for subchondral cysts. (orig.)

  9. Health Care Needs and Support for Patients Undergoing Treatment for Prosthetic Joint Infection following Hip or Knee Arthroplasty: A Systematic Review

    Science.gov (United States)

    Beswick, Andrew D.; Peters, Tim J.; Gooberman-Hill, Rachael; Whitehouse, Michael R.; Blom, Ashley W.

    2017-01-01

    Background Hip and knee arthroplasty are common interventions for the treatment of joint conditions, most notably osteoarthritis. Although many patients benefit from surgery, approximately 1% of patients develop infection afterwards known as deep prosthetic joint infection (PJI), which often requires further major surgery. Objective To assess support needs of patients undergoing treatment for PJI following hip or knee arthroplasty and to identify and evaluate what interventions are routinely offered to support such patients. Design Systematic review Data sources MEDLINE, EMBASE, Web of Science, PsycINFO, Cinahl, Social Science Citation Index, The Cochrane Library, and reference lists of relevant studies from January 01, 1980 to October 05, 2016. Selection criteria Observational (prospective or retrospective cohort, nested case-control or case-control) studies, qualitative studies, or clinical trials conducted in patients treated for PJI and/or other major adverse occurrences following hip or knee arthroplasty. Review methods Data were extracted by two independent investigators and consensus was reached with involvement of a third. Given the heterogeneous nature of study designs, methods, and limited number of studies, a narrative synthesis is presented. Results Of 4,213 potentially relevant citations, we identified one case-control, one prospective cohort and two qualitative studies for inclusion in the synthesis. Patients report that PJI and treatment had a profoundly negative impact affecting physical, emotional, social and economic aspects of their lives. No study evaluated support interventions. Conclusion The findings demonstrate that patients undergoing treatment for PJI have extensive physical, psychological, social and economic support needs. The interpretation of study results is limited by variation in study design, outcome measures and the small number of relevant eligible studies. However, our review highlights a lack of evidence about support

  10. Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement.

    Science.gov (United States)

    Purevsuren, Tserenchimed; Dorj, Ariunzaya; Kim, Kyungsoo; Kim, Yoon Hyuk

    2016-04-01

    The computational modeling approach has commonly been used to predict knee joint contact forces, muscle forces, and ligament loads during activities of daily living. Knowledge of these forces has several potential applications, for example, within design of equipment to protect the knee joint from injury and to plan adequate rehabilitation protocols, although clinical applications of computational models are still evolving and one of the limiting factors is model validation. The objective of this study was to extend previous modeling technique and to improve the validity of the model prediction using publicly available data set of the fifth "Grand Challenge Competition to Predict In Vivo Knee Loads." A two-stage modeling approach, which combines conventional inverse dynamic analysis (the first stage) with a multi-body subject-specific lower limb model (the second stage), was used to calculate medial and lateral compartment contact forces. The validation was performed by direct comparison of model predictions and experimental measurement of medial and lateral compartment contact forces during normal and turning gait. The model predictions of both medial and lateral contact forces showed strong correlations with experimental measurements in normal gait (r = 0.75 and 0.71) and in turning gait trials (r = 0.86 and 0.72), even though the current technique over-estimated medial compartment contact forces in swing phase. The correlation coefficient, Sprague and Geers metrics, and root mean squared error indicated that the lateral contact forces were predicted better than medial contact forces in comparison with the experimental measurements during both normal and turning gait trials.

  11. Research of the Resistance of Contact Welding Joint of R65 Type Rail

    Directory of Open Access Journals (Sweden)

    Kęstutis Dauskurdis

    2015-03-01

    Full Text Available In the article the R65 type rail joints that were welded by resistance welding are analysed. Survey methodology of the research consists of the following parts: visual inspection of welded joint, ultrasonic rail inspection, hardness test of upper part of the rail, fusion area research, the measurement hardness test of heat-softened area, the measurement microhardness test, microstructure research of the welded joint, impact strength experiments, chemical analysis of welded joint, wheel-rail interaction research using the finite element method (FEM. The results of the research are analysed and the quality of weld is evaluated. The conclusion is based on the results of this research.

  12. A COMPARATIVE ANALYSIS BETWEEN THE RECOVERY RESULTS OF PATIENTS WITH HIP JOINT REPLACEMENT IN THE PERIOD OF EARLY REHABILITATION AT HOME (13-45 DAYS AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    Maya St. Krastanova

    2016-04-01

    Full Text Available Rehabilitation of the patients with Hip Joint Arthroplasthy is an indispensable part of the functional recovery. The purpose of this report is to track and measure the results of an applied complex rehabilitation program during the early post-surgery period in home setting (13-45 days after surgery and to make a comparative analysis between the recovery results of patients who conducted a comprehensive rehabilitation treatment, and a control group of patients who conducted only early physical therapy and occupational therapy in the hospitalization in the Department of Orthopedics and Traumatology. Methods and materials: 152 patients (107 female and 45 male aged between 22 and 84 with Hip Joint Arthroplasthy due to osteoarthritis or femoral neck fracture participated in the study, divided into two groups, according to postoperative behavior. The rehabilitation program consists of: kinesitherapy (positional therapy, isometric exercises, movement of the artificial hip joint within the allowed volumes, exercises for upper limbs and the healthy lower limb and ergotherapy (ergonomic home environment adjusted to performing the daily activities of life. Patients in the second control group have conducted kinesitherapy and occupational therapy only in the early postoperative period in orthopedic clinic. Results: Locomotion test and DAL test measurements were taken and the results for each patient were stored in a special patient file. Conclusion: Ensuring an ergonomic home environment and independent practice of kinesitherapeutic and ergotherapeutic stimulate the recovery of the patients’ self-reliance significantly improve the psycho-emotional balance and self-respect, and serves as an important basis for the latter stages of rehabilitation.

  13. Validation of the English language Forgotten Joint Score-12 as an outcome measure for total hip and knee arthroplasty in a British population.

    Science.gov (United States)

    Hamilton, D F; Loth, F L; Giesinger, J M; Giesinger, K; MacDonald, D J; Patton, J T; Simpson, A H R W; Howie, C R

    2017-02-01

    To validate the English language Forgotten Joint Score-12 (FJS-12) as a tool to evaluate the outcome of hip and knee arthroplasty in a United Kingdom population. All patients undergoing surgery between January and August 2014 were eligible for inclusion. Prospective data were collected from 205 patients undergoing total hip arthroplasty (THA) and 231 patients undergoing total knee arthroplasty (TKA). Outcomes were assessed with the FJS-12 and the Oxford Hip and Knee Scores (OHS, OKS) pre-operatively, then at six and 12 months post-operatively. Internal consistency, convergent validity, effect size, relative validity and ceiling effects were determined. Data for the TKA and THA patients showed high internal consistency for the FJS-12 (Cronbach α = 0.97 in TKAs, 0.98 in THAs). Convergent validity with the Oxford Scores was high (r = 0.85 in TKAs, r = 0.79 for THAs). From six to 12 months, the change was higher for the FJS-12 than for the OHS in THA patients (effect size d = 0.21 versus -0.03). Ceiling effects at one-year follow-up were low for the FJS-12 with just 3.9% (TKA) and 8.8% (THA) of patients achieving the best possible score. The FJS-12 has strong measurement properties in terms of validity, internal consistency and sensitivity to change in TKA and THA patients. Low ceiling effects and good relative validity allow the monitoring of longer term outcomes, particularly in well-performing groups after total joint arthroplasty. Cite this article: Bone Joint J 2017;99-B:218-24. ©2017 Hamilton et al.

  14. Effects of administration of adipose-derived stromal vascular fraction and platelet-rich plasma to dogs with osteoarthritis of the hip joints.

    Science.gov (United States)

    Upchurch, David A; Renberg, Walter C; Roush, James K; Milliken, George A; Weiss, Mark L

    2016-09-01

    OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressure-sensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS AND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group.

  15. [Evaluation of Artificial Hip Joint with Radiofrequency Heating Issues during MRI Examination: A Comparison between 1.5 T and 3 T].

    Science.gov (United States)

    Yamazaki, Masaru; Ideta, Takahiro; Kudo, Sadahiro; Nakazawa, Masami

    2016-06-01

    In magnetic resonance imaging (MRI), when radiofrequency (RF) is irradiated to a subject with metallic implant, it can generate heat by RF irradiation. Recently 3 T MRI scanner has spread widely and imaging for any regions of whole body has been conducted. However specific absorption rate (SAR) of 3 T MRI becomes approximately four times as much as the 1.5 T, which can significantly affect the heat generation of metallic implants. So, we evaluated RF heating of artificial hip joints in different shapes and materials in 1.5 T and 3 T MRI. Three types of artificial hip joints made of stainless alloy, titanium alloy and cobalt chrome alloy were embedded in the human body-equivalent phantom respectively and their temperature change were measured for twenty minutes by 1.5 T and 3 T MRI. The maximum temperature rise was observed at the bottom head in all of three types of artificial hip joints, the rise being 12°C for stainless alloy, 11.9°C for titanium alloy and 6.1°C for cobalt chrome alloy in 1.5 T. The temperature rise depended on SAR and the increase of SAR had a good linear relationship with the temperature rise. It was found from the result that the RF heating of metallic implants can take place in various kinds of material and the increase of SAR has a good linear relationship with the temperature rise. This experience shows that reduction of SAR can decrease temperature of metallic implants.

  16. Complications after Hip Arthroscopy

    Science.gov (United States)

    Larson, Christopher M.; Clohisy, John C.; Beaule, Paul; Kelly, Bryan T.; Giveans, Russell; Stone, Rebecca M.; Samuelson, Kathryn M.

    2013-01-01

    Objectives: There is very little published literature looking at comprehensive complication rates after hip arthroscopy with current techniques and indications. Methods: Between 01/2011 and 11/2012, 1,026 consecutive hips (507 males, 519 females) with a mean age of 31.2 years (range 12 - 73) underwent hip arthroscopy at three institutions. The diagnosis, demographic information, and procedures were recorded, and a validated complications grading classification for hip joint surgery (Clavian classification) was utilized for all patients prospectively. Results: There were 951 primary hip arthroscopies and 75 revision hip arthroscopies. Arthroscopy was performed for FAI in 936 hips (91.2%), and 760 hips (74.1%) had a labral repair and 229 hips (22.3%) had a labral debridement. The most common event (18.7% of hips) noted was post-operative sensory disturbance adjacent to the portals or involving the distal anterolateral thigh consistent with LFC nerve disturbance. This was typically not noticed by patients and found on physical examination and only persisted beyond 6 months in 7 hips (0.7%). Iatrogenic chondral injury was noted for 20 hips (1.9%), iatrogenic labral puncture in 11 hips (1.1%), superficial portal infection in 6 hips (0.6%), sensory deficit about the foot in 9 hips (0.9%), deep venous thrombosis in 3 hips (0.3%), pulminary embolism in 1 hip (0.1%), pulmonary edema in 1 hip (0.1%), wound hematoma in 2 hips (0.2%), perineal numbness (pudendal nerve) in 9 hips (0.9%), heterotopic ossification in 4 hips (0.4%), reflex sympathetic dystrophy in 1 hip (0.1%) and wound/skin (traction) dehiscence in 1 hips (0.1%). There were no femoral neck fractures, iatrogenic instability, AVN, or extra-abdominal fluid extravasation in this cohort. The overall complication rate not including temporary periportal and thigh numbness (sequalae) was 6.9% (71 hips). Overall 88.7% had a grade 1, 5.6% Grade 2, 4.2% grade 3, and 1.4% grade 4 complication. There was no difference in the

  17. Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

  18. Hip joint replacement

    Science.gov (United States)

    ... easier. Practice using a cane, walker , crutches , or wheelchair correctly to: Get in and out of the shower Go up and down stairs Sit down to use the toilet and stand up after using the toilet Use the shower chair On the day of your surgery: You will ...

  19. Design of artificial hip joint prosthesis and analysis of interface stress%人工髋关节假体的设计及界面应力分析

    Institute of Scientific and Technical Information of China (English)

    安明勋

    2012-01-01

    背景:骨正确选择与宿主相容性良好的假体是保证全髋关节置换成功的重要因素,与置换后人工关节的生物力学性能和使用寿命有着密切的关系.目的:总结人工髋关节假体的研究进展,分析人工髋关节假体设计与界面力学对假体植入后生物相容的影响.方法:采用电子检索的方式在万方数据库中检索2000-01/2011-12有关髋关节假体材料及人工髋关节置换先关的研究,关键词为"髋关节、假体、置换、生物力学".排除重复研究、普通综述或Meta分析类文章.结果与结论:共纳入34篇文献进行评价.全髋关节置换后人工关节的生物力学性能与使用寿命有着密切的关系,假体受力可以分解为正应力和剪切应力两部分,正应力有益于假体的固定和力的传递,而剪切力会导致假体松动.假体周围骨质及骨量的变化,假体松动、脱位,假体周围骨折,材料磨损及假体周围感染是髋关节置换后影响中远期效果的常见并发症.目前还缺乏生物相容性好、生物力学相容性好的理想假体,人工髋关节设计、制造工艺、假体材料的耐磨性与界面应力等生物力学性能均有待于进一步提高,从而更好地适应宿主.%BACKGROUND: A correct prosthesis with good compatibility to the host is the key for the success of total hip arthroplasty, and it relates to the biomechanical properties and service life of artificial joint after replacement. OBJECTIVE: To summarize the research progress about artificial hip joint prosthesis and to analyze the effect of artificial hip joint prosthesis design and interface stress on the compatibility of clinically used metal hip joint. METHODS: An electronic retrieve was performed in Wanfang database from January 2000 to December 2011 for articles regarding the hip prosthesis materials and artificial hip replacement, key words were "hip joint, prosthesis, replacement, biomechanics" in Chinese. The

  20. A three-dimensional finite element model for biomechanical analysis of the hip.

    Science.gov (United States)

    Chen, Guang-Xing; Yang, Liu; Li, Kai; He, Rui; Yang, Bin; Zhan, Yan; Wang, Zhi-Jun; Yu, Bing-Nin; Jian, Zhe

    2013-11-01

    The objective of this study was to construct a three-dimensional (3D) finite element model of the hip. The images of the hip were obtained from Chinese visible human dataset. The hip model includes acetabular bone, cartilage, labrum, and bone. The cartilage of femoral head was constructed using the AutoCAD and Solidworks software. The hip model was imported into ABAQUS analysis system. The contact surface of the hip joint was meshed. To verify the model, the single leg peak force was loaded, and contact area of the cartilage and labrum of the hip and pressure distribution in these structures were observed. The constructed 3D hip model reflected the real hip anatomy. Further, this model reflected biomechanical behavior similar to previous studies. In conclusion, this 3D finite element hip model avoids the disadvantages of other construction methods, such as imprecision of cartilage construction and the absence of labrum. Further, it provides basic data critical for accurately modeling normal and abnormal loads, and the effects of abnormal loads on the hip.

  1. Effects and countermeasures of osteoporosis on artiifcial hip joint revision%骨质疏松对人工髋关节翻修手术的影响及对策

    Institute of Scientific and Technical Information of China (English)

    郜振武; 吴斗; 郑艮强; 郭军政; 刘强

    2015-01-01

    With the advent of an aging society, geriatric hip fracture and the incidence of age-related osteoarthritis are increasing year by year. Artificial hip replacement is considered to be effective to relieved painand improve the quality of life. However, complications such as loosening, sinking, dislocation and osteolysis occur and revision procedures are needed to restore joint functions. Anti osteoporosis treatment, inhibiting osteolysis and promoting bone regeneration, matches the prevention and control of the mechanism of complications mentioned above.

  2. Hip Implant Systems

    Science.gov (United States)

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

  3. Manipulative reduction of shoulder lift for the treatment of posterior dislocation of hip joint%肩顶复位法治疗髋关节后脱位

    Institute of Scientific and Technical Information of China (English)

    孙权; 唐孝富

    2012-01-01

    目的:观察肩顶复位法治疗髋关节后脱位的临床疗效.方法:2001年7月至2010年6月,14例髋关节后脱位,男12例,女2例;年龄18-57岁,平均34.6岁;病程2 h-3d,平均1.1d.采用肩顶复位法整复,复位后配以牵引、练功及中药等治疗.根据Harris功能评分系统评价疗效.结果:14例均一次复位成功并获随访,时间8-24个月,平均16个月.Harris功能总分为(97.14±4.90)分,其中髋部疼痛、关节活动度、日常功能活动、畸形分别为(42.86±1.88)、(4.71±0.47)、(45.57±9.26)、(4.00-±0.00)分;优12例,良2例.均未出现股骨头缺血性坏死等并发症.结论:肩顶复位法可单人操作,有效整复髋关节后脱位,为患髋康复奠定良好基础.%Objective: To observe the effects of shoulder lift reduction for treatment of posterior dislocation of hip joint. Methods:From July 2001 to June 2010,14 cases of posterior dislocation of hip joint were treated with shoulder lift reduction involving 12 males and 2 females with an average age of 34.6 years ranging from 18 to 57 years. After recduction,all patients were assisted with the traction,exercise and traditional Chinese medicine. The mean duration between injured and treatment was 1.1 days (2 hours to 3 days). According to Harris scoring system the hip joint function were evaluated. Results: All patients were followed-up for 8 to 24 months (means 16 months). Fourteen cases were reset well in first without any complication. The Harris score was (97.14±4.90) in total, involving hip pain (42.86±1.88),articular activity (4.71 ±0.47), daily activity (45.57±9.26) .deformity (4.00±0.00) ,the clinical outcome was excellent in 12 cases,good in 2. There were not complications such as avascular necrosis of the femoral head, and so on. Conclusion: The shoulder lift reduction can be used by one person, and the treatment of posterior dislocation of hip joint is effective. It established a good foundation for the rehabilitation of

  4. Metal artefact suppression at 3 T MRI: comparison of MAVRIC-SL with conventional fast spin echo sequences in patients with Hip joint arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Kretzschmar, Martin; Nardo, Lorenzo; Han, Misung M.; Heilmeier, Ursula; Sam, Craig; Joseph, Gabby B.; Krug, Roland; Link, Thomas M. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Koch, Kevin M. [Medical Collage of Wisconsin, Departments of Biophysics and Radiology, Milwaukee, WI (United States)

    2015-08-15

    The aim of our study was to evaluate the clinical feasibility and diagnostic value of a new MRI metal artefact reduction pulse sequence called MAVRIC-SL in a 3 T MRI environment. Two MAVRIC-SL sequences obtained in 61 patients with symptomatic total hip replacement were compared with standard FSE-STIR sequences optimized for imaging around metal. Artefact size was measured on the slice of greatest extent. Image quality, fat saturation, image distortion, visibility of anatomical structures, and detectability of joint abnormalities were visually assessed and graded on qualitative scales. Differences between MAVRIC-SL and FSE sequences were tested with the Wilcoxon signed-rank test. MAVRIC-SL sequences at 3 T showed significantly smaller metal artefacts compared to FSE-STIR sequences (p < 0.0001). The general image quality of MAVRIC-SL sequences was reduced with regard to spatial resolution, noise and contrast (p = 0.001), and fat saturation (p < 0.0001). The reduction of artefact size and image distortion significantly improved visualization of joint anatomy (p < 0.0001) and diagnostic confidence regarding implant-associated abnormalities (p = 0.0075 to <0.0001). Although the image quality of MAVRIC-SL sequences is limited at 3 T, its clinical application is feasible and provides important additional diagnostic information for the workup of patients with symptomatic hip replacement through substantially reduced metal artefacts. (orig.)

  5. Validity of gradient-echo three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage: A histologically 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); Herten, Monika, E-mail: Moherten@web.de [Univ Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstraße 5, D-40225 Dusseldorf (Germany); Kurzidem, Sabine, E-mail: sabine.kurzidem@uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstraße 5, D-40225 Dusseldorf (Germany); Jäger, Marcus [Univ Essen, Medical Faculty, Department of Orthopaedic Surgery, D-45147 Essen (Germany); König, Dietmar, E-mail: Dietmarpierre.koenig@lvr.de [LVR Clinic for Orthopedic Surgery, D-41749 Viersen (Germany); 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, Rüdiger, 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: bernd.bittersohl@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstraße 5, D-40225 Dusseldorf (Germany)

    2013-02-15

    Objective: To validate gradient-echo three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) by means of histological analyses in the assessment of hip joint cartilage. Materials and methods: Twenty-one femoral head specimens collected from 21 patients (7 males, 14 females, mean age: 60.9 ± 9.6 years; range: 37.6–77.3 years), who underwent total hip replacement for symptomatic hip joint osteoarthritis, underwent MRI and histological assessment. A region of 2 cm{sup 2} at the weight-bearing area was marked with four pins to enable multi-planar MRI reformatting to be matched with histological sections. MRI was performed at 3 T with a 3D double-echo steady-state (DESS) sequence for morphological cartilage assessment and 3D Volumetric Interpolated Breathhold Examination (VIBE) for T1{sub Gd} mapping. Histological sections were evaluated according to the Mankin score system. Total Mankin score, grade of toluidine staining (sensitive for glycosaminoglycan content) and a modified Mankin score classification system with four sub-groups of cartilage damage were correlated with MRI data. Results: Spearman's rho correlation analyses revealed a statistically significant correlation between T1{sub Gd} mapping and histological analyses in all categories including total Mankin score (r = −0.658, p-value ≤ 0.001), toluidine staining (r = −0.802, p-value < 0.001) and modified Mankin score (r = −0.716, p-value < 0.001). The correlation between morphological MRI and histological cartilage assessment was statistically significant but inferior to the biochemical cartilage MRI (r-values ranging from −0.411 to 0.525, p-values < 0.001). Conclusions: Gradient-echo dGEMRIC is reliable while offering the unique features of high image resolution and 3D biochemically sensitive MRI for the assessment of early cartilage degeneration.

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

    Science.gov (United States)

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

    1978-11-09

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

  7. CT Manifestations of Sacroiliac Joint, Facet Joint of Lumbar and Hip Joint in Patients with Ankylosing Spodylitis%强直性脊柱炎骶髂关节、腰椎小关节及髋关节的CT表现

    Institute of Scientific and Technical Information of China (English)

    赵菁

    2012-01-01

    Objective To investigate CT features of sacroiliac joint, facet joint of lumbar and hip joint in patients with ankylosing spodylitis (AS), so as to improve the accuracy of diagnosis and differential diagnosis. Methods Between January and October 2011, CT scan was performed for 86 patients with AS, involving sacroiliac joint in 44 cases, lumbar vertebra in 28, and hip joint in 14. Their CT findings were retrospectively analyzed. Results CT findings of AS showed that the disease mainly involved iliac side of synovial section in sacroiliac joint, facet joint of lumbar and hip joint, and the main manifestations of the disease included altered joint space, coarse articular surface or cystic destruction, subchondral sclerosis and erosion. Conclusion CT manifestations of ankylosing spodylitis in sacroiliac joint, facet joint of lumbar and hip joint have some special characteristic signs, thus CT can play an important role in diagnosis and differential diagnosis of the disease.%目的 探讨强直性脊柱炎(AS)受累骶髂关节、腰椎小关节及髋关节的病变CT表现特点,以提高诊断与鉴别诊断水平.方法 2011年1月-10月对临床确诊的强直性脊柱炎患者44例骶髂关节、28例腰椎及14例髋关节行CT扫描,回顾性分析骶髂关节、腰椎小关节及髋关节的CT表现.结果 AS患者的CT表现特点为病变主要累及骶髂关节滑膜部的髂骨侧,腰椎小关节及髋关节则表现为关节间隙改变、关节面毛糙及囊状破坏、面下骨硬化或吸收等改变.结论 AS骶髂关节、腰椎小关节及髋关节的CT表现具有一定特征,CT具有重要的诊断及鉴别诊断价值.

  8. The utility of ultrasonography for the diagnosis of developmental dysplasia of hip joint in congenital muscular torticollis

    NARCIS (Netherlands)

    Park, H.K.; Kang, E.Y.; Lee, Shermin; Kim, K.M.; Jung, A.Y.; Nam, D.H.

    2013-01-01

    OBJECTIVE: To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). METHODS: Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed

  9. Modeling of Human Joint Structures.

    Science.gov (United States)

    1982-09-01

    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  10. 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...

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

    Science.gov (United States)

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

    2012-01-01

    The revision rate of large head metal-on-metal and resurfacing hips are significantly higher than conventional total hip replacements. The revision of these components has been linked to high wear caused by edge loading; which occurs when the head–cup contact patch extends over the cup rim. There are two current explanations for this; first, there is loss of entrainment of synovial fluid resulting in breakdown of the lubricating film and second, edge loading results in a large local increase in contact pressure and consequent film thickness reduction at the cup rim, which causes an increase in wear. This paper develops a method to calculate the distance between the joint reaction force vector and the cup rim – the contact patch centre to rim (CPCR) distance. However, the critical distance for the risk of edge loading is the distance from the contact patch edge to rim (CPER) distance. An analysis of explanted hip components, divided into edge worn and non-edge-worn components showed that there was no statistical difference in CPCR values, but the CPER value was significantly lower for edge worn hips. Low clearance hips, which have a more conformal contact, have a larger diameter contact patch and thus are more at risk of edge loading for similarly positioned hips. PMID:22558836

  12. 儿童臀肌挛缩症的骨关节X线变化%X-ray changes of pelvis and hip joint in children with gluteus contracture

    Institute of Scientific and Technical Information of China (English)

    韩镜明; 代品华; 李达泉; 张平; 张文

    1997-01-01

    Objective:To discuss the changes of the pelvis and hip joints,timing and effect of operation in children with gluteus contracture.Methods:The X-ray films of pelvis and hips of 38 cases of gluteus contracture were compared with those of 30 normal children.Results:In the contracture group,the CE angle of Wiberg(X = 36.32°,P<0.01)and the neck-shaft angle of the femur(X=153°,P<0.01)increased,but the femeral head index decreased(X=0.44,P<0.01).Twenty of the 38 cases with gluteus contracture were followed-up for 6-7yrs.of them,the CE angle(X=35°),neck shaft angle(X= 134.95)and femeral head index have returned to normal range.Conclusions:Gluteus contracture may result in secondary changes of the pelvis and hip.An opertion is helpful to the recovery of shape and function of the hip joint.%目的:探讨臀肌挛缩症致骨盆、髋关节方面变化,阐明手术时机和效果.方法:比较38例臀肌挛缩症与30例非臀肌挛缩症骨盆、髋关节平片,38例臀肌挛缩症中,20例术后6~7年随访.结果:臀肌挛缩症患儿的CE角增大(X=36.32°,P<0.01),颈干角增大(X=153°,P<0.01),股骨头指数下降(X=0.44,P<0.01).20例臀肌挛缩症术后6~7年随访,CE角(X=35°)颈干角(X=134.95°)肌骨头指数(X=0.489)均恢复同龄组正常均值内.结论:臀肌挛缩症可引起骨盆、髋关节继发性改变,手术有助于髋关节形态和功能恢复.

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

    Science.gov (United States)

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  14. Hip Ultrasound

    Science.gov (United States)

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

  15. 髋周良性骨病的影像诊断%Imaging Diagnosis of Benign Osteopathy around the Hip Joint

    Institute of Scientific and Technical Information of China (English)

    唐浩; 邹丹凤; 廖昕; 陈卫国

    2011-01-01

    目的 评价57例髋周良性骨病的影像学表现.方法 回顾性分析57例经穿刺活检或手术病理证实的髋周良性骨病的影像学表现.全部病例均行X线平片检查,32例同时行CT检查,21例行MRI检查.结果 骨囊肿13例,动脉瘤样骨囊肿16例,骨巨细胞瘤6例,软骨母细胞瘤2例(合并动脉瘤样骨囊肿1例),骨母细胞瘤1例,骨样骨瘤3例,骨化性纤维瘤2例,非骨化性纤维瘤3例,骨纤维异常增殖症6例,嗜酸性肉芽肿3例,骨结核2例.结论 髋周良性骨病以骨囊肿及动脉瘤样骨囊肿为好发病种.%Objective To evaluate imaging findings of benign osteopathy around the hip joint. Methods Fifty-seven cases with histologically confirmed benign osteopathy around the hip joint were reviewed. Radiography was performed in all cases,CT in 32 patients and MRI in 21 cases were done. Results There were simple bone cyst was in 13 cases,aneurysmal bone cyst in 16 cases,giant cell tumor in 6 cases,chondroblastoma in 2 cases (one case accompanied with aneurysmal bone cyst) osteoblastoma in 1 case,osteoid osteoma in 3 cases,ossifying fibroma in 2 cases, non-ossifying fibroma in 3 cases,fibrous dysplasia of bone in 6 cases, eosinophilic granuloma in 3 cases and bone tuberculosis in 2 cases. Conclusion Simple bone cyst and aneurysmal bone cyst are common benign osteopathy around the hip joint.

  16. Standardized Loads Acting in Hip Implants.

    Directory of Open Access Journals (Sweden)

    Georg Bergmann

    Full Text Available With the increasing success of hip joint replacements, the average age of patients has decreased, patients have become more active and their expectations of the implant durability have risen. Thus, pre-clinical endurance tests on hip implants require defining realistic in vivo loads from younger and more active patients. These loads require simplifications to be applicable for simulator tests and numerical analyses. Here, the contact forces in the joint were measured with instrumented hip implants in ten subjects during nine of the most physically demanding and frequent activities of daily living. Typical levels and directions of average and high joint loads were extracted from the intra- and inter-individually widely varying individual data. These data can also be used to analyse bone remodelling at the implant-bone interface, evaluate tissue straining in finite element studies or validate analytical loading predictions, among other uses. The current ISO standards for endurance tests of implant stems and necks are based on historic analytical data from the 1970s. Comparisons of these test forces with in vivo loads unveiled that their unidirectional orientations deviate from the time-dependent in vivo directions during walking and most other activities. The ISO force for testing the stem is substantially too low while the ISO force for the neck better matches typical in vivo magnitudes. Because the magnitudes and orientations of peak forces substantially vary among the activities, load scenarios that reflect a collection of time-dependent high forces should be applied rather than using unidirectional forces. Based on data from ten patients, proposals for the most demanding activities, the time courses of the contact forces and the required cycle numbers for testing are given here. Friction moments in the joint were measured in addition to the contact forces. The moment data were also standardized and can be applied to wear tests of the implant

  17. Standardized Loads Acting in Hip Implants.

    Science.gov (United States)

    Bergmann, Georg; Bender, Alwina; Dymke, Jörn; Duda, Georg; Damm, Philipp

    2016-01-01

    With the increasing success of hip joint replacements, the average age of patients has decreased, patients have become more active and their expectations of the implant durability have risen. Thus, pre-clinical endurance tests on hip implants require defining realistic in vivo loads from younger and more active patients. These loads require simplifications to be applicable for simulator tests and numerical analyses. Here, the contact forces in the joint were measured with instrumented hip implants in ten subjects during nine of the most physically demanding and frequent activities of daily living. Typical levels and directions of average and high joint loads were extracted from the intra- and inter-individually widely varying individual data. These data can also be used to analyse bone remodelling at the implant-bone interface, evaluate tissue straining in finite element studies or validate analytical loading predictions, among other uses. The current ISO standards for endurance tests of implant stems and necks are based on historic analytical data from the 1970s. Comparisons of these test forces with in vivo loads unveiled that their unidirectional orientations deviate from the time-dependent in vivo directions during walking and most other activities. The ISO force for testing the stem is substantially too low while the ISO force for the neck better matches typical in vivo magnitudes. Because the magnitudes and orientations of peak forces substantially vary among the activities, load scenarios that reflect a collection of time-dependent high forces should be applied rather than using unidirectional forces. Based on data from ten patients, proposals for the most demanding activities, the time courses of the contact forces and the required cycle numbers for testing are given here. Friction moments in the joint were measured in addition to the contact forces. The moment data were also standardized and can be applied to wear tests of the implant. It was shown that

  18. Effect of Leg Length Discrepancy after Total Hip Replacement on Hip Joint Function%全髋关节置换术后双下肢长度不等长对髋关节功能的影响

    Institute of Scientific and Technical Information of China (English)

    陶冶; 赵新友; 邵士元; 房光

    2016-01-01

    目的:研究人工全髋关节置换术后双下肢长度不等长对髋关节功能的影响。方法选取2013年5月到2015年5月我院行人工髋关节置换术患者150例,然后行骨盆平片检查,测量双下肢长度,根据双下肢长度差值(limbs length discrepancy,LLD)将患者分为对照组41例(LLD≤5 mm)、Ⅰ组80例(5 mm ﹤ LLD≤10 mm),Ⅱ组20例(10 mm ﹤ LLD≤20 mm),Ⅲ组9例(LLD ﹥20 mm),应用 Harris 评分标准评价各组髋关节功能,并比较各组满意度。结果对照组和组 Harris 评分显著高于Ⅱ组和Ⅲ组(P ﹤0.05),对照组和Ⅰ组 Harris 评分比较差异无统计学意义(P﹥0.05),Ⅰ组和Ⅱ组 Harris 评分显著高于Ⅲ组,比较差异具有统计学意义(P ﹤0.05);对照组满意率显著高于Ⅰ组、Ⅱ组和Ⅲ组,Ⅰ组满意率显著高于Ⅱ组和Ⅲ组,Ⅱ组满意率显著高于Ⅲ组,比较差异具有统计学意义(P ﹤0.05)。结论人工全髋关节置换术后双下肢长度不等超过10 mm 对髋关节功能具有一定影响。%Objective To study the effect of leg length discrepancy after total hip replacement on hip joint function. Methods We selected 150 cases who underwent artificial hip joint replacement in our hospital from May 2013 to May 2015, then examined plain films and measured the length of the double lower limbs. The patients were divided into control group (LLD≤5 mm,41 caess),group Ⅰ(5 mm ﹤ LLD ≤10 mm,80 cases),group Ⅱ(10 mm ﹤ LLD≤20 mm,20 cases),groupⅢ(LLD ﹥ 20 mm,9 cases)according to the difference of the length of the shorter limbs(LLD),hip joint function was evalu-ated by Harris score,the degree of satisfaction was compared. Results The Harris score of the control group and the group I was significantly higher than that in the group Ⅱ and the group Ⅲ(P ﹤ 0. 05). There was no statistical significance between control group and group I(P ﹥ 0. 05). The Harris score of

  19. Influence of the experience of the reader on reliability of joint space width measurement. A cross-sectional multiple reading study in hip osteoarthritis.

    Science.gov (United States)

    Ornetti, Paul; Maillefert, Jean-Francis; Paternotte, Simon; Dougados, Maxime; Gossec, Laure

    2011-10-01

    The objectives were to evaluate improvement in reliability of joint space width (JSW) measurements, according to the previous experience of the readers in hip osteoarthritis (OA). Fifty radiographs in hip OA patients from a randomized controlled trial (ECHODIAH) were read 12 times by two readers with different levels of experience in radiographic interpretation. Intra-reader reliability and inter-reader reliability were assessed through calculation of the smallest detectable difference (SDD) and the intra-class correlation coefficient (ICC). Intra-reader reliability: for the experienced reader, no significant change in SDD was observed with repeated JSW measurements. For the junior reader, the SDD decreased significantly from 0.90 mm to 0.65 mm (P=0.002). A plateau of SDD was reached after reading 200 to 300 radiographs, with a value close to the mean SDD of the experienced reader (0.67 mm). ICCs were high (>0.88) for both the senior and the junior readers. Inter-reader reliability: no improvement in inter-reader reliability was noted with repeated measurements of JSW (SDD=0.81 mm). However, no additional training sessions were performed. ICCs were high (>0.85). This study indicated for the first time a learning curve in analyzing JSW in hip OA for an inexperienced reader. After analyzing 200 to 300 radiographs, the junior reader reached an intra-reader reliability similar to the experienced reader. Moreover, the information brought by the ICC was not sufficient, suggesting that the SDD should be systematically reported in studies evaluating OA radiographic progression, on top of the ICC, to help in interpreting the JSW reliability. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  20. Assessment of adult hip dysplasia and the outcome of surgical treatment

    DEFF Research Database (Denmark)

    Troelsen, Anders

    2012-01-01

    Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist, ...

  1. Oxidation in ultrahigh molecular weight polyethylene and cross-linked polyethylene acetabular cups tested against roughened femoral heads in a hip joint simulator.

    Science.gov (United States)

    Taddei, Paola; Affatato, Saverio; Fagnano, Concezio; Toni, Aldo

    2006-06-01

    This study was aimed at comparing the oxidative degradation of commercial acetabular cups made of cross-linked polyethylene (XLPE) and conventional ultrahigh molecular weight polyethylene (UHMWPE). After testing against deliberately scratched CoCrMo femoral heads in a hip joint simulator, the cups, microtomed parallel to the articulating surface, were analyzed by IR spectroscopy. Due to the potential for artifacts caused by absorbed contaminants, the IR spectra were compared only after hexane extraction; actually, XLPE was found to absorb more serum than UHMWPE. The two sets of unworn acetabular cups showed different oxidation patterns with consequently different distributions of carbonyl species; unworn XLPE was characterized by lower contents of carbonyl species and hydrogen-bonded alcohols and higher contents of trans-vinylene species than unworn UHMWPE. Upon simulator testing, UHMWPE showed more significant changes in oxidation indexes and distribution of carbonyl compounds than XLPE, confirming a better wear behavior for XLPE under the adopted testing conditions.

  2. Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report

    Directory of Open Access Journals (Sweden)

    Abhijeet Ashok Salunke

    Full Text Available ABSTRACT CONTEXT: Hardware breakage during hip surgery can pose challenging and difficult problems for orthopedic surgeons. Apart from technical difficulties relating to retrieval of the broken hardware, complications such as adjacent joint arthritis and damage to neurovascular structures and major viscera can occur. Complications occurring during the perioperative period must be informed to the patient and proper documentation is essential. The treatment options must be discussed with the patient and relatives and the implant company must be informed about this untoward incident. CASE REPORT: We report a case of complete removal of the implant and then removal of the broken guidewire using a combination of techniques, including a cannulated drill bit, pituitary forceps and Kerrison rongeur. CONCLUSIONS: We suggest some treatment options and recommendations for preventing an avoidable surgical catastrophe.

  3. Early alterations in the hip joint following epiphysiolysis for slipped femoral head. Results of an MRI study; Fruehveraenderugen im Hueftgelenk nach Epiphysiolysis capitis femoris. MRT-Untersuchungsergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Stoever, B. [Freiburg Univ. (Germany). Radiologische Klinik; Sigmund, G. [Freiburg Univ. (Germany). Radiologische Klinik; Huhle, P. [Freiburg Univ. (Germany). Orthopaedische Abteilung; Zwack, P. [Freiburg Univ. (Germany). Orthopaedische Abteilung; Reichert, A. [Freiburg Univ. (Germany). Orthopaedische Abteilung; Langer, M. [Freiburg Univ. (Germany). Radiologische Klinik

    1994-01-01

    With the aim of detecting patients at risk of developing coxarthritis, 34 patients were investigated prospectively by MRI 6-14 years after epiphysiolysis for slipped capital femoral head. In particular, cartilage changes were analysed by gradient-echo sequences. In 40% of the hip joints investigated cartilaginous lesions were present, detectable as irregularity and flattening of contour and more rarely as changes in signal intensity. In contrast, only 18% of the radiographs available revealed any pathology. When pelvic X-rays are normal or reveal slight sclerosis, cartilaginous lesions on MRI are considered early signs of coxarthrosis. This combination was seen especially often in patients with a primarily high angle of dislocation and in those who needed treatment by reposition or osteotomy. Only in 8 of the 17 hip joints showing sclerosis on conventional radiograms, sclerosis was also diagnosed by MRI, possibly because of partial volume and susceptibility effects at high field strength. Even with limited spatial resolution, cartilage examinations is warranted in young patients in whom early osteoarthritis can be expected. (orig.) [Deutsch] Mit dem Ziel, Veraenderungen am Hueftgelenk bei Patienten mit Arthroserisiko rechtzeitig zu erfassen, wurden 34 Patienten 6-14 Jahre nach einer Epiphysiolysis capitis femoris mittels MRT im Hochfeld bei 2/T nachuntersucht. Insbesondere sollten anhand der `FLASH`-Gradientenechosequenzen Knorpelveraenderungen analysiert werden. In 40% der untersuchten Hueftgelenke lagen Knorpellaesionen vor, sichtbar als Verduennung der Knorpelschicht, Konturunregelmaessigkeit und seltener als Signalintensitaetsveraenderungen. Dagegen waren nur 18% der vorhandenen Roentgenbefunde eindeutig pathologisch. Die kernspintomographisch sichtbaren Laesionen des Knorpels sind bei normalem Roentgenbild als Fruehveraenderungen zu werten und waren haeufiger bei Patienten mit primaer hohem Dislokationswinkel nachweisbar wie auch bei Patienten, bei denen eine

  4. 强直性脊柱炎64例髋关节病变X线与MRI特点分析%Analysis of X-ray and MRI characteristic of hip-joint lesion in 64 patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    倪春五; 李志军

    2014-01-01

    目的 探讨强直性脊柱炎(AS)髋关节损害的x线与MRI表现特点,为AS的诊断、病情活动性判断、治疗反应、预后与鉴别诊断提供借鉴.方法 分析64例AS髋关节病变的X线片与MRI表现特点.结果 X线片示有髋关节囊变42例,髋关节骨质增生47例,髋关节间隙狭窄13例,髋关节骨质疏松11例.MRI发现:有滑膜炎症改变64例,软骨下骨髓水肿48例,关节软骨破坏、关节面下囊状骨改变42例,肌腱、韧带附着点炎24例,关节间隙改变13例.结论 AS髋关节病变X线片下通常只有髋关节囊性变、骨质增生及关节间隙狭窄等表现,通过MRI检查可以发现大多数AS患者有滑膜炎、软骨下骨髓水肿及关节软骨破坏、关节节面下囊状骨改变,提示病变活动;AS患者疑有髋关节病变者做MIR检查有利于病情活动性判断与治疗方案选择.%Objective To explore the X-ray and MRI manifestations of hip joint lesion in ankylosing spondylitis patients and give useful reference for diagnosis,assess of disease activity and therapeutic response and prognosis.Methods The X-ray manifestation and MRI manifestation of 64 cases of patients with ankylosing spondylitis were analyzed.Results In X-ray analyzed acetabulum joint changes 42,hip joint hyperostosis 47,hip joint interval narrow 13,hip joint osteoporosis 11,MRI analyzed synovial inflammatory change 64,subcartilaginous bone marrow edema 48,joint cartilage lesion and joint surface saccular change 42,tendon and ligament of enthesopathy 24,joint space change 13.Conclusion In patients with ankylosing spondylitis,X-ray manifestation of hip-joint lesion commonly included leacetabulum joint changes,hip joint hyperostosis and hip joint space narrowing while MRI manifestation included inflammation of synovium,edema of subcartilaginous bone marrow,and tendon of enthesopathy which suggested high disease activity.To suspicious hip-joint lesion in patients with ankylosing spondylitis

  5. Hip Arthropathy in Haemophilia

    Directory of Open Access Journals (Sweden)

    Christian Carulli

    2017-04-01

    Full Text Available Hip arthropathy in haemophilic patients is disabling for hip and other common target joints. Even if bleedings in the hip are not frequent, femoroacetabular alterations may affect the functional ability of patients at a very young age. A haematologic prophylaxis combined with an adequate lifestyle and regular and low-traumatic physical activity are the keys to preventing such arthropathy. In the early stages of arthropathy, anti-inflammatory drugs and physical therapy may be sufficient to limit its progression. In cases of recurrent symptoms, viscosupplementation with hyaluronic acid, and chemical synoviorthesis are useful options. In more advanced stages, hip arthroscopy may be treated by synovectomy or loose body removal. For late stages, total hip arthroplasty (THA is mandatory. Until a few decades ago, the clinical outcomes after hip arthroplasty were variable, due to the different management of patients and the use of old generation implants and couplings. In the last decade, the introduction of the multidisciplinary management and the use of modern cementless implants with high performing materials and less invasive surgical techniques have dramatically improved the functional results. Nowadays, as is the case for other target joints, the purpose of the management in haemophilia centers is the early detection of any hip alterations—by clinical and ultrasound (US evaluations of patients in childhood—to reveal any early articular damage and to provide adequate treatment in case of symptoms. The present paper represents an updated review of the several approaches to hip arthropathy in haemophilia.

  6. Hip arthroscopy in the setting of hip dysplasia

    Science.gov (United States)

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  7. Determination of contact force at facet joint with different sagittal orientation under shearing loads:a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘耀升; 陈其昕; 刘蜀彬

    2008-01-01

    [目的]探讨腰椎活动节段关节突矢状方向对关节接触力和接触部位的作用和意义.[方法] 采用一种有效的CAD方法精确构建三种关节突矢状方向的三维腰椎L4、5活动节段有限元模型.剪力载荷下,分别对3种有限元模型的关节突接触力和接触部位进行测试.[结果]前剪载荷条件下,关节突接触力随关节突矢状方向角度的增加而减小;后剪载荷下,关节突接触力随关节突矢状方向角度的增加而增大.前剪和后剪载荷条件下,关节突接触力的矢状和水平分力均随关节突矢状方向角度的减小而增大.相同载荷条件下,不同矢状方向的关节突其接触部位相同.[结论]与矢状型关节突相比,冠状型关节突的空间方向和形态结构对抵抗关节突水平和矢状方向的运动更加有效;前剪载荷较后剪载荷在促进冠状型关节突退变方面起着更为突出的作用.%[Objective] The efleet of sagittal orientations of articular facet on the contact force and contact regions of a lumbar spine segment was evaluated.[Methods] [Results]Three-dimensional geometrical and mechanical accurate finite element models of the lumbar L4、5 motion segment representing three sagittal-orientations articular facet were generated and invalidated by an effective CAD method.Contact force and contact regions of the articular facets of three finite element models were predicted under the pure shearing loads.[Result] Under anterior shear condition,the contact force on the facet decreased with the increase of sagittal 0rientation of articular facet.however.in posterior shear load,the contact force on the facet increased with the increase of sagittal orientation.Meanwhile,under both pure shear loading,the percentages of the sagittal and the transversal components are increased with the dectease of the sagittal angle.However,under the salne load condition,there are no difference between the contact regions of the three models

  8. Thermal contact resistance measurement of conduction cooled binary current lead joint block in cryocooler based self field I-V characterization facility

    Science.gov (United States)

    Kundu, Ananya; Das, Subrat Kumar; Agarwal, Anees Bano Pooja; Pradhan, Subrata

    2016-05-01

    In the present study thermal resistance of conduction cooled current lead joint block employing two different interfacial material namely AlN sheet and Kapton Film have been studied in the temperature range 5K-35K. In each case, the performance of different interlayer materials e.g. Indium foil for moderately pressurized contacts (contact pressure <1 MPa), and Apiezon N Grease, GE varnish for low pressurized contact (contact pressure <1 MPa) is studied. The performances of AlN joint with Indium foil and with Apeizon N Grease are studied and it is observed that the contact resistance reduces more with indium foil as compared to greased contact. The contact resistance measurements of Kapton film with Apiezon N grease and with GE varnish were also carried out in the same temperature range. A comparative study of AlN joint with Indium foil and Kapton with GE varnish as filler material is carried out to demonstrate better candidate material among Kapton and AlN for a particular filler material in the same temperature range.

  9. The Effect of Mechanical Combined Contact Stress with Buckling Load on the Stress Distribution in the Ball and SocketJoint Mechanism

    Directory of Open Access Journals (Sweden)

    Fatima Salman

    2010-01-01

    Full Text Available The design of components subjected to contact stress as local compressive stress is important in engineering application especially in ball and socket Joining. Two kinds of contact stress are introduced in the ball and socket joint, the first is from normal contact while the other is from sliding contact. Although joining two long links (drive shaft in steering cars will cause the effect of flexural and tensional buckling stress in hollow columns through the ball and socket ends on the failure condition of the joining mechanism. In this paper the consideration of the combined effect of buckling Load and contact stress on the ball and socket joints have been taken, epically on the stress distribution in the contact area. Different parameters have been taken in the design of joint. This is done by changing the angles for applied loads with the principle axis, the angle of contact between ball and socket and using different applied loads. The problem has been solved using analytical solution for computing the critical loads and using these loads for calculating the stress distribution with finite element method using ANSYS 10. The numerical results have been compared with the experimental method using photo elasticity pattern which shows good agreement between experimental and simulation results.

  10. The utility of ultrasonography for the diagnosis of developmental dysplasia of hip joint in congenital muscular torticollis.

    Science.gov (United States)

    Park, Hyeng Kue; Kang, Eun Young; Lee, Sung Hoon; Kim, Kyoung Min; Jung, A Young; Nam, Doo Hyoun

    2013-02-01

    To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed the medical charts and diagnostic examination. We also assessed the coincidence of CMT and DDH, and investigated the clinical features of CMT related to DDH. Twenty (15.0%) patients out of 133 CMT patients were diagnosed as having DDH by US. Of whom, 8 patients were radiographically positive and 4 patients were both clinically and radiographically positive. Nine patients were treated with a harness and 1 of them needed closed reduction and casting. Out of 9 patients treated with a harness, only 4 were clinically positive. The difference and ratio of the sternocleidomastoid (SCM) muscle thickness between the normal and abnormal side was significantly greater in DDH patients (p=0.014). Further, receiver operating characteristic analysis showed when the SCM ratio is greater than 2.08 and the SCM difference is greater than 6.1 mm, the efficiency of US for the diagnosis of the DDH was found to be the best (p<0.05). To evaluate DDH, physical examination showed low sensitivity and radiologic study has limitation for the child before 4 to 6 months of age. Therefore, we recommend that hip is screened by US for the diagnosis of DDH associated with CMT when physical examination is positive or CMT patients with large SCM difference and high SCM ratio.

  11. Irradiation response in weldment and HIP joint of reduced activation ferritic/martensitic steel, F82H

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Takanori [Japan Atomic Energy Agency (JAEA); Sokolov, Mikhail A [ORNL; Ando, M. [Japan Atomic Energy Agency (JAEA); Tanigawa, H. [Japan Atomic Energy Agency (JAEA); Shiba, K. [Japan Atomic Energy Agency (JAEA); Stoller, Roger E [ORNL; Odette, G.R. [University of California, Santa Barbara

    2013-11-01

    This work investigates irradiation response in the joints of F82H employed for a fusion breeding blanket. The joints, which were prepared using welding and diffusion welding, were irradiated up to 6 dpa in the High Flux Isotope Reactor at the Oak Ridge National Laboratory. Post-irradiation tests revealed hardening in weldment (WM) and base metal (BM) greater than 300 MPa. However, the heat affected zones (HAZ) exhibit about half that of WM and BM. Therefore, neutron irradiation decreased the strength of the HAZ, leaving it in danger of local deformation in this region. Further the hardening in WM made with an electron beam was larger than that in WM made with tungsten inert gas welding. However the mechanical properties of the diffusion-welded joint were very similar to those of BM even after the irradiation.

  12. Irradiation response in weldment and HIP joint of reduced activation ferritic/martensitic steel, F82H

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, T., E-mail: hirose.takanori@jaea.go.jp [Japan Atomic Energy Agency, Naka, Ibaraki (Japan); Sokolov, M.A. [Oak Ridge National Laboratory, Oak Ridge, TN (United States); Ando, M.; Tanigawa, H.; Shiba, K. [Japan Atomic Energy Agency, Naka, Ibaraki (Japan); Stoller, R.E. [Oak Ridge National Laboratory, Oak Ridge, TN (United States); Odette, G.R. [University of California Santa Barbara, Santa Barbara, CA (United States)

    2013-11-15

    This work investigates irradiation response in the joints of F82H employed for a fusion breeding blanket. The joints, which were prepared using welding and diffusion welding, were irradiated up to 6 dpa in the High Flux Isotope Reactor at the Oak Ridge National Laboratory. Post-irradiation tests revealed hardening in weldment (WM) and base metal (BM) greater than 300 MPa. However, the heat affected zones (HAZ) exhibit about half that of WM and BM. Therefore, neutron irradiation decreased the strength of the HAZ, leaving it in danger of local deformation in this region. Further the hardening in WM made with an electron beam was larger than that in WM made with tungsten inert gas welding. However the mechanical properties of the diffusion-welded joint were very similar to those of BM even after the irradiation.

  13. Prediction of gait outcome with the knee-ankle-foot orthosis with medial hip joint in patients with spinal cord injuries: a study using recursive partitioning analysis.

    Science.gov (United States)

    Suzuki, T; Sonoda, S; Saitoh, E; Onogi, K; Fujino, H; Teranishi, T; Oyobe, T; Katoh, M; Ohtsuka, K

    2007-01-01

    Retrospective study of the degree of gait independence achieved by persons with spinal cord injury (SCI) using knee-ankle-foot orthosis with a medial single hip joint (MSH-KAFO). To examine the effects of the neurological level, degree of paresis, age, and inhibitory physical/other factors on the gait with a MSH-KAFO in patients with SCIs. Three university hospitals and two rehabilitation hospitals in Japan. The 45 patients (36 men, nine women) examined included 10 with injuries in the cervical cord between C6 and C8 (group C), 20 with injuries in the upper-middle thoracic cord between T4 and T10 (group UT), and 15 with injuries in the lower thoracic-lumbar cord between T12 and L1 (group TL). Mean age was 34.0 years (range 16-68 years). Of these patients, 13 used the Walkabout, four used the gear joint, and 28 used the Primewalk as the medial hip joint. Recursive partitioning, which predicted the final status of gait from the level, degree of paresis, age, and inhibitory factors, was performed, and a decision tree for gait was constructed. Inhibitory factors were spasticity, involuntary spasms or muscle contractions, pain, contracture, weakness of the upper extremities, and decreased motivation to perform gait exercise. The degree of gait independence was rated on the following five-point scale: outdoor independent gait (5 points), indoor independent gait (4 points), indoor supervised gait (3 points), indoor assisted gait (2 points), and gait within parallel bars (1 point). New branches were added to the decision tree for gait based on the clinical experience, thereby constructing a new decision tree. The coincident ratio between the value predicted on the basis of the decision tree of gait and the value actually observed was 53.3%. The coincident ratio between the value predicted on the basis of the modified decision tree of gait and the actually observed value was 68.9%. The results provide valuable information to medical teams that may assist prescription of

  14. Morgan line and its relationship with distraction index, angle of inclination and degenerative joint disease in the diagnosis of canine hip dysplasia

    Directory of Open Access Journals (Sweden)

    F.G. Miranda

    2016-08-01

    Full Text Available ABSTRACT We evaluated 160 hip joint radiographs of 40 dogs of different large breeds (25 females and 15 males from the metropolitan area of Belo Horizonte, Minas Gerais, Brazil. The radiographs of each dog were obtained at two different stages: stage 1 (mean 7.23 months and stage 2 (mean 14.25. The conventional radiographic method (CRM and the radiographic distraction method (RDM were used, carried out in both stages. CRM measured the Norberg angle (NA, the angle of inclination (AI and evaluated the presence of degenerative joint disease (DJD. The MRD was performed to establish the distraction index (DI. The aims were to evaluate the presence of the Morgan line and other signs of DJD and correlate them with the degree of canine hip dysplasia (CHD and also check if the DI greater than 0.3 (first stage was associated with the presence of ML (second stage. It was found that DI, AI and changes of femoral neck and the formation of osteophytes were associated with the presence of ML. It was observed that if the DI is greater than 0.3 at the first stage, the chance of a positive outcome of ML in the second stage increases by 7.2 times. Thus, 49 joints showed DI > 0.3 at the first stage, in which 31 (63.3 % presented ML at the second stage. Of the 31 animals that showed DI ≤ 0.3 at first, six (19.4% had LM at the second stage. There has been a significant association between the presence of ML and the degree of CHD. The more severe the CHD, the higher the percentage of positive ML results. Thus, among the 24 (60 % animals that showed ML, 11 (45.83 % were classified as severe dysplastics, 5 (20.83% as moderate and 8 (33.33 % as mild. None of the animals classified as normal or borderline presented ML. Among the 8 animals classified as mild dysplastics, 5 showed only ML as DJD.

  15. 髋关节后外侧入路中软组织松解对髋关节张力的影响%The influence of soft tissue release on the tension around hip joint through posterolateral hip approach

    Institute of Scientific and Technical Information of China (English)

    吕明; 张洪; 郭盛杰

    2009-01-01

    目的 研究髋关节后外侧入路中不同软组织结构松解对髋关节伸直位张力的影响.方法 新鲜冰冻尸体5具10个髋关节,均采用髋关节后外侧入路显露.在骨盆髂前上棘位置垂直于床面固定一枚克氏针,在股骨干侧方固定另一枚克氏针.测量不同软组织松解操作前后两枚克氏针之间的位移变化.结果 单纯进行牵引、外旋肌切断、后关节囊切开和臀大肌止点切断等操作前后,位移没有明显变化.股骨头切除、阔筋膜髂胫束切断、关节囊全部切除和髂腰肌腱切断后,两枚克氏针距离平均延长1.5mm(1~3mm)、8.0mm(2~19mm)、5.5mm(1~13mm)、1.8mm(1~3mm).同时切断关节囊和阔筋膜髂胫束前后位移变化最大,测量距离平均延长13.5 mm(11~20mm).结论 前关节囊、阔筋膜髂胫束和髂腰肌腱的松解可以降低髋关节伸直位的软组织张力,其中前关节囊和阔筋膜髂胫束的作用最大.髋关节周围的软组织对张力的影响相互制约,单一松解其中一种结构不能获得满意的松解效果.阔筋膜和髂胫束的紧张度可以帮助判断肢体的延长情况.%Objective To investigate the influence of selective soft tissue release on the tension around hip joint through posterolateral approach, and to ascertain the sequence of soft tissue release in total hip arthroplasty. Methods Five fresh frozen cadavers with ten intact lower extremities were used in the study. All the pelves of cadavers were fixed on the operating table by a special designed fixer on a lateral position. Femoral supracondylar bone traction was employed for axial traction. The force for traction was 15 kg. Posterolateral approach was used for exposure and two sequences for soft tissue release were studied. One Kirschner wire was fixed at the bone near the anterior superior iliac spine, and the wire was perpendicu-lar to the operating table. Another Kirschner wire was fixed into the bone at lateral femoral

  16. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day.

  17. OMERACT/OARSI initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Gossec, Laure; Hawker, Gillian; Davis, Aileen M

    2007-01-01

    OBJECTIVE: Time to theoretical indication of joint replacement surgery has been proposed as a primary outcome for potential structure-modifying interventions for osteoarthritis (OA). The objectives of this OMERACT/OARSI Working Group were to identify pain, physical function, and structure states ...

  18. The Effect of a Complex (3-Week) Therapy on the Hip and Knee Joints in Obese Patients

    Science.gov (United States)

    Tóvári, Anett; Hermann, Mária; Tóvári, Ferenc; Prisztóka, Gyöngyvér; Kránicz, János

    2015-01-01

    Currently, overweight and obesity are the most widespread problems in life-style having a significant impact on everyday life, and thus, conduct of life. Further contributory problems may develop in patients with weight problems: deformities of the joints and skeleton (coxarthrosis and gonarthrosis), circulatory problems and arrhythmia. Overweight…

  19. Hip Ultrasound

    Science.gov (United States)

    ... be used in infants to check for developmental dysplasia of the hip. Ultrasound is safe, noninvasive, and does not use ... be used to check the hips for developmental dysplasia of the hip (DDH), which in infants can range from a ...

  20. Hip Fracture

    Science.gov (United States)

    Diseases and Conditions Hip fracture By Mayo Clinic Staff A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age. Older people are at a ...

  1. Static and Dynamic Mechanics Analysis on Artificial Hip Joints with Different Interface Designs by the Finite Element Method

    Institute of Scientific and Technical Information of China (English)

    Hai-bo Jiang

    2007-01-01

    Four different structural models of artificial joints were developed and the finite element method (FEM) was employed to investigate their mechanical characteristics under static and dynamic conditions. The materials used in the FEM calculation were ultra-high molecular weight polyethylene (UHMWPE), 316L stainless steel, CoCrMo alloy and Ti6A14V alloy. The stress distribution, strain, and elastic deformation under static and dynamic conditions were obtained. Analysis and comparison of the calculation results of different models were conducted. It is shown that with the same parameters the model of a metallic femur head covered with an artificial cartilage layer is more similar to the structure of the natural human joint and its mechanical characteristics are the best of the four models.

  2. The Effect of a Complex (3-week) Therapy on the Hip and Knee Joints in Obese Patients

    OpenAIRE

    2015-01-01

    Currently, overweight and obesity are the most widespread problems in life-style having a significant impact on everyday life, and thus, conduct of life. Further contributory problems may develop in patients with weight problems: deformities of the joints and skeleton (coxarthrosis and gonarthrosis), circulatory problems and arrhythmia. Overweight definitely has an effect on motion: some people are not involved in certain activities as it is impossible for them because of their weight problem...

  3. Contact sport and osteoarthritis.

    LENUS (Irish Health Repository)

    Molloy, Michael G

    2011-04-01

    Osteoarthritis (OA) is the most common joint disease in the world and the single largest cause of disability for those over 18 years. It affects more than twice as many people as does cardiac disease, and increases in incidence and prevalence with age. Animal and human studies have shown no evidence of increased risk of hip or knee OA with moderate exercise and in the absence of traumatic injury, sporting activity has a protective effect. One age-matched case control study found recreational runners who ran 12-14 miles per week for up to 40 years had no increase in radiological or symptomatic hip or knee OA. However, higher rates of hip OA occur in contact sports than in age-matched controls, with the highest rate in professional players. Soccer players with torn anterior cruciate ligaments (ACL) are more likely to develop knee OA than those with intact ACL. Early ACL repair reduces the risk of knee OA, but does not prevent it. Established injury prevention programmes have been refined to prevent injuries such as ACL rupture.

  4. Differences in Gait Characteristics of Patients with Lumbar Spinal Canal Stenosis (L4 Radiculopathy) and Those with Osteoarthritis of the Hip.

    Science.gov (United States)

    Yokogawa, Noriaki; Toribatake, Yasumitsu; Murakami, Hideki; Hayashi, Hiroyuki; Yoneyama, Takeshi; Watanabe, Tetsuyou; Tsuchiya, Hiroyuki

    2015-01-01

    It is important to differentially diagnose thigh pain from lumbar spinal stenosis (particularly lumbar fourth nerve root radiculopathy) and osteoarthritis of the hip. In this study, using a treadmill and a motion analysis method, gait characteristics were compared between these conditions. Patients with lumbar fourth nerve root radiculopathy had increased physiological knee flexion immediately after foot-ground contact, possibly owing to a slight decrease in the muscle strength of the quadriceps femoris muscle. Patients with osteoarthritis of the hip had decreased range of motion of the hip joint probably due to anatomically limited mobility as well as gait strategy to avoid pain resulting from increased internal pressure on the hip joint during its extension. Our facile and noninvasive method can be useful for the differential diagnosis of lumbar spinal canal stenosis from osteoarthritis of the hip.

  5. The Effects of Dynamic Range of Motion Exercises and Static Stretching on Strength and Range of Motion of the Hip Joint.

    Science.gov (United States)

    Kanetzke, Carol A.

    The effects of Dynamic Range of Motion (D'ROM) exercises and static stretch on hip flexibility and hip strength were examined. One hundred one male and female college students were divided into three groups: D'ROM, static stretch (ST), and control (C). All subjects were measured before and after treatment for hip flexibility and strength. Two…

  6. Slide track analysis of eight contemporary hip simulator designs.

    Science.gov (United States)

    Calonius, Olof; Saikko, Vesa

    2002-11-01

    In an earlier paper, the authors presented a new method of computation of slide tracks in the relative motion between femoral head and acetabular cup of total hip prostheses. For the first time, computed tracks were verified experimentally and with an alternative method of computation. Besides being an efficient way to illustrate hip kinematics, the shapes of the slide tracks are known to be of fundamental importance regarding the wear behaviour of prostheses. The verified method was now applied to eight contemporary hip simulator designs. The use of correct motion waveforms and an Euler sequence of rotations in each case was again found to be essential. Considerable differences were found between the simulators. For instance, the shapes of the tracks drawn by the resultant contact force included a circle, ellipse, irregular oval, leaf, twig, and straight line. Computation of tracks correctly for the most widely used hip simulator, known as biaxial, was made possible by the insight that the device is actually three-axial. Slide track patterns have now been computed for virtually all contemporary hip simulators, and both for the heads and for the cups. This comparative analysis forms a valuable basis for studies on the relationship between