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Sample records for hip joint measured

  1. Hip joint replacement

    Science.gov (United States)

    ... a part of the pelvic bone called the acetabulum) The upper end of the thighbone (called the ... Other reasons for replacing the hip joint are: Fractures in the thigh bone. Older adults often have ...

  2. 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

  3. Validity and responsiveness of radiographic joint space width metric measurement in hip osteoarthritis: a systematic review.

    Science.gov (United States)

    Chu Miow Lin, D; Reichmann, W M; Gossec, L; Losina, E; Conaghan, P G; Maillefert, J F

    2011-05-01

    To perform a systematic review of the literature on the concurrent validity, predictive validity and responsiveness of radiographic metric measurement of femoro-acetabular joint space width (JSW) in hip osteoarthritis (OA). studies reporting any data on (1) JSW on X-rays in hip OA patients and (2) concurrent validity (correlations with clinical symptoms), predictive validity (correlations with future symptomatic state, joint space loss or joint replacement), and/or responsiveness (JSW change over time evaluated using the standardized response mean (SRM)). Medline PUBMED and Embase databases. Random-effects models were constructed to obtain pooled SRMs. Of 448 articles, 79 met the abstract inclusion criteria and were read for further screening. Of these, 15 reported measures of validity and 11 reported measures of responsiveness. Concurrent validity: Five studies suggested an association between JSW and symptoms in the general population. Two evaluated the correlations between JSW and symptoms in hip OA patients, with conflicting results. Five demonstrated that JSW is predictive of future hip joint replacement. Responsiveness was moderate (SRM=0.66; 95% confidential interval (95%CI): 0.41, 0.91), but tended to be lower in randomized clinical trials than in cohort studies (0.35 vs 0.83), using an intention to treat rather than a completer analysis (0.30 vs 0.80), and using manual rather than computer-based measurement (0.47 vs 1.12). There is evidence of a weak association between JSW and symptoms, of predictive validity for subsequent joint replacement, and of moderate responsiveness of metric measurement of JSW. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Ines Kutzner

    Full Text Available 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

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

    Science.gov (United States)

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

    2015-09-05

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

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

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    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.

  8. Dorsolateral subluxation of hip joints in dogs measured in a weight-bearing position with radiography and computed tomography.

    Science.gov (United States)

    Farese, J P; Todhunter, R J; Lust, G; Williams, A J; Dykes, N L

    1998-01-01

    develop a radiographic procedure to measure dorsolateral subluxation (DLS) of the femoral head in canine coxofemoral (hip) joints in a weight-bearing position. DLS measured on a radiographic projection was compared with DLS measured on computed tomography (CT) images of hip joints in a weight-bearing position. A total of 24 dogs of varying ages were examined including Labrador retrievers, greyhounds, and Labrador-greyhound crossbreeds. Anesthetized dogs were placed in sternal recumbency in a kneeling position in a foam rubber mold. The stifles were flexed and adducted with the femora perpendicular to, and in contact with, the table. To test for DLS, dogs were imaged in this weight-bearing position (DLS test) with routine radiography and CT. For each hip, the DLS score was determined by measuring the percentage of the femoral head medial to the lateralmost point of the cranial acetabular rim on the dorsoventral radiographic projection and the lateralmost point of the central, dorsal acetabular rim on the CT image. Higher DLS scores indicated better coverage of the femoral head by the acetabulum. DLS scores were compared with the distraction index (DI) by grouping joints according to their probability of developing osteoarthritis (OA) as predicted by the DI. The DLS score in the new position ranged from 29% to 71% for radiography and 15% to 59% for CT. Joints classified as OA unsusceptible had a mean score of 64% +/- 1.5% for radiography and 55% +/- 0.8% for CT (n = 10); hip joints having a high probability of developing OA had a score of 39% +/- 2.6% for radiography and 26% +/- 1.9% for CT (n = 8). When the DLS test was repeated on the same dogs at a different time, the intraclass correlation coefficient for the DLS score on the radiographs was 0.85 (left hip) and 0.89 (right hip). There was a strong correlation (r = .89 for both hips) between the DLS score measured on the weight-bearing radiograph and the CT image. A strong correlation also was observed between the

  9. Unilateral hip osteoarthritis: The effect of compensation strategies and anatomic measurements on frontal plane joint loading.

    Science.gov (United States)

    Schmidt, André; Meurer, Andrea; Lenarz, Katharina; Vogt, Lutz; Froemel, Dara; Lutz, Frederick; Barker, John; Stief, Felix

    2017-08-01

    In order to reduce pain caused by the affected hip joint, unilateral hip osteoarthritis patients (HOAP) adopt characteristic gait patterns. However, it is unknown if the knee and hip joint loading in the non-affected (limbnon-affected ) and the affected (limbaffected ) limb differ from healthy controls (HC) and which gait parameters correlate with potential abnormal joint loading. Instrumented 3D-gait analysis was performed on 18 HOAP and 18 sex, age, and height matched HC. The limbnon-affected showed greater first and second peak external hip adduction moments (first HAM: +15%, p = 0.014; second HAM: +15%, p = 0.021, respectively), than seen in HC. In contrast, the second peak external knee adduction moment (KAM) in the limbaffected is reduced by about 23% and 30% compared to the limbnon-affected and HC, respectively. Furthermore, our patients showed characteristic gait compensation strategies including reduced peak vertical forces (pvF), a greater foot progression angle (FPA), and reduced knee range of motion (ROM) in the limbaffected . The limbaffected was 5.6 ± 3.8 mm shorter than the limbnon-affected . Results of stepwise regression analyses showed that increased first pvF explain 16% of first HAM alterations, whereas knee ROM and FPA explain 39% of second KAM alterations. We therefore expect an increased rate of progression of OA in the hip joint of the limbnon-affected and suggest that the shift in the medial-to-lateral knee joint load distribution may impact the rate of progression of OA in the limbaffected . The level of evidence is III. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1764-1773, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Hip joint mobility in dancers: preliminary report.

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    Drężewska, Marlena; Gałuszka, Renata; Sliwiński, Zbigniew

    2012-01-01

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

  11. Relationship between degenerative joint disease and hip joint laxity by use of distraction index and Norberg angle measurement in a group of cats.

    Science.gov (United States)

    Langenbach, A; Green, P; Giger, U; Rhodes, H; Gregor, T P; LaFond, E; Smith, G

    1998-11-15

    To determine the relationship between degenerative joint disease (DJD) and passive laxity of the hip joint in a group of cats. Prospective study. A select (nonrandomized) group of 78 cats. Standard hip-extended radiographic views and compression and distraction views of the pelvis were obtained from cats during sedation. Radiographs were evaluated, using an Orthopedic Foundation for Animals (OFA)-like scoring system for dogs. Passive joint laxity was measured, using Norberg angle (NA) and distraction index (DI). Hip laxity in cats with DJD was compared with hip laxity in cats without DJD. Hip dysplasia (HD) was subjectively diagnosed radiographically in 25 of 78 (32%) cats using the OFA-like scoring system. Nineteen cats had mild HD 4 had moderate HD, and 2 had severe HD. Fifteen of the 25 cats with HD had DJD. The NA ranged from 56 to 105. The mean NA in cats with DJD was (84 degrees) significantly lower than in cats without DJD (95 degrees). The DI ranged from 0.2 to 0.84. The mean DI for cats with DJD was (0.6) significantly higher than that for cats without DJD (0.49). Cats with a DI joint, as measured by NA or DI. The mean NA for radiographically normal cats (92.4 degrees) was lower than that in radiographically normal dogs (103 degrees). The overall mean DI for cats in this group (0.51) is similar to dogs of breeds with high joint laxity, such as the Labrador Retriever (0.5). As in dogs, there is a relationship between DJD and laxity in the hip joint of cats.

  12. Atraumatic Anterior Dislocation of the Hip Joint

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    Tadahiko Ohtsuru

    2015-01-01

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

  13. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  14. Associations among exercise duration, lameness severity, and hip joint range of motion in Labrador Retrievers with hip dysplasia.

    Science.gov (United States)

    Greene, Laura M; Marcellin-Little, Denis J; Lascelles, B Duncan X

    2013-06-01

    To evaluate factors associated with lameness severity and hip joint range of motion in dogs with hip dysplasia and to assess the association between hip joint range of motion and degree of lameness. Prospective case series. 60 client-owned Labrador Retrievers with hip dysplasia. Owners completed a questionnaire regarding their dogs' daily exercise duration and type (i.e., low impact vs high impact) and lifestyle. Range of motion of affected hip joints was measured with a transparent plastic goniometer. The presence of subluxation or luxation of hip joints as a consequence of hip dysplasia and the size of the largest osteophytes or enthesophytes of hip joints on ventrodorsal radiographic images of the pelvis were recorded. Multivariate analyses were performed to identify factors associated with lameness, loss of hip joint flexion, and loss of hip joint extension and to identify factors associated with the presence of large osteophytes. Exercise was associated with a decrease in the severity of lameness in dogs with hip dysplasia. The strength of this inverse relationship increased with longer exercise duration. Lameness was more severe in dogs with hip joint luxation than in dogs without luxation. Hip joint extension was 1° lower for each year of age, and osteophyte or enthesophyte size was 1 mm larger with each 3-year increase in age. Longer daily exercise duration was associated with lower lameness scores in dogs with hip dysplasia. Dogs with hip joint luxation secondary to hip dysplasia had higher lameness scores than did dogs without hip joint luxation.

  15. Chronic Periprosthetic Hip Joint Infection

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Søballe, Kjeld

    2016-01-01

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

  16. 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

  17. Relationships between results of the Ortolani method of hip joint palpation and distraction index, Norberg angle, and hip score in dogs.

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    Puerto, D A; Smith, G K; Gregor, T P; LaFond, E; Conzemius, M G; Cabell, L W; McKelvie, P J

    1999-02-15

    To determine whether results of the Ortolani method of hip joint palpation in dogs were related to distraction index (DI), Norberg angle, or radiographic hip score. Cross-sectional study. 459 clinically normal dogs. Dogs were sedated for radiography and palpation of the hip joints. Results of hip joint palpation were classified as negative, mild positive, moderate positive, or severe positive. Distraction indices were measured for all dogs. Norberg angles were measured for 380 dogs for which ventrodorsal hip-extended radiographic projections were available. Hip scores assigned by the Orthopedic Foundation for Animals (OFA) were available for 95 dogs. Age, weight, and sex were not significantly associated with results of hip joint palpation. There was moderate correlation between results of hip joint palpation and DI (r = 0.636), low-moderate correlation between results of hip joint palpation and OFA hip scores (rs = 0.437), and weak negative correlation (r = -0.236) between results of hip joint palpation and Norberg angle. For joints without degenerative joint disease (DJD), there was a significant linear relationship between results of hip palpation and DI; however, for joint with DJD, there was not. Results of hip joint palpation were 5.3-fold as likely to be negative for dogs with DJD as for dogs without. Results of hip joint palpation were at best moderately correlated with radiographic measures of hip joint laxity. Therefore, hip joint palpation should be combined with hip-extended and stress radiography when assessing hip joint quality.

  18. Synovial joint fluid cytokine levels in hip disease.

    Science.gov (United States)

    Abe, Hirohito; Sakai, Takashi; Ando, Wataru; Takao, Masaki; Nishii, Takashi; Nakamura, Nobuo; Hamasaki, Toshimitsu; Yoshikawa, Hideki; Sugano, Nobuhiko

    2014-01-01

    The purpose of this study was to evaluate cytokine level characteristics in the hip joint fluid, including rapidly destructive coxopathy (RDC), OA, osteonecrosis (ON) of the femoral head and RA. Thirty-three hips with RDC, 57 with OA, 36 with ON and 10 with RA were included in the study. OA hips were divided into two groups: 20 hips with early OA without joint space narrowing and 37 hips with terminal OA. ON hips were divided into three groups: 13 hips with hips with >3 mm collapse and 9 hips with terminal ON. Joint fluid was collected during surgery. Cytokine levels including IL-1β, IL-6, IL-8 and TNF-α were measured using homogeneous time-resolved fluorescence. All measured cytokine levels in RDC were significantly higher than those in OA (P 3 mm collapse were higher than those found in the ON group with hip diseases. The IL-8 level may reflect the aggressiveness of joint destruction in RDC, and IL-6 and TNF-α levels may also reflect ongoing destruction in OA and ON.

  19. Pain in the hip joint

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    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.

  20. Hip joint contact forces calculated using different muscle optimization techniques

    NARCIS (Netherlands)

    Wesseling, M.; Derikx, L.C.; de Groote, F.; Bartels, W.; Meyer, C.; Verdonschot, Nicolaas Jacobus Joseph; Jonkers, I.

    2013-01-01

    The goal of this study was to calculate muscle forces using different optimization techniques and investigate their effect on hip joint contact forces in gait and sit to stand. These contact forces were compared to measured hip contact forces [3]. The results showed that contact forces were

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

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    Xian-Zhao Wei

    2015-01-01

    Conclusions: Using the SFA, to evaluate RHF could prevent compromised measurements due to the movements of pelvis and lumbar spine during hip flexion, and is, therefore, a more accurate and objective method with reasonable reliability and validity.

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

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    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.

  3. Radiographic Hip Joint Phenotype of the Pembroke Welsh Corgi

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

    2013-01-01

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

  4. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

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    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.

  5. Computed tomography through the hip joint

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W.

    1981-09-01

    Computed tomography through the hip joint should be used only after conventional radiographs (at least a.p. views). It may provide information that is diagnostic or helpful, e.g. in bacterial infections, trauma of praearthrotic states. Indications for surgery may be obtained in the presence of inflammatory-rheumatic and degenerative hip disease, arthritic deformities and trauma, and the type of suitable operation may be indicated. The obturator internus muscle, which can be seen medial to the acetabulum on the scan, is an important diagnostic indicator where there is trauma or bacterial infection of the hip joint. The capsule of the hip joint can be visualized directly. Slice thickness of 6 mm, or less is necessary.

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

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    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.)

  7. HIP JOINT PATHOLOGY IN THE NEONATAL PERIOD

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    A. G. Baindurashvili

    2011-01-01

    Full Text Available The frequency of developmental hip dysplasia among newborns and its change with ultrasound application are presented. The ultrasound estimation of coxofemoral joints in children of the first days of life is resulted and the analysis of conformity of the clinical and ultrasonic data is carried out. The tactical algorithm of screening and monitoring of coxofemoral joints is offered.

  8. HIP JOINT PATHOLOGY IN THE NEONATAL PERIOD

    OpenAIRE

    A. G. Baindurashvili; I. Y. Chukhraeva

    2011-01-01

    The frequency of developmental hip dysplasia among newborns and its change with ultrasound application are presented. The ultrasound estimation of coxofemoral joints in children of the first days of life is resulted and the analysis of conformity of the clinical and ultrasonic data is carried out. The tactical algorithm of screening and monitoring of coxofemoral joints is offered.

  9. Reliability of performance-based measures in people awaiting joint replacement surgery of the hip or knee.

    Science.gov (United States)

    Gill, Stephen; McBurney, Helen

    2008-09-01

    Understanding the reliability of selected measurement tools is a prerequisite to understanding the effects of clinical interventions. The aim of this investigation was to determine the reliability of the 50-Foot Timed Walk (50 FTW) and 30-second Chair Stand Test (30 CST) in subjects awaiting joint replacement surgery of the hip or knee. Eighty-two subjects participating in a 6-week exercise programme were assessed at baseline, 7 weeks and 15 weeks. Four trials of the 50 FTW and two trials of the 30 CST were completed at each assessment. Eleven trained assessors completed the assessments. Intra-class correlations were consistently high for the 50 FTW and 30 CST at all assessments. At the baseline assessment, trial 1 was found to be significantly different from subsequent trials for both the 50 FTW and 30 CST. This effect was not evident at the 7-week and 15-week assessments. At the baseline assessment, scores for the 50 FTW became stable after the first trial. Estimates of minimum detectable change indicated that participants needed to change by more than 3.08 seconds and 1.64 stands to be 90% confident that a real change had occurred for the 50 FTW and 30 CST, respectively. The 50 FTW and 30 CST can be reliable measures of physical performance. However, because we found a practice effect at the baseline assessment, a practice trial should be allowed before data collection begins. Because only two trials of the 30 CST were completed, further research is required to confirm whether scores at the initial assessment become stable on repeated testing. Copyright (c) 2008 John Wiley & Sons, Ltd.

  10. Finite element analysis of artificial hip joint movement during human activities

    NARCIS (Netherlands)

    Saputra, Eko; Budiwan, I.; Jamari, Jamari; van der Heide, Emile

    2014-01-01

    The range of motion of artificial hip joint during human activities, measured from the postoperative total hip arthroplasty patients, has been reported previously. There were two human activities discussed, i.e. Western-style and Japanese-style. This paper analyzes the hip joint movement during

  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. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    OpenAIRE

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric re...

  13. 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.

  14. 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).

  15. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study.

    Science.gov (United States)

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric repetitions on the Cybex Normö dynamometer; the average torque was determined for both pre- and post-intervention measurements. These data were analyzed using the independent samples t-test with the significance level set at Phip abductor torque in the experimental group (P=0.03). The experimental group demonstrated a 17.35% increase in average torque whereas the control group demonstrated a 3.68% decrease in average torque. These findings are consistent with other studies demonstrating that the use of grade IV non-thrust mobilization improves strength immediately post-intervention in healthy individuals. The results of this pilot study provide physical therapists with further support for the utilization of manual therapy in conjunction with therapeutic exercise to enhance muscle strength.

  16. [Arthroscopic synovectomy of the hip joint].

    Science.gov (United States)

    Wünsch, M; Rühmann, O; Lipka, W; Stark, D A; Lerch, S

    2014-10-01

    The aim of the treatment is reduction of hip pain through arthroscopic synovectomy of the hip joint, reduction in activity of the synovial disease and removal of loose bodies in chondromatosis. Synovialitis of the hip due to synovial disease, such as pigmented villonodular synovitis (PVNS) and chondromatosis, synovialitis of the hip due to a further diseases of the hip. The disease must be treatable by arthroscopy (e.g. femoroacetabular impingement and lesion of the acetabular labrum). Suspicion of malignant synovial disease, extensive synovitis, especially in those areas of the hip which are difficult to reach or inaccessible to arthroscopy, primary disease not sufficiently treatable by arthroscopy, e.g. coxarthrosis. Arthroscopy of the central compartment of the hip is carried out by lateral, anterolateral (alternatively inferior anterolateral) and posterolateral portals, using all portals both for the camera and for instruments. In the central compartment synovectomy of the acetabular fossa is performed. A shaver and/or a high frequency diathermy applicator (HF applicator) are employed for removal of the synovial membrane. For arthroscopy of the peripheral compartment lateral, anterolateral (alternatively inferior anterolateral) and superior anterolateral portals are established and all portals are used both for the camera and instruments. In the peripheral compartment, the synovial membrane of the anterior, anteromedial, anterolateral and as far as possible posterolateral areas of the hip is removed. The dorsolateral synovial plica needs to be spared. Non-steroidal anti-inflammatory drugs (NSAIDs) are administered as prophylaxis of heterotopic ossification for 10 days. Contraindications for NSAIDs need to be considered. Thrombosis prophylaxis with low molecular weight heparin over 5 days. Mobilization with full weight bearing. Intensive physiotherapeutic exercises for at least 6 and possibly up to 12 postoperative weeks. Radiosynoviorthesis 6-8 weeks after

  17. In vivo hip joint loads and pedal forces during ergometer cycling.

    Science.gov (United States)

    Damm, P; Dymke, J; Bender, A; Duda, G; Bergmann, G

    2017-07-26

    The rising prevalence of osteoarthritis and an increase in total hip replacements calls for attention to potential therapeutic activities. Cycling is considered as a low impact exercise for the hip joint and hence recommended. However, there are limited data about hip joint loading to support this claim. The aim of this study was to measure synchronously the in vivo hip joint loads and pedal forces during cycling. The in vivo hip joint loads were measured in 5 patients with instrumented hip implants. Data were collected at several combinations of power and cadence, at two saddle heights. Joint loads and pedal forces showed strong linear correlation with power. So the relationship between the external pedal forces and internal joint forces was shown. While cycling at different cadences the minimum joint loads were acquired at 60RPM. The lower saddle height configuration results in an approximately 15% increase compared to normal saddle height. The results offered new insights into the actual effects of cycling on the hip joint and can serve as useful tools while developing an optimum cycling regimen for individuals with coxarthrosis or following total hip arthroplasty. Due to the relatively low contact forces, cycling at a moderate power level of 90W at a normal saddle height is suitable for patients. Copyright © 2017 Elsevier Ltd. 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...... population-based database of 4151 individuals, all of whom had a standard anteroposterior weight-bearing pelvic radiograph taken. Hip joints were classified according to type and degree of deformity. We defined hip osteoarthritis by a minimum joint space width of ... 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...

  19. [Practical significance of sonographic type IIa of dysplastic hip joint according to Graf's classifications].

    Science.gov (United States)

    Peled, Eli; Fishkin, Michael; Eidelman, Mark; Katzman, Alexander; Bialik, Victor

    2004-06-01

    Hip joint assessment in newborns and neonates is currently performed with ultrasonography due to the high degree of sensitivity and specificity of this technology as compared to the usual radiography. Measuring the alpha and beta angles is indicative in assessing the hip joint. The alpha angle represents the bony acetabular components and the beta angle represents the cartilaginous roof. According to Graf's classifications, type IIa is subdivided into two subgroups; type IIa- and IIa+. This study examined the need for following-up on these hip joints in newborn and neonate. The study population included the newborns and neonates born in our facility between the period 1/1/1999 to 1/4/2002. We routinely screened 10,432 newborns both clinically and ultrasonographically. This included a total of 20,862 hip joints, of which 915 were pathological according to Graf's classifications. Type IIa was diagnosed in 232 newborns and a total of 330 hip joints. The follow-up examinations were performed at 6 and 12 weeks of age, and at six months of age. Each follow-up visit included clinical and sonographic evaluation and alpha angle measuring. The incidence of type IIa was 1.6% of all hips and 36.9% of the pathological hip joints. These joints were divided into two subgroups. Group A included 254 hip joints among 156 newborns, 116 girls [74.3%] and 40 boys [25.6%]. Group A members had bilateral or unilateral type IIa hip joints. In the latter case, the other joint was type I-normal. Group B included 76 hip joints among 76 newborns, 72 girls [94.5%] and four boys [5.5%]. Group B members had one type IIa hip joint and a second more severely graded hip joint. Follow-up only was required in 88% of the type IIa hip joints and 12% were treated using Pavlik's method. Surprisingly, all the joints with unilateral type IIa hips developed into normal or type I by six months of age without treatment, independent of the alpha angle value, and the pathology on the opposite side.

  20. [Nerve distribution and density in the canine hip joint capsule. Comparison of healthy and dysplastic hip joints].

    Science.gov (United States)

    Giebels, Felix; Prescher, Andreas; Wagenpfeil, Stefan; Bücker, Arno; Kinzel, Sylvia

    2017-04-19

    The hip-joint capsule is exposed to increased tension forces during canine hip dysplasia, resulting in inflammation of the capsular tissue. It has been postulated that inflammation is associated with an increased nerve-distribution density. Therefore, it could be supposed that the nerve-distribution density in the hip-joint capsule is higher in dogs with dysplastic hip compared to healthy dogs. In 16 Labrador Retriever dogs that had been euthanised due to unrelated reasons, the hip joints were classified as normoplastic (group 1, n = 18) or dysplastic (group 2, n = 14) based on radiography. Following staining of the capsular nerve fibres by the Sihler method, histological specimens of the hip-joint capsules were scanned. By subdividing each specimen into 10 quadrants numbered from dorsomedial (Q01) to craniodorsolateral (Q10), the ratio of black to white pixels was calculated digitally for each specimen and each quadrant by using a semiautomatic image analysis. Statistical analysis was performed using an independent t-test. Comparison of the mean values of each quadrant showed a significantly higher (p hip-joint capsule in dogs with dysplastic hip could be the result of increased tension forces on this area following hip-joint dysplasia. The craniodorsal region of the hip-joint capsule is an important origin of pain and coxarthrosis in canine hip dysplasia. The results provide the pathophysiological basis for the efficacy of hip-joint denervation. Denervation of the cranial region of the acetabular rim is essential to reduce capsular inflammation and joint-related pain in canine hip dysplasia.

  1. Hip joint range of motion improvements using three different interventions.

    Science.gov (United States)

    Moreside, Janice M; McGill, Stuart M

    2012-05-01

    The purpose of this study was to analyze the effect of 3 different exercise interventions plus a control group on passive hip range of motion (ROM). Previous research studies into the methods of improving passive hip mobility have focused on stretching protocols aimed specifically at the hip joint. The effect of core stabilization, motor training, and myofascial stretching techniques on hip mobility in a selected asymptomatic group with limited hip mobility is unclear. In this study, 24 young men with limited hip mobility (stretching, stretching with motor control exercises for the hip and trunk, core endurance with motor control exercises, and the control group. Six-week home exercise programs were individually prescribed based on the assigned group, hip ROM, movement patterns, and timed core endurance. Two-way analyses of variances were conducted to analyze the effect of group assignment on hip ROM improvements. Both stretching groups demonstrated significant improvements in hip ROM (p stretching also demonstrated a moderate increase in ROM but only significantly so in rotation. Average core endurance holding times improved 38-53%. These results indicate that stretches aimed at the myofascial components of the upper body, in addition to the hip joint, resulted in dramatic increases in hip ROM in a group of young men with limited hip mobility. Hip ROM also improved in the group that did no active stretching, highlighting the potential role of including stabilization or "proximal stiffening training" when rehabilitating the extremities.

  2. 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

    was significantly associated to self reported pain in or around the hip joint in both sexes. CONCLUSION: Measurements of minimum hip JSW did not seem to be significantly influenced by varying spatial orientation of the pelvis during X-ray recordings. An inclusion criteria of minimum JSW... definite degenerative pathology in hips will be used by the current authors in future studies....

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

    Science.gov (United States)

    Peters, Christopher L

    2015-07-01

    Treatment of structural hip disease such as FAI and acetabular dysplasia has increased dramatically over the past decade with the goal of preservation of the native hip joint. A number of patient and disease specific parameters including the amount of underlying hip osteoarthrosis can help predict success with joint preservation surgery. Total hip arthroplasty remains a very good option in young patients who are not ideal candidates for joint preservation surgery. Future developments will help to better identify ideal surgical candidates and improve understanding of the disease processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. The joint capsule and joint laxity in dogs with hip dysplasia.

    Science.gov (United States)

    Madsen, J S

    1997-05-15

    Present knowledge of the complexity of joint diseases makes it difficult to investigate the causes and early pathogenesis of canine hip dysplasia. Clinical signs of canine hip dysplasia including joint laxity may be a result of primary or secondary alterations of the joint. We already know that joint laxity is related to effusive synovitis (ie, accumulation of synovial fluid) and to other primary collagenous diseases. Canine hip dysplasia may be a third collagenous disease associated with joint laxity. This paper summarizes some of the studies that investigated the relationship between joint laxity and a defect in collagen metabolism and the influence that alterations in transsynovial flow have on joint laxity.

  5. [Hip joint arthrolysis due to heterotopic ossification].

    Science.gov (United States)

    Anagnostakos, Konstantinos; Schmid, Nora; Kohn, Dieter

    2009-12-01

    Restoration of joint mobility with preservation of femoral head perfusion and warranty of joint stability. Pain reduction. Enhancement of the autonomous daily mobility (if possible regarding the cognitive status) as well as the ability to sit. For nonambulatory, bedridden patients ease of sanitary tasks and improvement of patients' convenience. Joint stiffness with limitation of the quality of life. Pain. Joint deformity, especially in cases of progressive subluxation. Relative: radiologically and scintigraphically immature heterotopic ossification (HO) with moderate limitation of motion and patients who are not able to tolerate the demanding postoperative management. The patient is positioned depending on size and location of ectopic bone. Ectopic bone is released from surrounding soft tissue or by making use of a gap between original bone and ectopic bone from the femur or pelvis. If ectopic bone is close to neurovascular structures, these have to be identified and protected. Postoperative irradiation in patients > 50 years. Generally, medicamentous prevention for recurrent cases with nonsteroidal anti-inflammatory drugs. Intensive and aggressive physical therapy, especially in patients with neurologic disorders. Depending on the extent of arthrolysis and the cause of HO, full, partial, or no weight bearing of the extremity over the first 6 postoperative weeks. The literature does not allow to draw firm conclusions regarding the occurrence of HO. The incidence of HO after primary total hip arthroplasty is estimated at 42%. In 9% of these cases, a severe HO with major limitation of motion or ankylosis occurs. In patients with neurologic injuries (brain injuries, spinal cord injuries) the incidence varies between 20-40%, but only one third of these patients show limited function or ankylosis. After surgical arthrolysis, the recurrence rate amounts to 25-30% at a mean follow-up of 6 years.

  6. Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty.

    Science.gov (United States)

    Czech, Szymon; Hermanson, Jacek; Rodak, Piotr; Stołtny, Tomasz; Rodak, Łukasz; Kasperczyk, Sławomir; Koczy, Bogdan; Mielnik, Michał

    2017-12-01

    An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients' willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

  7. Hip joint mechanics during walking in individuals with mild-to-moderate hip osteoarthritis.

    Science.gov (United States)

    Constantinou, Maria; Loureiro, Aderson; Carty, Christopher; Mills, Peter; Barrett, Rod

    2017-03-01

    The purpose of this case-control study was to characterise hip joint kinematics and moments during gait in people with mild-to-moderate hip osteoarthritis (OA). Eligible participants were allocated to the hip OA group (n=27) or the age-matched control group (n=26) based on radiographic and symptomatically defined inclusion criteria. Participants walked barefoot along a 10-m walkway at their self-selected gait speed. Trajectories of 43 markers attached to the trunk, pelvis, upper and lower limbs were recorded using a 12-camera motion capture system. Ground reaction force data were simultaneously collected. Individuals in the hip OA group had a 10% higher body mass, 13% slower self-selected walking speed, 10% shorter step length, 2% and 9% longer relative stance and double support duration (% stride) respectively, 41% lower sagittal plane hip range of motion, and 28% and 45% lower peak sagittal and transverse plane hip joint moments respectively during gait compared to controls (phip OA experienced less net hip joint loading over a reduced range of hip motion for a longer proportion of the gait cycle when walking at their preferred gait speed suggest that the mechanics of the hip joint are altered in hip OA, and could have implications for disease progression through altered mechano-biological processes within the joint. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Biomorphological features of the hip joint of some Strigiformes

    OpenAIRE

    DRUZ N.V.

    2012-01-01

    This article describes the biomorphological features of the hip joint muscles of representatives of the order Strigiformes(Snowy Owl and Strix). It was found that in representatives of this order the degree of differentiation of the knee joint muscles is caused by the jumping type of bipedal locomotion and biomorphological static features, which in turn has an influence on the degree of every hip joint muscle development.

  9. Relationships of hip joint volume ratios with degrees of joint laxity and degenerative disease from youth to maturity in a canine population predisposed to hip joint osteoarthritis.

    Science.gov (United States)

    D'Amico, Laura L; Xie, Lin; Abell, Lindsey K; Brown, Katherine T; Lopez, Mandi J

    2011-03-01

    To assess relationships of acetabular volume (AV), femoral head volume (FV), and portion of the femoral head within in the acetabulum (FVIA) with each other and with degrees of hip joint laxity and degenerative joint disease from youth to maturity in dogs predisposed to developing hip joint osteoarthritis (OA). 46 mixed-breed half- or full-sibling hound-type dogs. The distraction index (DI), AV, FV, FVIA, and degree of osteoarthritis (OA score) were quantified in 1 hip joint at 16, 32, and 104 weeks of age. Relationships among variables were evaluated within and between ages. Ratios corresponding to OA scores were compared within ages. Differences among 16-week ratios corresponding to 32-week OA scores and among 16- and 32-week ratios corresponding to 104-week OA scores were evaluated. Significant positive relationships existed between FV and AV across ages as well as between FVIA/FV and FVIA/AV and between DI and OA score across and within most ages. Such relationships also existed within these variables across most ages. Negative relationships of DI and OA scores with FVIA/FV and FVIA/AV within and among all ages were significant. Sixteen-week AVs, FVs, and FVIAs were greater and FV/AVs and OA scores were less than 32- and 104-week values. The 32-week FVIA/FV was less than 16- and 104-week values, and the 32-week FVIA/AV was less than the 104-week value. The FVIA/FV and FVIA/AV were lower and the DI was higher with higher OA scores within and among most ages. Structural volumes in lax canine hip joints changed predictably relative to each other during growth, despite degenerative changes. Measures developed in this study may augment current diagnosis and treatment strategies for hip dysplasia in dogs.

  10. Relationships of hip joint volume ratios with degrees of joint laxity and degenerative disease from youth to maturity in a canine population predisposed to hip joint osteoarthritis

    Science.gov (United States)

    D’Amico, Laura L.; Xie, Lin; Abell, Lindsey K.; Brown, Katherine T.; Lopez, Mandi J.

    2013-01-01

    Objective To assess relationships of acetabular volume (AV), femoral head volume (FV), and portion of the femoral head within in the acetabulum (FVIA) with each other and with degrees of hip joint laxity and degenerative joint disease from youth to maturity in dogs predisposed to developing hip joint osteoarthritis (OA). Animals 46 mixed-breed half- or full-sibling hound-type dogs. Procedures The distraction index (DI), AV, FV, FVIA, and degree of osteoarthritis (OA score) were quantified in 1 hip joint at 16, 32, and 104 weeks of age. Relationships among variables were evaluated within and between ages. Ratios corresponding to OA scores were compared within ages. Differences among 16-week ratios corresponding to 32-week OA scores and among 16- and 32-week ratios corresponding to 104-week OA scores were evaluated. Results Significant positive relationships existed between FV and AV across ages as well as between FVIA/FV and FVIA/AV and between DI and OA score across and within most ages. Such relationships also existed within these variables across most ages. Negative relationships of DI and OA scores with FVIA/FV and FVIA/AV within and among all ages were significant. Sixteen-week AVs, FVs, and FVIAs were greater and FV/AVs and OA scores were less than 32- and 104-week values. The 32-week FVIA/FV was less than 16- and 104-week values, and the 32-week FVIA/AV was less than the 104-week value. The FVIA/FV and FVIA/AV were lower and the DI was higher with higher OA scores within and among most ages. Conclusions and Clinical Relevance Structural volumes in lax canine hip joints changed predictably relative to each other during growth, despite degenerative changes. Measures developed in this study may augment current diagnosis and treatment strategies for hip dysplasia in dogs. PMID:21355741

  11. Computational Modelling and Movement Analysis of Hip Joint with Muscles

    Science.gov (United States)

    Siswanto, W. A.; Yoon, C. C.; Salleh, S. Md.; Ngali, M. Z.; Yusup, Eliza M.

    2017-01-01

    In this study, the model of hip joint and the main muscles are modelled by finite elements. The parts included in the model are hip joint, hemi pelvis, gluteus maximus, quadratus femoris and gamellus inferior. The materials that used in these model are isotropic elastic, Mooney Rivlin and Neo-hookean. The hip resultant force of the normal gait and stair climbing are applied on the model of hip joint. The responses of displacement, stress and strain of the muscles are then recorded. FEBio non-linear solver for biomechanics is employed to conduct the simulation of the model of hip joint with muscles. The contact interfaces that used in this model are sliding contact and tied contact. From the analysis results, the gluteus maximus has the maximum displacement, stress and strain in the stair climbing. Quadratus femoris and gamellus inferior has the maximum displacement and strain in the normal gait however the maximum stress in the stair climbing. Besides that, the computational model of hip joint with muscles is produced for research and investigation platform. The model can be used as a visualization platform of hip joint.

  12. Taking care of your new hip joint

    Science.gov (United States)

    ... of activity. But, even when you do your everyday activities, you will need to move carefully so that you do not dislocate your hip. You will need to learn exercises to make your new hip stronger. After you ...

  13. New concepts of coxofemoral joint stability and the development of a clinical stress-radiographic method for quantitating hip joint laxity in the dog.

    Science.gov (United States)

    Smith, G K; Biery, D N; Gregor, T P

    1990-01-01

    From mechanical principles and postmortem observations of coxofemoral joints of dogs, a hydrostatic mechanism influencing hip joint stability was discovered. This discovery led to the development of a stress-radiographic positioning method to quantitate hip joint laxity in dogs. The method incorporated 2 views with the dog in supine position and hips at neutral flexion/extension angle: a compression view, with the femoral heads fully seated in the acetabula; and a distraction view, with the femoral heads at maximal lateral displacement. An index measurement method was formulated to quantitate the relative degree of joint laxity appearing in either the compression or distraction view. Clinical evaluation of 6 dogs was done to compare the compression/distraction method with the standard hip-extended radiographic method. Also, the stress-radiographic method was performed on 16-week-old Borzoi and German Shepherd Dogs to compare the characteristics of inherent hip joint laxity in these breeds. In all dogs tested, hip joint laxity was masked by the standard hip-extended view as indicated by a 2.5-fold improvement in sensitivity to hip joint laxity of the new method (P less than 0.00001). Moreover, the mean hip joint laxity of 16-week-old German Shepherd Dogs exceeded the mean hip joint laxity of Borzois by 79% (P less than 0.00001). Reports in the literature document the incontrovertible association of hip joint laxity to the development of hip dysplasia in dogs. We believe the ability to accurately quantitate hip joint laxity will provide key diagnostic and prognostic criteria for the selection of pet dogs, and more importantly, breeding stock.

  14. [Viscosity determination of synovial fluids from the canine hip and elbow joint as well as the human knee joint].

    Science.gov (United States)

    Helms, Gabriele; Rittmann, Pia; Wefstaedt, Patrick; Windhagen, Henning; Pressel, Thomas; Behrens, Bernd-Arno; Nolte, Ingo

    2008-01-01

    The development of pathological changes in both human and canine hip joints is mainly caused by a lack of synovial fluid lubrication. This results in an increased joint abrasion. Even after implantation of joint prosthesis, inadequate lubrication can lead to abrasion in the tribological pair. This can finally result in aseptic loosening of the prosthesis. In spite of the enormous number of studies that have been performed on human, only little knowledge about the tribological properties of the joints in dogs is available in the literature. For this reason the viscosities of synovial fluid, derived from physiological and pathologically changed canine elbow joints were measured. The viscosities were determined by the use of a cone-plate viscometer at different temperatures and shear rates. The obtained values were compared with the viscosity values of pathologically changed synovial fluids from human knee joints as well as with pathological samples from the canine hip joint. The results show that the viscosity values vary within a series of measurements and are inversely proportional to the temperature of the sample and the shear rate. The differences between the average viscosities of canine and human synovial fluids taken from pathologically changed joints are below 4% (22.5 s(-1) at theta1 = 25 degrees C). The findings of this study are being implemented in a FE-Model for the computation of actual forces in the hip joint during different movements. This would represent a contribution to an improved prosthetic treatment of canine and human hips.

  15. Friction measurement in a hip wear simulator.

    Science.gov (United States)

    Saikko, Vesa

    2016-05-01

    A torque measurement system was added to a widely used hip wear simulator, the biaxial rocking motion device. With the rotary transducer, the frictional torque about the drive axis of the biaxial rocking motion mechanism was measured. The principle of measuring the torque about the vertical axis above the prosthetic joint, used earlier in commercial biaxial rocking motion simulators, was shown to sense only a minor part of the total frictional torque. With the present method, the total frictional torque of the prosthetic hip was measured. This was shown to consist of the torques about the vertical axis above the joint and about the leaning axis. Femoral heads made from different materials were run against conventional and crosslinked polyethylene acetabular cups in serum lubrication. Regarding the femoral head material and the type of polyethylene, there were no categorical differences in frictional torque with the exception of zirconia heads, with which the lowest values were obtained. Diamond-like carbon coating of the CoCr femoral head did not reduce friction. The friction factor was found to always decrease with increasing load. High wear could increase the frictional torque by 75%. With the present system, friction can be continuously recorded during long wear tests, so the effect of wear on friction with different prosthetic hips can be evaluated. © IMechE 2016.

  16. ULTRASONOGRAPHY OF THE HIP JOINT EXAMINATION HIP JOINT IN THE ASSESSMENT OF THE EFFECTIVENESS OF TREATMENT IN CHILDREN WITH LEGG-CALVE-PERTHES DISEASE AND HIP OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Татьяна Ивановна Тихоненко

    2014-09-01

    Full Text Available We performed dynamic hip doppler ultrasonography in children with Legg-Calve-Perthes disease (LCPD in order to determine the effectiveness of the conservative and surgical treatment. The study included children aged from 3 to 7 years old with LCPD who had pain in the hip joints during admission. We assessed the structural changes in the head of the femur and the hip joint (B-mode, when the Doppler study analyzed diameter of enveloping hip vessels, blood velocity and resistance index. The study found that severe pain and contracture of the hip during admission appeared as a manifestation of concomitant hip osteoarthritis. On admission all patients had signs of arterial spasm and venous stasis in the hip joints, which determined the administration of a comprehensive arthrologic, osteogenesis stimulating and angioprotective therapy, according to the data of dynamic ultrasound.

  17. 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......) periprosthetic hip joint infection diagnosis code in the Danish National Patient Register. METHODS: Patients were identified with an ICD-10 discharge diagnosis code of T84.5 ("Infection and inflammatory reaction due to internal joint prosthesis") in association with hip-joint associated surgical procedure codes...... in The Danish National Patient Register. Medical records of the identified patients (n = 283) were verified for the existence of a periprosthetic hip joint infection. Positive predictive values with 95% confidence intervals (95% CI) were calculated. RESULTS: A T84.5 diagnosis code irrespective of the associated...

  18. Paraplegic flexion contracture of hip joints: An unsolvable problem.

    Science.gov (United States)

    Bhattacharyya, Sailendra

    2016-01-01

    Paraplegic flexion contracture of hip joints beyond 90° is a difficult condition to treat for any orthopedic surgeon. There is no fixed protocol of treatment described, by and large it is individualized. A 20 year old female presented with paraplegia for last 15 years due to irrecoverable spinal cord disease with complete sensory and motor loss of both lower extremities and was admitted with acute flexion contracture of both hip joints with trunk resting on thighs. She underwent bilateral proximal femoral resection. Both hip joints were straight immediately after surgery and patient could lie on her back. In a course of time, she started sitting on her buttocks, led a comfortable wheelchair life with a sitting balance. Proximal femoral resection is an effective method to treat long standing irrecoverable paraplegic acute flexion deformity of the hip joint.

  19. 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...... population-based database of 4151 individuals, all of whom had a standard anteroposterior weight-bearing pelvic radiograph taken. Hip joints were classified according to type and degree of deformity. We defined hip osteoarthritis by a minimum joint space width of ... 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...

  20. [Juvenile rheumatoid diseases: Endoprosthetic care of destroyed hip joints].

    Science.gov (United States)

    Rehart, S; Henniger, M

    2015-07-01

    Patients with juvenile idiopathic arthritis (JIA) often suffer from involvement of the hip joints, with joint destruction and related functional limitations, making hip replacement necessary. To discover what special features are to be expected in patients with JIA and hip arthroplasty and what impact they have on surgical indication, choice of implant, and technique. Selective literature review and evaluation of our patient population. Compared with osteoarthritis patients, JIA patients are on average much younger at the time of hip replacement. Owing to the onset of the disease in childhood or adolescence and the frequent glucocorticoid therapy, growth disorders or abnormal anatomical findings are common in these patients. Bone density is often reduced at an early age. The perioperative management of medication has to be planned. Special implants for patients with rheumatic diseases do not exist, but the above peculiarities of this group of patients should be considered for surgical procedure and choice of implant and material. Overall, the results of hip arthroplasty in juvenile rheumatic diseases, in terms of pain relief and functional improvement, are good. The limited life of the arthroplasty is problematic. By relieving pain, improvement of the range of motion and activity level very high patient satisfaction is usually achieved by hip arthroplasty in JIA patients. In the case of involvement of the contralateral hip or the ipsilateral knee joint it may be useful to perform a simultaneous, single-stage joint replacement of both joints.

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

    OpenAIRE

    Tsai, Kate L.; Murphy, Keith E.

    2006-01-01

    Canine hip dysplasia (CHD) is characterized by a malformation of the hip joint that leads to joint laxity and consequential degenerative joint disease. The most widely used method for diagnosis of CHD is the ventrodorsal hip-extended radiologic view, commonly referred to as the Orthopedic Foundation for Animals (OFA) method. The method of the University of Pennsylvania Hip Improvement Program (PennHIP), an alternative technique that is based on hip joint laxity, provides a quantitative assess...

  2. 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.

  3. Quantitative assessment of bone scintigraphy in the hip joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Yukiharu

    1985-05-01

    Quantitative assessment of bone scintigraphy was performed in fifty-six patients with hip joint disease including femoral neck fracture, aseptic necrosis of the femoral head, traumatic dislocation of the hip, Perthes disease, and transient synovitis of the hip. In the static study, bone scintigraphy was obtained 3 hours after injection of sup(99m)Tc-MDP by gamma camera equipped with a computer and uptake ratios were calculated. In the dynamic study, bone scintigraphy was performed in one, 3 and 5 hours after injection of radionuclide. Femoral head uptake ratio was markedly decreased in osteonecrosis following femoral neck fracture and characteristically increased in aseptic necrosis of the femoral head but prolonged retention of sup(99m)Tc-MDP could be observed. Uptake ratios of epiphysis were decreased in Perthes disease but normal in transient synovitis of the hip. Static and dynamic study of bone scintigraphy may be useful for early diagnosis and treatment in the hip joint disease. (author).

  4. Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

    Directory of Open Access Journals (Sweden)

    Czech Szymon

    2017-12-01

    Full Text Available An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients’ willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

  5. 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

    2016-10-01

    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.

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

    African Journals Online (AJOL)

    after dislocation and acetabular fracture treatment by mold arthroplasty J Bone Joint. Surg (Am) 1969;51A:737-55. 10. Fender D, Harper WM, Gregg PJ. Outcome of Charnley total hip replacement across a single health region in England. J Bone Joint. Surg (Br) 1999;81-B(4):577-81. 11. Havelin LI, Espehaug B, Vollset SE,.

  7. 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.)

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

    OpenAIRE

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

    2004-01-01

    In dogs hip joint laxity that can lead to degenerative joint disease (DJD) is frequent and heritable, providing a genetic model for some aspects of the human disease. We have used Portuguese water dogs (PWDs) to identify Quantitative trait loci (QTLs) that regulate laxity in the hip joint.A population of 286 PWDs, each characterized by ca. 500 molecular genetic markers, was analyzed for subluxation of the hip joint as measured by the Norberg angle, a quantitative radiographic measure of laxit...

  9. 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

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

    Science.gov (United States)

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

    1995-03-01

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

  11. Static balance according to hip joint angle of unsupported leg during one-leg standing.

    Science.gov (United States)

    Cha, Ju-Hyung; Kim, Jang-Joon; Ye, Jae-Gwan; Lee, Seul-Ji; Hong, Jeong-Mi; Choi, Hyun-Kyu; Choi, Ho-Suk; Shin, Won-Seob

    2017-05-01

    [Purpose] This study aimed to determine static balance according to hip joint angle of the unsupported leg during one-leg standing. [Subjects and Methods] Subjects included 45 healthy adult males and females in their 20s. During one-leg standing on the non-dominant leg, the position of the unsupported leg was classified according to hip joint angles of point angle was class. Static balance was then measured using a force plate with eyes open and closed. The total length, sway velocity, maximum deviation, and velocity on the mediolateral and anteroposterior axes of center of pressure were measured. [Results] In balance assessment with eyes open, there were significant differences between groups according to hip joint angle, except for maximum deviation on the anteroposterior axis. In balance assessment with eyes closed, there were significant differences between total length measurements at 0° and 30°, 60° and between 30° and 90°. There were significant differences between sway velocity measurements at 0° and 30° and between 30° and 90°. [Conclusion] Thus, there were differences in static balance according to hip joint angle. It is necessary to clearly identify the hip joint angle during one-leg standing testing.

  12. Development of the hip joint in relation to congenital dislocation.

    Science.gov (United States)

    Ferrer-Torrelles, M; Ceballos, T; Ferrer-Loewinsohn, A

    1990-01-01

    As an introduction to the pathology and treatment of C.D.H., a simplified outline of fundamental embryologic events and growth characteristics of the hip joint (selected from past and actual bibliography) is presented. Congenital dislocation of the hip appears to be the result of various genetic, developmental, environmental and mechanical factors that affect articular structures in the perinatal period. At this time, the hip joint is anatomically and functionally more vulnerable to alterations of its normal concentric disposition. If incongruency persists, subsequent morphological changes, characteristic of dysplasia will develop. The main conclusions derived from a review of the development of the hip joint in relation to C.D.H. are: 1) The hip joint is an anatomical and functional unit derived from a common primitive blastema. 2) Primitive condensed sclerotomic mesenchyme transforms into cartilage that shapes in a genetically determined pattern to form the femur and os innominatum in continuity. 3) The joint space develops by autolytic degeneration in the 7-8 week embryo. By the 11th week, the joint cavity, evolved in the capsule lined internally by synovium, has a well differentiated labrum and ligamentum teres with the basic morphology of a developed hip joint. Only after this stage is displacement possible. 4) Depth (and stability) of the acetabulum increase with development of the glenoid labrum and cartilaginous rim (incomplete only in its inferior portion). Here a fibrous band (transverse ligament) offers less resistance to displacement, but on occasions is an anatomic barrier to concentric reduction. 5) In the early fetal period, the acetabulum is a deep set cavity, becoming shallower at the time of birth. Femoral head coverage at birth is more deficient than at any other previous or subsequent stage of development. 6) The relationship between femoral and acetabular anteversion (instability index) is more important than absolute values which are variable

  13. Joint space width in dysplasia of the hip

    DEFF Research Database (Denmark)

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

    2005-01-01

    . 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......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...

  14. Radiological diagnosis of hip joint abnormalities in children

    Directory of Open Access Journals (Sweden)

    Михаил Михайлович Камоско

    2015-06-01

    Full Text Available Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.

  15. Outcome of Hip Impingement Surgery: Does Generalized Joint Hypermobility Matter?

    Science.gov (United States)

    Naal, Florian D; Müller, Aileen; Varghese, Viju D; Wellauer, Vanessa; Impellizzeri, Franco M; Leunig, Michael

    2017-05-01

    Generalized joint hypermobility (JH) might negatively influence the results of surgical femoroacetabular impingement (FAI) treatment, as JH has been linked to musculoskeletal pain and injury incidence in athletes. JH may also be associated with worse outcomes of FAI surgery in thin females. To (1) determine the results of FAI surgery at a minimum 2-year follow-up by means of patient-reported outcome measures (PROMs) and failure rates, (2) assess the prevalence of JH in FAI patients and its effect on outcomes, and (3) identify other risk factors associated with treatment failure. Cohort study; Level of evidence, 3. We included 232 consecutive patients (118 females; mean age, 36 years) with 244 hips surgically treated for symptomatic FAI between 2010 and 2012. All patients completed different PROMs preoperatively and at a mean follow-up of 3.7 years. Satisfaction questions were used to define subjective failure (answering any of the 2 subjective questions with dissatisfied/ very dissatisfied and/or didn't help/ made things worse). Conversion to total hip replacement (THR) was defined as objective failure. JH was assessed using the Beighton score. All PROM values significantly ( P FAI surgery yielded favorable outcomes at short- to midterm follow-up. JH as assessed by the Beighton score was not consistently associated with subjective and objective results. Joint degeneration was the most important risk factor for conversion to THR. Although statistical significance was not reached, female patients with no joint degeneration, only mild FAI deformity, and higher Oxford scores at the time of surgery seemed to be at increased risk for subjective dissatisfaction.

  16. 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. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Joint Loading in the Sagittal Plane During Gait Is Associated With Hip Joint Abnormalities in Patients With Femoroacetabular Impingement.

    Science.gov (United States)

    Samaan, Michael A; Schwaiger, Benedikt J; Gallo, Matthew C; Sada, Kiyoshi; Link, Thomas M; Zhang, Alan L; Majumdar, Sharmila; Souza, Richard B

    2017-03-01

    Femoroacetabular impingement (FAI) is a morphological abnormality of the hip joint that results in functional impairments during various activities of daily living (ADL) such as walking. Purpose/Hypothesis: The purpose of this study was to determine if lower extremity joint loading differed between patients with FAI and controls and to determine whether these altered biomechanical parameters were associated with intra-articular abnormalities. It was hypothesized that patients with FAI would exhibit altered lower extremity joint loading during walking when compared with healthy controls and that these altered joint loading patterns would be associated with intra-articular abnormalities. Controlled laboratory study. Lower extremity kinetics was assessed during walking at a self-selected speed in 15 presurgical patients with FAI and 34 healthy controls matched for age and body mass index. All participants underwent unilateral hip magnetic resonance imaging (MRI) to assess hip joint abnormalities. Hip joint abnormalities were assessed using a semiquantitative MRI-based scoring system. Self-reported outcomes of pain and function were obtained using the Hip disability and Osteoarthritis Outcome Score (HOOS), and physical performance was measured using the 6-minute walk test (6MWT). Group differences were assessed using an independent t test and analysis of variance. In the patients with FAI, associations of joint kinetics with HOOS subscores and intra-articular abnormalities were assessed using the Pearson ( r) and Spearman (ρ) correlation coefficients, respectively. Compared with the control group, the FAI group exhibited a significantly increased severity of acetabular (FAI: 1.87 ± 1.55; control: 0.47 ± 0.79; P FAI: 3.27 ± 2.79; control: 1.21 ± 1.55; P = .002) cartilage abnormalities, increased levels of pain (FAI: 65.0 ± 18.8; control: 98.2 ± 3.4; P = .001), and reduced function (FAI: 67.2 ± 21.5; control: 98.9 ± 3.4; P FAI: 1.55 ± 0.19 m/s; control: 1.63

  19. Hip-joint congruity after Dega osteotomy in patients with cerebral palsy: long-term results.

    Science.gov (United States)

    Braatz, Frank; Staude, Daniel; Klotz, Matthias C; Wolf, Sebastian I; Dreher, Thomas; Lakemeier, Stefan

    2016-08-01

    Neurogenic hip dislocation is quite common in children with cerebral palsy (CP). The purpose of this study was to evaluate the long-term outcome of single-event multilevel surgery (SEMLS) in combination with hip reconstruction by using a periacetabular osteotomy as described by Dega concerning post-operative remodeling and plasticity of the femoral head post-operatively. A total of 72 patients with CP as the primary disease and in whom a complex surgical hip reconstruction was performed during SEMLS between 1998 and 2004 were included in the study. There were 45 men and 27 women, with a median age of 7.6 (4.7-16.3) years at the time SEMLS was performed. The mean follow-up time was 7.7 years (4.9-11.8). X-rays were taken before and after surgery, and Rippstein 1 and 2 were used for follow-up. As the most reliable value for decentration, migration percentage (MP) as described by Reimers was used. To measure hip-joint cover at follow-up, the centre-edge angle was used. The hip was divided into four different categories according to sphericity and congruity. Using this approach, we could evaluate joint remodeling. Pre-operatively, the mean MP measured by X-ray was 68 %. Directly after surgery, this value decreased on average by 12 % and at the long-term follow-up was 16.0 % on average. A high rate of incongruence was observed on X-rays taken directly after surgery: 66 hip joints were classified as incongruent. The number of aspherical and incongruent joints decreased to 54 at the follow-up examination. Data of our study with high plasticity of the hip joint suggest that even if the femoral head is deformed and a persistent incongruency after surgery is expected, hip reconstruction can be recommended.

  20. 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....... METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test...

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

    Science.gov (United States)

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

    2015-01-01

    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) periprosthetic hip joint infection diagnosis code in the Danish National Patient Register. Patients were identified with an ICD-10 discharge diagnosis code of T84.5 ("Infection and inflammatory reaction due to internal joint prosthesis") in association with hip-joint associated surgical procedure codes in The Danish National Patient Register. Medical records of the identified patients (n = 283) were verified for the existence of a periprosthetic hip joint infection. Positive predictive values with 95% confidence intervals (95% CI) were calculated. A T84.5 diagnosis code irrespective of the associated surgical procedure code had a positive predictive value of 85% (95% CI: 80-89). Stratified to T84.5 in combination with an infection-specific surgical procedure code the positive predictive value increased to 86% (95% CI: 80-91), and in combination with a noninfection-specific surgical procedure code decreased to 82% (95% CI: 72-89). Misclassification must be expected and taken into consideration when using administrative discharge registers for epidemiological research on periprosthetic hip joint infection. We believe that the periprosthetic hip joint infection diagnosis code can be of use in future single-source register based studies, but preferably should be used in combination with alternate data sources to ensure higher validity.

  2. Traumatic posterior urethral fistula to hip joint following gunshot injury: a case report

    Directory of Open Access Journals (Sweden)

    Rezaee Ahmad

    2009-11-01

    Full Text Available Abstract Introduction Urinary system fistula 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. Case presentation A 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure on the same day. Ten months later, he developed urinary retention. He underwent retrograde urethrography and antegrade cystography which showed a stricture measuring 5 cm in length. There was also a history of progressive pain in the right hip joint accompanied by low grade fever which started 2 months after the initial injury. Hip X-ray showed evidence of an 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. Conclusion Hip joint contamination with urine following a urethro-acetabular fistula can lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should keep these fistulas in mind as a complication of penetrating urethral injury and every attempt should be made for their early diagnosis and prompt treatment.

  3. 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.)

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

    Science.gov (United States)

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

    2015-09-18

    Epidemiologic studies of osteoarthritis of the hip indicate a possible connection between work related activities and the pathogenesis of the disease. This study investigated the hip joint contact forces for physically demanding occupational tasks (lifting, carrying, transferring of a weight (mass: 25 kg, 40 kg and 50 kg); stair climbing without and with additional load of 25 kg; ladder climbing) and compared these with everyday activities (level gait, sitting down and getting up). The hip joint contact force was calculated with the human multibody simulation software AnyBody employing motion capture and ground reaction force measurements by force plates and an instrumented staircase and ladder. Although the results for 11 male test subjects showed individual variations, a general trend could be observed in regards of force curves' characteristics and maxima. The largest joint contact forces calculated were (637 ± 148)%-body weight for horizontal transfer of a 50 kg weight. For several of the occupational activities the computed hip joint contact forces were significantly larger compared to the investigated examples of activities of daily living. This study provides original data of simulated hip joint contact forces for physically demanding activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Postural control in degenerative diseases of the hip joint.

    Science.gov (United States)

    Sziver, Edit; Nagy, Edit; Preszner-Domján, Andrea; Pósa, Gabriella; Horvath, Gyöngyi; Balog, Attila; Tóth, Kálmán

    2016-06-01

    Few studies investigated the postural control in patients with hip joint impairments; in some cases, balance impairments have been found, while other researchers have seen no significant changes. The goal of this study was to characterize postural stability in patients suffering from unilateral osteoarthritis or rheumatoid arthritis in different balance tasks and to reveal potential differences between the two diseases in this respect. Ten patients with hip osteoarthritis (mean age: 62.3years), 10 patients with rheumatoid arthritis (mean age: 55.4years) and 10 healthy control subjects (mean age: 54.3years) took part in the study. Displacement of centre of pressure was measured with a force plate in mediolateral and anteroposterior directions during two-leg standing on firm and compliant surfaces with eyes opened and closed. Standing on a firm surface sway path increased significantly in the anteroposterior direction in both patient groups and in the mediolateral direction in all groups with eyes closed as compared to eyes opened condition. Standing on a compliant surface, sway paths increased significantly in both directions in all groups with eyes closed as compared to eyes opened condition; furthermore, sway paths were significantly longer with eyes closed in patients with rheumatoid arthritis in comparison with control and osteoarthritis groups. Our data revealed that the manipulation of both visual and somatosensory information can reveal subtle impairments in balance control. Thus, this paradigm can unmask the effects of decreased proprioception due to joint capsule lesion in patients with rheumatoid arthritis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. An in vitro simulation method for the tribological assessment of complete natural hip joints

    OpenAIRE

    Groves, Dawn; Fisher, John; Williams, Sophie

    2017-01-01

    The use of hip joint simulators to evaluate the tribological performance of total hip replacements is widely reported in the literature, however, in vitro simulation studies investigating the tribology of the natural hip joint are limited with heterogeneous methodologies reported. An in vitro simulation system for the complete natural hip joint, enabling the acetabulum and femoral head to be positioned with different orientations whilst maintaining the correct joint centre of rotation, was su...

  7. 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

    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...... 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....

  8. Comparison of arthroscopic and radiographic abnormalities in the hip joints of juvenile dogs with hip dysplasia.

    Science.gov (United States)

    Holsworth, Ian G; Schulz, Kurt S; Kass, Philip H; Scherrer, William E; Beale, Brian S; Cook, James L; Hornof, William J

    2005-10-01

    To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia. Case series. 52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy. A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone). In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions > or = grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities. Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions.

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

    African Journals Online (AJOL)

    Girdlestones, without any deterioration in function or mobility. The X-ray appearance of loosening was common, although clinical symptoms were not associated with the findings. It was therefore found that hip surgery in this setting is of great benefit to Mseleni Joint Disease patients, although further attention needs to be ...

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

    African Journals Online (AJOL)

    Septic arthritis of the hip joint in two children, originally thought to be cases of acute abdomen is presented. In one case, the discovery of extra-peritoneal purulent fluid at surgery, obviated the need for laparotomy and in the other, the true nature of the disease became apparent one week after laparotomy. These cases ...

  11. 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

    . METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test...

  12. Total dislocation of the hip joint after arthroscopy and ileopsoas tenotomy.

    Science.gov (United States)

    Sansone, Mikael; Ahldén, Mattias; Jónasson, Páll; Swärd, Leif; Eriksson, Thomas; Karlsson, Jon

    2013-02-01

    The hip is a highly stable joint. Non-traumatic dislocation of the hip is extremely uncommon. In this article, we report two cases of non-traumatic hip dislocations following hip arthroscopy. In both cases, capsulotomy and ileopsoas tenotomy had been performed. These cases raise questions about the importance of the natural stabilisers of the hip. Level of evidence V.

  13. Static balance according to hip joint angle of unsupported leg during one-leg standing

    OpenAIRE

    Cha, Ju-Hyung; Kim, Jang-Joon; Ye, Jae-Gwan; Lee, Seul-Ji; Hong, Jeong-Mi; Choi, Hyun-Kyu; Choi, Ho-Suk; Shin, Won-Seob

    2017-01-01

    [Purpose] This study aimed to determine static balance according to hip joint angle of the unsupported leg during one-leg standing. [Subjects and Methods] Subjects included 45 healthy adult males and females in their 20s. During one-leg standing on the non-dominant leg, the position of the unsupported leg was classified according to hip joint angles of point angle was class. Static balance was then measured using a force plate with eyes open and closed. The total length, sway velocity, maximu...

  14. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Within- and between-examiner repeatability of distraction indices of the hip joints in dogs.

    Science.gov (United States)

    Smith, G K; LaFond, E; Gregor, T P; Lawler, D F; Nie, R C

    1997-10-01

    To evaluate in vivo repeatability of the distraction index method of evaluating hip joint laxity in dogs. 31 two-year-old Labrador Retrievers. Each dog was anesthetized and radiographically evaluated for hip joint laxity 4 times: twice by an experienced examiner and twice by an examiner who had no previous knowledge of or training in the technique prior to the first day of testing. Distraction indices (DI) were determined from the radiographs and intraclass correlation coefficients were calculated to evaluate the repeatability of DI measurements between and within examiners. Intraclass correlation coefficients were high (range, 0.85 to 0.94). Lower limits of the 95% confidence intervals for the intraclass correlation coefficients ranged from 0.75 to 0.89. Between- and within-examiner repeatabilities of DI measurements were high, suggesting that the technique is clinically reliable. Distraction index is a reliable measure of hip joint laxity and a good predictor of the risk of development of degenerative joint disease associated with hip dysplasia in dogs. Establishment of high repeatability of DI measurements suggests that the stress-radiographic method may be used by multiple examiners with the expectation of comparable and consistent results.

  17. Verification of an improved hip joint center prediction method.

    Science.gov (United States)

    Miller, Emily J; Kaufman, Kenton R

    2018-01-01

    In motion analysis, the hip joint center (HJC) is used to define the proximal location of the thigh segment and is also the point about which hip moments are calculated. The HJC cannot be palpated; its location must be calculated. Functional methods have been proposed but are difficult to perform by some clinical populations. Therefore, regression methods are utilized, but yield large errors in estimating the HJC location. These prediction methods typically utilize the anterior and posterior superior iliac spines, where excessive adipose tissue makes correctly locating difficult. A new regression method (Hara) utilizes leg length and has been shown to improve HJC location in cadavers and less error than previous pelvic based regression methods, such as those proposed by Harrington et al. This study compared the accuracy of the HJC location calculated with both of the Harrington methods and the Hara method. The coronal knee angle was calculated for each method using a static motion analysis trial, and compared to the tibiofemoral angle measured on a gold standard digital full-leg coronal radiograph. This study demonstrated that the Hara method was more accurate than either of the Harrington methods. The mean error between the gold standard x-ray measurement and the motion analysis calculation for the Harrington (stepwise and LOOCV), the Harrington (linear regression), and Hara regression methods, respectively were 6.0°, 4.0°, and 1.8°. Accurately modeling the HJC is critical for data interpretation and patient care. This study confirmed that the Hara HJC regression method is valid in an in-vivo setting. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. 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.

  19. 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.

  20. In vivo hip joint contact distribution and bony impingement in normal and dysplastic human hips.

    Science.gov (United States)

    Akiyama, Keisuke; Sakai, Takashi; Koyanagi, Junichiro; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2013-10-01

    Our objectives were to clarify the 3D articular contact areas of the in vivo normal hip joint and acetabular dysplasia during specific positions using magnetic resonance imaging (MRI), voxel-based registration, and proximity mapping. Forty-two normal and 24 dysplastic hips were examined. MRI was performed at four positions: neutral; 45° flexion; 15° extension; and the Patrick position. Femur and pelvis bone models were reconstructed at the neutral position and superimposed over the images of each different position using voxel-based registration. The inferred cartilage contact and bony impingement were investigated using proximity mapping. The femoral head translated in the anterior or posteroinferior, anterosuperior, and posteroinferior direction from neutral to 45° flexion, 15° extension, and the Patrick position, respectively. Multiple regression analyses showed age, femoral head sphericity, and acetabular sphericity to be associated with higher hip instability. The present technique using subject-specific models revealed the in vivo hip joint contact area in a population of healthy individuals and dysplastic patients without radioactive exposure. These results can be used for analyzing disease progression in the dysplastic hip and pathogenesis of acetabular labral tear. Copyright © 2013 Orthopaedic Research Society.

  1. Regression models to predict hip joint centers in pathological hip population.

    Science.gov (United States)

    Mantovani, Giulia; Ng, K C Geoffrey; Lamontagne, Mario

    2016-02-01

    The purpose was to investigate the validity of Harrington's and Davis's hip joint center (HJC) regression equations on a population affected by a hip deformity, (i.e., femoroacetabular impingement). Sixty-seven participants (21 healthy controls, 46 with a cam-type deformity) underwent pelvic CT imaging. Relevant bony landmarks and geometric HJCs were digitized from the images, and skin thickness was measured for the anterior and posterior superior iliac spines. Non-parametric statistical and Bland-Altman tests analyzed differences between the predicted HJC (from regression equations) and the actual HJC (from CT images). The error from Davis's model (25.0 ± 6.7 mm) was larger than Harrington's (12.3 ± 5.9 mm, pmodels. Measured skin thickness was 9.7 ± 7.0mm and 19.6 ± 10.9 mm for the anterior and posterior bony landmarks, respectively, and correlated with body mass index. Skin thickness estimates can be considered to reduce the systematic error introduced by surface markers. New adult-specific regression equations were developed from the CT dataset, with the hypothesis that they could provide better estimates when tuned to a larger adult-specific dataset. The linear models were validated on external datasets and using leave-one-out cross-validation techniques; Prediction errors were comparable to those of Harrington's model, despite the adult-specific population and the larger sample size, thus, prediction accuracy obtained from these parameters could not be improved. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Seidenbusch, Michael C; Schneider, Karl

    2014-09-01

    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 (Säteilyturvakeskus 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.

  3. 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

    medius (GM) muscle would lead to increased external knee adduction moment during level walking in healthy subjects. Reduced GM muscle function was induced experimentally, by means of intramuscular injections of hypertonic saline that produced an intense short-term muscle pain and reduced muscle function......Hip and knee functions are intimately connected and reduced hip abductor function might play a role in development of knee osteoarthritis (OA) by increasing the external knee adduction moment during walking. The purpose of this study was to test the hypothesis that reduced function of the gluteus......-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...

  4. Micro-Raman spectroscopy for the crystallinity characterization of UHMWPE hip cups run on joint simulators

    Science.gov (United States)

    Bertoluzza, A.; Fagnano, C.; Rossi, M.; Tinti, A.; Cacciari, G. L.

    2000-03-01

    In this work Raman microspectrometry was used to evaluate the crystallinity changes of hip cups made of ultra-high molecular weight polyethylene (UHMWPE). In vitro experiments were carried out using hip joint movement-wear simulators, run for five million cycles in water or bovine calf serum. The hip cups were subjected to mechanical friction with ceramic femoral heads (alumina-zirconia blend). The crystallinity of the polymer hip cups was studied as a function of inner surface position and thickness, from the stressed surface to the unstressed outer one. The Partial Least Square (PLS-l) calibration was used to correlate the Raman spectra with the crystallinity of the polymer measured with DSC calorimetry.

  5. Clinical evaluation of hip joint rotation range of motion in adults.

    Science.gov (United States)

    Kouyoumdjian, P; Coulomb, R; Sanchez, T; Asencio, G

    2012-02-01

    Data on hip joint rotation range of motion (ROM) are rare; the methods of measurement vary and reproducibility has not been evaluated, in particular in relation to the subject's position (prone or supine, seated). Hip joint rotation ROM is symmetrical, and ROM is not modified by the patient's position when data is obtained. This series included 120 adults between 20 and 60 years old (71 women, 49 men), who had no hip, spine or lower extremity disorders. External (ER) and internal (IR) rotation ROM was obtained using a photographic method by two observers. Measurements were obtained with the patient in three positions: the dorsal decubitus (supine) (P1), and ventral decubitus (prone) (P2) with the hip in extension and seated with the hip in flexion (P3). Hip rotation ROM was P1: 68.1° (ER=38.5°; IR=29.6°); P2: 77.1°(ER=41.8°; IR=35.2°); P3: 78.5° (ER=78.5°; IR=37.9°) with no significant difference among the three positions. Interobserver reproducibility was satisfactory (concordance correlation coefficient (ccc) 0.7) and was comparable in the three positions with a ccc of 0.7072 (P1), 0.7426 (P2) and 0.7332 (P3), respectively. Hip rotation ROM balance was ER predominant in 47.5%, neutral in 39.5% and IR predominant in 13%. Hip rotation ROM balance was symmetric in both hips in 73 subjects (61%). Hip rotation ROM was reduced with age (P<0.0001), and was 4.7° less in men (P=0.0078), and in overweight subjects (P<0.0006). Our values are probably lower than those in the literature because of the difference in study population. In our series, age, BMI and gender seemed to be determining factors. Hip rotation ROM balance is usually ER predominant or neutral. Hip rotation ROM can be measured in the three positions with no significant difference, with satisfactory interobserver reproducibility for each. Diagnostic prospective study: level III. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. IBADAN KNEE/HIP OSTEOARTHRITIS OUTCOME MEASURE ...

    African Journals Online (AJOL)

    and psychometric properties.15 The Ibadan Knee/Hip. Osteoarthritis Outcome Measure was developed as an environment and culture friendly tool for the assessment of therapeutic interventions in Nigerian patients with osteoarthritis of the knee and/or hip. However, many of these published existing instruments do not have ...

  7. Single nucleotide polymorphisms refine QTL intervals for hip joint laxity in dogs.

    Science.gov (United States)

    Zhu, L; Zhang, Z; Feng, F; Schweitzer, P; Phavaphutanon, J; Vernier-Singer, M; Corey, E; Friedenberg, S; Mateescu, R; Williams, A; Lust, G; Acland, G; Todhunter, R

    2008-04-01

    Hip laxity is one characteristic of canine hip dysplasia (CHD), an inheritable disease that leads to hip osteoarthritis. Using a genome-wide screen with 250 microsatellites in a crossbreed pedigree of 159 dysplastic Labrador retrievers and unaffected greyhounds, we previously identified putative (P dogs including 105 Labrador retrievers, seven greyhounds, four generations of their crossbreed offspring and three German shepherds for 111 and 171 SNPs on CFA11 and CFA29 respectively. The distraction index (DI, a measure of maximum hip laxity) was used as an intermediate phenotype that predicts whether a hip joint will or will not develop osteoarthritis. Using a multipoint linkage analysis, significant evidence (95% posterior probability) was found for QTL contributing to hip laxity in the 16.2-21 cM region on CFA11 that explained 15-18% of the total variance in DI. Evidence for an independent QTL on CFA29 was weaker than that on CFA11. Identification of the causative mutation(s) will lead to better understanding of biochemical pathways in both dogs and humans with hip laxity and dysplasia.

  8. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyun Soo; Juhng, Seon Kwan; Kim, Eun A; Kim, Jeong Ho; Song, Ha Heon; Shim, Dae Moo [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2002-12-01

    To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14{sup x}17{sup f}ilm was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.

  9. Biomechanical study of the effect of coxofemoral positioning on passive hip joint laxity in dogs.

    Science.gov (United States)

    Heyman, S J; Smith, G K; Cofone, M A

    1993-02-01

    Ten coxofemoral joints from 5 dog cadavers were used to study the effect of coxofemoral positioning on passive hip laxity. A material test system was used to measure lateral translation when force was between 20 N of compression and 40 N of distraction. Using the orthogonal coordinate system imposed in this study, neutral position was empirically defined at 15 degrees of extension and 10 degrees of abduction, relative to the plane of the pelvis, and no internal or external rotation of the femur. The hips were mounted in a custom-designed jig that allowed 1 rotational degree of freedom (ie, either flexion/extension, adduction/abduction, or internal/external rotation), while holding the other 2 constant. Lateral translation of the hips was tested at 10 degrees intervals from 30 degrees of flexion to 70 degrees of extension, 40 degrees of adduction to 60 degrees of abduction, and 30 degrees of internal rotation to 40 degrees of external rotation. Lateral displacement was maximal at 10 degrees of extension, 20 degrees of abduction, and 10 degrees of external rotation, approximating the neutral coxofemoral position during stance. As the hips were rotated into extreme positions, the amount of lateral displacement occurring with the same applied load decreased significantly to 32.0 to 65.3% of the maximal displacement. Determining the position of the hip associated with maximal passive laxity in vitro is essential to the design of a precise and accurate clinical stress-radiographic method to quantitate joint laxity in dogs. Our results confirm earlier work that passive hip joint laxity is at a maximum with the hip approximately in a neutral weight-bearing position.

  10. The painful bone marrow edema syndrome of the hip joint.

    Science.gov (United States)

    Hofmann, Siegfried

    2005-02-01

    In this issue of the WKW, Aigner et al have published that, for the first time, a conservative approach with iloprost has shown to be equally successful as the well-documented core decompression surgical approach in patients with BMES of the hip joint. The BME pattern on MR-imaging of the hip joint represents a common but unspecific finding, which may be associated with several diseases requiring different therapeutic strategies (Table 1). It is still controversial, whether BMES of the hip represents a distinct self-limiting disease also known as transient osteoporosis, transient marrow edema, or algodystrophy, or merely reflects a subtype of ON. Since prognosis and therapeutic consequences vary significantly, differential diagnosis between BMES, CRPS and ON is of clinical interest (Table 2). Both, BMES and ON show similar ON risk factors and a male prevalence, while classical CRPS has a history of trauma and a prevalence among females. Clinical presentation of BMES and ON is similar with typical mechanical pain and prevalence of the hip joint. In contrast, classical CRPS shows a diffuse and burning pain in combination with trophic and vasomotor signs, mainly in the hands and feet. Imaging patterns of BMES are more diffuse, across the entire femoral head, while focal and subchondral in ON. In both, the patterns are limited to the femoral head. In contrast to classical CRPS, the imaging changes are located in all periarticular bones, and the soft tissues are always affected. The histological bone marrow changes are similar in all three diseases, but with abundant new bone formation in BMES and CRPS, whereas in ON only limited new bone formation surrounds the focal necrosis with a sclerotic rim. Protected weight-bearing and treatment with iloprost for BMES, but operative treatment for ON, and a sophisticated physiotherapy for CRPS in combination with iloprost are the preferred treatment strategies in our institution.

  11. Hydroxyapatite crystal deposition causing rapidly destructive arthropathy of the hip joint

    Directory of Open Access Journals (Sweden)

    Jae-Hyuk Yang

    2011-01-01

    Full Text Available Destructive arthropathy of the hip joint can be attributed to various etiologies like rheumatoid arthritis, aseptic necrosis of the femur head, Charcot′s joint, subacute septic arthritis, and tubercular arthritis. A disease that results in much rapid destruction of the hip joint and is not associated with clinical syndrome of above mentioned disease has been reported way back in 1970. However, no evidence-based study has been published to support hydroxyapatite (HA crystals as a probable cause of rapidly destructive arthropathy of the hip joint. We report a case with microscopic and biochemical confirmation of HA crystal deposition causing destructive arthropathy of the hip joint.

  12. In vivo hip joint loading during post-operative physiotherapeutic exercises.

    Directory of Open Access Journals (Sweden)

    Verena Schwachmeyer

    Full Text Available INTRODUCTION: After hip surgery, it is the orthopedist's decision to allow full weight bearing to prevent complications or to prescribe partial weight bearing for bone ingrowth or fracture consolidation. While most loading conditions in the hip joint during activities of daily living are known, it remains unclear how demanding physiotherapeutic exercises are. Recommendations for clinical rehabilitation have been established, but these guidelines vary and have not been scientifically confirmed. The aim of this study was to provide a basis for practical recommendations by determining the hip joint contact forces and moments that act during physiotherapeutic activities. METHODS: Joint contact loads were telemetrically measured in 6 patients using instrumented hip endoprostheses. The resultant hip contact force, the torque around the implant stem, and the bending moment in the neck were determined for 13 common physiotherapeutic exercises, classified as weight bearing, isometric, long lever arm, or dynamic exercises, and compared to the loads during walking. RESULTS: With peak values up to 441%BW, weight bearing exercises caused the highest forces among all exercises; in some patients they exceeded those during walking. During voluntary isometric contractions, the peak loads ranged widely and potentially reached high levels, depending on the intensity of the contraction. Long lever arms and dynamic exercises caused loads that were distributed around 50% of those during walking. CONCLUSION: Weight bearing exercises should be avoided or handled cautiously within the early post-operative period. The hip joint loads during isometric exercises depend strongly on the contraction intensity. Nonetheless, most physiotherapeutic exercises seem to be non-hazardous when considering the load magnitudes, even though the loads were much higher than expected. When deciding between partial and full weight bearing, physicians should consider the loads relative to

  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. An in vitro simulation method for the tribological assessment of complete natural hip joints.

    Science.gov (United States)

    Groves, Dawn; Fisher, John; Williams, Sophie

    2017-01-01

    The use of hip joint simulators to evaluate the tribological performance of total hip replacements is widely reported in the literature, however, in vitro simulation studies investigating the tribology of the natural hip joint are limited with heterogeneous methodologies reported. An in vitro simulation system for the complete natural hip joint, enabling the acetabulum and femoral head to be positioned with different orientations whilst maintaining the correct joint centre of rotation, was successfully developed for this study. The efficacy of the simulation system was assessed by testing complete, matched natural porcine hip joints and porcine hip hemiarthroplasty joints in a pendulum friction simulator. The results showed evidence of biphasic lubrication, with a non-linear increase in friction being observed in both groups. Lower overall mean friction factor values in the complete natural joint group that increased at a lower rate over time, suggest that the exudation of fluid and transition to solid phase lubrication occurred more slowly in the complete natural hip joint compared to the hip hemiarthroplasty joint. It is envisaged that this methodology will be used to investigate morphological risk factors for developing hip osteoarthritis, as well as the effectiveness of early interventional treatments for degenerative hip disease.

  15. An in vitro simulation method for the tribological assessment of complete natural hip joints.

    Directory of Open Access Journals (Sweden)

    Dawn Groves

    Full Text Available The use of hip joint simulators to evaluate the tribological performance of total hip replacements is widely reported in the literature, however, in vitro simulation studies investigating the tribology of the natural hip joint are limited with heterogeneous methodologies reported. An in vitro simulation system for the complete natural hip joint, enabling the acetabulum and femoral head to be positioned with different orientations whilst maintaining the correct joint centre of rotation, was successfully developed for this study. The efficacy of the simulation system was assessed by testing complete, matched natural porcine hip joints and porcine hip hemiarthroplasty joints in a pendulum friction simulator. The results showed evidence of biphasic lubrication, with a non-linear increase in friction being observed in both groups. Lower overall mean friction factor values in the complete natural joint group that increased at a lower rate over time, suggest that the exudation of fluid and transition to solid phase lubrication occurred more slowly in the complete natural hip joint compared to the hip hemiarthroplasty joint. It is envisaged that this methodology will be used to investigate morphological risk factors for developing hip osteoarthritis, as well as the effectiveness of early interventional treatments for degenerative hip disease.

  16. Comparison of global and joint-to-joint methods for estimating the hip joint load and the muscle forces during walking.

    Science.gov (United States)

    Fraysse, F; Dumas, R; Cheze, L; Wang, X

    2009-10-16

    A three-dimensional musculoskeletal model of the lower limb was developed to study the influence of biarticular muscles on the muscle force distribution and joint loads during walking. A complete walking cycle was recorded for 9 healthy subjects using the standard optoelectronic motion tracking system. Ground contact forces were also measured using a 6-axes force plate. Inverse dynamics was used to compute net joint reactions (forces and torques) in the lower limb. A static optimization method was then used to estimate muscle forces. Two different approaches were used: in the first one named global method, the biarticular muscles exerted a torque on the two joints they spanned at the same time, and in the second one called joint-by-joint method, these biarticular muscles were divided into two mono-articular muscles with geometrical (insertion, origin, via points) and physiological properties remained unchanged. The hip joint load during the gait cycle was then calculated taking into account the effect of muscle contractions. The two approaches resulted in different muscle force repartition: the biarticular muscles were favoured over any set of single-joint muscles with the same physiological function when using the global method. While the two approaches yielded only little difference in the resultant hip load, the examination of muscle power showed that biarticular muscles could produce positive work at one joint and negative work at the other, transferring energy between body segments and thus decreasing the metabolic cost of movement.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    of primary surgery, and most notably in the first 3 months. The risk of revision due to infection increased in all 4 countries. Risk factors for revision due to infection were male sex, hybrid fixation, cement without antibiotics, and THA performed due to inflammatory disease, hip fracture, or femoral head......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...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA....

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

    Science.gov (United States)

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

    2015-11-01

    Saul-Wilson syndrome (SWS) is a rare congenital skeletal syndrome characterized by postnatal onset of short stature, relative microcephaly, frontal bossing, prominent eyes with shallow orbits, midface hypoplasia, cataract, and generalized skeletal changes, including spondylar dysplasia, overtubulation of the long bones with metaphyseal flaring and megaepiphyses, coxa valga, elbow deformity, and brachydactyly. We describe a boy with the overall clinical and radiological features fitting the characteristics of SWS, although cataract, elbow deformity, and overt brachydactyly were not seen. He presented with painful hip joint due to hip subluxation in late childhood, which exacerbated with age and ultimately, required surgical intervention. Awareness of this orthopedic complication in SWS is essential in the management of patients with SWS. © 2015 Wiley Periodicals, Inc.

  19. FACTS: Fully Automatic CT Segmentation of a Hip Joint.

    Science.gov (United States)

    Chu, Chengwen; Chen, Cheng; Liu, Li; Zheng, Guoyan

    2015-05-01

    Extraction of surface models of a hip joint from CT data is a pre-requisite step for computer assisted diagnosis and planning (CADP) of periacetabular osteotomy (PAO). Most of existing CADP systems are based on manual segmentation, which is time-consuming and hard to achieve reproducible results. In this paper, we present a Fully Automatic CT Segmentation (FACTS) approach to simultaneously extract both pelvic and femoral models. Our approach works by combining fast random forest (RF) regression based landmark detection, multi-atlas based segmentation, with articulated statistical shape model (aSSM) based fitting. The two fundamental contributions of our approach are: (1) an improved fast Gaussian transform (IFGT) is used within the RF regression framework for a fast and accurate landmark detection, which then allows for a fully automatic initialization of the multi-atlas based segmentation; and (2) aSSM based fitting is used to preserve hip joint structure and to avoid penetration between the pelvic and femoral models. Taking manual segmentation as the ground truth, we evaluated the present approach on 30 hip CT images (60 hips) with a 6-fold cross validation. When the present approach was compared to manual segmentation, a mean segmentation accuracy of 0.40, 0.36, and 0.36 mm was found for the pelvis, the left proximal femur, and the right proximal femur, respectively. When the models derived from both segmentations were used to compute the PAO diagnosis parameters, a difference of 2.0 ± 1.5°, 2.1 ± 1.6°, and 3.5 ± 2.3% were found for anteversion, inclination, and acetabular coverage, respectively. The achieved accuracy is regarded as clinically accurate enough for our target applications.

  20. Hip joint torques in type II diabetes with and without neuropathy

    Directory of Open Access Journals (Sweden)

    Laleh Abadi, MS (PT

    2017-12-01

    Full Text Available Background: Patients with diabetes and peripheral neuropathy demonstrate significantly reduced peak torques at the peripheral joints. Objectives: The aim of this study was to assess isometric and concentric peak torques of the hip joint in people with type II diabetes with and without peripheral neuropathy in comparison with healthy participants. Methods: 27 patients with type II diabetes including 15 patients without peripheral neuropathy, 12 patients with diabetes and peripheral neuropathy and 15 healthy people participated. Isometric and concentric peak torques of hip flexion, extension, adduction and abduction of the non-dominant leg were measured by motorized dynamometer. Results: Peak and average peak concentric torques of the hip extension and abduction in patients with diabetes and peripheral neuropathy were lower than those patients with diabetes and control group. Angle of extension peak torque was significantly greater in patients with diabetes and peripheral neuropathy compared with other groups. Angle of flexion peak torque was lower in the patients with diabetes and peripheral neuropathy. Conclusions: Torque related parameters in patients with type II diabetes with or without peripheral neuropathy, are different from healthy subjects. As a result, patients with diabetes especially with peripheral neuropathy are more susceptible of injury and disability in lower limbs. Keywords: type II diabetes, hip, joint, torques, peripheral neuropathy

  1. 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...

  2. Osteochondromatosis of the hip Joint. Report of a Cast.

    Directory of Open Access Journals (Sweden)

    Kh. MOAZZEZ

    1975-06-01

    Full Text Available Osteochondromatosis of the hip is a rare disease inwhich segments of synovial membrane become cartilaginous. These may calcify or ossify formin- g osteocartilag-inous masses as loose bodies. It occurs most often in young or middle-aged adults and the etiology or the condition is unknown. The diagnosis can be apparent with due consideration on clinical history and proper X-ray examination or the joint. One case or such disease with typical X-ray findings is reported.

  3. Asymmetrical lumbosacral transitional vertebrae in dogs may promote asymmetrical hip joint development.

    Science.gov (United States)

    Flückiger, Mark A; Steffen, Frank; Hässig, Michael; Morgan, Joseph P

    2017-03-20

    This study examines the relationship between the morphology of the lumbosacral transitional vertebra (LTV) and asymmetrical development of the hip joints in dogs. A total of 4000 dogs which had been consecutively scored for canine hip dysplasia were checked for the presence of a LTV. A LTV was noted in 138 dogs and classified depending on the morphology of the transverse processes and the degree of contact with the ilium. In dogs with an asymmetrical LTV, the hip joint was significantly more predisposed to subluxation and malformation on the side of the intermediate or sacral-like transverse process (p hip joint conformation was less affected on the side featuring a free transverse process (p hip joint, and secondary osteoarthritis. Asymmetrical hip conformation may therefore be the sequela of a LTV and mask or aggravate genetically induced canine hip dysplasia.

  4. Hips, elbows and stifles: common joint diseases in the cat.

    Science.gov (United States)

    Grierson, James

    2012-01-01

    Cats commonly present with joint disease and trauma. A methodical approach to diagnostics and treatment can aid the clinician in the management of these cases. Cats with joint disease may present with a vague history owing to their independent nature, and gait assessment is often challenging when compared with the dog. Knowledge of feline-specific anatomy is important to avoid over- or misinterpretation of physical examination or imaging findings. This review of feline joint disease focuses on the more common, non-traumatic conditions of the hip, stifle and elbow. It aims to provide first opinion clinicians with a guide to decision making that will assist them in achieving a diagnosis and formulating a management strategy. There is an extensive body of original articles and textbooks in the published literature relating to aspects of feline joint disease. This article combines information from key companion animal and feline-specific references together with the author's clinical experience to provide a practical overview of joint disease, and highlight important differences between cats and dogs in terms of presentation and treatment.

  5. 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

  6. Rapidly destructive arthropathy of the hip joint in patients with rheumatoid arthritis.

    Science.gov (United States)

    Yun, Ho Hyun; Song, Seung Yeop; Park, Sung Bum; Lee, Jee Wun

    2012-06-01

    This article describes 3 patients with rheumatoid arthritis in which hip joint conditions were similar to rapidly destructive arthropathy of the hip joint. The patients had the following additional characteristics: (1) age at diagnosis was comparatively older; (2) rheumatoid arthritis had an onset after age 40 years; (3) severe rheumatoid arthritis was present in >4 major joints; (4) long-term steroids and disease-modifying antirheumatic drugs were taken due to the high activity of rheumatoid arthritis; and (5) patients were underweight, with body mass indexes hip joint rarely occurs in osteoarthritis, avascular necrosis of the femoral head, and rheumatoid arthritis. Clinically, rapidly destructive arthropathy of the hip joint occurs in elderly patients who report severe pain but have a relatively preserved range of motion. Typical radiologic changes in rapidly destructive arthropathy of the hip joint are rapid destruction, resorption, or subluxation of the femoral head, destruction of the acetabulum, and minimal spur formation developing 6 to 12 months after symptom onset. Destruction of the hip joint in rheumatoid arthritis occurs in the sequence of depression, flattening, and loss, and commonly progresses gradually. When patients with rheumatoid arthritis report persistent and severe pain in the hip joint with no specific cause, rapidly destructive arthropathy of the hip joint must be identified through repetitive follow-up radiographic observations. Copyright 2012, SLACK Incorporated.

  7. Hip-Knee-Ankle-Foot Orthosis Using a Medial Single Hip Joint : A Clinical Study of a Paraplegic Child

    OpenAIRE

    Watanabe, Susumu

    1998-01-01

    This study describes and discusses a clinical experience with a hip-knee-ankle-foot orthotic (HKAFO) system using a medial single hip joint (MSH-KAFO). The MSH-KAFO (Walkabout(R))was invented by Stewart MacKay in 1992. It has many merits compared with other HKAFO systems because the hip joint is compact and removable. This system was clinically tested with a paraplegic child (female, 14 years old) whose condition was the result of a thoracic spinal cord injury. Her functional level was T-6. A...

  8. Alumina-alumina artificial hip joints. Part II: characterisation of the wear debris from in vitro hip joint simulations.

    Science.gov (United States)

    Tipper, J L; Hatton, A; Nevelos, J E; Ingham, E; Doyle, C; Streicher, R; Nevelos, A B; Fisher, J

    2002-08-01

    Until recently it was not possible to reproduce clinically relevant wear rates and wear patterns in in vitro hip joint simulators for alumina ceramic-on-ceramic hip prostheses. The introduction of microseparation of the prosthesis components into in vitro wear simulations produced clinically relevant wear rates and wear patterns for the first time. The aim of this study was to characterise the wear particles generated from standard simulator testing and microseparation simulator testing of hot isostatically pressed (HIPed) and non-HIPed alumina ceramic-on-ceramic hip prostheses, and compare these particles to those generated in vivo. Standard simulation conditions produced wear rates of approximately 0.1 mm3 per million cycles for both material types. No change in surface roughness was detected and very few wear features were observed. In contrast, when microseparation was introduced into the wear simulation, wear rates of between 1.24 (HIPed) and 1.74 mm3 per million cycles (non-HIPed) were produced. Surface roughness increased and a wear stripe often observed clinically on retrieved femoral heads was also reproduced. Under standard simulation conditions only nanometre-sized wear particles (2-27.5 nm) were observed by TEM, and it was thought likely that these particles resulted from relief polishing of the alumina ceramic. However, when microseparation of the prosthesis components was introduced into the simulation, a bi-modal distribution of particle sizes was observed. The nanometre-sized particles produced by relief polishing were present (1-35nm). however, larger micrometre-sized particles were also observed by both transmission electron microscopy (TEM) (0.021 microm) and scanning electron microscopy (SEM) (0.05-->10 microm). These larger particles were thought to originate from the wear stripe and were produced by trans-granular fracture of the alumina ceramic. In Part I of this study, alumina ceramic wear particles were isolated from the periprosthetic

  9. [Analysis of development of hip joint dysplasia in dogs].

    Science.gov (United States)

    Ledecký, V; Sevcík, A; Capík, I; Trbolová, A

    1997-01-01

    Hip joint dysplasia in dogs occurs mainly in large and heavy breeds. It brings about changes on the acetabulum (socket) and the head of thigh bone, thus causing pain, tiredness, refusal to jump and refusal of increased activity. Even though presently the genetic basis of development of this disease, numerous literary sources indicate existence of pre-disposing factors that facilitate development in later stages of life. Diet and unbalanced development of skeleton and support tissues-ligaments, joint capsule and musculature also have the effect on development of dysplasia. We have analyzed acquired results of X-ray examination of dogs-German shepherds. The size of the group was 4 206 and the examination was aimed at incidence of hip-joint dysplasia during the period of 1977-1995 in the Slovak Republic. We have found out that in 1977 there were 70.7% positive cases out of the total number of examined individuals. Gradual exclusion of dogs with heavier grades of dysplasia (D, E) decreased occurrence of dysplasia to current rate of 40.8%. We considered it to be a high incidence rate. Internal structure of the positive group has changed. The number of dogs with the lightest grade of dysplasia (B) has increased, while the number of heavier grade dysplasia (C, D, E) decreased. In other breeds of dogs, of which more than 20 have been examined at the clinic, the following results have been acquired: Slovak chuvash-32%, Bavarian and Hannover bloodhound-30.6%, Rotweiler-28.6%, Newfoundland dog-26.3%, Bern sheep-dog-13.6%. At the same time we analyze the incidence of dysplasia in dogs whose parents were negative. Group of descendants of 11 negative males and 28 females consisted of 73 dogs. Through x-ray examination, 42.5% of dogs were found to have dysplasia B, C and D at the age of 1 year.

  10. Dorsal root ganglion neurons with dichotomizing axons projecting to the hip joint and the knee skin in rats: possible mechanism of referred knee pain in hip joint disease.

    Science.gov (United States)

    Miura, Yoko; Ohtori, Seiji; Nakajima, Takayuki; Kishida, Shinji; Harada, Yoshitada; Takahashi, Kazuhisa

    2011-11-01

    Patients who have hip joint diseases sometimes complain of knee pain as well as hip joint area pain. However, the precise sensory innervation pattern and correlation of the sensory nerves of the hip joint and knee are unknown. The purpose of this study was to investigate dorsal root ganglion (DRG) neurons with dichotomizing axons projecting to both the hip joint and the knee skin in rats using double fluorescent labeling techniques, and to examine characteristics of the DRG neurons with dichotomizing axons using immunohistochemical staining for inflammatory neuropeptides such as calcitonin gene-related peptide (CGRP). For 20 rats, two kinds of neurotracers, Fluoro-Gold (FG) and 1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanine perchlorate (DiI), were used in the double-labeling study. FG was injected into the left hip joint, and DiI was applied to the left medial portion of knee skin. Ten days after application, bilateral DRGs were harvested and immunohistochemically stained for CGRP. DRG neurons double labeled with FG and DiI were observed only from L2 to L4 on the left side. Approximately 1.6% of all DRG neurons innervating the hip joints had other axons that extended to the medial portion of knee skin, and 35% of double-labeled neurons were CGRP positive. Our results showed that the double-labeled neurons had peripheral axons that dichotomized into both the hip joint and the knee skin. CGRP-positive neurons of these dichotomizing fibers may play some role in the manifestation of referred knee pain with hip joint pain.

  11. Weightlifting performance is related to kinematic and kinetic patterns of the hip and knee joints.

    Science.gov (United States)

    Kipp, Kristof; Redden, Josh; Sabick, Michelle B; Harris, Chad

    2012-07-01

    The purpose of this study was to investigate the correlations between biomechanical outcome measures and weightlifting performance. Joint kinematics and kinetics of the hip, knee, and ankle were calculated while 10 subjects performed a clean at 85% of 1 repetition maximum (1RM). Kinematic and kinetic time-series patterns were extracted with principal components analysis. Discrete scores for each time-series pattern were calculated and used to determine how each pattern was related to body mass-normalized 1RM. Two hip kinematic and 2 knee kinetic patterns were significantly correlated with relative 1RM. The kinematic patterns captured hip and trunk motions during the first pull and hip joint motion during the movement transition between the first and second pulls. The first kinetic pattern captured a peak in the knee extension moment during the second pull. The second kinetic pattern captured a spatiotemporal shift in the timing and amplitude of the peak knee extension moment. The kinematic results suggest that greater lift mass was associated with steady trunk position during the first pull and less hip extension motion during the second-knee bend transition. Further, the kinetic results suggest that greater lift mass was associated with a smaller knee extensor moments during the first pull, but greater knee extension moments during the second pull, and an earlier temporal transition between knee flexion-extension moments at the beginning of the second pull. Collectively, these results highlight the importance of controlled trunk and hip motions during the first pull and rapid employment of the knee extensor muscles during the second pull in relation to weightlifting performance.

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

    Science.gov (United States)

    Tsai, Kate L; Murphy, Keith E

    2006-04-01

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

  13. 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...

  14. Knee joint changes in patients with neglected developmental hip dysplasia: a prospective case-control study.

    Science.gov (United States)

    Li, Qiwei; Kadhim, Muayad; Zhang, Lijun; Cheng, Xiangjun; Zhao, Qun; Li, Lianyong

    2014-12-01

    Few reports are available describing knee changes in neglected developmental dysplasia of the hip (DDH). The purpose of this study was to assess the radiographic morphology of knee joints in adults with neglected DDH. Thirty-seven patients (35 females and two males) with neglected DDH were prospectively recruited with an average age of 32.6 years. Twenty-three patients had unilateral and 14 patients had bilateral neglected DDH. Thirty-seven healthy individuals were recruited to form a matched control group. Three groups of knee joints were examined: affected knees (on the same side of the neglected DDH), unaffected knees (contralateral to the neglected DDH in patients with unilateral involvement), and control knees. A series of radiographic parameters of the knee joint were measured in the coronal and sagittal plane, and they were compared between patients and normal controls. In the coronal plane, the affected knees had increased valgus angulation related to increased height of the medial femoral condyle, decreased height of the lateral femoral condyle and decreased lateral distal femoral angle compared to control knees. In the sagittal plane, both distal femoral and proximal tibial joints of the affected knees developed a decrease in posterior angles. Additionally, the unaffected knees also developed radiographic changes compared to control knees. Patients with neglected DDH may develop changes in both knee joints. These changes should be considered during surgery to the hip, femur and knee to prevent potential complications. Level 2. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Effect of posture on hip joint moment during pregnancy, while performing a standing task.

    Science.gov (United States)

    Paul, J A; Sallé, H; Frings-Dresen, M H W

    1996-03-01

    In this paper the combined effect on reactive hip joint moment due to changes in (1) segment mass, (2) trunk centre of mass, and (3) working posture during pregnancy was estimated, and the relative contributions of these three changes to the change in the moment were assessed. The situation studied concerned standing work at a table. Sixteen women were studied monthly during pregnancy. The working posture was assessed by two-dimensional photographic posture recording and description. Body dimensions were measured to assess segment characteristics. A two-dimensional static model was used to estimate the reactive hip joint moment at 10, 20, 30 and 40 weeks of pregnancy. Between 10 and 40 weeks of pregnancy the moment increase was 52 Nm, i.e. the load at 40 weeks of pregnancy is 2.8 times the load at 10 weeks of pregnancy. On average half of this increase was due to postural changes. Changes in segment mass, trunk centre of mass, and the interaction between the three changes accounted for rougly 10, 20 and 15% of the load increase respectively. The increase in reactive hip joint moment may be minimized by preventing adverse postural changes, and optimizing the posture to reduce the contribution of changes in body weight (distribution).

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

    NARCIS (Netherlands)

    Tjin-Kam-Jet-Siemons, Liseth; ten Klooster, Peter M.; van de Laar, Mart A F J; van den Ende, 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

  17. A case report of severely damaged hip joint caused by SAPHO syndrome treated with 2-stage total hip arthroplasty.

    Science.gov (United States)

    Yeo, Ingwon; Cha, Hoon-Suk; Yoon, Young Cheol; Park, Youn-Soo; Lim, Seung-Jae

    2016-07-01

    Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an increasingly recognized entity. The hip joint is known as a less frequently affected site in SAPHO syndrome, and there has been limited reports about hip joint diseases caused by SAPHO syndrome, and as such adequate treatment for this disease spectrum is still not fully elucidated. We describe the case of a 52-year-old man admitted for SAPHO syndrome who went on to be diagnosed with advanced secondary hip arthritis associated with disabling right hip pain. The diagnosis of SAPHO syndrome was delayed; the patient was given a clinical diagnosis of osteomyelitis and treated with prolonged courses of antibiotics and open surgical debridement at previous tertiary health facility. The patient underwent 2-stage joint replacement surgery in our hospital. At 1 year after the surgery, he is well, with minimal right hip pain and the prosthesis is functioning well. This case shows the safety and effectiveness of the 2-stage joint replacement in treating destructive hip disease caused by SAPHO syndrome mimicking infectious arthritis.

  18. [Clinical evaluation of the hip joint after implantation of cementless Mittelmeier type and Parhofer-Mönch type hip prosthesis].

    Science.gov (United States)

    Grzegorzewski, A; Synder, M; Witoński, D

    2000-01-01

    Total hip replacement is the most common procedure in the treatment of severe degenerative changes in the hip joint. The authors present clinical evaluation of 129 patients (151 hips) who underwent total hip replacement using either the Mittelmeier type or the Parhofer-Mönch type hip prothesis. The age of the patients ranged at the time of the operation between 17 and 74 years (average 44.9). The follow-up ranged from 24 to 143 months (average 61.2 months). The P-M prothesis was implanted in 53 hips, the P-M "Plasmapore" prothesis in 42 patients, Mittelmeier Autophor 900 prothesis in 49 patients and the Mittelmeier Autophor 900S prothesis in 7 patients. Clinical evaluation was performed according to the d'Aubigne-Postel method with the Charnley modification. The results were graded as very good in 17 cases, good in 64 cases, satisfactory in 53 cases and poor in 17 cases. Very good and good results were mainly observed after implantation of the P-M type prothesis and P-M "Plasmapore" type prothesis. Worse results were observed in patients, who at the time of the operation were aged 45 years or less and who had congenital hip dysplasia. P-M type prothesis gives better clinical results in the treatment of degenerative changes of the hip joint.

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

    Science.gov (United States)

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

    2017-12-01

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

  20. 21 CFR 888.3358 - Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  1. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular...

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

    Science.gov (United States)

    2010-04-01

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

  3. Modern Radiological Imaging of Osteoarthritis of The Hip Joint With Consideration of Predisposing Conditions.

    Science.gov (United States)

    Weber, M-A; Merle, C; Rehnitz, C; Gotterbarm, T

    2016-07-01

    Osteoarthritis is the most common disease of the hip joint in adults and has a high socioeconomic impact. This review article discusses the value of three imaging modalities in the diagnosis of osteoarthritis of the hip joint: projection radiography, computed tomography, and magnetic resonance imaging (MRI). Besides established imaging diagnostics of osteoarthritis, this review also outlines new MRI techniques that enable the biochemical analysis of hip joint cartilage and discusses predisposing deformities of the hip joint including femoroacetabular impingement (FAI) with labral pathologies, hip joint dysplasia, malrotation, and, finally, femoral head necrosis, for which early detection and an exact description of the extent and localization of the necrotic area are extremely important. Conventional X-rays remain indispensable for the diagnosis of osteoarthritis, while MRI is able to depict additional early symptoms and signs of activity of the disease. With the increasing number of joint-preserving interventions such as surgical hip luxation and hip joint arthroscopy for treating FAI, high-resolution imaging is gaining further importance for both pre- and postoperative diagnostics because it can accurately recognize early stages of joint damage. With high-resolution MR sequences and MR arthrography, the detailed depiction of the thin cartilaginous coating of the hip joint has become quite possible. • Projection radiography is the method of choice for the diagnostic work-up of osteoarthritis of the hip joint.• Using computed tomography, the amount of acetabular bone stock prior to total hip arthroplasty is assessed in selected patients.• Magnetic resonance imaging can substantiate the indication of surgery in case of discrepancy between clinical symptoms and radiological findings of the hip joint.• If distinct and left untreated, predisposing conditions (such as femoroacetabular impingement) may lead to early development of osteoarthritis of the

  4. Periacetabular osteotomy for painful non-paralytic dysplastic hip joints in adults affected by poliomyelitis.

    Science.gov (United States)

    Lin, Tzu-Ping; Ko, Jih-Yang; Chen, Sung-Hsiung; Wu, Re-Wen; Wong, To; Chou, Wen-Yi

    2007-01-01

    Few researchers have discussed hip joint dysplasia in adults affected by poliomyelitis. We retrospectively studied the outcomes of hip joint function in poliomyelitic adults who underwent periacetabular osteotomy for the contralateral painful non-paralytic dysplastic hip joints. Eight female patients with the mean age of 35.9 years underwent periacetabular osteotomy from January 1991 through July 2002. The procedure was performed on eight non-paralytic hip joints via a modified Ollier transtrochanteric approach. Harris hip joint scores and radiographs were used to evaluate the hip joint functions. At a mean of 9.0 +/- 3.8 years postoperatively, the modified Harris hip joint scores had improved from 45.6 +/- 12.9 points preoperatively to 75.8 +/- 20.9 points. Radiographically, the degree of osteoarthrosis remained unchanged in seven hip joints and got worse in one. The anterior center-edge (CE) angle increased from 14.0 +/- 17.5 to 30.9 +/- 10.4 degrees. The lateral CE angle increased from -16.0 +/- 11.7 to 18.0 +/- 23.3 degrees. The acetabular index angle improved from 26.0 +/- 6.9 to 11.3 +/- 4.4 degrees. The acetabular head index increased from 36.1 +/- 11.7 to 63.1 +/- 20.7%. With an outcome system combining modified Harris hip joint scores and radiographic severity of osteoarthrosis, six patients had satisfactory results. Coxa valga usually occurred bilaterally with the neck-shaft angle of 159.1 +/- 15.7 degrees for the operated non-paralytic hip joints versus 161.4 +/- 6.7 degrees for the non-operated paralytic hip joints. Complications included osteonecrosis of the rotated acetabular fragment, acetabulofemoral impingement, a defect on the rotated ilium, and non-union of the superior pubic ramus (one hip joint each). Acetabular dysplasia can be severe in the non-paralytic leg because of coxa valga, leg length discrepancy, and pelvic tilt. Periacetabular osteotomy through a modified Ollier transtrochanteric approach provides extensive correction and relief of

  5. Biomechanical and clinical alterations of the hip joint following femoral neck fracture and implantation of bipolar hip endoprosthesis.

    Science.gov (United States)

    Smrke, Dragica; Biscević, Mirza; Smrke, Barbara U R; Zupan, Blaz

    2010-09-01

    The implantation of a bipolar partial hip endoprosthesis is a treatment of choice for displaced medial femoral neck fracture. We present an experimental study which asses and compare biomechanical and clinical status through period before and after hip fracture and implantation of bipolar partial hip endoprosthesis. This study encompassed 75 patients who suffered from an acute medial femoral neck fracture and were treated with the implantation of a bipolar partial hip endoprosthesis. Their biomechanical status (stress distribution on the hip joint weight bearing area) and clinical status (Harris Hip Score) were estimated for the time prior to the injury and assessed at the follow-up examination that was, on average, carried out 40 months after the operation. Despite ageing, the observed Harris Hip Score at the follow-up examination was higher than that estimated prior to the injury (77.9 > 69.6; p = 0.006). Similarly, the hip stress distribution was reduced (2.7 MPa endoprosthesis for patients with displaced medial femoral neck fractures improves the biomechanical and clinical features of the hip, what should have on mind during making decision about treatment.

  6. 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......: 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....

  7. Computer-based estimation of the hip joint reaction force and hip flexion angle in three different sitting configurations.

    Science.gov (United States)

    Van Houcke, J; Schouten, A; Steenackers, G; Vandermeulen, D; Pattyn, C; Audenaert, E A

    2017-09-01

    Sitting is part of our daily work and leisure activities and can be performed in different configurations. To date, the impact of different sitting configurations on hip joint loading has not been studied. We therefore evaluated the hip joint reaction force (HJRF) and hip flexion angle in a virtual representative male Caucasian population by means of musculoskeletal modelling of three distinct sitting configurations: a simple chair, a car seat and a kneeling chair configuration. The observed median HJRF in relation to body weight and hip flexion angle, respectively, was 22.3% body weight (%BW) and 63° for the simple chair, 22.5%BW and 79° for the car seat and 8.7%BW and 50° for the kneeling chair. Even though the absolute values of HJRF are low compared to the forces generated during dynamic activities, a relative reduction of over 50% in HJRF was observed in the kneeling chair configuration. Second, the hip flexion angles were both in the kneeling chair (-29°) and simple chair configuration (-16°) lower compared to the car seat and, as such, did not reach the threshold value for femoroacetabular conflict. In conclusion, the kneeling chair appears to hold the greatest potential as an ergonomic sitting configuration for the hip joint. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Evaluation of the relationship between Orthopedic Foundation for Animals' hip joint scores and PennHIP distraction index values in dogs.

    Science.gov (United States)

    Powers, Michelle Y; Karbe, Georga T; Gregor, Thomas P; McKelvie, Pamela; Culp, William T N; Fordyce, Hilary H; Smith, Gail K

    2010-09-01

    To compare 2 screening methods for detecting evidence of hip dysplasia (Orthopedic Foundation for Animals [OFA] and PennHIP) in dogs. Diagnostic test evaluation study. Animals-439 dogs >or= 24 months of age that received routine hip joint screening from June 1987 through July 2008. Dogs were sedated, and PennHIP radiography was performed (hip joint- extended [HE], compression, and distraction radiographic views). The HE radiographic view was submitted for OFA evaluation. A copy of the HE radiographic view plus the compression and distraction radiographic views were submitted for routine PennHIP evaluation, including quantification of hip joint laxity via the distraction index (DI). 14% (60/439) of dogs had hip joints scored as excellent by OFA standards; however, 52% (31/60) of those had a DI >or= 0.30 (range, 0.14 to 0.61). Eighty-two percent of (183/223) dogs with OFA-rated good hip joints had a DI >or= 0.30 (range, 0.10 to 0.77), and 94% (79/84) of dogs with OFA-rated fair hip joints had a DI >or= 0.30 (range, 0.14 to 0.77). Of all dogs with fair to excellent hip joints by OFA standards, 80% (293/367) had a DI >or= 0.30. All dogs with OFA-rated borderline hip joints or mild, moderate, or severe hip dysplasia had a DI >or= 0.30 (range, 0.30 to 0.83). Dogs judged as phenotypically normal by the OFA harbored clinically important passive hip joint laxity as determined via distraction radiography. Results suggested that OFA scoring of HE radiographs underestimated susceptibility to osteoarthritis in dogs, which may impede progress in reducing or eliminating hip dysplasia through breeding.

  9. DIAGNOSTIC APPLICATION OF MULTIROW COMPUTED TOMOGRAPHY OF THE HIP JOINT OF JAPANESE QUAILS (COTURNIX JAPONICA

    Directory of Open Access Journals (Sweden)

    S Paśko

    Full Text Available ABSTRACT The morphological assessment of selected parts of the hindlimb of Japanese quails (Temminck & Schlegel, 1849, with particular emphasis on hip joint structures, was performed, using a 128-row scanner (GE Optima Aquilion, Toshiba, Japan. Eight dead 3-month-old Japanese quails were evaluated. During intravital examination of those birds, no hindlimb abnormalities or locomotion disorders were detected. Bird body, which hip joints and other structures of hindlimbs were studied, was examined in posterioranterior position. The following hip joint structures, on both sides, were assessed in this study: hip joint gap width, acetabulum width, femoral head diameter, and femoral shaft width. The applied imaging method allowed accurate assessment of the selected structures. There was low variability between left and right hindlimbs and among individuals. Modern imaging techniques, such as multirow computed tomography (MCT allows quick intravital assessment of normal and pathological structures of poultry bones and joints.

  10. Hip joint geometry effects on cartilage contact stresses during a gait cycle.

    Science.gov (United States)

    Hui-Hui Wu; Dong Wang; An-Bang Ma; Dong-Yun Gu

    2016-08-01

    The cartilage surface geometry of natural human hip joint is commonly regarded as sphere. It has been widely applied in computational simulation and hip joint prosthesis design. Some new geometry models have been developed and the sphere assumption has been questioned recently. The objective of this study was to analyze joint geometry effects on cartilage contact stress distribution and investigate contact patterns during a whole gait cycle. Hip surface was reconstructed from CT data of a healthy volunteer. Three finite element (FE) models of hip joint were developed from different cartilage geometries: natural geometry, sphere and rotational ellipsoid. Loads at ten instants of gait cycle were applied to these models based on published in-vivo data. FE predictions of peak contact pressure during gait of natural hip were compared with sphere and rotational ellipsoid replaced hip joint. Contact occurs mainly in upper anterior region of both acetabulum and femur distributing along sagittal plane of human body. It moves towards inferolateral aspect as the resultant joint reaction force changes during walking for natural hip. Peak pressures at the instant with maximum contact force were 7.48 MPa, 14.97 MPa and 13.12 MPa for models with natural hip surface, sphere replaced and rotational ellipsoid replaced surface respectively. During the whole gait cycle, contact pressure of natural hip ranked lowest in most of the instants, followed by rotational ellipsoid replaced and sphere replaced hip. The results indicate that rotational ellipsoid is more consistent with natural hip cartilage geometry than sphere during normal walking. This means rotational ellipsoid prosthesis could give a better description of physiological structure compared with standard sphere prosthesis. Therefore, rotational ellipsoid would be a better choice for prosthesis design.

  11. 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.

  12. Acetabular cartilage defects cause altered hip and knee joint coordination variability during gait.

    Science.gov (United States)

    Samaan, Michael A; Teng, Hsiang-Ling; Kumar, Deepak; Lee, Sonia; Link, Thomas M; Majumdar, Sharmila; Souza, Richard B

    2015-12-01

    Patients with acetabular cartilage defects reported increased pain and disability compared to those without acetabular cartilage defects. The specific effects of acetabular cartilage defects on lower extremity coordination patterns are unclear. The purpose of this study was to determine hip and knee joint coordination variability during gait in those with and without acetabular cartilage defects. A combined approach, consisting of a semi-quantitative MRI-based quantification method and vector coding, was used to assess hip and knee joint coordination variability during gait in those with and without acetabular cartilage lesions. The coordination variability of the hip flexion-extension/knee rotation, hip abduction-adduction/knee rotation, and hip rotation/knee rotation joint couplings were reduced in the acetabular lesion group compared to the control group during loading response of the gait cycle. The lesion group demonstrated increased variability in the hip flexion-extension/knee rotation and hip abduction-adduction/knee rotation joint couplings, compared to the control group, during the terminal stance/pre-swing phase of gait. Reduced variability during loading response in the lesion group may suggest reduced movement strategies and a possible compensation mechanism for lower extremity instability during this phase of the gait cycle. During terminal stance/pre-swing, a larger variability in the lesion group may suggest increased movement strategies and represent a compensation or pain avoidance mechanism caused by the load applied to the hip joint. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Surgery of a Rare Case of Multiple Synovial Osteochondromatosis of the Hip Joint.

    Science.gov (United States)

    Zhang, Yi Min; Liu, Xiaoguang

    2016-01-01

    Primary synovial osteochondromatosis of the hip is a benign disorder, which is not frequently seen clinically. The characteristic of this disease is proliferation of synovium and formation of loose bodies inside the joint. It is known that only the loose bodies derived from synovium were called synovial osteochondromatosis. Although it can take place in any joint, the knee is most commonly affected, involvement of the hip joint is relatively rare. We report a young man who has multiple synovial osteochondromatosis in his left hip. A 21-year-old young man, who had progressive pain and functional impairment of his left hip, came to our hospital. He complained that 2 years ago, he began to feel painful of his left hip joint when walking and squatting. Physical examination found that the motion range of the hip was obviously limited, with internal rotation, abduction in particular. The Harris hip score was just 38 points. X-ray shew multiple osteochondromatosis with mild degenerative osteoarthritis existing inside the hip joint. Magnetic resonance imaging shew that the synovial osteochondromatosis intersperse inside the hip joint. During the operation, posterolateral incision of the hip was chosen with dislocation of the femoral head for total exposure of the hip joint to debride extensive loose bodies and proliferative synovial tissue. Pulse irrigation was applied to flush out the residuals. More than 872 of osteochondromatosis were removed out of the hip joint (some small ones were sucked during the operation). The size of the loose bodies ranged from 3 cm × 3 cm × 2.5 cm to 0.2 cm × 0.2 cm × 0.15 cm. Post-operation radiography shew most pathological tissues were taken out. After the operation, the patient rehabilitated fast. The pain relieved and he could bear weight and walked 3 days postoperatively. 1 and 3 months postoperatively, the patient came to us for visit, and he said that he just had a relatively satisfactory function of his affected hip. He could

  14. Periprosthetic hip joint infection with Aspergillus terreus: A clinical case and a review of the literature

    Directory of Open Access Journals (Sweden)

    Rachel Bartash

    2017-12-01

    Full Text Available Fungal periprosthetic joint infections due to Aspergillus species are rare but are associated with significant cost and morbidity. We present a case of Asperigillus terreus prosthetic joint infection of the hip. The patient was successfully treated with a prolonged course of systemic antifungals along with surgical management. Keywords: Fungal prosthetic joint infection, Aspergillus terreus

  15. 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 (QualsisTM) 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. Copyright © 2016 IPEM. All rights reserved.

  16. 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.

  17. Purulent Necrotic Dislocation of the Hip Joint Associated with Umbilical Infection in a Foal

    Science.gov (United States)

    MAGATA, Fumie; ISHII, Mitsuo; OIKAWA, Eri; FURUOKA, Hidefumi; YAMADA, Kazutaka; SASAKI, Naoki; SHIMIZU, Syo; INOKUMA, Hisashi

    2010-01-01

    A 42-day-old heavy draft horse fell into sudden astasia. Significant swelling and heat sensation of the left femoral region were observed. Because of a friction sound in the left hip, we supposed that the hip joint was dislocated or the hip bone was fractured. Computed Tomography (CT) examination showed that the left hip joint was dislocated and the left femoral head was disjunct. We carried out a pathological autopsy, and made a diagnosis of the foal as fracture of the hip bone and femoral head with suppurative umbilical arteritis. Pathologic changes in the umbilical artery and hind leg were completely unilateral, suggesting that left umbilical arteritis spread to the blood circulation, causing arthritis and dislocation of the hip bone. PMID:24833975

  18. 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

  19. [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

  20. Sonographic evaluation of hip joint effusion in osteoarthritis with correlation to radiographic findings.

    Science.gov (United States)

    Birn, Jeff; Pruente, Ryan; Avram, Raluca; Eyler, William; Mahan, Meredith; van Holsbeeck, Marnix

    2014-05-01

    Hip joint effusion is expected in rapidly destructive osteoarthritis, a diagnosis often only made retrospectively at the end stage of the disease. This study assesses whether the presence of an effusion identified during routine ultrasound-guided hip injection may suggest a more aggressive process such as rapidly destructive osteoarthritis. After the observation of 10 index cases of rapidly destructive osteoarthritis in patients who presented with a joint effusion on ultrasound, we retrospectively reviewed 94 hips from 89 patients who underwent ultrasound-guided hip injection for pain. Preinjection longitudinal ultrasound images of the anterior capsule adjacent to the femoral neck and inferior to the femoral head were reviewed to determine if a joint effusion was present and the size of the effusion if one was there. Comparison of effusion size was then made between those hips that had a clinical and radiographic diagnosis of osteoarthritis and those who had rapidly destructive osteoarthritis by comparing the severity of joint effusion, if one was present. Patients with rapidly destructive osteoarthritis were more likely to have a large joint effusion 60% (3/5) than were those with osteoarthritis 6.7% (6/89) (p = 0.013). Large joint effusions identified sonographically correlate well with radiographic findings of rapidly destructive osteoarthritis. Given rapid onset and severity of the disease, when a large joint effusion is identified on routine hip intervention, patients should be forewarned of the potential for this disease process. Copyright © 2013 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2004-01-30

    In dogs hip joint laxity that can lead to degenerative joint disease (DJD) is frequent and heritable, providing a genetic model for some aspects of the human disease. We have used Portuguese water dogs (PWDs) to identify Quantitative trait loci (QTLs) that regulate laxity in the hip joint. A population of 286 PWDs, each characterized by ca. 500 molecular genetic markers, was analyzed for subluxation of the hip joint as measured by the Norberg angle, a quantitative radiographic measure of laxity. A significant directed asymmetry was observed, such that greater laxity was observed in the left than the right hip. This asymmetry was not heritable. However, the average Norberg angle was highly heritable as were the Norberg angles of either the right or left hips. After correction for pedigree effects, two QTLs were identified using the metrics of the left and right hips as separate data sets. Both are on canine chromosome 1 (CFA1), separated by about 95 Mb. One QTL, associated with the SSR marker FH2524 was significant for the left, but not the right hip. The other, associated with FH2598, was significant for the right but not the left hip. For both QTLs, some extreme phenotypes were best explained by specific interactions between haplotypes. Copyright 2003 Wiley-Liss, Inc.

  2. Traumatic dislocation of the hip joint - pattern and management in a ...

    African Journals Online (AJOL)

    Traumatic dislocation of the hip is an orthopaedic emergency for which early reduction is indicated. This article describe our experience of the pattern and choice of management of traumatic dislocation of the hip joint in a tropical African population. Majority of the dislocation (87%) were Thompson and Epstein's grades I ...

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

    DEFF Research Database (Denmark)

    Gundtoft, P H; Pedersen, Alma Becic; Schønheyder, H C

    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...

  4. 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

  5. The influence of Hip Joint Stiffness on Crutch Supported Paraplegic Standing - A modeling Study

    NARCIS (Netherlands)

    van der Spek, J.H.; Veltink, Petrus H.; Hermens, Hermanus J.

    1999-01-01

    In this study, the use of hip joint stiffness to control crutch supported paraplegic stance was investigated. A model was made and simulations were performed. Currently experiments are performed to validate the modelling results

  6. Choice of a Perioperative Analgesia Mode during Hip Joint Replacement

    Directory of Open Access Journals (Sweden)

    D. B. Borisov

    2010-01-01

    Full Text Available Objective: to evaluate the efficiency and safety of various perioperative analgesia modes during total hip joint replacement (THR. Subjects and methods. A randomized controlled trial enrolled 90 patients who were divided into 3 groups according to the choice of a perioperative analgesia mode on day 1: general sevofluorane anesthesia, by switching to intravenous patient-controlled analgesia with fentanyl (PCA, GA group, a combination of general and spinal bupiva-caine anesthesia, by switching to PCA with fentanyl (SA group, a combination of general and epidural ropivacaine anesthesia with continuous postoperative epidural ropivacaine infusion (EA group. All the patients received non-opi-oid analgesics after surgery. Results. Prolonged epidural block ensures better postoperative analgesia at rest and during mobilization and a less need for opioids than other analgesia modes (p<0.05. With neuroaxial block, the preoperative need for sympatomimetics is much higher than that in the GA group (p<0.05. There is also a trend toward a higher incidence of cardiac arrhythmias and postoperative nausea and vomiting in the SA and EA groups. There are no differences in the frequency of hemotransfusion and postoperative complications and the length of hospital stay. Conclusion. Prolonged epidural block provides excellent perioperative analgesia during THR, but the risk-benefit ratio needs to be carefully assessed when an analgesia mode is chosen.

  7. Influence of weak hip abductor muscles on joint contact forces during normal walking: probabilistic modeling analysis.

    Science.gov (United States)

    Valente, Giordano; Taddei, Fulvia; Jonkers, Ilse

    2013-09-03

    The weakness of hip abductor muscles is related to lower-limb joint osteoarthritis, and joint overloading may increase the risk for disease progression. The relationship between muscle strength, structural joint deterioration and joint loading makes the latter an important parameter in the study of onset and follow-up of the disease. Since the relationship between hip abductor weakness and joint loading still remains an open question, the purpose of this study was to adopt a probabilistic modeling approach to give insights into how the weakness of hip abductor muscles, in the extent to which normal gait could be unaltered, affects ipsilateral joint contact forces. A generic musculoskeletal model was scaled to each healthy subject included in the study, and the maximum force-generating capacity of each hip abductor muscle in the model was perturbed to evaluate how all physiologically possible configurations of hip abductor weakness affected the joint contact forces during walking. In general, the muscular system was able to compensate for abductor weakness. The reduced force-generating capacity of the abductor muscles affected joint contact forces to a mild extent, with 50th percentile mean differences up to 0.5 BW (maximum 1.7 BW). There were greater increases in the peak knee joint loads than in loads at the hip or ankle. Gluteus medius, particularly the anterior compartment, was the abductor muscle with the most influence on hip and knee loads. Further studies should assess if these increases in joint loading may affect initiation and progression of osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-03-01

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

  9. Preoperative Joint Space Width Predicts Patient-Reported Outcomes After Total Hip Arthroplasty in Young Patients.

    Science.gov (United States)

    Stambough, Jeffrey B; Xiong, Ao; Baca, Geneva R; Wu, Ningying; Callaghan, John J; Clohisy, John C

    2016-02-01

    In a new health care economy, there is an emerging need to understand and quantify predictors of total hip arthroplasty (THA) outcomes. We investigated the association between preoperative radiographic disease (as measured quantitatively by joint space width [JSW]) and patient-reported function, activity, pain, and quality of life after THA. We retrospectively analyzed 146 patients (146 hips) 55 years or younger with a diagnosis of osteoarthritis who underwent cementless THA between January 2009 and December 2010. Preoperative pelvic radiographs were measured by 1 author blinded to clinical outcomes to establish JSW, defined as the shortest distance between the femoral head margin and the superolateral weight-bearing portion of the acetabulum. The JSW value was treated as a continuous variable when applied to statistical modeling. The relationship between the JSW and the improvement of clinical outcome was examined via a general linear modeling approach with adjustments for patients' age, body mass index, and sex. We identified an inverse relationship between preoperative JSW and improvements in functional, activity, pain, and quality of life. We found that, as JSW decreased by 1 mm, the outcome measure improvements were modified Harris Hip Score of 6.3 (pjoint space have less predictable improvement in terms of function, pain relief, and activity. These findings suggest that THA in young patients with a JSW less than 1.5 to 2 mm provides more predictable improvements in pain and functional outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. 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

    that represent the progression from early to late disease for individuals with OA of the hip and knee, and to create a composite measure of these 3 domains to define states of OA severity and a surrogate measure of "need for joint replacement surgery." METHODS: For pain, focus groups and one-on-one interviews....... For structure, a comparison of existing indices (Kellgren-Lawrence, OARSI stages, and joint space width) was performed for the hip and the knee. RESULTS: For pain, key features of pain that are most distressing to people with OA from early to late disease were identified. For function, the reduction......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...

  11. Development and verification of a protocol to quantify hip joint kinematics: an evaluation of ice hockey goaltender pads on hip motion.

    Science.gov (United States)

    Frayne, Ryan J; Kelleher, Leila K; Wegscheider, Peter K; Dickey, James P

    2015-09-01

    The butterfly save technique is commonly used by ice hockey goaltenders and has recently been identified as a potential mechanism for hip joint injuries due to the extreme body positions involved. Unfortunately, commonly used kinematic marker sets that determine these body positions are heavily influenced by skin motion artifact and are obscured by protective equipment, making it difficult to obtain reliable measures of hip motion. To create a new kinematic protocol that could be used when protective equipment prevents typical marker placements and to use this protocol to quantify hip kinematics and butterfly performance in 4 different goalie pad conditions. Controlled laboratory study. A new marker set consisting of marker clusters attached to the lateral thigh and posterior leg was developed. This marker set was verified by evaluating the root mean square (RMS) difference between the developed testing marker set and the calibrated anatomic systems technique marker set during passive range of motion (ROM) tests. The testing marker set was then used in a repeated-measures study in which 12 junior goaltenders performed 5 butterfly movements on synthetic ice, in 4 different goalie pad conditions (control, flexible-wide leg channel, flexible-tight leg channel, and stiff-wide leg channel). The grouped RMS differences and SDs calculated during verification were 1.43° ± 0.41°, 1.0° ± 0.39°, and 3.32° ± 1.32° for hip flexion-extension, abduction-adduction, and internal-external rotation, respectively. There was no significant main effect of goal pad condition on the peak amount of hip internal rotation; however, there was a significant main effect of goal pad condition on the butterfly width (P = .022). Post hoc comparisons revealed that the butterfly width was significantly smaller in the control pad condition compared with the flexible-tight pad condition (P = .03). The new marker set enabled measurements of hip joint kinematics while subjects are wearing

  12. Development of a model to induce transient synovitis and lameness in the hip joint of dogs.

    Science.gov (United States)

    Hassan, Elham A; Lambrechts, Nicolaas E; Moore, George E; Weng, Hsin-Yi; Heng, Hock Gan; Breur, Gert J

    2015-10-01

    To develop a model of hip joint synovitis on the basis of intra-articular injection of a sodium urate suspension in dogs and to characterize associated gait changes. 6 healthy adult dogs. Each dog was sedated, and synovitis was induced by injection of 1 mL of a sodium urate suspension (20 mg/mL) into the right hip joint under ultrasonographic guidance. Observational and instrumented gait analyses to determine temporospatial, kinetic, and kinematic variables were performed prior to and 4, 8, and 24 hours after sedation and synovitis induction. Injection of a sodium urate suspension into the hip joint of healthy dogs resulted in lameness of the ipsilateral pelvic limb as determined by observational and instrumented gait analyses. For all dogs, lameness was clinically detectable within 1.5 to 2 hours after injection, reached its maximum intensity at 4 hours after injection, and had subsided by 24 hours after injection. Results indicated that injection of a sodium urate suspension into the hip joint of healthy dogs reliably induced synovitis and signs of pain and lameness in the ipsilateral pelvic limb that lasted 24 hours. This model can be used in conjunction with instrumented gait analysis to provide information on gait changes associated with hip joint disease and might be useful for evaluating the efficacy of analgesics or other interventions for the treatment of hip joint disease in dogs.

  13. Concurrent validity and reliability of two-dimensional video analysis of hip and knee joint motion during mechanical lifting.

    Science.gov (United States)

    Norris, Beth S; Olson, Sharon L

    2011-10-01

    Movement patterns used during mechanical lifting are usually assessed subjectively by clinicians as a stoop or squat based on visual estimation of joint motion and position. Two-dimensional (2D) video analysis has the potential to objectively measure joint motion during a mechanical lifting task. This study investigated concurrent validity, intrarater, interrater, and test-retest reliability of 2D video analysis using Dartfish software for the measurement of sagittal plane angles at the hip and knee during mechanical lifting. Fifteen healthy female participants (mean age 27.1 ± 7.1 years) were recruited to perform mechanical lifting on 2 separate test days. Concurrent validity was determined by comparing 2D derived hip and knee flexion angles to goniometric measures. Intrarater and interrater reliability of the 2D kinematic procedures was determined by using examiners with varying experience in the use of Dartfish software. Between-day test-retest reliability of hip and knee 2D kinematics during mechanical lifting was assessed. Concurrent validity of 2D angle analysis using Dartfish software was supported by high correlations (Pearson r ≥ 0.95) and nonsignificant differences between 2D and goniometric measures of sagittal plane hip and knee motion. Both intrarater and interrater reliability values of hip and knee flexion angles were excellent (ICC ≥ 0.91). ICCs for test-retest reliability were 0.79 and 0.91 for hip and knee flexion, respectively. These findings and the ease of data capture using this system provide support for the clinical utility of 2D video analysis to provide objective measures of movement patterns at the hip and knee during a dynamic functional task.

  14. Validation of functional calibration and strap-down joint drift correction for computing 3D joint angles of knee, hip, and trunk in alpine skiing.

    Science.gov (United States)

    Fasel, Benedikt; Spörri, Jörg; Schütz, Pascal; Lorenzetti, Silvio; Aminian, Kamiar

    2017-01-01

    To obtain valid 3D joint angles with inertial sensors careful sensor-to-segment calibration (i.e. functional or anatomical calibration) is required and measured angular velocity at each sensor needs to be integrated to obtain segment and joint orientation (i.e. joint angles). Existing functional and anatomical calibration procedures were optimized for gait analysis and calibration movements were impractical to perform in outdoor settings. Thus, the aims of this study were 1) to propose and validate a set of calibration movements that were optimized for alpine skiing and could be performed outdoors and 2) to validate the 3D joint angles of the knee, hip, and trunk during alpine skiing. The proposed functional calibration movements consisted of squats, trunk rotations, hip ad/abductions, and upright standing. The joint drift correction previously proposed for alpine ski racing was improved by adding a second step to reduce separately azimuth drift. The system was validated indoors on a skiing carpet at the maximum belt speed of 21 km/h and for measurement durations of 120 seconds. Calibration repeatability was on average ski-boots. Joint angle precision was alpine skiing and could be used outdoors. Errors were similar to the values reported in other studies for gait. The system may be well suited for within-athlete analysis but care should be taken for between-athlete analysis because of a possible athlete-specific joint angle bias.

  15. 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.)

  16. Effects of acetabular rim trimming on hip joint contact pressures: how much is too much?

    Science.gov (United States)

    Bhatia, Sanjeev; Lee, Simon; Shewman, Elizabeth; Mather, Richard C; Salata, Michael J; Bush-Joseph, Charles A; Nho, Shane J

    2015-09-01

    In patients with femoroacetabular impingement (FAI), acetabular rim trimming removes the offending area of the acetabular deformity in patients with pincer-type and mixed-type FAI to improve hip joint kinematics. Although the rationale for arthroscopic acetabular rim trimming in patients with FAI is well established, the amount of rim resection has not been quantified, and the threshold at which excessive rim resection results in abnormal hip contact pressures has not been described. To investigate the changes in contact areas, contact pressures, and peak forces within the hip joint with sequential acetabular rim trimming. Controlled laboratory study. Six fresh-frozen, nondysplastic, human cadaveric hemipelvises were analyzed utilizing thin-film piezoresistive load sensors to measure the contact area, contact pressure, and peak force after anterosuperior acetabular rim trimming at depths of 0 mm (intact), 2 mm, 4 mm, 6 mm, and 8 mm. Each specimen was examined at 20° of extension and 60° of flexion. Analysis was performed on 2 regions of interest: the acetabular rim and the acetabular base (deep part of the acetabulum). After each experimental condition, the acetabulum was normalized with respect to the intact state to account for specimen variability. Statistical analysis was conducted through 1-way analysis of variance with post hoc Games-Howell tests. At the acetabular base, there were significant increases in the contact area after 4-mm resection (60°: 169.12% ± 30.64%; P = .0138), contact pressure after 6-mm resection (60°: 292.76% ± 79.07%; P = .009), and peak force after 6-mm resection (60°: 166.00% ± 34.40%; P = .027). At the acetabular rim, there were significant decreases in the contact area after 6-mm resection (60°: 66.32% ± 18.80%; P = .0354) (20°: 65.47% ± 15.87%; P = .0127), contact pressure after 6-mm resection (60°: 50.77% ± 11.49%; P < .001) (20°: 58.01% ± 23.10%; P = .0335), and peak force after 6-mm resection (60°: 60.67% ± 9

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

    Science.gov (United States)

    Leunig, M; Ganz, R

    2014-01-01

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

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

    NARCIS (Netherlands)

    Horstmann, W.G.

    2011-01-01

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

  19. Do joint registries report true rates of hip dislocation?

    Science.gov (United States)

    Devane, Peter A; Wraighte, Philip J; Ong, David C G; Horne, J Geoffrey

    2012-11-01

    Despite advances in primary THA, dislocation remains a common complication. In New Zealand (NZ), dislocations are reported to the National Joint Registry (NJR) only when prosthetic components are revised in the treatment of a dislocation. Closed reductions of dislocated hips are not recorded by the NJR. We compared the true dislocation rate for patients receiving primary THA in the Wellington region with the rate reported by the NZ NJR for the same group of patients. The NZ NJR identified 570 patients undergoing primary THA from January 1, 2008, to December 31, 2009, with addresses in the Wellington region. The mean age was 67.5 years (range, 27-96 years). The minimum followup was 2 years (mean, 3 years; range, 2-4 years). Six patients required revision of at least one component for dislocation. There was 100% agreement between the hospital database and the NJR. Using the NJR criteria of revision of any component as an end point, the dislocation rate in the Wellington region after primary THA was 1.05%. The hospital database identified a further eight patients who presented with a dislocation of their primary THA and underwent a closed reduction. These patients were not recorded by the NJR. The true rate of all dislocations, which includes closed reductions, was 2.46%. This article documents the discrepancy between the NZ NJR reported rate of revision for dislocation and the true rate of dislocation in primary THA. We recommend documentation of all dislocations by NJR in their database to allow more accurate comparisons between centers and research outcomes. Level IV, clinical research study. See Guidelines for Authors for a complete description of levels of evidence.

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

    Science.gov (United States)

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

    2013-08-09

    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 simply be summed up. A total of 401 patients with hip or knee OA completed questionnaires on demographic variables and joint-pain comorbidities. Rasch analysis was performed to evaluate whether a sum score of joint-pain comorbidities can be calculated. Self-reported joint-pain comorbidities showed a good fit to the Rasch model and were not biased by gender, age, disease duration, BMI, or patient group. As a group, joint-pain comorbidities covered a reasonable range of severity levels, although the sum score had rather low reliability levels suggesting it cannot discriminate well among patients. Joint-pain comorbidities, in other than the primary affected joints, can be summed into a joint pain comorbidity score. Nevertheless, its use is discouraged for individual decision making purposes since its lacks discriminative power in patients with minimal or extreme joint pain.

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  2. Association of hip joint effusion volume with early osteonecrosis of the femoral head.

    Science.gov (United States)

    Liu, Bingli; Yi, Hongli; Zhang, Zhigang; Li, Zirong; Yue, Debo; Sun, Wei

    2012-01-01

    This study aimed to examine the association between hip joint effusion volume and osteonecrosis of the femoral head (ONFH) using the Association Research Circulation Osseous (ARCO) classification. Patients (n = 403) who were diagnosed with ONFH were enrolled between February 2005 and December 2008. Only patients (n = 109) with complete clinical and imaging data and at early to mid ARCO stage (I - III) were eligible for further analysis, including 94 males and 15 females. All the included patients had hip joint radiographic examinations (anteroposterior and frog-leg views) and magnetic resonance imaging scans (axial and coronal views). Out of 109 patients included in this study, 185 hip joints were involved (unilateral disease in 33 patients and bilateral diseases in 76 patients). The patients had a mean age of 39 ± 11 years (range, 13-70). All the affected hip joints exhibited effusion, classified as grade 1 (n = 70, 37.8%), grade 2 (n = 62, 33.5%), and grade 3 (n = 53, 28.7%). The volume of joint effusion varied significantly among stage I, II, and III (X2 = 29.210, P 0.05), whereas it differed significantly among stage IIIA, IIIB, and IIIC (X2 =11.556, P hip joint effusion was associated with the ARCO stage, and increased over the staging.

  3. [Evaluation of treatment outcomes in tuberculosis of knee and hip joints in 2005-2012].

    Science.gov (United States)

    Chocholáč, D; Kala, B; Gallo, J; Netval, M; Chaloupka, R

    2013-01-01

    Tuberculosis (TB) in a joint region presents high risk of damage to the joint. Consequences of a late diagnosis and inadequate therapy may be serious particularly in the large joints of lower extremities. Tuberculosis of knee and hip joints accounts for about 25% to 35% of osteoarticular tuberculosis (OAT). The aim of this study was to evaluate the objective and subjective results of tuberculosis treatment in knee and hip joints. Of 258 OAT patients treated at the Specialised Treatment Centre Jevíčko between January 2005 and September 2012, tuberculosis of the hip joint was diagnosed in 31 patients in whom three hips were treated by incision and drainage and 10 by total hip replacement; 18 patients had tuberculosis of the knee joint with the following treatment: puncture in seven knees, incision and drainage in eight, excochleation of a tuberculous focus in the proximal tibia in two, removal of a bursa in one, arthrodesis in four and total knee replacement in four patients. The patients continued to be followed up at the Jevíčko Centre. The scale of 1 to 5 (best to worst) was established for evaluation of objective and subjective results of the treatment. The data were analysed using the basic statistical characteristics and compared. The objective evaluation was better for the hip joint; the sums of relative frequencies of marks 1 to 3 were 72.22% in the knee and 80.65% in the hip. In the knee more than 50% of the cases fell in the interval , in the hip this was . The hip joint was better subjectively evaluated, it had a higher sum of relative frequencies of marks 1 to 3, i.e., 96.77% as compared with 88.89% for the knee. In the knee more than 50% of the cases had marks in the interval ; in the hip this was . The hip joint was better evaluated both objectively and subjectively. An early diagnosis allows for the treatment of synovitis, which has a better prognosis than an arthritic disease. The subjective perception of treatment results showed a better

  4. [Biodynamics of the hip joint. The elasticity of the human femur and its importance].

    Science.gov (United States)

    Wenzl, H R

    1976-01-22

    Pauwels' biomechanical analysis of hip joint function shows that the dynamic forces acting on the joint can be large. In these techniques, spring mechanisms are being used to neutralize dynamic forces. The question remains as to whether such a mechanism in humans exists in the vicinity of the hip joint, i.e. in the femur. Fresh human femoral bones were put under axial stress and their qualities examined. Different spring qualities were found in the various femora; and by comparing these, 6 groups were established which were then subjected to statistical analysis. More than half the bones examined possessed good spring qualities. A practical example proves that the spring qualities of the femur are apt to absorb a considerable amount of kinetic energy during the axial stress and thus lessen the vertical mechanical strain vector of the hip joint.

  5. 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.

  6. Hip joint structures assessment in juvenile idiopathic (chronic arthritis with ultrasound TOC \\o "1-5" \\h \\z examination

    Directory of Open Access Journals (Sweden)

    G. R. Movsisyan

    2004-01-01

    Full Text Available Sonographic (SG examination of hip joints was performed in 100 pts with juvenile chronic arthritis (JCA with different forms, activity and duration. SG signs of hip joint inflammation in JCA were identified. SG features in pts with different disease duration, form and activity were revealed. SG changes of clinically unchanged hip joints were noted which may be of important significance for early diagnosis of coxitis. More wide use of arthrosonography in pediatric rheumatology was proved.

  7. 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

    2017-04-01

    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. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  8. [Manipulative reduction of shoulder lift for the treatment of posterior dislocation of hip joint].

    Science.gov (United States)

    Sun, Quan; Tang, Xiao-Fu

    2012-07-01

    To observe the effects of shoulder lift reduction for treatment of posterior dislocation of hip joint. 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. 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. 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 trouble hip.

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

    Science.gov (United States)

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

    2014-07-15

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

  10. A computer-aided tracking and motion analysis with ultrasound (CAT & MAUS) system for the description of hip joint kinematics.

    Science.gov (United States)

    Jia, Rui; Mellon, Stephen; Monk, Paul; Murray, David; Noble, J Alison

    2016-11-01

    Investigation of joint kinematics contributes to developing a better understanding of musculoskeletal conditions. However, the most commonly used optoelectronic motion analysis systems cannot determine the movements of underlying bone landmarks with high accuracy because of soft tissue artefacts. The aim of this paper was to present a computer-aided measurement system to track the underlying bone anatomy in a 3D global coordinate frame and describe hip joint kinematics of ten healthy volunteers during gait. We have developed a measurement tool with an image-based computer-aided post-processing pipeline for automatic bone segmentation in ultrasound (US) images and a globally optimal 3D surface-to-surface registration method to quantify hip joint movements. The segmentation algorithm exploits US intensity profiles, including information about the integrated backscattering, acoustic shadows, and local phase features. A global optimization method is applied based on the traditional iterative closest point registration algorithm, which is robust to initialization. The International Society of Biomechanics recommended joint kinematics descriptor has been adapted to calculate the joint kinematics. The developed system prototype has been validated with a ball-joint femoral phantom and tested in vivo with 10 volunteers. The maximum Euclidean distance error of the automatic bone segmentation is less than 2 pixels (approximately 0.2 mm). The maximum absolute rotation angle error is less than [Formula: see text]. This computer-aided tracking and motion analysis with ultrasound (CAT & MAUS) system shows the feasibility of describing hip joint kinematics for clinical investigation and diagnosis using an image-based solution.

  11. A Rare Case of Morel-Lavallee Syndrome Complicating an Anterior Dislocation of Hip Joint.

    Science.gov (United States)

    Nekkanti, Supreeth; Vijay, C; Theja, Sujana; Shankar, R Ravi; Verma, Anubhav

    2016-01-01

    Hip dislocations are serious injuries as hip joint is an extremely stable joint. It requires a significant amount of force to produce such an injury. Anterior dislocations are uncommon. Potential complications of anterior hip dislocations are a neurovascular injury to femoral vessels or acetabular fractures. We report a rare late complication of Morel-Lavallee syndrome occurring 3 weeks after an anterior dislocation of the hip in a 43-year-old male. The patient presented to us with history. Morel-Lavallee syndrome is a rare complication. However if diagnosed early can be successfully treated with minimal burden to the patient. The authors recommend surgeons to have a high index of suspicion for this syndrome and a stringent follow-up examination of the patient.

  12. 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.

  13. 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

  14. A Preliminary Multifactorial Approach Describing the Relationships Among Lower Extremity Alignment, Hip Muscle Activation, and Lower Extremity Joint Excursion

    Science.gov (United States)

    Nguyen, Anh-Dung; Shultz, Sandra J.; Schmitz, Randy J.; Luecht, Richard M.; Perrin, David H.

    2011-01-01

    Context: Multiple factors have been suggested to increase the risk of faulty dynamic alignments that predict noncontact anterior cruciate ligament injury. Few researchers have examined this relationship using an integrated, multifactorial approach. Objective: To describe the relationship among static lower extremity alignment (LEA), hip muscle activation, and hip and knee motion during a single-leg squat. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Thirty men (age = 23.9 ± 3.6 years, height = 178.5 ± 9.9 cm, mass = 82.0 ± 14.1 kg) and 30 women (age = 22.2 ± 2.6 years, height = 162.4 ± 6.3 cm, mass = 60.3 ± 8.1 kg). Main Outcome Measure(s): Pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, and genu recurvatum were measured to the nearest degree; navicular drop was measured to the nearest millimeter. The average root mean square amplitude of the gluteus medius and maximus muscles was assessed during the single-leg squat and normalized to the peak root mean square value during maximal contractions for each muscle. Kinematic data of hip and knee were also assessed during the single-leg squat. Structural equation modeling was used to describe the relationships among static LEA, hip muscle activation, and joint kinematics, while also accounting for an individual's sex and hip strength. Results: Smaller pelvic angle and greater femoral anteversion, tibiofemoral angle, and navicular drop predicted greater hip internal-rotation excursion and knee external-rotation excursion. Decreased gluteus maximus activation predicted greater hip internal-rotation excursion but decreased knee valgus excursion. No LEA characteristic predicted gluteus medius or gluteus maximus muscle activation during the single-leg squat. Conclusions: Static LEA, characterized by a more internally rotated hip and valgus knee alignment and less gluteus maximus activation, was related to commonly observed components of

  15. 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.

  16. 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.

  17. Joint replacement in Zambia: A review of Hip & Knee Replacement ...

    African Journals Online (AJOL)

    Background: Incidence of major joint replacement surgery is on the rise in Africa but this trend has not been matched by proper audits in the form of National Joint Registries. Objective: This paper presents the short-term findings from a joint replacement register started at the Zambian-Italian Orthopaedic Hospital (ZIOH) in ...

  18. 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...... of the Copenhagen Osteoarthritis Study cohort of 3,913 adults (1,470 male/2,443 female) with a mean age of 60 years (range, 18-92) were analyzed using X-Posure digital software, version 2.0 (Sectra-Pronosco). The system is operator independent. From 1,200 individual measurements per radiograph, mean BMD...... 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...

  19. 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 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. Copyright © 2012 Orthopaedic Research Society.

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

    Science.gov (United States)

    Gibson, W; Campbell, A; Allison, G

    2013-09-01

    Motor output in activities such as walking and hopping is suggested to be mediated neurally by purported stretch reflex augmentation of muscle output. Reflex EMG activity during these tasks has been frequently investigated in the soleus muscle; with alterations in reflex amplitude being associated with changes in hip joint angle/phase of the gait cycle. Previous work has focussed on reflex activity induced by an artificial perturbation or by induction of H-reflexes. As such, it is currently unknown if stretch reflex activity induced intrinsically (as part of the task) is modulated by changes in hip joint angle. This study investigated whether hip joint angle modulated reflex EMG 'burst' activity during a hopping task performed on a custom-built partially reclined sleigh. Ten subjects participated; EMG and kinematic data (VICON motor capture system) was collected for each hop cycle. Participants completed 5 sets of 30s of self-paced hopping in (1) hip neutral and (2) hip 60° flexion conditions. There was no difference in EMG 'burst' activity or in sagittal plane kinematics (knee/ankle) in the hopping task between the two conditions. The results indicate that during a functional task such as hopping, changes in hip angle do not alter the stretch reflex-like activity associated with landing. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. 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

  2. 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.

  3. [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.

  4. 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.

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

    Science.gov (United States)

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

    2013-10-01

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

  6. ANTERIOR SUPERIOR DISLOCATION OF THE HIP JOINT: A ...

    African Journals Online (AJOL)

    transchondral or indentation type) and/or neck of the femur. C. Associated fracture of the acetabulum. Of these, most are of the inferior variety, with the classical history of a violent abduction force at the hip having caused the insult. The limb in an ...

  7. Translation of the Ibadan Knee/Hip Osteoarthritis Outcome Measure ...

    African Journals Online (AJOL)

    Dr Olaleye

    ABSTRACT: The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM), a Nigerian culture and environment- friendly clinical tool was developed at the University of Ibadan, Nigeria for measuring end results of care in patients with knee or Hip Osteoarthritis OA. Translated and validated Yoruba and Hausa versions of ...

  8. Translation of the Ibadan Knee/Hip Osteoarthritis Outcome Measure ...

    African Journals Online (AJOL)

    The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM), a Nigerian culture and environmentfriendly clinical tool was developed at the University of Ibadan, Nigeria for measuring end results of care in patients with knee or Hip Osteoarthritis OA. Translated and validated Yoruba and Hausa versions of IKHOAM are ...

  9. Influence of borderline hip dysplasia on joint kinematics of clinically sound Belgian Shepherd dogs.

    Science.gov (United States)

    Bockstahler, Barbara A; Henninger, Wolfgang; Müller, Marion; Mayrhofer, Elisabeth; Peham, Christian; Podbregar, Iztok

    2007-03-01

    To detect changes in joint kinematics of clinically sound dogs with or without radiographically detectable borderline hip dysplasia (HD). 20 Belgian Shepherd Dogs (Malinois; mean +/- SD age, 2.75 +/- 1.32 years) with no clinical signs of HD. Kinematic gait analysis was performed in Malinois walking on a treadmill. On the basis of results of radiographic examination for HD and in accordance with guidelines established by the Fédération Cynologique Internationale, dogs were assigned to group 1 (no radiographic signs of HD; 8 dogs) or group 2 (borderline HD; 12 dogs). Ground reaction forces and weight distribution among limbs and differences between groups were evaluated. Maximal sagittal angle during the stance and swing phases, the time at which they were detected, and angle velocities were calculated for joints of the hind limbs. Ground reaction forces revealed no differences between groups. Dogs in group 1 had significant changes (earlier time for maximal flexion of the hip joint and less flexion and less range of motion of the stifle joint), compared with results for dogs in group 2. Maximal angle velocity of the stifle and tarsal joints was significantly lower during the swing phase in group 1 than in group 2. This study revealed that dogs with borderline HD had altered joint kinematics. Our data provide basic kinematic values for clinically sound and affected dogs and can be used to investigate the long-term effects for subclinical radiographic changes of the hip joints of dogs.

  10. An alternative radiographic measure for cam-type FAI in patients with idiopathic hip pain.

    Science.gov (United States)

    Chen, Guang X; Zhang, Ying; Wang, Wen B; Wang, Kai F; He, Rui; Gu, Ling C; Zhang, En Q; Dai, Gang; Duan, Xiao J; Guo, Lin; Yang, Liu

    2011-01-01

    Femoroacetabular impingement (FAI) has been accepted as a potential cause of idiopathic hip pain and osteoarthritis. Few cases of FAI have been reported in the Chinese population. We reviewed radiographic features of patients with idiopathic hip pain to characterize FAI in the Chinese population, any alternative radiographic measures, and potential symptom association. All anteroposterior pelvic radiographs of outpatients (n = 1,128) between December 2007 and August 2008 were reviewed. The radiographic measurements, including anteroposterior alpha angle (AP-a), radial height/radius ratio (R1), and 1/2 radial height/radius ratio (R2) as well as crossover signs, were recorded on both hip joints of all patients. The differences in AP-a, R1, and R2 were compared between cam-type hips (including mixed FAI) and non-cam-type hips (including non-FAI). From the group of patients, 269 were eligible for further evaluation, including those exhibiting FAI at the site of complaint (n = 38) or without symptoms (n = 7). FAI was significantly associated with hip pain (P = 0.009). For painful hips, the frequency of FAI was higher in males than in females (P = 0.038). AP-a was significantly higher in cam-type hips than in non-cam-type hips for either gender (P 0.05, P > 0.05), whereas R2 differed significantly (P FAI was underestimated in Chinese patients showing negative radiographic findings with idiopathic hip pain. In addition, R2 was used to differentiate cam-type FAI from non-cam-type FAI.

  11. 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.

  12. [Autogenous femoral head bone grafting combined with total hip arthroplasty for the treatment of old dislocation of hip joint center in 16 cases].

    Science.gov (United States)

    Li, Shuai-lei; Sun, Yong-qiang

    2015-10-01

    To study effects of autogenous femoral head bone grafting combined with total hip replacement for the treatment of old center dislocation of hip joint, and to evaluate the superiority of acetabular defect reconstruction with autogenous bone. From March 2008 to December 2013, 16 patients (16 hips) with old center dislocation of hip joint were treated with autologous bone graft combined with total hip replacement. There were 11 males and 5 females, ranging in age from 41 to 72 years old, with an average of 56.3 years old. The duration of the disease ranged from 3.6 to 37.2 years. Twelve patients had injuries caused by traffic accidents and 4 patients were caused by falling down. The hip joint pain at the first month after operation, Harris score and hip joint movement of all patients were observed by using electronic case follow-up system. All the patients were followed up, and the duration ranged from 11 to 78 months, with an average of 27.3 months. The postoperative hip joint movement of (56.2±23.4)° VAS 86.3±7.2 and Harris score 32.6±12.6 were all better than preoperative (181.8±17.6)°, 11.1±2.6 and 86.3±7.2. The joint pain was reduced and the function limitation was improved after operation, and the prosthesis position was good. When the autologous femoral head bone grafting combined with total hip arthroplasty is used to treat old hip central dislocation, the initial and long-term stability of acetabular bone grafting is good, and the technique can avoid allogeneic bone complications, bone source rationally and reduce the economic burden of patients.

  13. Functional improvement after hip arthroscopy in cases of active paediatric hip joint tuberculosis: a retrospective comparative study vis-à-vis conservative management.

    Science.gov (United States)

    Tiwari, Vivek; Khan, Shah Alam; Kumar, Ashok; Poudel, Rishiram; Kumar, Venkatesan Sampath

    2015-12-01

    Tuberculosis of the hip joint is a significant cause of preventable disability, especially in children. The aim of our study was to evaluate the functional results of hip arthroscopy done in a cohort of patients with hip joint tuberculosis and to compare them with the outcome of conservatively managed cases. This was a retrospective cohort study in which we evaluated the records of 22 hip arthroscopies performed in known cases of tuberculosis of the hip joint in children less than 12 years of age. A note of the demographic and clinical parameters like age, duration of symptoms, stage of the disease, time period of follow-up, any complications during surgery, and pre- and post-operative modified Harris hip score (MHHS) was made in all cases. We compared the results with an age-matched cohort of 44 children with hip joint tuberculosis who were treated non-operatively with anti-tuberculosis therapy and traction in the same tertiary care institute. The arthroscopic findings in our series included synovitis, chondral erosions of the femoral head and/or acetabulum, pannus formation over the femoral head and/or acetabulum, and labral tears. The various arthroscopic procedures which were done included joint lavage, synovectomy, labral debridement and cheilectomy. The mean follow-up was 45 months, with the minimum being 36 months. There was a statistically significant change in the mean MHHS after hip arthroscopic procedures (p hip arthroscopy and that after conservative management. Arthroscopy of the hip joint in children in cases of tuberculosis can serve as an emerging therapeutic modality. It is an effective and safe minimally invasive procedure, and helps in improving the functional outcome in early disease.

  14. The S-measurement in the diagnosis of canine hip dysplasia.

    Science.gov (United States)

    Ogden, Daniel M; Scrivani, Peter V; Dykes, Nathan; Lust, George; Friedenberg, Steven G; Todhunter, Rory J

    2012-01-01

    To propose a direct measure of subluxation of the femoral head (S) in the assessment of hip joint laxity and evaluate it for clinical use. Method comparison study. Dogs (n = 51). Dogs were sedated or anesthetized for a dorsolateral subluxation (DLS) examination. Two sets of radiographs were acquired, 1 each by a different technologist. A calibrated measuring bar was included on the image at the height of the hip to assess magnification. The DLS was calculated for each hip and different persons unaware of these details measured the "S"-value. One person measured the S-value 3 times over 3 days. Box plots were used to determine a cut-off for the empiric (8 mm) and corrected (4 mm) S-value. Of 51 dogs, 33 were dysplastic based on a DLS score hip (95% of differences were ≤1.3 mm and 100% ≤ 1.9) but not for the left hip. Using a cut-off value of 5 mm, the empirical S measurement can be used to exclude hip dysplasia in young dogs of various body proportions. © Copyright 2011 by The American College of Veterinary Surgeons.

  15. Obturator externus bursa: prevalence of communication with the hip joint and associated intra-articular findings in 200 consecutive hip MR arthrograms.

    Science.gov (United States)

    Kassarjian, Ara; Llopis, Eva; Schwartz, Richard B; Bencardino, Jenny T

    2009-11-01

    The purpose of the study was to demonstrate the prevalence of communication between the hip joint and the obturator externus bursa on hip MR arthrography. Following institutional review board approval, 200 hip MR arthrograms in 196 subjects were independently reviewed by two musculoskeletal radiologists. Discrepancies were resolved by adjudication. The presence or absence of communication between the hip joint and the obturator externus bursa was recorded. Associated lesions involving the acetabular labrum and articular cartilage were recorded. The obturator externus bursa was shown to communicate with the hip joint in 11 of the 200 (5.5%) hip MR arthrograms. Of these, six were in men and five were in women. The age range was 15-63 years with a mean age of 34 years. All 11 patients had labral tears. Eight of the 11 had cartilage lesions. The obturator externus bursa can be seen to communicate with the hip joint in 5.5% of hip MR arthrograms. Associated labral and cartilage lesions are common.

  16. 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.

  17. Joint-preserving surgical options for management of chondral injuries of the hip.

    Science.gov (United States)

    El Bitar, Youssef F; Lindner, Dror; Jackson, Timothy J; Domb, Benjamin G

    2014-01-01

    Management of injuries to the articular cartilage is complex and challenging; it becomes especially problematic in weight-bearing joints such as the hip. Several causes of articular cartilage damage have been described, including trauma, labral tears, and femoroacetabular impingement, among others. Because articular cartilage has little capacity for healing, nonsurgical management options are limited. Surgical options include total hip arthroplasty, microfracture, articular cartilage repair, autologous chondrocyte implantation, mosaicplasty, and osteochondral allograft transplantation. Advances in hip arthroscopy have broadened the spectrum of tools available for diagnosis and management of chondral damage. However, the literature is still not sufficiently robust to draw firm conclusions regarding best practices for chondral defects. Additional research is needed to expand our knowledge of and develop guidelines for management of chondral injuries of the hip.

  18. Traumatic dislocation of the hip joint--pattern and management in a tropical African population.

    Science.gov (United States)

    Alonge, T O; Ogunlade, S O; Idowu, O E

    2002-01-01

    Traumatic dislocation of the hip is an orthopaedic emergency for which early reduction is indicated. This article describe our experience of the pattern and choice of management of traumatic dislocation of the hip joint in a tropical African population. Majority of the dislocation (87%) were Thompson and Epstein's grades I and II which were easily managed by closed reduction following the administration of titrated intravenous analgesic and intravenous diazepam. This treatment option is cheap and readily administrable to avoid undue delays in the management of this orthopaedic emergency. All the close reduction were carried out in the accident and emergency room except for one patient with bilateral posterior hip dislocation who had his reduction on the ward. Early diagnosis and treatment of traumatic hip dislocation are essential to reduce the morbidities that are commonly associated with delay in reduction.

  19. 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.)

  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 us...

  1. 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

    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...

  2. Automated measurement of diagnostic angles for hip dysplasia

    DEFF Research Database (Denmark)

    de Raedt, Sepp; Mechlenburg, I.; Stilling, M.

    2013-01-01

    A fully automatic method for measuring diagnostic angles of hip dysplasia is presented. The method consists of the automatic segmentation of CT images and detection of anatomical landmarks on the femur and acetabulum. The standard angles used in the diagnosis of hip dysplasia are subsequently...

  3. Ibadan Knee/Hip Osteoarthritis Outcome Measure: Process of ...

    African Journals Online (AJOL)

    The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM) was developed as a Nigerian-environment and culturefriendly instrument for the assessment of the effectiveness of therapeutic interventions in individuals with osteoarthritis of the knee and/or hip. This article outlines the steps involved in developing an ...

  4. Enhancing the CuCrZr/316L HIP-joint by Ni electroplating

    Energy Technology Data Exchange (ETDEWEB)

    Wei, R. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Science Island Branch of Graduate School, University of Science & Technology of China, Hefei, 230031 (China); Zhao, S.X., E-mail: sxzhao@impcas.ac.cn [Institute of Modern Physics, Chinese Academy of Science, Lanzhou, 730000 (China); Dong, H.; Che, H.Y. [Advanced Technology and Materials Co. Ltd., Beijing, 100081 (China); Li, Q.; Wang, W.J.; Wang, J.C.; Wang, X.L.; Sun, Z.X. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Luo, G.-N. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Science Island Branch of Graduate School, University of Science & Technology of China, Hefei, 230031 (China); Hefei Center for Physical Science and Technology, Hefei, 230022 (China); Hefei Science Center of Chinese Academy of Sciences, Hefei, 230027 (China)

    2017-04-15

    Highlights: • The quality of CuCrZr/316L HIP-joint can be enhanced by nickel electroplating on CuCrZr and 316L. • Nickel layer can prevent the occurrence of nickel-poor region in 316L and protect CuCrZr from oxidation. • A Charpy Impact Value as high as 111.5 ± 3.3 J/cm{sup 2} can be obtained by HIP at 980 °C, 140 MPa for 2 h. • At high temperature, CuCrZr is easily oxidized even in the situation of a high vacuum degree of 2 × 10{sup −5} Pa. - Abstract: The quality of CuCrZr/316L joint is crucial for the safety of ITER hypervapotron cooling structure and hot isostatic pressing (HIP) is an important bonding technique for this structure. In this paper, the authors present a finding that the CuCrZr/316L HIP-joint can be enhanced by nickel electroplating on 316L and CuCrZr. A Charpy Impact Value as high as 111.5 ± 3.3 J/cm{sup 2}, which is more than two times the value in a published article, is obtained. The influence of nickel electroplating is twofold: (1) it can prevent the occurrence of nickel-poor region in 316L and the formation of ferrite; (2) it can protect CuCrZr from oxidation during the heating stage of HIP. However, tensile test is not as effective as Charpy Impact Test in characterizing the bonding quality of the CuCrZr/316L HIP-joint. The surface treatment employed in this study is amenable to batch-scale industrial manufacturing at low cost.

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

    Science.gov (United States)

    Salmingo, Remel Alingalan; Skytte, Tina Lercke; Traberg, Marie Sand; Mikkelsen, Lars Pilgaard; Henneberg, Kaj-Åge; Wong, Christian

    2017-01-01

    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 in the unaffected hip were well distributed. Elevated concentrations of stress and contact pressure were found in the Perthes' hip. The highest femoral cartilage von Mises stress 3.9 MPa and contact pressure 5.3 MPa were found in the Perthes' hip, whereas 2.4 MPa and 4.9 MPa in the healthy hip, respectively. 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 for the preoperative planning to obtain stress relief for the highly stressed areas in the malformed hip. This single-patient study demonstrated that the biomechanical alterations in Perthes' disease can be evaluated individually by patient-specific finite element contact modeling using MRI. A multi-patient study is required to test the strength of the proposed method as a pre-surgery planning tool.

  6. The Relationship between Isokinetic Relative Torque of Hip, Knee and Ankle Joints and the Height of Guide Leg Jump in Young Men

    OpenAIRE

    Saeed Nikoukheslat; Shirin Yazdani; Ebrahim Hosseini Houri Pasand

    2016-01-01

    Objective: The aim of this study was to investigate the relationship between isokinetic relative torques of hip, knee and ankle joints and the height of guide leg jump in young men. Methods: 27 college male athletes with mean age of 25±3.5 years, height 178.5±7.8 cm and weight of 75.7±10.7 kg voluntarily participated in this study. Isokinetic torque of hip, knee and ankle joints and the height of vertical jump were measured using BIODEX SYSTEM PRO 4 and digital vertic...

  7. Computer and experimental analyses of the stress state in the cement hip joint endoprosthesis body.

    Science.gov (United States)

    Tabaković, Slobodan; Grujić, Jovan; Zeljković, Milan; Blagojević, Zoran; Radojević, Bojan; Popović, Zoran; Zivković, Aleksandar; Stevanović, Vladan

    2014-11-01

    One of the possible complications after implantation of a cement hip-joint endoprosthesis is frac- ture in the endoprosthesis body. Fractures arise from overload or material fatigue of which an implant is made. The purpose of this research was to define the intensity of maximum stress and the positions of a critical cross-section in the endoprosthesis body. Unilaterally changing forces which act on the hip joint during walking as well as the loads result in flexible deformations of the endoprosthesis body. Biomechanical analysis of the forces acting on the hip joint determine their direction and intensity, whereas on the basis of Gruen's classification of the endoprosthesis body loosening the level of fixation is established. The bodies of cement hip joint endoprosthesis are made of cobalt-chromium-molybdenum (CoCrMo) alloy, suitable for vacuum casting, are submitted to the analysis. Analysis of the critical stress in the endoprosthesis body was performed on the endoprosthesis body by means of the finite element method. The experimental verification of the obtained results was carried out on the physical prototype under laboratory conditions. Computer analysis, by means of the finite element method, determined the stress state by calculation of the maximum Von Mises stress and critical cross-sections for different angles of the resultant force action. The results obtained by the computer and experimental method correlate and are comparable to the results of similar analyses conducted on various endoprosthesis types. The analyses described in the paper make the basis for improving the process designing of hip joint endoprostheses and their customization to each individual patient (custom made).

  8. 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.

  9. Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, and Rottweilers.

    Science.gov (United States)

    Smith, G K; Mayhew, P D; Kapatkin, A S; McKelvie, P J; Shofer, F S; Gregor, T P

    2001-12-15

    To determine whether age, breed, sex, weight, or distraction index (DI) was associated with the risk that dogs of 4 common breeds (German Shepherd Dog, Golden Retriever, Labrador Retriever, Rottweiler) would have radiographic evidence of degenerative joint disease (DJD) associated with hip dysplasia. Cross-sectional prevalence study. 15,742 dogs. Hips of dogs were evaluated radiographically by use of the ventrodorsal hip-extended view, the compression v ew, and the distraction view. The ventrodorsal hip-extended view was examined to determine whether dogs had DJD. For each breed, a multiple logistic regression model incorporating age, sex, weight, and DI was created. For each breed, disease-susceptibility curves were produced, using all dogs, regardless of age, and dogs grouped on the basis of age. Weight and DI were significant risk factors for DJD in all breeds. For German Shepherd Dogs, the risk of having DJD was 4.95 times the risk for dogs of the other 3 breeds combined. In all breeds, the probability of having DJD increased with age. Results indicated that the probability of having hip DJD increased with hip joint laxity as measured by use of DI. This association was breed-specific, indicating that breed-specific information on disease susceptibility should be incorporated when making breeding decisions and when deciding on possible surgical treatment of hip dysplasia.

  10. Measurement of muscle length-related electromyography activity of the hip flexor muscles to determine individual muscle contributions to the hip flexion torque.

    Science.gov (United States)

    Jiroumaru, Takumi; Kurihara, Toshiyuki; Isaka, Tadao

    2014-01-01

    This study aimed to investigate muscle length-related electromyography (EMG) of the iliopsoas (IL) and other hip flexor muscles to determine individual muscle contributions to the hip flexion torque. Ten healthy sedentary young men participated in the EMG experiment. A subgroup of six subjects underwent a magnetic resonance imaging (MRI) measurement to confirm the region of the skin over the IL. Surface EMG signals were sampled from the IL, rectus femoris (RF), sartorius (SA), and tensor fasciae latae (TFL) using an active electrode. The subjects performed maximum voluntary isometric hip flexion with the right hip joint set at -10°, 0°, 30°, and 60°. The root mean square (RMS) value for the TFL at 30° (0.81 ± 0.19, p muscle length changes were significantly correlated in the IL (r =0.39, p muscles.

  11. [Ultrasonographic examination of the hip joint region and bony pelvis in cattle].

    Science.gov (United States)

    Grubelnik, M; Kofler, J; Martinek, B; Stanek, Ch

    2002-01-01

    Transcutaneous and transrectal ultrasonographic examination of the hip joint region and the pelvis was carried out in 7 cadavers, transcutaneous ultrasonography in 17 healthy young and adult cattle, and transrectal sonography was performed in 12 healthy cows in order to study the normal ultrasonographic appearance of these regions. 7.5 MHz linear-, 5.0 MHz and 3.5 MHz convex transducers and a 7.5 MHz rectal probe were used. The bone surfaces of the greater trochanter, the femoral neck and head, the acetabulum and the other pelvic bones were visualised as hyperechoic contours. The coxofemoral joint space was identified in all cadavers and live cattle. The joint pouch could not be visualised, neither in cadavers nor in live cattle. After experimental filling of the coxofemoral joint pouch by injection of 35-45 ml eosin-solution it appeared as a large anechoic zone between the articular surface and the echogenic joint capsule. The inner contours of the pelvic girdle, both iliosacral joint spaces, the abdominal aorta and the external iliac arteries were depicted clearly by transrectal ultrasonography. The practical application of diagnostic ultrasound in these regions is demonstrated in clinical patients suffering from a septic coxarthritis and a sequestration of a part of the tuber coxae following an open fracture. These results serve as reference data for ultrasonographic investigation of disorders of the hip joint and the pelvic region in cattle.

  12. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    African Journals Online (AJOL)

    The objective of this project was to ascertain whether it is reasonable to perform specialist surgery for Mseleni Joint Disease (MJD) in a rural hospital by assessing the medium-term outcome of surgery for MJD performed at Mseleni. The study was designed as a review of patients at Mseleni Hospital in rural KwaZulu Natal, ...

  15. 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.

  16. 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.)

  17. Interfacial properties of HIP joint between beryllium and reduced activation ferritic/martensitic steel

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, T. [Blanket Engineering Group, Japan Atomic Energy Agency, Naka, Ibaraki (Japan); Ogiwara, H. [Japan Atomic Energy Agency, Tokai-mura, Naga-gun, Ibaraki-ken (Japan); Enoeda, M. [Naka Fusion Research Establishment, J.A.E.R.I., Japan Atomic Energy Research Institute, Naka-gun, Ibaraki-ken (Japan); Akiba, M. [Naka Fusion Institute, Japan Atomic Energy Agency, Naka, Ibaraki (Japan)

    2007-07-01

    Full text of publication follows: ITER test blanket module is the most important components to validate energy production and fuel breeding process for future demonstration reactor. Reduced activation ferritic / martensitic steel is recognized as a promising structural material for breeding blanket systems. And Beryllium must be used as plasma facing materials for ITER in vessel components. In this work, interfacial properties of beryllium/reduced activation ferritic/martensitic steel (RAF/Ms) joint were investigated for a first wall of ITER test blanket module (TBM). The starting materials were ITER grade Beryllium, S65C and a Japanese RAF/M, F82H. The joint was produced by solid state hot isostatic pressing (HIP) method. Chromium layer with the thickness of 1 {mu}m and 10 {mu}m were formed by plasma vapor deposition on the beryllium surface as a diffusion barrier. The HIP was carried out at 1023 K and 1233 K which are determined by standard normalizing and tempering temperature of F82H. The joint made at 1233 K was followed by tempering at 1033 K. The bonding interface was characterized by electron probe microanalysis (EPMA). The bonding strength was also investigated by isometric four point bending tests at ambient temperature. EPMA showed chromium layer effectively worked as a diffusion barrier at 1023 K. However, the beryllium rich layer was formed in F82H after HIP at 1233 K followed by tempering. Bending tests revealed that thin chromium layer and low temperature HIP is preferable. The high temperature HIP introduce brittle BeFe inter metallic compounds along bonding interface. On the other hand, joint with thick chromium layer suffer from brittleness of chromium itself. (authors)

  18. 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.

  19. 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. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Impact of low-frequency pulsed electromagnetic fields and interference currents in the formation of heterotopic ossification after total hip instalation in the hip joint

    Directory of Open Access Journals (Sweden)

    Ivković S.

    2015-01-01

    Full Text Available Due to the extension of life expectancy, the number of elderly people increases, and thus the number of disease and injuries of the locomotor system, especially the hip joint. One of the persistent trend is an increasing trend in the number of patients with coxarthrosis and implanted total hip endoprosthesis. One of the postoperative complications that occurred after implantation a total hip endoprosthesis is heterotopic ossification (HO. HO is the most common complication that occurs after the implantation a total hip endoprosthesis with recorded cases in the range of 9-90%. HO are insufficiently understood phenomenon, which is characterized by the formation of bone in periarticular tissues. We prospectively followed patients who implanted total hip endoprostheses in the department of orthopedics ZC in Kos. Mitrovica in 2008. and 2009. year. We examined the influence of physical agents on the prevention of HO near the hip joint. In these patients the treatment was carried out kinesiotherapeutic at the Center for Rehabilitation Health Center Kosovska Mitrovica, as well as pulse therapy low frequency magnetic field frequency of 30 Hz, 30 minutes, 8 mT intensity and 15 minutes interferential current, 0-100 Hz frequency. All patients were on the rehabilitation of one month (20 days. Based on this research we confirmed the assumption that the use of low frequency pulsed magnetic fields, interference currents and kinesitherapy prevents HO in patients after implantation of total endoprosthesis of the hip joint.

  1. 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.

  2. [Motion Analysis of Lumbar Spine and Hip Joint on Sequential Radiographs Acquired with a Dynamic Flat-panel Detector (FPD) System].

    Science.gov (United States)

    Shimada, Kosuke; Kawashima, Hiroki; Yoshioka, Katsuhito; Sanada, Shigeru

    2015-12-01

    To design an evaluation method for lumbar spine and hip joint function using dynamic radiography using a flat-panel detector (FPD) system. Sixteen healthy subjects (males; age range, 22-60 years; median, 27 years) and 9 patients (7 males and 2 females; age range, 67-85 years; median, 73 years) with L4 degenerative spondylolisthesis were examined using a dynamic FPD system (CANON Inc.). Sequential images were captured with the subjects in the standing position with maximal forward bending followed by backward bending for 10 s. The lateral lumbar radiographs were obtained at 2 frames/s (fps). The flexion-extension angles of L1 and S1 were measured on those images. The range of motion (ROM) of the lumbar joints was significantly larger in the healthy group (82.4 ± 8.7°) than in the disease group (50.4 ± 8.5°; pdisease group (53.1 ± 17.6°; pdisease group, hip joint movements tended to be completed earlier compared with those in the healthy group. In the disease group, the loss of lumbar flexibility was compensated by an increase in hip joint motion due to the lumbar disease. The dynamic FPD system is a convenient imaging modality for the diagnosis of lumbar diseases through the assessment of locomotive function in the lumbar spine and hip joints.

  3. 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.

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

    Science.gov (United States)

    Sherepo, K M

    1995-01-01

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

  5. 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.

  6. 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.

  7. 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.

  8. 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

    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

  9. Rapid destruction of the hip joint associated with enlarged iliopsoas bursa in a patient with refractory rheumatoid arthritis.

    Science.gov (United States)

    Yoshioka, Taro; Tachihara, Akitoshi; Koyama, Tairo; Iwakawa, Kayo; Sakane, Manabu; Nakamura, Hiroshi

    2008-08-01

    A case of refractory rheumatoid arthritis with a rapid destruction of the hip joint and an enlarged iliopsoas bursa is presented. Rapidly destructive coxarthrosis, chondrocalcinosis, suppurative arthritis, and pigmented villonodular synovitis were the differential diagnoses. Radiological examination showed that rheumatoid arthritis was most likely diagnosis. The patient was treated with total hip arthroplasty and etanercept, with good results.

  10. Influence of footwear and equipment on stride length and range of motion of ankle, knee and hip joint

    National Research Council Canada - National Science Library

    Schulze, Christoph; Lindner, Tobias; Woitge, Sandra; Schulz, Katharina; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

    2014-01-01

    .... The aim of the present study was to investigate by means of gait analysis how army-provided footwear and equipment influence the range of motion of hip, knee and ankle joints as well as stride length...

  11. Autonomous Quality Control of Joint Orientation Measured with Inertial Sensors

    Directory of Open Access Journals (Sweden)

    Karina Lebel

    2016-07-01

    Full Text Available Clinical mobility assessment is traditionally performed in laboratories using complex and expensive equipment. The low accessibility to such equipment, combined with the emerging trend to assess mobility in a free-living environment, creates a need for body-worn sensors (e.g., inertial measurement units—IMUs that are capable of measuring the complexity in motor performance using meaningful measurements, such as joint orientation. However, accuracy of joint orientation estimates using IMUs may be affected by environment, the joint tracked, type of motion performed and velocity. This study investigates a quality control (QC process to assess the quality of orientation data based on features extracted from the raw inertial sensors’ signals. Joint orientation (trunk, hip, knee, ankle of twenty participants was acquired by an optical motion capture system and IMUs during a variety of tasks (sit, sit-to-stand transition, walking, turning performed under varying conditions (speed, environment. An artificial neural network was used to classify good and bad sequences of joint orientation with a sensitivity and a specificity above 83%. This study confirms the possibility to perform QC on IMU joint orientation data based on raw signal features. This innovative QC approach may be of particular interest in a big data context, such as for remote-monitoring of patients’ mobility.

  12. Remote transient Lactobacillus animalis bacteremia causing prosthetic hip joint infection: a case report

    Directory of Open Access Journals (Sweden)

    R. Somayaji

    2016-11-01

    Full Text Available Abstract Background Lactobacillus spp. are uncommon pathogens in immunocompetent hosts, and even rarer causes of prosthetic device infections. Case presentation A case of chronic hip prosthetic joint infection (PJI caused by L. animalis is described. This occurred 5 years after a transient bacteremia with the same organism. Whole genome sequencing of both isolates proved this PJI infection resulted from this remote bacteremia. Conclusions We document that prosthetic joint infections may be a consequence of bacteremia as much as 3 years before the onset of symptoms.

  13. Osteoarthritis in other joints (hip, elbow, foot, ankle, toes, wrist) after sports injuries.

    Science.gov (United States)

    Koh, Jason; Dietz, Jeffrey

    2005-01-01

    Osteoarthritis of nonknee joints, although less common than knee osteoarthritis, remains a significant and disabling condition for many present and former athletes. These injuries can be caused by repeated loads or following a specific traumatic event. The resulting pain and loss of motion can limit function and ability. Arthroscopic techniques in many cases enable surgeons to symptomatically treat limitations of range of motion and pain, prolonging active careers. Joint replacement remains the ultimate solution for hip osteoarthritis, and may be a viable option in ankle osteoarthritis.

  14. Identification of quantitative trait loci for osteoarthritis of hip joints in dogs.

    Science.gov (United States)

    Mateescu, Raluca G; Burton-Wurster, Nancy I; Tsai, Kate; Phavaphutanon, Janjira; Zhang, Zhiwu; Murphy, Keith E; Lust, George; Todhunter, Rory J

    2008-10-01

    To identify quantitative trait loci (QTL) associated with osteoarthritis (OA) of hip joints of dogs by use of a whole-genome microsatellite scan. 116 founder, backcross, F1, and F2 dogs from a crossbred pedigree. Necropsy scores and an optimized set of 342 microsatellite markers were used for interval mapping by means of a combined backcross and F2 design module from an online statistical program. Breed and sex were included in the model as fixed effects. Age of dog at necropsy and body weight at 8 months of age were also included in the model as covariates. The chromosomal location at which the highest F score was obtained was considered the best estimate of a QTL position. Chromosome-wide significance thresholds were determined empirically from 10,000 permutations of marker genotypes. 4 chromosomes contained putative QTL for OA of hip joints in dogs at the 5% chromosome-wide significance threshold: chromosomes 5, 18, 23, and 31. Osteoarthritis of canine hip joints is a complex disease to which many genes and environmental factors contribute. Identification of contributing QTL is a strategy to elucidate the genetic mechanisms that underlie this disease. Refinement of the putative QTL and subsequent candidate gene studies are needed to identify the genes involved in the disease process.

  15. Subsequent Total Joint Arthroplasty After Primary Total Knee or Hip Arthroplasty: A 40-Year Population-Based Study.

    Science.gov (United States)

    Sanders, Thomas L; Maradit Kremers, Hilal; Schleck, Cathy D; Larson, Dirk R; Berry, Daniel J

    2017-03-01

    Despite the large increase in total hip arthroplasties and total knee arthroplasties, the incidence and prevalence of additional contralateral or ipsilateral joint arthroplasty are poorly understood. The purpose of this study was to determine the rate of additional joint arthroplasty after a primary total hip arthroplasty or total knee arthroplasty. This historical cohort study identified population-based cohorts of patients who underwent primary total hip arthroplasty (n = 1,933) or total knee arthroplasty (n = 2,139) between 1969 and 2008. Patients underwent passive follow-up through their medical records beginning with the primary total hip arthroplasty or total knee arthroplasty. We assessed the likelihood of undergoing a subsequent total joint arthroplasty, including simultaneous and staged bilateral procedures. Age, sex, and calendar year were evaluated as potential predictors of subsequent arthroplasty. During a mean follow-up of 12 years after an initial total hip arthroplasty, we observed 422 contralateral total hip arthroplasties (29% at 20 years), 76 contralateral total knee arthroplasties (6% at 10 years), and 32 ipsilateral total knee arthroplasties (2% at 20 years). Younger age was a significant predictor of contralateral total hip arthroplasty (p hip arthroplasties (3% at 20 years), and 29 ipsilateral total hip arthroplasties (2% at 20 years). Older age was a significant predictor of ipsilateral or contralateral total hip arthroplasty (p hip arthroplasty or total knee arthroplasty can be informed of a 30% to 45% chance of a surgical procedure in a contralateral cognate joint and about a 5% chance of a surgical procedure in noncognate joints within 20 years of initial arthroplasty. Increased risk of contralateral total knee arthroplasty following an initial total hip arthroplasty may be due to gait changes prior to and/or following total hip arthroplasty. The higher prevalence of bilateral total hip arthroplasty in younger patients may result from

  16. The association between ambulatory activity, body composition and hip or knee joint replacement due to osteoarthritis: a prospective cohort study.

    Science.gov (United States)

    Munugoda, I P; Wills, K; Cicuttini, F; Graves, S E; Lorimer, M; Jones, G; Callisaya, M L; Aitken, D

    2018-02-20

    To examine the association between ambulatory activity (AA), body composition measures and hip or knee joint replacement (JR) due to osteoarthritis. At baseline, 1082 community-dwelling older-adults aged 50 - 80 years were studied. AA was measured objectively using pedometer and body composition by dual-energy x-ray absorptiometry. The incidence of primary (first-time) JR was determined by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry. Log binomial regression with generalized estimating equations were used to estimate the risk of JR associated with baseline AA and body composition measures, adjusting for age, sex, x-ray disease severity, and pain. Over 13 years of follow-up, 74 (6.8%) participants had a knee replacement (KR) and 50 (4.7%) a hip replacement (HR). AA was associated with a higher risk of KR (RR 1.09/1000 steps/day, 95% CI 1.01, 1.16) and a lower risk of HR (RR 0.90/1000 steps/day, 95% CI 0.81, 0.99). BMI (RR 1.07/kg/m 2 , 95% CI 1.03, 1.12), total fat mass (RR 1.04/kg, 95% CI 1.02, 1.07), trunk fat mass (RR 1.04/kg, 95% CI 1.02, 1.07), and waist circumference (RR 1.03/cm, 95% CI 1.01, 1.05) were associated with a higher risk of KR. Body composition measures were not associated with HR. An objective measure of AA was associated with a small increased risk of KR and a small reduced risk of HR. Worse body composition profiles were associated with knee, but not hip replacement. Altogether this may suggest different causal pathways for each site with regard to habitual activity and obesity. Copyright © 2018. Published by Elsevier Ltd.

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

    Science.gov (United States)

    Kim, Seong-Gil; Kim, Eun-Kyung

    2016-03-01

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

  18. 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.

  19. Symphysis pubis width and unaffected hip joint width in patients with slipped upper femoral epiphysis: widening compared with normal values

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard; Cassar-Pullicino, Victor; Haddaway, Mike [RJAH Orthopaedic Hospital, Department of Radiology, Shropshire (United Kingdom)

    2010-04-15

    The exact pathomechanism of slipped upper femoral epiphysis (SUFE) remains elusive. This paper suggests a generalised abnormality of the development or maturation of cartilage as a possible cause. It is proposed that SUFE is part of a generalised abnormality of the cartilage formation or maturation resulting in abnormal measurements of cartilaginous joint structures. Radiographs of SUFE patients were assessed for the width of the unaffected hip joint and the symphysis pubis. Comparison with previously published normal values was made. Fifty-one patients were assessed, 35 male, 16 female. The average age was 12 years and 11 months combined for both sexes, 13 years 8 months for boys, 11 years 4 months for girls. Width of the symphysis pubis was assessed on 46 datasets, and comparison with normal values was performed using the Wilcoxon paired rank test. Statistical significance was set as p < 0.05. The average expected width was 5.8 mm (5.4-6.2 mm), the average measured width was 7.3 mm (3.5-12 mm), median value 7.0 mm, and the difference is statistically significant. Cartilage thickness of the uninvolved hip joint could be assessed in 46 cases, and comparison using the Wilcoxon paired rank test resulted in a statistically significant difference (significance set as p < 0.05). The average expected width was 4.9 mm (3.6-6.5 mm), the average measured width was 5.5 mm (4-8 mm), and median 5.3 mm. The results indicate that SUFE patients display a generalised increased width of joint cartilage for their age. This could be due to increased cartilage formation or decreased maturation or a combination of the two, and could explain the increased mechanical vulnerability of these children to normal or abnormal stresses, despite histologically normal organisation of the physis as shown in previous studies. (orig.)

  20. 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.

  1. Unilateral and bilateral neurogenic dislocation of the hip joint--which deformity is more difficult to treat?

    Science.gov (United States)

    Koch, Aleksander; Jóźwiak, Marek

    2011-01-01

    Authors present and compare the results of treatment of spastic hip dislocation in a group of patients with unilateral or bilateral dislocation. We analyzed a group of 77 patients (109 hips) with a dislocated hip joint (MP>80%). The patients were divided into Group 1 (47 hip joints, 47 patients) with unilateral dislocation and Group 2 (62 hips, 31 patients) with bilateral dislocation. The mean duration of follow-up was 2.5 years (range 1.2-7.5) in Group 1 and 3.4 years (1.2-10.2) in Group 2. The hips were evaluated clinically and radiographically in the pre- and post-operative period. The relation of the femoral head to the acetabulum was described as the Acetabular Index (AI) and Reimers' migration percentage (MP). The Pelvic Femoral Angle (PFA) was used to measure the degree of windblown deformity. There were three cases of post-operative redislocation (MP>80%) and four cases of severe subluxation (MP>50%) in Group 1 compared to no dislocations in Group 2. In Group 1, AI improved from 31.3°(20°-50°) to 22.7°(3°-50°) and MP improved from 98.8% (85%-100%) to 23.4% (0%-100%). In Group 2, AI improved from 30.5° (10°-62°) to 19.9° (4°-40°) and MP improved from 98.8% (82%-100%) to 9.6% (0%-60%). In Group 1, PFA before surgery was -10.3° (-40° to 10°) for the dislocated side and 6.6° (-16° to 55°) for the non-dislocated side and after surgery it was -5.7° (-46 to 45) for the treated side and 5.6° (-18° to 45°) for the untreated side. In Group 2, PFA was -3.1° (-22° to 9°) before surgery and -0.15° (-18° to 25°) after surgery. We found improved ranges of motion for the movements investigated. The clinical and radiological results of operative treatment presented in this paper allow for the conclusion that patients with unilateral dislocations run a higher risk of redislocation, subluxation, and windblown deformity.

  2. Discrete element analysis is a valid method for computing joint contact stress in the hip before and after acetabular fracture.

    Science.gov (United States)

    Townsend, Kevin C; Thomas-Aitken, Holly D; Rudert, M James; Kern, Andrew M; Willey, Michael C; Anderson, Donald D; Goetz, Jessica E

    2018-01-23

    Evaluation of abnormalities in joint contact stress that develop after inaccurate reduction of an acetabular fracture may provide a potential means for predicting the risk of developing post-traumatic osteoarthritis. Discrete element analysis (DEA) is a computational technique for calculating intra-articular contact stress distributions in a fraction of the time required to obtain the same information using the more commonly employed finite element analysis technique. The goal of this work was to validate the accuracy of DEA-computed contact stress against physical measurements of contact stress made in cadaveric hips using Tekscan sensors. Four static loading tests in a variety of poses from heel-strike to toe-off were performed in two different cadaveric hip specimens with the acetabulum intact and again with an intentionally malreduced posterior wall acetabular fracture. DEA-computed contact stress was compared on a point-by-point basis to stress measured from the physical experiments. There was good agreement between computed and measured contact stress over the entire contact area (correlation coefficients ranged from 0.88 to 0.99). DEA-computed peak contact stress was within an average of 0.5 MPa (range 0.2-0.8 MPa) of the Tekscan peak stress for intact hips, and within an average of 0.6 MPa (range 0-1.6 MPa) for fractured cases. DEA-computed contact areas were within an average of 33% of the Tekscan-measured areas (range: 1.4-60%). These results indicate that the DEA methodology is a valid method for accurately estimating contact stress in both intact and fractured hips. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Yoo, Sarang; Dedova, Irina; Pather, Nalini

    2015-09-01

    The short lateral rotators (piriformis, obturator internus, superior and inferior gemelli, obturator internus, and quadratus femoris) are functionally important muscles, significantly contributing to hip joint stability. They act as "postural muscles", holding the femoral head in the acetabulum during hip movements, thus are frequently monitored in gait analysis and for muscle rehabilitation post-injury. Despite the need to precisely identify and repair these muscles for stability postoperatively, clinical complications have resulted from the inadequate and inconsistent understanding of their morphological and functional anatomy. Furthermore, the short lateral rotators have complex entheses (osteotendinous insertions on bone) and may be subject to overuse injury in sport. This study aims to review the reported morphology of the short lateral rotators in order to ascertain whether discrepancies exist in our understanding of these muscles, and if further investigation is required to aid in gait analysis, clinical management of hip pathologies, and prevention of overuse injuries. Following a literature search strategy, 59 primary references were retrieved from three databases, with additional 26 anatomical textbooks selected for critical evaluation. Numerous inaccuracies and inconsistencies in the anatomical descriptions of the attachments, patterns of innervation and actions exist, and often insufficiently supported by primary findings. There is also a paucity of information regarding the architectural pattern of the muscles, which would be useful in clarifying the function of these dynamic stabilizers of the hip joint. A better anatomical understanding of these muscles will better inform hip reconstruction and lead to improved surgical outcomes by reducing post-operative complications. © 2015 Wiley Periodicals, Inc.

  4. Radiological findings for hip dysplasia at skeletal maturity. Validation of digital and manual measurement techniques.

    Science.gov (United States)

    Engesæter, Ingvild Øvstebø; Laborie, Lene Bjerke; Lehmann, Trude Gundersen; Sera, Francesco; Fevang, Jonas; Pedersen, Douglas; Morcuende, José; Lie, Stein Atle; Engesæter, Lars Birger; Rosendahl, Karen

    2012-07-01

    To report on intra-observer, inter-observer, and inter-method reliability and agreement for radiological measurements used in the diagnosis of hip dysplasia at skeletal maturity, as obtained by a manual and a digital measurement technique. Pelvic radiographs from 95 participants (56 females) in a follow-up hip study of 18- to 19-year-old patients were included. Eleven radiological measurements relevant for hip dysplasia (Sharp's, Wiberg's, and Ogata's angles; acetabular roof angle of Tönnis; articulo-trochanteric distance; acetabular depth-width ratio; femoral head extrusion index; maximum teardrop width; and the joint space width in three different locations) were validated. Three observers measured the radiographs using both a digital measurement program and manually in AgfaWeb1000. Inter-method and inter- and intra-observer agreement were analyzed using the mean differences between the readings/readers, establishing the 95% limits of agreement. We also calculated the minimum detectable change and the intra-class correlation coefficient. Large variations among different radiological measurements were demonstrated. However, the variation was not related to the use of either the manual or digital measurement technique. For measurements with greater absolute values (Sharp's angle, femoral head extrusion index, and acetabular depth-width ratio) the inter- and intra-observer and inter-method agreements were better as compared to measurements with lower absolute values (acetabular roof angle, teardrop and joint space width). The inter- and intra-observer variation differs notably across different radiological measurements relevant for hip dysplasia at skeletal maturity, a fact that should be taken into account in clinical practice. The agreement between the manual and digital methods is good.

  5. Radiological findings for hip dysplasia at skeletal maturity. Validation of digital and manual measurement techniques

    Energy Technology Data Exchange (ETDEWEB)

    Engesaeter, Ingvild Oevsteboe [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Haukeland University Hospital, The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Bergen (Norway); Laborie, Lene Bjerke; Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Lehmann, Trude Gundersen; Fevang, Jonas; Engesaeter, Lars Birger [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Sera, Francesco [University College London Institute of Child Health, Medical Research Council Centre of Epidemiology for Child Health, London (United Kingdom); Pedersen, Douglas; Morcuende, Jose [University of Iowa Hospital and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, IA (United States); Lie, Stein Atle [Uni Health, Uni Research, Bergen (Norway)

    2012-07-15

    To report on intra-observer, inter-observer, and inter-method reliability and agreement for radiological measurements used in the diagnosis of hip dysplasia at skeletal maturity, as obtained by a manual and a digital measurement technique. Pelvic radiographs from 95 participants (56 females) in a follow-up hip study of 18- to 19-year-old patients were included. Eleven radiological measurements relevant for hip dysplasia (Sharp's, Wiberg's, and Ogata's angles; acetabular roof angle of Toennis; articulo-trochanteric distance; acetabular depth-width ratio; femoral head extrusion index; maximum teardrop width; and the joint space width in three different locations) were validated. Three observers measured the radiographs using both a digital measurement program and manually in AgfaWeb1000. Inter-method and inter- and intra-observer agreement were analyzed using the mean differences between the readings/readers, establishing the 95% limits of agreement. We also calculated the minimum detectable change and the intra-class correlation coefficient. Large variations among different radiological measurements were demonstrated. However, the variation was not related to the use of either the manual or digital measurement technique. For measurements with greater absolute values (Sharp's angle, femoral head extrusion index, and acetabular depth-width ratio) the inter- and intra-observer and inter-method agreements were better as compared to measurements with lower absolute values (acetabular roof angle, teardrop and joint space width). The inter- and intra-observer variation differs notably across different radiological measurements relevant for hip dysplasia at skeletal maturity, a fact that should be taken into account in clinical practice. The agreement between the manual and digital methods is good. (orig.)

  6. CT evaluation of native acetabular orientation and localization: sex-specific data comparison on 336 hip joints.

    Science.gov (United States)

    Tohtz, Stephan W; Sassy, Danny; Matziolis, Georg; Preininger, Bernd; Perka, Carsten; Hasart, Olaf

    2010-01-01

    The reorientation of the acetabular component in total hip replacement is currently carried out under consideration of the safe zone, respecting the best possible range of motion and is influenced by wear debris of different bearings. Is the preferred orientation a reconstruction of the native anatomy and are there sex-specific differences? On the basis of 168 CT datasets (72 women, 96 men) 336 native hip joints were analysed. The abduction and anteversion of the acetabulum as well as the location of the hip center were detected. As a reference the anterior pelvic plane was used. The 144 female hip joints showed a mean abduction of 53.0 degrees (SD 6.14 degrees ) and an anteversion of 24.63 degrees (SD 6.61 degrees ). The 192 male hip joints showed an abduction of 53.58 degrees (SD 6.68 degrees ) and an anteversion of 21.31 degrees (SD 6.17 degrees ). Significant differences were observed on comparison between the sexes in relation to the anteversion and the location of the hip center. Likewise, there was a significant correlation between the position of the hip center and the degree of anteversion. In total hip arthroplasty a reconstruction of the native acetabular orientation is not possible, gender specific characteristics should be considered.

  7. 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.

  8. Assessment of congruence and impingement of the hip joint in professional ballet dancers: a motion capture study.

    Science.gov (United States)

    Charbonnier, Caecilia; Kolo, Frank C; Duthon, Victoria B; Magnenat-Thalmann, Nadia; Becker, Christoph D; Hoffmeyer, Pierre; Menetrey, Jacques

    2011-03-01

    Early hip osteoarthritis in dancers could be explained by femoroacetabular impingements. However, there is a lack of validated noninvasive methods and dynamic studies to ascertain impingement during motion. Moreover, it is unknown whether the femoral head and acetabulum are congruent in typical dancing positions. The practice of some dancing movements could cause a loss of hip joint congruence and recurrent impingements, which could lead to early osteoarthritis. Descriptive laboratory study. Eleven pairs of female dancer's hips were motion captured with an optical tracking system while performing 6 different dancing movements. The resulting computed motions were applied to patient-specific hip joint 3-dimensional models based on magnetic resonance images. While visualizing the dancer's hip in motion, the authors detected impingements using computer-assisted techniques. The range of motion and congruence of the hip joint were also quantified in those 6 recorded dancing movements. The frequency of impingement and subluxation varied with the type of movement. Four dancing movements (développé à la seconde, grand écart facial, grand écart latéral, and grand plié) seem to induce significant stress in the hip joint, according to the observed high frequency of impingement and amount of subluxation. The femoroacetabular translations were high (range, 0.93 to 6.35 mm). For almost all movements, the computed zones of impingement were mainly located in the superior or posterosuperior quadrant of the acetabulum, which was relevant with respect to radiologically diagnosed damaged zones in the labrum. All dancers' hips were morphologically normal. Impingements and subluxations are frequently observed in typical ballet movements, causing cartilage hypercompression. These movements should be limited in frequency. The present study indicates that some dancing movements could damage the hip joint, which could lead to early osteoarthritis.

  9. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  12. One-year incidence of prosthetic joint infection in total hip arthroplasty

    DEFF Research Database (Denmark)

    Gundtoft, P H; Pedersen, A B; Schønheyder, Henrik C.

    2017-01-01

    . The most common micro-organisms identified in the 271 PJI were Staphylococcus aureus (36%) and coagulase-negative staphylococci (CoNS) (33%); others commonly identified included Enterobacteriaceae, enterococci, and streptococci. Antimicrobial resistance to beta-lactams and gentamicin did not change during......OBJECTIVE: To examine the trend of Prosthetic Joint Infections (PJI) following primary total hip arthroplasty (THA) and the antimicrobial resistance of the bacteria causing these infections. MATERIALS AND METHODS: We identified a population-based cohort of patients in the Danish Hip Arthroplasty...... the study period. CONCLUSION: The risk of PJI within 1-year after primary THA and the antimicrobial resistance of the most prevalent bacteria remained unchanged during the 2005-2014 study period....

  13. 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.

  14. 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.

  15. [Impact of joint capsule repair and external rotators suture on prognosis in primary total hip arthroplasty by posterolateral approach].

    Science.gov (United States)

    Shen, Pengcheng; Xu, Neng; Jiang, Fugui; Zhu, Lifan; Weng, Fengbiao; Wang, Youhua

    2012-11-01

    To investigate the impact of joint capsule repair and external rotators suture on the prognosis in primary total hip arthroplasty (THA) by posterolateral approach. Between January 2006 and June 2009, 159 patients with femoral neck fracture underwent primary THA by posterolateral approach, and were divided into 4 groups according to different treatments: joint capsule repair and external rotators suture were given in group A (n=38), only joint capsule repair in group B (n=39), only external rotators suture in group C (n=41), and no joint capsule repair or external rotators suture in group D (n=41). There was no significant difference in gender, age, cause of injure, disease duration, type of fracture, combined medical disease, or prosthesis selection among 4 groups (P > 0.05). The bleeding volume, drainage, postoperative hip dislocation rate, hip Harris score, and the hip range of motion (ROM) in internal rotation and external rotation were compared. There was no significant difference in operative time, bleeding volume, or drainage among 4 groups (P > 0.05). Postoperative hip dislocation occurred in 0, 0, 4 (9.8%), and 4 (9.8%) cases of groups A, B, C, and D, respectively, showing significant difference in incidence of postoperative hip dislocation among 4 groups (chi2=7.910, P=0.048). The hip Harris scores were significantly improved after operation when compared with preoperative scores in 4 groups (P hip Harris score at 6 weeks and 6 months after operation among 4 groups (P hip ROM in internal rotation among 4 groups at 6 weeks and 6, 12 months after operation (P > 0.05); but the hip ROM in external rotation were significantly bigger in groups A and C than in groups B and D at 6 weeks and 6 months after operation (P Joint capsule repair and external rotators suture in primary THA by posterolateral approach do not increase the bleeding volume and drainage, but can reduce the early postoperative hip dislocation risk, increase the Harris score, and recover the

  16. Microstructure and mechanical analysis of W/P91 steel HIP-joint with Ti interlayer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Ji-chao [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Science Island Branch of Graduate School, University of Science & Technology of China, Hefei, 230031 (China); Wang, Wanjing, E-mail: wjwang@ipp.ac.cn [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Sun, Zhaoxuan; Wang, Xingli; Wei, Ran [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Science Island Branch of Graduate School, University of Science & Technology of China, Hefei, 230031 (China); Xie, Chunyi; Li, Qiang [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Luo, Guang-nan [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, 230031 (China); Science Island Branch of Graduate School, University of Science & Technology of China, Hefei, 230031 (China); Hefei Center for Physical Science and Technology, Hefei, 230022 (China); Hefei Science Center of Chinese Academy of Sciences, Hefei, 230027 (China)

    2016-11-15

    Highlights: • W and P91 steel can be joined successfully using the Hot Isostatic Pressing (HIP) method with Ti interlayer. • The experiment was conducted at 760 °C below the P91 steel austenitizing temperature with the pressure 150 MPa for 4 h. • The residual stress concentration is responsible for the fracture of HIP joints under low joining temperature. • Low temperature can reduce the reaction products and improve the mechanical properties of W/Ti/P91 steel joints. - Abstract: W and P91 steel were joined by using the Hot Isostatic Pressing method with Ti interlayer, and the experiments were conducted at 760 °C. The mechanical property, bonding quality and interface microstructure were tested by the Torsion test, Non-Destructive Test, Scanning Electron Microscope and Nano-indentation test. The minimum shear strength of joints was 225 MPa and the failure occurred at the W/Ti interfaces. Metallographic analysis revealed good bonding quality across bonding lines. Almost no reaction products were found in the diffusion region and the Nano-indentation test demonstrated that the solid solution strengthening was caused by inter-diffusion in the diffusion zone. The effect of low joining temperature on reducing reaction products and improving mechanical properties of W/Ti/Steel diffusion bonding were investigated in this paper.

  17. Normal hip joint contact pressure distribution in single-leg standing--effect of gender and anatomic parameters.

    Science.gov (United States)

    Genda, E; Iwasaki, N; Li, G; MacWilliams, B A; Barrance, P J; Chao, E Y

    2001-07-01

    A practical and easy-to-use analysis technique that can study the patient's hip joint contact force/pressure distribution would be useful to assess the effect of abnormal biomechanical conditions and anatomical deformities on joint contact stress for treatment planning purpose. This technique can also help to establish the normative database on hip joint contact pressure distribution in men and women in different age groups. Twelve anatomic parameters and seven biomechanical parameters of the hip joint in a normal population (41 females, 15 males) were calculated. The inter-parameter correlations were investigated. The pressure distribution in the hip joint was calculated using a three-dimensional discrete element analysis (DEA) technique. The 3D contact geometry of the hip joint was estimated from a 2D radiograph by assuming that the femoral head and the acetabular surface were spherical in shape. The head-trochanter ratio (HT), femoral head radius, pelvic height, the joint contact area, the normalized peak contact pressure, abductor force, and the joint contact force were significantly different between men and women. The normalized peak contact pressure was correlated both with acetabular coverage and head-trochanter ratio. Change of abductor force direction within normal variation did not affect the joint peak contact pressure. However, in simulated dysplastic conditions when the CE angle is small or negative, abductor muscle direction becomes very sensitive in joint contact pressure estimation. The models and the results presented can be used as the reference base in computer simulation for preoperative planning in pelvic or femoral osteotomy.

  18. [Shortening osteotomy for alloarthoplastic joint replacement for hip dislocation in adults].

    Science.gov (United States)

    Tohtz, S W; Perka, C

    2012-04-01

    Total hip arthroplasty to create an articulating hip joint. Acetabular cup implantation in the original rotational center of the pelvis. Simultaneous femoral shortening osteotomy to prevent neurovascular damage and equalize leg length in patients with unilateral occurrence. Developmental dysplasia of the hip (DDH) in adults; type 3 and 4 dislocation according to Crowe. Cerebrospinal dysfunction with permanent restriction of coordination ability, muscular dystrophies, and multiple malformations of the musculoskeletal system. Apparent disturbance of the bone metabolism. The Watson-Jones interval approach to the hip joint is used to avoid functional disorders of the hip abductors. After preparation of the proximal femur and femoral neck resection, adjustment of the non-regularly developed acetabular cavity with reduced anterior coverage takes place. The cup component is implanted and the interval between the vastus intermedius and the vastus lateralis below the lesser trochanter examined. Loss of periosteum of the femoral cortex due to blunt spreading is to be avoided. Following the femoral shortening osteotomy initially the preparation of the distal bone segment takes place to adjust the endofemoral canal for shaft implantation in the following preparation of the metaphyseal segment. Afterwards osteotomy-bridging implantation of a cementless, distal anchoring stem design is performed. Partial weight bearing of the leg with 20 kp is necessary for 6 weeks combined with therapy of existing contractures and active pelvic rotation training. Within 10 postoperative weeks full weight bearing is usually reached. After this period mobilization without crutches is possible. Inpatient rehabilitation is possible after bony recovery of the femoral osteotomy. From 1993 to 1999, the first 15 total hip arthroplasties were performed in adult patients with DDH; they were treated with simultaneous femoral shortening osteotomy and without additive osteosynthesis. During the midterm

  19. Comparison of gluteus medius muscle activity during functional tasks in individuals with and without osteoarthritis of the hip joint.

    Science.gov (United States)

    Dwyer, Maureen K; Stafford, Kelly; Mattacola, Carl G; Uhl, Timothy L; Giordani, Mauro

    2013-08-01

    Neuromuscular alterations have been reported for patients with osteoarthritis of the hip joint; however, the underlying cause associated with altered gluteus medius muscle function has not been examined. This study assessed electromyographic amplitudes of the gluteus medius muscles during function in patients with unilateral end-stage osteoarthritis of the hip joint compared to controls. Patients with unilateral end-stage hip joint osteoarthritis (n=13) and asymptomatic control participants (n=17) participated. Average root-mean squared muscle amplitudes represented as a percent of maximum voluntary isometric contraction for both the involved and uninvolved limb gluteus medius muscles were analyzed during step up, step down, and gait. The association between muscle activation and impact forces during stepping tasks was assessed. Patients with hip osteoarthritis exhibited increased gluteus medius muscle electromyographic amplitudes bilaterally during stair ascent, stair descent, and gait compared to controls, regardless of which limb they led. Involved limb muscle activity was inversely related to impact force during step down onto the ipsilateral limb. Patients with hip osteoarthritis demonstrated increased gluteus medius muscle activation levels during stepping tasks and gait when compared to controls. The increased activation is most likely a compensatory response to muscle weakness. Therefore, application of strengthening exercises which target the gluteal muscles should assist in neuromuscular control and result in improved strength for patients with hip joint osteoarthritis. © 2013. Published by Elsevier Ltd on behalf of American Society of Biomechanics. All rights reserved.

  20. ANATOMICAL AND CLINICAL ORBSERVATIONS ON STRUCTURAL CHANGES OF THE HIP JOINT.

    Science.gov (United States)

    Macovei, Luana-Andreea; Rezus, Elena

    2016-01-01

    The hip, the second largest joint of the human body, with its primary contribution to locomotion, is exposed to numerous traumatic or non-traumatic risks. Regardless of the initial pathology, there is always almost the same result: diminution of range of motion, onset of pain and functional impotence, as well as change of biomechanics of walking. Through its high frequency, morpho-functional imbalance (clinically expressed both imagistic and biologically, in one or several joints), osteoarthritis is a disease with a multifactorial etiology and a complex pathogeny. The study included 244 patients aged between 18-85 years, clinically and paraclinically investigated, especially for the osteoarthritis of the hip, admitted to Rheumatology Clinic I, Rehabilitation Hospital in Iasi, from January 2012 to December 2014. The high prevalence of degenerative diseases of the joints in old age is analyzed in accordance with the results of the estimations, which showed that, in fact, most of the patients remain undetected, undiagnosed and untreated. Main symptoms are pain in the coxofemoral joint, radiating or not on the lateral or anterior face of the thigh down to the knee, morning stiffness after a long rest, limping or walking with small steps, and muscle atrophy of the group of muscles that are responsible for the stability of the joint. A strict discipline is needed from the patient's side, in order to keep and apply the doctor's indications in a chronic disease that requires a long therapy, on one hand; on the other hand, a close cooperation between various experts is needed, in order to customize and apply the most effective program, at the right time.

  1. Contribution of hip joint proprioception to static and dynamic balance in cerebral palsy: a case control study.

    Science.gov (United States)

    Damiano, Diane L; Wingert, Jason R; Stanley, Christopher J; Curatalo, Lindsey

    2013-06-15

    Balance problems are common in cerebral palsy (CP) but etiology is often uncertain. The classic Romberg test compares ability to maintain standing with eyes open versus closed. Marked instability without vision is a positive test and generally indicates proprioceptive loss. From previous work showing diminished hip joint proprioception in CP, we hypothesized that static and dynamic balance without vision (positive Romberg) would be compromised in CP. Force plate sway and gait velocity data were collected using 3D motion capture on 52 participants, 19 with diplegic CP, 13 with hemiplegic CP, and 20 without disability. Center of mass (COM) and center or pressure (COP) velocity, excursion, and differences between COM and COP in AP and ML directions were computed from static standing trials with eyes open and closed. Mean gait velocity with and without dribble glasses was compared. Hip joint proprioception was quantified as the root mean square of magnitude of limb positioning errors during a hip rotation task with and without view of the limb. Mixed model repeated measures analysis of variance (ANOVA) was performed with condition as within-subject (EO, EC) and group as between-subject factors (hemiplegia, diplegia, controls). Sway characteristics and gait speed were correlated with proprioception values. Groups with CP had greater sway in standing with eyes open indicating that they had poorer balance than controls, with the deficit relatively greater in the ML compared to AP direction. Contrary to our hypothesis, the decrement with eyes closed did not differ from controls (negative Romberg); however, proprioception error was related to sway parameters particularly for the non-dominant leg. Gait speed was related to proprioception values such that those with worse proprioception tended to walk more slowly. Postural instability is present even in those with mild CP and is yet another manifestation of their motor control disorder, the specific etiology of which may vary

  2. Contribution of hip joint proprioception to static and dynamic balance in cerebral palsy: a case control study

    Science.gov (United States)

    2013-01-01

    Background Balance problems are common in cerebral palsy (CP) but etiology is often uncertain. The classic Romberg test compares ability to maintain standing with eyes open versus closed. Marked instability without vision is a positive test and generally indicates proprioceptive loss. From previous work showing diminished hip joint proprioception in CP, we hypothesized that static and dynamic balance without vision (positive Romberg) would be compromised in CP. Methods Force plate sway and gait velocity data were collected using 3D motion capture on 52 participants, 19 with diplegic CP, 13 with hemiplegic CP, and 20 without disability. Center of mass (COM) and center or pressure (COP) velocity, excursion, and differences between COM and COP in AP and ML directions were computed from static standing trials with eyes open and closed. Mean gait velocity with and without dribble glasses was compared. Hip joint proprioception was quantified as the root mean square of magnitude of limb positioning errors during a hip rotation task with and without view of the limb. Mixed model repeated measures analysis of variance (ANOVA) was performed with condition as within-subject (EO, EC) and group as between-subject factors (hemiplegia, diplegia, controls). Sway characteristics and gait speed were correlated with proprioception values. Results Groups with CP had greater sway in standing with eyes open indicating that they had poorer balance than controls, with the deficit relatively greater in the ML compared to AP direction. Contrary to our hypothesis, the decrement with eyes closed did not differ from controls (negative Romberg); however, proprioception error was related to sway parameters particularly for the non-dominant leg. Gait speed was related to proprioception values such that those with worse proprioception tended to walk more slowly. Conclusions Postural instability is present even in those with mild CP and is yet another manifestation of their motor control disorder

  3. 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....... The results strongly indicate that degradation of Ti-6Al-4V has occurred with the same mechanism for both the implants and the laboratory tested samples and, hence, block-on-ring tribocorrosion testing was found to be a useful tool for mimicking the degradation occurring in the body.The degradation mechanism...

  4. The Effect of Ratio of Contraction to Relaxation Durations in PNF Exercises on the Muscle Strength and Range of Motion of Hip Joint

    Directory of Open Access Journals (Sweden)

    Hossein Rashedi

    2015-09-01

    Full Text Available Objective: The aim of the present study was to compare the effect of ratios of contraction- Relaxation on the muscle strength and range of motion of hip joint in PNF exercises. Methods: Thirty nine nonathletic male students (Mean±SD; age, 13±1.2 years; body mass, 55±9.8 kg were assigned .Three groups designated as I, II and III groups. The ratios of contraction to relaxation periods for groups were 1, 2 and 3 respectively. Training program included three sessions per week (CR-PNF for 6 weeks. Measurements of hip extensors muscles stretch and strength were performed at the beginning and at the end of training using an inclinometer (during leg raise test and dynamometer. Data were analyzed using dependent samples t-test and one-way ANOVA. Results: The results of the present study showed significant increases in hip extensor muscles flexibility and strength for three groups. This increase the in the strength in group I equaled 6 kg, in group II 4 kg and in group III 7 kg. The amount of increase in the hip extensor muscles flexibility in group I, II and II were 15, 8 and 12 degrees, respectively. The increase in these two variables was significant and similar in all three groups. Conclusion: Different contraction to relaxation ratio normally, 0.5, 1 and 2, did not show any meaningful differences on hip extensor muscular strength and hip range of motion.

  5. Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association

    OpenAIRE

    Matsumoto, Tadami; Kaneuji, Ayumi; Ichiseki, Toru; Hiejima, Yoshimitsu; Sugiyama, Hajime; Akiyama, Haruhiko; Atsumi, Takashi; Ishii, Masaji; Izumi, Kiyoko; Ito, Hiroshi; Okawa, Takahiro; Ohzono, Kenji; Otsuka, Hiromi; Kishida, Shunji; Kobayashi, Seneki

    2011-01-01

    Background The Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease. Methods With the aim of more accurately classifying QOL for Japan...

  6. Reliability of measures used in radiographic evaluation of the adult hip

    Energy Technology Data Exchange (ETDEWEB)

    Bjarnason, J.A.; Reikeras, O. [Oslo University Hospital, Department of Orthopedics, Oslo (Norway); Pripp, A.H. [Oslo University Hospital, Department of Biostatistics, Oslo (Norway)

    2015-02-20

    The reliability of radiographic measurements has been studied in pediatric hips, but less has been published on the adult hip, and none have examined the reliability of measurements for the location of the center of rotation (COR) of the hip joint. We have investigated the reliability of various radiographic variables with a focus on the COR. The study was carried out on a standardized format for anterior-posterior radiographs of the pelvis. The measured variables were; (A) the distance from a sagittal reference line to the COR, (B) the distance from the sagittal reference line to the proximal end of the lateral cortical line of the femur, (C) the distance from the sagittal reference line to the medial rim of the acetabulum, (D) the distance from the horizontal reference line to the roof of the acetabulum, and (E) the distance from the horizontal reference line to the COR. One observer (JAB) conducted the measurements twice separated by a time interval of 45-60 days to assess intra-observer reliability, and the first measurements of JAB were compared to those performed by another observer (OR) to assess inter-observer reliability. Intraclass correlation coefficients were above 0.98 for all measurements, and the minimum and maximum values that statistically include 95 % of the observer differences were all within -3 to +3 mm. These measurements proved to have high reliability and agreement of both within the same observer and between two observers. They should therefore be reproducible in a clinical setting. (orig.)

  7. Quantitative measurement of hip protector use and compliance.

    Science.gov (United States)

    Evans, Katherine R; Lou, Edmond; Woloschuk, Chris; Hill, Doug; Li, Meng; Wong, Man-Sang

    2014-01-01

    Hip protectors are often prescribed to the elderly who are at risk of falling, with the goal of preventing hip fractures. However, determining the effectiveness of hip protectors has been hampered by unreliable compliance data. This study reports a reliable objective method of measuring compliance and the developed method could be used in any climate, regardless of temperature. Custom compliance monitors were built and embedded inside hip protectors. An algorithm was developed to utilize both temperature and acceleration to determine compliance. Seven young volunteers (age 24.6 ± 4.2 years old) wore the protectors for a total of 667 h while closely recording their compliance. One female (77 years old) who had hip fracture history wore the compliance monitors for 91.6 % of the time during a 1-week stay in a hospital. From the volunteers' trial, using temperature alone overpredicted compliance by 1.2 % and using acceleration alone overpredicted by 5.4 %, but using a combination of the two methods plus a correction factor only underestimated by 0.6 %. From the elderly data, the average compliance recorded from the temperature, acceleration, and combined methods with correction was 94.6, 88.9, and 90.2, respectively. The high accuracy of temperature sensors in this study will not be attainable in hot climates where most of the worldwide increase in hip fractures is occurring. The developed monitor with the algorithm provided high accuracy in determining compliance and was able to determine both the longitudinal and cross-sectional compliance at any time.

  8. Less invasive posterior surgical approach for hip joint replacement--complications and limitations.

    Science.gov (United States)

    Jabłoński, Mirosław; Gorzelak, Mieczysław; Kuczyński, Paweł; Piasecki, Jarosław; Turzańska, Karolina

    2007-01-01

    We attempted to analyse the difficulties and risk of complications associated with total hip replacement using a limited posterior approach and standard instrumentation. A series of 85 consecutive cases (47 females and 38 males; age range 22-87 years; mean age: 65.6 +/- 10.4) of total hip replacement using a modified Gibson approach were analyzed prospectively. Bilateral surgery was performed in 7 patients. There were 44 non-cemented arthroplasties. Body mass index varied from 22 to 36 (body weight 78-104 kg) and the length of the operative wound varied from 6.5 to 14 cm (mean 9.8 +/- 1.3 cm). The wound was 14 centimeters long in six subjects with a BMI of 35-36. The procedure was performed in a lateral decubitus position using an appropriately limited posterior approach. After careful coagulation of blood vessels surrounding the base of the femoral head posteriorly, the obturator and gemelli tendons and the posterior part of the joint capsule were cut through as close to the femoral attachment (T) as possible. This made it possible to dislocate the joint posteriorly. Further stages of the procedure were performed in a typical manner, with special attention paid to the preservation of the tendon of the piriformis muscle. Continuity of the muscle was re-examined following the reposition of the artificial joint. Two injuries to the piriform tendon were observed. Persistent bleeding from vessels surrounding the femoral neck base occurred in 5 patients while in four others there was transient paresis of the peroneal muscles and dorsal extensors of the ipsilateral foot, probably caused by extension of the sciatic nerve. There was one oblique fracture of the proximal femoral shaft. We did not observe significant errors in postoperative joint geometry. Mean intraoperative blood loss was 400 ml. We did not note postoperative dislocations or infections. On the basis of our observations of a series of 85 patients, minimizing the extent of the posterior surgical approach for

  9. Periprosthetic Joint Infection in Hip Arthroplasty: Is There an Association Between Infection and Bearing Surface Type?

    Science.gov (United States)

    Pitto, Rocco P; Sedel, Laurent

    2016-10-01

    Preliminary studies have raised the question of whether certain prosthetic biomaterials used in total hip arthroplasty (THA) bearings are associated with increased risk of periprosthetic joint infection (PJI). For example, some observational data suggest the risk of PJI is higher with metal-on-metal bearings. However, it is not known whether other bearings-including ceramic bearings or metal-on-polyethylene bearings-may be associated with a higher or lower risk of PJI. The objective of this study was to use a national arthroplasty registry to assess whether the choice of bearings-metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), ceramic-on-ceramic (CoC), or metal-on-metal (MoM)-is associated with differences in the risk of revision for deep infection, either (1) within 6 months or (2) over the entire period of observation, which spanned 15 years. Data from primary THAs were extracted from the New Zealand Joint Registry over a 15-year period. A total of 97,889 hips were available for analysis. Inclusion criterion was degenerative joint disease; exclusion criteria were previous surgery, trauma, and any other diagnosis (12,566 hips). We also excluded a small group of ceramic-on-metal THAs (429) with short followup. The median observation period of the selected group of hips (84,894) was 9 years (range, 1-15 years). The mean age of patients was 68 years (SD ± 11 years), and 52% were women. There were 54,409 (64%) MoP, 16,503 (19%) CoP, 9051 (11%) CoC, and 4931 (6%) MoM hip arthroplasties. Four hundred one hips were revised for deep infection. A multivariate assessment was carried out including the following risks factors available for analysis: age, sex, operating room type, use of body exhaust suits, THA fixation mode, and surgeon volume. Because of late introduction of data collection in the Registry, we were unable to include body mass index (BMI, recording started 2010) and medical comorbidities according to the American Society of Anesthesiologists

  10. 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.)

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

    Science.gov (United States)

    Suter, Aline; Dietrich, Tobias J; Maier, Matthias; Dora, Claudio; Pfirrmann, Christian W A

    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.

  12. The Investigation Of A 3-D Human Hip Joint Under The Effect Of Concentrated Force By Using Finite Element Method

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Çetin

    2012-06-01

    Full Text Available In this study, a three dimensionally modeled human hip joint with and without prosthesis was investigated by using finite element method. In scope of the study, 3 different types of cemented prosthesis namely; Charnley, Muller and Hipokrat were used. After preparing the solid models of the hip joint, the models were exported to Ansys Workbench program in order to create 3-D finite element models of the hip joint. The finite element analysis were then pursued for walking and stair climbing activities using concentrated force conditions applied statically. The von-Mises stresses and strains on the cortical and trabecular layers of bone, prosthesis and bone cement were determined at the end of the finite element analysis and compared to each other.

  13. [Surgical treatment of residual congenital dysplasia with dislocation of the hip joint after treatment with the Frejka pillow].

    Science.gov (United States)

    Lempicki, A; Wierusz-Kozłowska, M

    1990-01-01

    The characteristics of patients and the radiological condition of hip joints that required surgery because of residual dysplasia in the course of growth after treatment by the Frejka pillow have been presented. That treatment was employed in 4 per cent of the treated hips. The operations consisted in inspection of the joint, transiliac osteotomy after Dega with subtrochanteric osteotomy with detorsion of the femur, of the same type of operation without opening of the joint, performance of only transiliac osteotomy or only subtrochanteric osteotomy. Because late evaluation at over 10 years of life revealed 5 per cent of hips with poor rebuilding that should be treated surgically, it has been determined that the total number of cases requiring surgery after treatment by the Frejka pillow is 9 per cent.

  14. A low-friction high-load thrust bearing and the human hip joint

    Energy Technology Data Exchange (ETDEWEB)

    McIlraith, A H, E-mail: a.h.mci@xtra.co.n [Physics and Engineering Laboratory, Lower Hutt (New Zealand)

    2010-06-15

    A hydrostatic thrust bearing operating at a pressure of 130 MPa and with a coefficient of friction rising to 0.004 in 6 days is described. It consists of interleaved oil-coated Mylar and brass sheets, each 0.1 mm thick. At this pressure, the Mylar deforms to reveal a pool of lubricant bounded by contacting layers at its edges where the pressure tapers off to zero. Thus, most of the load is borne by the oil so its effective Coulomb (slip-stick) friction is very low. Expressions for the effective coefficient of friction, the area of the solid-to-solid contact and the torque needed to rotate the bearing are given in terms of its geometry, the viscosity of the lubricant and elapsed time. The mechanism of a bearing with similar geometry and properties, the human hip joint, is compared with this plastic bearing. While their low friction properties arise from the same basic cause, the different natures of their soft deformable materials lead to the hip joint having a much wider range of action. This work is an example of new engineering leading to a fresh insight into an action of Nature, which in turn suggests an improvement in engineering.

  15. A low-friction high-load thrust bearing and the human hip joint.

    Science.gov (United States)

    McIlraith, A H

    2010-06-01

    A hydrostatic thrust bearing operating at a pressure of 130 MPa and with a coefficient of friction rising to 0.004 in 6 days is described. It consists of interleaved oil-coated Mylar and brass sheets, each 0.1 mm thick. At this pressure, the Mylar deforms to reveal a pool of lubricant bounded by contacting layers at its edges where the pressure tapers off to zero. Thus, most of the load is borne by the oil so its effective Coulomb (slip-stick) friction is very low. Expressions for the effective coefficient of friction, the area of the solid-to-solid contact and the torque needed to rotate the bearing are given in terms of its geometry, the viscosity of the lubricant and elapsed time. The mechanism of a bearing with similar geometry and properties, the human hip joint, is compared with this plastic bearing. While their low friction properties arise from the same basic cause, the different natures of their soft deformable materials lead to the hip joint having a much wider range of action. This work is an example of new engineering leading to a fresh insight into an action of Nature, which in turn suggests an improvement in engineering.

  16. A simple technique to retrieve broken guide wire transfixing hip joint

    Directory of Open Access Journals (Sweden)

    Daya Krishna

    2015-01-01

    Full Text Available While operating on the hip joint, breaking of guide wire became a challenge for treating orthopedic surgeon. Here we report a simple method of removal, which requires limited resources and does not need sophisticated instrumentation. By using this method, we remove broken guide wire in a patient of sub-trochantric fracture of femur managed by close reduction and internal fixation by proximal femoral nail. During the removal of the guide wire, after placing distal screw in the neck the guide wire comes out with some difficulty in the final view on image intensifier - the guide wire broken and transfixes the hip joint but does not enter the pelvis. After removal of the distal screw, its cannulated drill bit was connected to a T-handle and introduced into the track of distal screw up to the broken distal end of guide wire and slow manual reaming done under C-arm image intensifier to prevent damage to the articular cartilage. This process was repeated three times after cleaning drill bit each time to clear the base of guide wire for grasping its distal end. With the help of Kerryson rounger/grasper, the distal end of the guide wire was grasped and easily removed. The distal screw was placed in its original track and the procedure was completed.

  17. 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 (Racracking, 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Biotribology of Cartilage Wear in Knee and Hip Joints Review of Recent Developments

    Science.gov (United States)

    Gulsen, Akdogan; Merve, Goncu; Meltem, Parlak

    2018-01-01

    Nowadays, the problem of wear in the knee and hip joints is an important issue that concerns many people and still requires new solutions. In recent years, researchers dealing with knee and hip articular cartilage erosion continue to investigate the subject in terms of biotribology. In this study, recent developments and studies in this relevant area are been examined. By using the basic principles of tribology, useful new methods that can be used in the field of biotribology can be produced. Artificial joints designed using various materials such as metals, ceramics, polymers and composites are still being studied. New studies in this area will affect the development of implant technology. Different alloys or composites are currently being tested for new implant designs. Moving implants with a risk of wear are tested in laboratory conditions in simulator devices before they are used in the human body. Major topics such as nanotechnology, tissue engineering, orthopedics, tribology, biotribology, lubrication, organ transplantation and artificial organs, which are still important today, will be useful in the search for finding suitable solutions in the future in biotribological studies. This review article aims to provide an overview of in-vitro studies at the theoretical and laboratory conditions that must be performed prior to clinical investigation.

  19. Effect of compensatory trunk movements on knee and hip joint loading during gait in children with different orthopedic pathologies.

    Science.gov (United States)

    Stief, Felix; Böhm, Harald; Ebert, Carsten; Döderlein, Leonhard; Meurer, Andrea

    2014-03-01

    Ipsilateral trunk lean toward the affected stance limb has been identified as a compensatory mechanism to unload the hip joint. However, this altered gait pattern increases the lever arm around the knee joint by shifting the ground reaction vector more lateral to the knee joint center, which could be sufficient to deform the lateral compartment of the knee. The purpose of the present study was to show the effect of ipsilateral trunk lean on hip and knee joint moments in the frontal plane in 132 young patients with different orthopedic diagnosis. Linear correlations between ipsilateral trunk lean and the external knee and/or hip adduction moment were detected for patients with Legg-Calvé-Perthes disease (LCPD), arthrogryposis multiplex congenita, myelomeningocele, and unilateral cerebral palsy (CP). In contrast, children with bilateral CP did not show such a relationship due to an increased internal foot placement. In comparison to the hip joint, the effect of ipsilateral trunk lean in patients with LCPD is obviously more pronounced in the knee joint. The valgus thrust of the knee could initiate degenerative changes by placing altered loads on regions of the articular cartilage that were previously conditioned for different load levels. The results suggest that the ipsilateral trunk lean should not be considered and recommended as unloading mechanism for the hip joint on its own but also as a potential increased joint loading of the lateral knee compartment. Therefore, an acceptable therapy concept for limping patients should aim for an inconspicuous gait pattern with a reduced trunk movement. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Wang, Yuanyuan; Simpson, Julie Anne; Wluka, Anita E; English, Dallas R; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M

    2011-01-16

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

  1. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial.

    Science.gov (United States)

    Sled, Elizabeth A; Khoja, Latif; Deluzio, Kevin J; Olney, Sandra J; Culham, Elsie G

    2010-06-01

    Hip abductor muscle weakness may result in impaired frontal-plane pelvic control during gait, leading to greater medial compartment loading in people with knee osteoarthritis (OA). This study investigated the effect of an 8-week home strengthening program for the hip abductor muscles on knee joint loading (measured by the external knee adduction moment during gait), strength (force-generating capacity), and function and pain in individuals with medial knee OA. The study design was a nonequivalent, pretest-posttest, control group design. Testing was conducted in a motor performance laboratory. An a priori sample size calculation was performed. Forty participants with knee OA were matched for age and sex with a control group of participants without knee OA. Participants with knee OA completed a home hip abductor strengthening program. Three-dimensional gait analysis was performed to obtain peak knee adduction moments in the first 50% of the stance phase. Isokinetic concentric strength of the hip abductor muscles was measured using an isokinetic dynamometer. The Five-Times-Sit-to-Stand Test was used to evaluate functional performance. Knee pain was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. Following the intervention, the OA group demonstrated significant improvement in hip abductor strength, but not in the knee adduction moment. Functional performance on the sit-to-stand test improved in the OA group compared with the control group. The OA group reported decreased knee pain after the intervention. Gait strategies that may have affected the knee adduction moment, including lateral trunk lean, were not evaluated in this study. Hip abductor strengthening did not reduce knee joint loading but did improve function and reduce pain in a group with medial knee OA.

  2. 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 osteoarthritis entered the regression model, however, greater spine BMD was associated with greater facet joint osteoarthritis (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.

  3. Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association.

    Science.gov (United States)

    Matsumoto, Tadami; Kaneuji, Ayumi; Hiejima, Yoshimitsu; Sugiyama, Hajime; Akiyama, Haruhiko; Atsumi, Takashi; Ishii, Masaji; Izumi, Kiyoko; Ichiseki, Toru; Ito, Hiroshi; Okawa, Takahiro; Ohzono, Kenji; Otsuka, Hiromi; Kishida, Shunji; Kobayashi, Seneki; Sawaguchi, Takeshi; Sugano, Nobuhiko; Nakajima, Ikumasa; Nakamura, Shigeru; Hasegawa, Yukiharu; Fukuda, Kanji; Fujii, Genji; Mawatari, Taro; Mori, Satoshi; Yasunaga, Yuji; Yamaguchi, Masao

    2012-01-01

    The Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease. With the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we prepared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Japanese patients with hip-joint disease and previously devised evaluation criteria. In the survey, we collected information on 501 cases, and 402 were subjected to factor analysis. From this, we formulated three categories-movement, mental, and pain-each comprising 7 items, for a total of 21 items to be used as evaluation criteria for hip-joint function. The Cronbach's α coefficients for the three categories were 0.93, 0.93, and 0.95, respectively, indicating the high reliability of the evaluation criteria. The 21 items included some related to the Asian lifestyle, such as use of a Japanese-style toilet and rising from the floor, which are not included in other evaluation tools. This self-administered questionnaire may become a useful tool in the evaluation of not only Japanese patients, but also of members of other ethnic groups who engage in deep flexion of the hip joint during daily activities.

  4. What is the success of treatment of hip and knee candidal periprosthetic joint infection?

    Science.gov (United States)

    Ueng, Steve W N; Lee, Ching-Yu; Hu, Chih-chien; Hsieh, Pang-Hsin; Chang, Yuhan

    2013-09-01

    Fungal infection at an arthroplasty site is rare and poses a therapeutic challenge. To the best of our knowledge, no reports have been published thus far on the success rate of prosthesis reimplantation after fungal prosthetic joint infections. We asked: (1) What is the success rate in terms of infection eradication using a two-stage exchange arthroplasty in patients with hip or knee fungal periprosthetic joint infections, particularly focusing on Candida infections? (2) What patient-, infection-, and treatment-related variables are associated with the success or failure of treatment? From January 2000 to December 2010, 16 patients with hip or knee candidal periprosthetic joint infections were treated with two-stage exchange arthroplasty at our institute. Treatment success was defined as a well-functioning joint without relapse of candidal infection after prosthesis reimplantation, while treatment failure was defined as uncontrolled or relapse of candidal infection or mortality. Variables, including age, sex, comorbidities, microbiology, antimicrobial agents used, and operative methods, were analyzed. Minimum followup was 28 months (mean, 41 months; range, 28-90 months). At latest followup, the treatment failed to eradicate the infection in eight of the 16 patients, and there were four deaths related to fungemia. Four patients required permanent resection arthroplasty owing to uncontrolled or recurrent candidal infections. All eight patients (50% successful rate) who had their infections eradicated and successful prosthesis reimplantation had prolonged treatment with oral fluconazole before (mean, 8 months) and after (mean, 2.2 months) prosthesis reimplantation. The antifungal therapy correlated with successful treatment. Renal insufficiency, hypoalbuminemia, anemia, and chronic obstructive pulmonary disease were significantly more prevalent in the treatment-failure group than in the treatment-success group. Half of the patients treated with two-stage exchange

  5. Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients.

    Directory of Open Access Journals (Sweden)

    Nussbaumer Silvio

    2010-08-01

    Full Text Available Abstract Background The aims of this study were to evaluate the construct validity (known group, concurrent validity (criterion based and test-retest (intra-rater reliability of manual goniometers to measure passive hip range of motion (ROM in femoroacetabular impingement patients and healthy controls. Methods Passive hip flexion, abduction, adduction, internal and external rotation ROMs were simultaneously measured with a conventional goniometer and an electromagnetic tracking system (ETS on two different testing sessions. A total of 15 patients and 15 sex- and age-matched healthy controls participated in the study. Results The goniometer provided greater hip ROM values compared to the ETS (range 2.0-18.9 degrees; P P Conclusions The present study suggests that goniometer-based assessments considerably overestimate hip joint ROM by measuring intersegmental angles (e.g., thigh flexion on trunk for hip flexion rather than true hip ROM. It is likely that uncontrolled pelvic rotation and tilt due to difficulties in placing the goniometer properly and in performing the anatomically correct ROM contribute to the overrating of the arc of these motions. Nevertheless, conventional manual goniometers can be used with confidence for longitudinal assessments in the clinic.

  6. Three-dimensional friction measurement during hip simulation.

    Directory of Open Access Journals (Sweden)

    Robert Sonntag

    Full Text Available Wear of total hip replacements has been the focus of many studies. However, frictional effects, such as high loading on intramodular connections or the interface to the bone, as well as friction associated squeaking have recently increased interest about the amount of friction that is generated during daily activities. The aim of this study was thus to establish and validate a three-dimensional friction setup under standardized conditions.A standard hip simulator was modified to allow for high precision measurements of small frictional effects in the hip during three-dimensional hip articulation. The setup was verified by an ideal hydrostatic bearing and validated with a static-load physical pendulum and an extension-flexion rotation with a dynamic load profile. Additionally, a pendulum model was proposed for screening measurement of frictional effects based on the damping behavior of the angular oscillation without the need for any force/moment transducer. Finally, three-dimensional friction measurements have been realized for ceramic-on-polyethylene bearings of three different sizes (28, 36 and 40 mm.A precision of less than 0.2 Nm during three-dimensional friction measurements was reported, while increased frictional torque (resultant as well as taper torque was measured for larger head diameters. These effects have been confirmed by simple pendulum tests and the theoretical model. A comparison with current literature about friction measurements is presented.This investigation of friction is able to provide more information about a field that has been dominated by the reduction of wear. It should be considered in future pre-clinical testing protocols given by international organizations of standardization.

  7. Anterior superior dislocation of the hip joint: A report of 3 cases and ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip forms approximately 11% of hip dislocations and is divided into superior and inferior types. Anterior superior hip dislocation accounts for 10% of anterior hip dislocations. The clinical appearance of anterior superior hip dislocation resembles that of a fracture of the femoral neck, ...

  8. Hinged distraction of the hip joint in the treatment of Perthes disease: evaluation at skeletal maturity.

    Science.gov (United States)

    Laklouk, Mohamed Abdel-Rehim; Hosny, Gamal Ahmed

    2012-09-01

    The aim of this work is to determine the effect of this type of treatment on the shape of the femoral head, the range of motion (ROM), radiological changes in the femoral head, and the prognosis of Perthes disease at skeletal maturity. From 1998 to 2007, 53 patients with Perthes disease were treated with a combination of soft tissue release and joint distraction with a hinged monolateral external fixator in 32 patients and by Ilizarov external fixator in 21 patients. Nineteen of our 53 patients attained skeletal maturity and were evaluated in our study. This study included 15 boys and four girls, mean age at surgery 9.3 years (range 7.2-13.1), and mean age at the last follow-up 17.4 years (range 14.9-21.3). The duration of symptoms varied from a period of 6 to 60 months before the operation. Radiographs taken during the fragmentation stage of the disease were classified by the lateral pillar classification of Herring; 19 of our patients attained skeletal maturity and were evaluated. Clinical assessment included the Harris hip score, hip ROM, and limb length discrepancy. Radiographic assessment included sharp transverse acetabular inclination, the uncoverage percentage, the epiphyseal index before surgery (modified Eyre-Brook), at frame removal, and at the last follow-up, the epiphyseal quotient (of Sjovall), and the Stulberg classification. The mean follow-up was 7.2 years (range 4.1-11.3). The mean Harris hip score was 87.1/100 (range 49.2-94.8). An improvement in hip (ROM) of 83.3% of the normal range was restored. There was a marked improvement in the degree of pain and limp postoperatively. The hip ROM was slightly limited in most patients, and seven patients had limb shortening of between 1 and 3 cm. The mean sharp transverse acetabular inclination of the affected side was 44° (range 35-51) compared with 37° for the unaffected side (P=0.042). The mean uncoverage percentage was 36% (range 24-45) compared with 21% for the unaffected side (P=0.027). The mean

  9. Normalizing hip muscle strength: establishing body-size-independent measurements.

    Science.gov (United States)

    Bazett-Jones, David M; Cobb, Stephen C; Joshi, Mukta N; Cashin, Susan E; Earl, Jennifer E

    2011-01-01

    To investigate the effectiveness of computing body-size-independent hip strength measures using muscle-specific allometric scaling and ratio standard normalization methods. Cross-sectional study. University laboratory. A convenience sample of healthy participants (N=113; 42 men, 71 women). Not applicable. Anthropometric measurements of the leg and thigh were obtained, and maximal hip strength was tested (medial and lateral rotation, abduction, adduction, flexion, extension). Strength was measured isometrically as force (kg) and then converted to torque (Nm). The allometric scaling analysis resulted in exponents for normalizing body mass (BM) in each muscle group assessed. In addition, a 6-muscle average exponent was also computed (bavg) for force (men, .554; women, .335) and torque (men, .792; women, .482). The nonsignificant results of the linear regression analysis revealed that normalizing hip strength to BM(bavg) (hip strength/BM(bavg)) effectively removed the influence of BM on force and torque. However, sex should be factored into analyses of allometric scaling because men have higher b-values than women for both force and torque. The linear regression analyses also demonstrated that force normalized to BM (P=.162-.895) and torque normalized to BM × Height (P=.146-.889) were body-size-independent measures. Force normalized to BM⁰·⁶⁷ (P=.001-.191) and body mass index (BMI) (P=normalized to BM (P=.004-.415) and BMI (PNormalizing force and torque to BM(bavg) is the most effective method of removing body-size dependence and allowing comparisons of persons with differing body sizes. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Bart Malfait

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

  11. Chondrogenic capability of osteoarthritic chondrocytes from the trapeziometacarpal and hip joints.

    Science.gov (United States)

    Lovati, Arianna B; Colombini, Alessandra; Recordati, Camilla; Ceriani, Cristina; Zagra, Luigi; Berzero, Gianfranco; Moretti, Matteo

    2016-03-01

    Osteoarthritis is the most common degenerative disease of joints like the hip and the trapeziometacarpal joint (rhizarthrosis). In this in vitro study, we compared the chondrogenesis of chondrocytes derived from the trapezium and the femoral head cartilage of osteoarthritic patients to have a deeper insight on trapezium chondrocyte behavior as autologous cell source for the repair of cartilage lesions in rhizarthrosis. Chondrocytes collected from trapezium and femoral head articular cartilage were cultured in pellets and analyzed for chondrogenic differentiation, cell proliferation, glycosaminoglycan production, gene expression of chondrogenic and fibrous markers, histological and immunohistochemical analyses. Our results showed a higher cartilaginous matrix deposition and a lower fibrocartilaginous phenotype of the femoral chondrocytes with respect to the trapezium chondrocytes assessed by a higher absolute glycosaminoglycan and type II collagen production, thus demonstrating a superior chondrogenic potential of the femoral with respect to the trapezium chondrocytes. The differences in chondrogenic potential between trapezium and femoral head chondrocytes confirmed a lower regenerative capability in the trapezium than in the femoral head cartilage due to the different environment and loading acting on these joints that affects the metabolism of the resident cells. This could represent a limitation to apply the cell therapy for rhizoarthrosis.

  12. Supramolecular Organization of Collagen Fibrils in Healthy and Osteoarthritic Human Knee and Hip Joint Cartilage.

    Directory of Open Access Journals (Sweden)

    Riccardo Gottardi

    Full Text Available Cartilage matrix is a composite of discrete, but interacting suprastructures, i.e. cartilage fibers with microfibrillar or network-like aggregates and penetrating extrafibrillar proteoglycan matrix. The biomechanical function of the proteoglycan matrix and the collagen fibers are to absorb compressive and tensional loads, respectively. Here, we are focusing on the suprastructural organization of collagen fibrils and the degradation process of their hierarchical organized fiber architecture studied at high resolution at the authentic location within cartilage. We present electron micrographs of the collagenous cores of such fibers obtained by an improved protocol for scanning electron microscopy (SEM. Articular cartilages are permeated by small prototypic fibrils with a homogeneous diameter of 18 ± 5 nm that can align in their D-periodic pattern and merge into larger fibers by lateral association. Interestingly, these fibers have tissue-specific organizations in cartilage. They are twisted ropes in superficial regions of knee joints or assemble into parallel aligned cable-like structures in deeper regions of knee joint- or throughout hip joints articular cartilage. These novel observations contribute to an improved understanding of collagen fiber biogenesis, function, and homeostasis in hyaline cartilage.

  13. High-tech hip implant for wireless temperature measurements in vivo.

    Directory of Open Access Journals (Sweden)

    Georg Bergmann

    Full Text Available When walking long distances, hip prostheses heat up due to friction. The influence of articulating materials and lubricating properties of synovia on the final temperatures, as well as any potential biological consequences, are unknown. Such knowledge is essential for optimizing implant materials, identifying patients who are possibly at risk of implant loosening, and proving the concepts of current joint simulators. An instrumented hip implant with telemetric data transfer was developed to measure the implant temperatures in vivo. A clinical study with 100 patients is planned to measure the implant temperatures for different combinations of head and cup materials during walking. This study will answer the question of whether patients with synovia with poor lubricating properties may be at risk for thermally induced bone necrosis and subsequent implant failure. The study will also deliver the different friction properties of various implant materials and prove the significance of wear simulator tests. A clinically successful titanium hip endoprosthesis was modified to house the electronics inside its hollow neck. The electronics are powered by an external induction coil fixed around the joint. A temperature sensor inside the implant triggers a timer circuit, which produces an inductive pulse train with temperature-dependent intervals. This signal is detected by a giant magnetoresistive sensor fixed near the external energy coil. The implant temperature is measured with an accuracy of 0.1°C in a range between 20°C and 58°C and at a sampling rate of 2-10 Hz. This rate could be considerably increased for measuring other data, such as implant strain or vibration. The employed technique of transmitting data from inside of a closed titanium implant by low frequency magnetic pulses eliminates the need to use an electrical feedthrough and an antenna outside of the implant. It enables the design of mechanically safe and simple instrumented implants.

  14. Effects of denervation of the hip joint on results of clinical observations and instrumented gait analysis in dogs with sodium urate crystal-induced synovitis.

    Science.gov (United States)

    Hassan, Elham A; Lambrechts, Nicolaas E; Weng, Hsin-Yi; Snyder, Paul W; Breur, Gert J

    2016-11-01

    OBJECTIVE To evaluate the effects of selective hip joint denervation on gait abnormalities and signs of hip joint pain in dogs. ANIMALS 6 healthy adult hound-type dogs. PROCEDURES Minimally invasive denervation was performed on the right hip joint of each dog. Two weeks later, sodium urate was injected into the right hip joint to induce synovitis. Dogs were evaluated clinically and by use of instrumented gait analysis before and 2 weeks after minimally invasive denervation and 4, 8, and 24 hours after induction of synovitis. Dogs were euthanized, and necropsy and histologic examination were performed. RESULTS No kinetic or kinematic gait modifications were detected 2 weeks after minimally invasive denervation. Denervation did not eliminate signs of pain and lameness associated with sodium urate-induced synovitis. Results of histologic examination confirmed that denervation was an effective method for transecting the innervation of the craniolateral and caudolateral aspects of the hip joint capsule. CONCLUSIONS AND CLINICAL RELEVANCE In this study, minimally invasive denervation did not result in gait modifications in dogs. Denervation did not abolish the signs of pain and lameness associated with generalized induced synovitis of the hip joint. Further studies are required before conclusions can be drawn regarding the clinical usefulness of hip joint denervation for dogs with hip dysplasia.

  15. 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

    . MATERIAL AND METHODS 167 LCP patients presented to our institution from 1941 to 1962. All patients were treated conservatively by a Thomas splint. Retrospectively medical records and radiographs were retrieved. At follow-up weight-bearing AP pelvis radiographs were obtained. OA was present when the minimum...... joint space width was lost...... to follow-up, 5) patients with previous surgery to pelvis or lower limbs and 6) dead persons. 52 patients (55 hips) were enrolled in the study and 115 patients (136 hips) were excluded. Mean age for men at follow-up was 53 years and for women 55 years. RESULTS In the LCP group four hips of 50 hips had OA...

  16. 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.

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

    Science.gov (United States)

    Haringová, Andrea; Stračár, Karol; Prikkel, Karol

    2014-12-01

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

  18. 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...

  19. Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain.

    Science.gov (United States)

    Nevin, Fiona; Delahunt, Eamonn

    2014-03-01

    The objective of the present study was to investigate whether differences exist in adductor squeeze test values and hip joint range of motion between athletes with longstanding groin pain and injury-free controls. Observational study with a case control design. Eighteen Gaelic football players with current longstanding groin pain and 18 matched injury-free controls were assessed on their performance of the adductor squeeze test. Adductor squeeze test values were quantified using a sphygmomanometer. A fluid-filled inclinometer was used to assess hip joint internal and external rotation range of motion. A bent knee fall-out test was also utilised to examine hip joint range of motion. A significant difference in adductor squeeze test values was observed between the control group (269 ± 25 mmHg) and longstanding groin pain group (202 ± 36 mmHg; pfootball players with longstanding groin pain exhibit decreased adductor squeeze test values and hip joint range of motion when compared to non-injured players. These findings have implications for assessment and rehabilitation practices, as well as return to play criteria. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of the bone mineral density of the subjects with avascular necrosis of hip joint.

    Science.gov (United States)

    Karimi, Mohammad Taghi; Nodoshan, Seyed Mohammad Mousavi

    2016-01-01

    The head of femur is deformed in subjects with Leg Calve Perthes Disease (LCPD). It may be due to an increase in loads applied on the hip, decrease in hip joint containment and decrease in bone mineral density (BMD) of femur. Unfortunately there is not enough evidence regarding BMD of femur in subjects with LCPD. Therefore, the aim of this study is to evaluate BMD in subjects with Perthes disease. Two subjects with LCPD participated in this study. The BMD and Young modulus of elasticity (E) of different parts of femur of both Perthes and sound sides were evaluated by use of Mimics software. The difference between BMD of femur in both sides of each subject was compared by use of two sample t test. There was no difference between the BMD and E modulus of femur in Perthes and sound sides in both subjects (p-value>0.05). As there is no difference between the BMD of femur in Perthes side, it can be concluded that the deformation of femur in these subjects may not be due to a change in BMD.

  1. Method of superconducting joint and its measurement

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo Gon; Lee, Ho Jin; Hong, Gye Won [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-04-01

    The development of joint techniques for superconducting wires is essential to fabricate the high quality superconducting magnet. In this report, the various joining methods and their measuring techniques were reviewed. In order to fabricate a precise superconducting magnet, joining and measuring experiment by using the field decay technique carried out. The contact resistance of coupled specimens with joint was measured as 3.0 x 10{sup -15} ohm at 1 Tesla which is lower than that of the real operating condition of MRI magnet. It is expected that these data can be used to design and fabricate the superconducting magnets successfully. (Author) 12 refs., 20 figs., 2 tabs.

  2. 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). © IMechE 2014.

  3. BILATERAL PATHOLOGICAL HIP DISLOCATION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Yuriy E. Garkavenko

    2017-03-01

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

  4. Wearable Conductive Fiber Sensors for Multi-Axis Human Joint Angle Measurements

    Directory of Open Access Journals (Sweden)

    Asada H Harry

    2005-03-01

    Full Text Available Abstract Background The practice of continuous, long-term monitoring of human joint motion is one that finds many applications, especially in the medical and rehabilitation fields. There is a lack of acceptable devices available to perform such measurements in the field in a reliable and non-intrusive way over a long period of time. The purpose of this study was therefore to develop such a wearable joint monitoring sensor capable of continuous, day-to-day monitoring. Methods A novel technique of incorporating conductive fibers into flexible, skin-tight fabrics surrounding a joint is developed. Resistance changes across these conductive fibers are measured, and directly related to specific single or multi-axis joint angles through the use of a non-linear predictor after an initial, one-time calibration. Because these sensors are intended for multiple uses, an automated registration algorithm has been devised using a sensitivity template matched to an array of sensors spanning the joints of interest. In this way, a sensor array can be taken off and put back on an individual for multiple uses, with the sensors automatically calibrating themselves each time. Results The wearable sensors designed are comfortable, and acceptable for long-term wear in everyday settings. Results have shown the feasibility of this type of sensor, with accurate measurements of joint motion for both a single-axis knee joint and a double axis hip joint when compared to a standard goniometer used to measure joint angles. Self-registration of the sensors was found to be possible with only a few simple motions by the patient. Conclusion After preliminary experiments involving a pants sensing garment for lower body monitoring, it has been seen that this methodology is effective for monitoring joint motion of the hip and knee. This design therefore produces a robust, comfortable, truly wearable joint monitoring device.

  5. A retrospective study of canine hip dysplasia in 116 military working dogs. Part I: Angle measurements and orthopedic foundation for animals (OFA) grading.

    Science.gov (United States)

    Banfield, C M; Bartels, J E; Hudson, J A; Wright, J C; Hathcock, J T; Montgomery, R D

    1996-01-01

    The progression of hip dysplasia was investigated in 116 military working dogs. Serial pelvic radiographs were graded for degree of dysplasia and degenerative joint disease (DJD). Norberg angles, angles of inclination, and joint space widths were measured. There was a significant correlation between the Norberg angle and the degree of dysplasia (p less than 0.0001). Angles of inclination and joint space width measurements did not demonstrate a correlation to canine hip dysplasia. Dysplastic dogs had a significant estimated risk for development of DJD compared to normal dogs (p less than 0.0001; odds ratio of 70.2). Dogs with normal hip conformation at 24 months of age or older did not develop moderate nor severe DJD.

  6. Experimental Joint Quantum Measurements with Minimum Uncertainty

    Science.gov (United States)

    Ringbauer, Martin; Biggerstaff, Devon N.; Broome, Matthew A.; Fedrizzi, Alessandro; Branciard, Cyril; White, Andrew G.

    2014-01-01

    Quantum physics constrains the accuracy of joint measurements of incompatible observables. Here we test tight measurement-uncertainty relations using single photons. We implement two independent, idealized uncertainty-estimation methods, the three-state method and the weak-measurement method, and adapt them to realistic experimental conditions. Exceptional quantum state fidelities of up to 0.999 98(6) allow us to verge upon the fundamental limits of measurement uncertainty.

  7. Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients.

    Science.gov (United States)

    Bozic, Kevin J; Lau, Edmund; Kurtz, Steven; Ong, Kevin; Rubash, Harry; Vail, Thomas P; Berry, Daniel J

    2012-05-02

    The patient-related risk factors for periprosthetic joint infection and postoperative mortality in elderly patients undergoing total hip arthroplasty are poorly understood. The purpose of this study was to identify the specific patient comorbidities that are associated with an increased risk of periprosthetic joint infection and of ninety-day postoperative mortality in U.S. Medicare patients undergoing total hip arthroplasty. The Medicare 5% sample claims database was used to calculate the relative risk of periprosthetic joint infection and of ninety-day postoperative mortality as a function of preexisting comorbidities in 40,919 patients who underwent primary total hip arthroplasty between 1998 and 2007. The impact of twenty-nine comorbid conditions on periprosthetic joint infection and on postoperative mortality was examined with use of Cox regression, controlling for age, sex, census region, public assistance, and all other baseline comorbidities. The adjusted hazard ratios for all comorbid conditions were evaluated, and the Wald chi-square statistic was used to rank the degree of association of each condition with periprosthetic joint infection and with postoperative mortality. The Bonferroni-Holm method was used to adjust for the multiple comparisons resulting from the number of comorbid conditions analyzed. Comorbid conditions associated with an increased adjusted risk of periprosthetic joint infection (in decreasing order of significance, p disease (hazard ratio [HR] = 1.71), obesity (HR = 1.73), coagulopathy (HR = 1.58), and preoperative anemia (HR = 1.36). Comorbid conditions associated with an increased adjusted risk of ninety-day postoperative mortality (in decreasing order of significance, p disease (HR = 1.98), dementia (HR = 2.04), hemiplegia or paraplegia (HR = 2.62), cerebrovascular disease (HR = 1.40), and chronic pulmonary disease (HR = 1.32). We identified specific patient comorbidities that were independently associated with an increased risk of

  8. 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

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

    Science.gov (United States)

    2012-01-01

    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 arthritis

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

    Science.gov (United States)

    Ackerman, Ilana N; Osborne, Richard H

    2012-12-20

    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). 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. 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 arthritis and hip OA) and greater

  11. Dynamic ultrasonographic measurement of passive coxofemoral joint laxity in puppies.

    Science.gov (United States)

    O'Brien, R T; Dueland, R T; Adams, W C; Meinen, J

    1997-01-01

    A new method of dynamic ultrasonographic evaluation of passive coxofemoral joint laxity was used to examine a total of 30 greyhound (n = 13) and nongreyhound (n = 17) puppies. Puppies were evaluated sonographically at four, six, eight, 12, 16, and 26 weeks of age. The coxofemoral joints were distracted manually, and the femoral head displacements were measured during distraction. The greyhounds had significantly smaller (p less than 0.01) maximum distraction distance (mean +/- standard deviation [SD], 0.11 +/- 0.04 cm) than nongreyhound puppies (mean +/- SD, 0.26 +/- 0.10 cm). In six- to eight-week-old puppies, the maximum distraction distance was correlated significantly (p of 0.0001, adjusted correlation coefficient [r2] of 0.27) with stress radiographic indices. Coxofemoral joints interpreted as being abnormal on hip-extended radiographs taken at one year of age were associated significantly (p of 0.0001) with higher maximum distraction distances in six- to eight-week-old puppies.

  12. 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.

  13. 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.

  14. Bacterial infective arthritis of the coxofemoral joint in dogs with hip dysplasia.

    Science.gov (United States)

    Benzioni, H; Shahar, R; Yudelevitch, S; Milgram, J

    2008-01-01

    The objective of this study was to describe seven cases of unilateral bacterial infective coxarthritis from a total of 19 cases of bacterial infective arthritis (BIA), presenting over a two year period. We recorded the history, clinical signs, diagnostic process, treatment and clinical outcome in these cases. The data were obtained from medical records, review of the radiographs, and telephone follow-up with the owners. All of the dogs in this study had severe chronic osteoarthritis secondary to hip dysplasia, which caused periodic hind limb lameness. They were all admitted with severe acute hind-limb lameness. Pelvic radiographs were performed under general anaesthesia shortly after presentation, followed immediately by arthrocentesis of the affected joint. The synovial fluid was evaluated microscopically by direct smear and a sample was sent for culture and sensitivity. An attempt was not made to drain or lavage the affected joint during the course of treatment. The initial choice of antibiotics was empiric and subsequently modified, as required, based on the sensitivity results. Four of the dogs showed a rapid return to weight-bearing after the initiation of antibiotic treatment, and all of the patients returned to their pre-BIA level of function. Neither recurrent infections nor any adverse sequela requiring further intervention were reported by the owners on telephone follow-up.

  15. Trends in the phenotypic hip status of selected breeds of dog as measured by the New Zealand Veterinary Association Hip Dysplasia scheme (1990-2008).

    Science.gov (United States)

    Worth, A J; Bridges, J P; Jones, G

    2011-03-01

    To determine whether there has been improvement in the phenotypic hip dysplasia status in four susceptible dog breeds as measured by the New Zealand Veterinary Association (NZVA) Canine Hip Dysplasia (CHD) scheme. A retrospective analysis of the NZVA CHD database was performed using records of all German Shepherd dogs, Labrador Retrievers, Golden Retrievers and Rottweilers that had undergone evaluation for hip dysplasia between 1990 and 2008. The effect of date of birth on the total hip score was analysed using linear regression, including the covariates of age and gender. When a significant effect of date of birth on total score was noted, ordinal logistic regression was performed to determine the probability of different grades of the Norberg angle and subluxation scores by year of birth; these categories being most indicative of laxity of the coxofemoral joint. Given the known heritability of hip phenotype, determined using radiological measurements, the hypothesis was that if sufficient selection pressure has been applied there would have been a trend towards a lower total score over time. For Labrador Retrievers (n=1,451), Golden Retrievers (n=896) and Rottweilers (n=313), there was no effect of date of birth on total score over the period of the study (p>0.1). For German Shepherd dogs (n=1,087), there was a significant trend to a lower total score over time (p=0.0003). However the actual size of the effect was small. Ordinal logistic regression on the Norberg angle and subluxation scores for German Shepherd dogs demonstrated a significant lowering of grade in both of these measures of hip laxity. This study failed to show significant improvement in the phenotypic hip status of three out of the four most populous large-dog breeds in the NZVA CHD database. Even in the German Shepherd dog, the trend towards a lower total score did not represent a substantial change. Lack of evidence of phenotypic improvement may be due to insufficient selection pressure over the

  16. Pathological gait in children with Legg-Calvé-Perthes disease and proposal for gait modification to decrease the hip joint loading.

    Science.gov (United States)

    Svehlík, Martin; Kraus, Tanja; Steinwender, Gerhard; Zwick, Ernst B; Linhart, Wolfgang E

    2012-06-01

    Legg-Calvé-Perthes disease (LCP) severely limits the range of hip motion and hinders a normal gait. Loading of the hip joint is a major consideration in LCP treatment. The aim of this study was to evaluate gait patterns in LCP and identify gait modifications to decrease the load on the affected hip. Forty children with unilateral LCP were divided into three groups based on the time base integral of the hip abductor moments during single stance on the affected side acquired during instrumented 3D gait analysis. X-rays of the affected hip were classified according to Herring and Catterall. Children in the "unloading" group spontaneously adopted a Duchenne-like gait with pelvis elevation, hip abduction and external rotation during single support phase. The "normal-loading" group showed pelvis elevation with a neutral hip position in the frontal plane. In the "overloading" group the pelvis dropped to the swinging limb at the beginning of stance accompanied by prolonged hip adduction. The time base integral of the hip abductor moments during single stance correlated positively with the X-ray classifications of Herring and Catterall, hip abduction angle and age. Older children preferred to walk in hip adduction during single stance, had more impaired hips and tended to overload them. The hip overloading pattern should be avoided in children with LCP. Gait training to unload the hip might become an integral component of conservative treatment in children with LCP.

  17. The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement

    DEFF Research Database (Denmark)

    Gossec, L; Paternotte, S; Maillefert, J F

    2011-01-01

    OBJECTIVE: To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). METHODS: Design: International cross-sectional study in 10 countries. Patients: Consecutive outpatients with definite hip or knee OA...... attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. Outcome measures: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome......: In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55...

  18. Development and testing of a pelvic goniometer designed to measure pelvic tilt and hip flexion.

    Science.gov (United States)

    Sprigle, Stephen; Flinn, Nannette; Wootten, Mary; McCorry, Stephanie

    2003-06-01

    To determine the reliability and validity of a pelvic goniometer designed to measure the pelvic tilt and hip flexion during seated posture. Assessment of the seated posture requires measurement of the pelvis and hip. Determining accurate pelvic tilt and hip flexion angles during sitting is often difficult using standard techniques. A pelvic goniometer has been designed to measure pelvic tilt and hip flexion angle of persons in a seated posture. VALIDATION of the pelvic goniometer was done radiographically. Ten male volunteers sat in three postures--erect, forward or anterior tilt, and posterior tilt. Pelvic tilt and hip angle were recorded using radiographs and the pelvic goniometer. Reliability of pelvic and conventional goniometers was done using seated nondisabled subjects with physical therapists performing measurements. the average differences and correlation between the pelvic goniometer and radiographic measures were as follows--pelvic tilt: -4.9 degrees, 0.93; hip angle 1.2 degrees, 0.81. Reliability: average range of hip angle across three measures was about 3 degrees for both goniometers. The data indicate that the pelvic goniometer has utility in measuring pelvic tilt and hip angle, especially within the seated posture. Because it measures both pelvic tilt and hip angle, the pelvic goniometer has an advantage over conventional goniometers that only measure the latter. A valid and reliable tool that measures pelvic tilt and hip angle of persons in a seated posture is needed for clinical research and practice. Its applications include wheelchair seating evaluations and ergonomic assessments of seated workers.

  19. Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years.

    Science.gov (United States)

    Comba, Fernando; Yacuzzi, Carlos; Ali, Pablo J; Zanotti, Gerardo; Buttaro, Martin; Piccaluga, Francisco

    2016-01-01

    The purpose of this study is to evaluate the clinical outcomes, radiological degenerative progression and the joint preservation rate in a series of patients with Femoroacetabular Impingement (FAI) treated with hip arthroscopy at a minimum follow-up of 7 years. The predictive factors for total hip arthroplasty (THA) requirement were analyzed. Between February 2008 and February 2009, 42 consecutive patients treated with hip arthroscopy due to FAI syndrome were included. There were 15 women and 27 men with an average age of 38 years (range 23 to 56 years). The surgery involved joint damage stabilization (labral tears and/or chondrolabral injuries) and correction of associated bony deformities (cam and/or pincer lesions). A prospective clinical follow-up was made with no patient lost. We specifically addressed the need for THA. Predictive factors for THA were also analyzed. At final follow up, joint preservation rate was 83.33% (CI 95% 68,64%-93,03%). Probability of evolving to a THA in patients with radiographic preoperative Tonnis grades 0 and I was of 0% (CI 95%: 0-12.77). Probability of evolving to a THA in patients with preoperative Tonnis grades II and III was 46,67% (CI 95%21.27%-73,41%). A statistically significant difference was present between both groups (p= 0.002). Patients older than 45 years at the time of hip arthroscopy were at significant risk of evolving to a THA (p=0.0012). Excluding those patients who undergone a THA: modified HHS was 88.25 points (80-96) and radiographic analysis addressed a 14,29% (IC95% 4,81%-30,26%) of progressive degenerative changes without affecting clinical results. Hip arthroscopy for the treatment of patients with FAI syndrome showed favorable results regarding joint preservation. Patients with preoperative radiographic evidence of advanced-stage osteoarthritis and those older than 45 years at the time of surgery have higher risk of requiring THA. IV.

  20. Potential Risk to the Superior Gluteal Nerve During the Anterior Approach to the Hip Joint: An Anatomical Study.

    Science.gov (United States)

    Grob, Karl; Manestar, Mirjana; Ackland, Timothy; Filgueira, Luis; Kuster, Markus S

    2015-09-02

    The anterior approach to the hip joint is widely used in pediatric and adult orthopaedic surgery, including hip arthroplasty. Atrophy of the tensor fasciae latae muscle has been observed in some cases, despite the use of this internervous approach. We evaluated the nerve supply to the tensor fasciae latae and its potential risk for injury during the anterior approach to the hip joint. Cadaveric hemipelves (n = 19) from twelve human specimens were dissected. The course of the nerve branch to the tensor fasciae latae muscle, as it derives from the superior gluteal nerve, was studied in relation to the ascending branch of the lateral circumflex femoral artery where it enters the tensor fasciae latae. The nerve supply to the tensor fasciae latae occurs in its proximal half by divisions of the inferior branch of the superior gluteal nerve. The nerve branches were regularly coursing in the deep surface on the medial border of the tensor fasciae latae muscle. In seventeen of nineteen cases, one or two nerve branches entered the tensor fasciae latae within 10 mm proximal to the entry point of the ascending branch of the lateral circumflex femoral artery. Coagulation of the ascending branch of the lateral circumflex femoral artery and the placement of retractors during the anterior approach to the hip joint carry the potential risk for injury to the motor nerve branches supplying the tensor fasciae latae. During the anterior approach, the ligation or coagulation of the ascending branch of the lateral circumflex femoral artery should not be performed too close to the point where it enters the tensor fasciae latae. The nerve branches to the tensor fasciae latae could also be compromised by the extensive use of retractors, broaching of the femur during hip arthroplasty, or the inappropriate proximal extension of the anterior approach. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  1. Comparison of global and joint-to-joint methods for estimating the hip joint load and the muscle forces during walking

    OpenAIRE

    FRAYSSE, François; DUMAS, Raphaël; CHEZE, Laurence; WANG, Xuguang

    2009-01-01

    A three-dimensional musculoskeletal model of the lower limb was developed to study the influence of biarticular muscles on the muscle force distribution and joint loads during walking. A complete walking cycle was recorded for 9 healthy subjects using the standard optoelectronic motion tracking system. Ground contact forces were also measured using a 6-axes force plate. Inverse dynamics was used to compute net joint reactions (forces and torques) in the lower limb. A static optimization metho...

  2. 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.

  3. 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.

  4. 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.

  5. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Is the Kinect system suitable for evaluation of the hip joint range of motion and as a screening tool for femoroacetabular impingement (FAI)?

    Science.gov (United States)

    Lahner, Matthias; Mußhoff, Dennis; von Schulze Pellengahr, Christoph; Willburger, Roland; Hagen, Marco; Ficklscherer, Andreas; von Engelhardt, Lars Victor; Ackermann, Ole; Lahner, Nina; Vetter, Gregor

    2015-01-01

    In the clinical evaluation of femoroacetabular impingement (FAI), there is a lack of quantitative, reliable and informative assessment methods for the overall functional capability of an individual. We compared clinical and radiological measurements of the hip joint with a new methodology based on the concept of 3-dimensional reachable workspace using Microsoft Kinect. We assessed the correlation between the alpha angle of Nötzli on full-length radiographs and the clinical internal rotation. We evaluated the accuracy of joint positions and angles of the hip between the Kinect system and clinical examination including range of motion (ROM). The results of our clinical trial with 24 study participants showed a significant difference between normal internal rotation (> 21°) and reduced internal rotation (⩽ 21°) in comparison to the radiological alpha angle of Nötzli (P=0.026). The acquired reachable Kinect data demonstrated a moderate agreement between the Kinect and clinical examination (correlation coefficients between 0.230 and 0.375). The findings suggest that a higher grade alpha angle of Nötzli accompanies reduced clinical internal rotation. The Kinect system provides reliable results of hip ROM. However, further test series must be performed for the application of Kinect in the clinical evaluation of FAI.

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

    Science.gov (United States)

    Hou, Yali; Wang, Yachun; Lust, George; Zhu, Lan; Zhang, Zhiwu; Todhunter, Rory J

    2010-02-24

    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. 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. 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.

  8. 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.

  9. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-06-26

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

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

    Science.gov (United States)

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

    1992-07-01

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

  11. Kikuchi-Fujimoto Disease Misdiagnosed as Relapse of the Infection after Treatment of Periprosthetic Hip Joint Infection.

    Science.gov (United States)

    Min, Kyung-Keun; Min, Byung-Woo; Lee, Kyung-Jae; Choi, Jung-Hoon

    2016-12-01

    Periprosthetic joint infection (PJI) of the hip can be difficult to treat and can lead to a number of problems including: i) severe functional decline of the hip joint and ii) increasing financial burden for patients due to long treatment periods and the need for repeated surgical interventions. Because there is risk of inadequate control of infection or relapse of a preexisting infection following the treatment of PJI through surgery, it is important to closely observe clinical symptoms such as systemic fever. Kikuchi-Fujimoto disease is usually a self-limiting disease characterized by fever and cervical lymphadenopathy. We report one case of Kikuchi-Fujimoto disease, with literatures review, that was mistaken for an infection relapse after surgical treatment of the PJI due to sustained fever postoperatively.

  12. Chemical Coding of Sensory Neurons Supplying the Hip Joint Capsule in the Sheep.

    Science.gov (United States)

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

    2017-04-01

    Immunohistochemical properties of nerve fibres supplying the joint capsule were previously described in many mammalian species, but the localization of sensory neurons supplying this structure was studied only in laboratory animals, the rat and rabbit. However, there is no comprehensive data on the chemical coding of sensory neurons projecting to the hip joint capsule (HJC). The aim of this study was to establish immunohistochemical properties of sensory neurons supplying HJC in the sheep. The study was carried out on 10 sheep, weighing about 30-40 kg. The animals were injected with a retrograde neural tracer Fast Blue (FB) into HJC. Sections of the spinal ganglia (SpG) with FB-positive (FB+) neurons were stained using antibodies against calcitonin gene-related peptide (CGRP) substance P (SP), pituitary adenylate cyclase-activating peptide (PACAP), nitric oxide synthase (n-NOS), neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), Leu-5-enkephalin (Leu-Enk), galanin (GAL) and vesicular acetylcholine transporter (VACHT). The vast majority of FB+ neurons supplying HJC was found in the ganglia from the 5th lumbar to the 2nd sacral. Immunohistochemistry revealed that most of these neurons were immunoreactive to CGRP or SP (80.7 ± 8.0% or 56.4 ± 4.8%, respectively) and many of them stained for PACAP or GAL (52.9 ± 2.9% or 50.6 ± 19.7%, respectively). Other populations of FB+ neurons were those immunoreactive to n-NOS (37.8 ± 9.7%), NPY (34.6 ± 6.7%), VIP (28.7 ± 4.8%), Leu-Enk (27.1 ± 14.6) and VACHT (16.7 ± 9.6). © 2016 Blackwell Verlag GmbH.

  13. 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. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  14. Scan posture definition and hip girth measurement: the impact on clothing design and body scanning.

    Science.gov (United States)

    Gill, Simeon; Parker, Christopher J

    2017-08-01

    Ergonomic measurement is central to product design and development; especially for body worn products and clothing. However, there is a large variation in measurement definitions, complicated by new body scanning technology that captures measurements in a posture different to traditional manual methods. Investigations of hip measurement definitions in current clothing measurement practices supports analysis of the effect of scan posture and hip measurement definition on the circumferences of the hip. Here, the hip girth is a key clothing measurement that is not defined in current body scanning measurement standards. Sixty-four participants were scanned in the standard scan posture of a [TC] 2 body scanner, and also in a natural posture similar to that of traditional manual measurement collection. Results indicate that scan posture affects hip girth circumferences, and that some current clothing measurement practices may not define the largest lower body circumference. Recommendations are made concerning how the hip is defined in measurement practice and within body scanning for clothing product development. Practitioner Summary: The hip girth is an important measurement in garment design, yet its measurement protocol is not currently defined. We demonstrate that body posture during body scanning affects hip circumferences, and that current clothing measurement practices may not define the largest lower body circumference. This paper also provides future measurement practice recommendations.

  15. Three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage at 3T: a prospective controlled study.

    Science.gov (United States)

    Zilkens, Christoph; Miese, Falk; Kim, Young-Jo; Hosalkar, Harish; Antoch, Gerald; Krauspe, Rüdiger; Bittersohl, Bernd

    2012-11-01

    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. 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 T1Gd assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions. T1Gd mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1Gd values were significantly higher in the control group than in the patient group whereas significant differences in T1Gd values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group. 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. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. 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.

  17. 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.

    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

  18. Combination of Acupuncture and Aquapuncture Using Vitamin B Complex for Treatment of Chronic Degenerative Changes of Hip Joints and Anal Relaxation in a Dog

    National Research Council Canada - National Science Library

    Kui-Ming Chang; Kuan-Sheng Chen; Hsien-Chi Wang; Cheng-Hung Lai; Yu-Ta Hsieh; Hsing-Hui King; Wei-Ming Lee

    2012-01-01

      A beagle dog, aged 10 years old, was presented with anal relaxation. Chronic arthrosis of hip joints had been diagnosed and treated on this dog's first visit to the National Chung Hsing University Veterinary Medicine Teaching hospital...

  19. The Main Biomechanical Risk Factors for the Prevalence of the Left Hip Joint Traumatic and Degenerative Changes

    OpenAIRE

    Lovrić, Ivan; Splavski, Bruno; Jovanović, Savo; Soldo, Ivan; Kvolik, Slavica; Has, Borislav

    2009-01-01

    The aim of this paper is to examine characteristic biomechanical features leading to the acetabular fracture and hip joint arthrosis, and to explain the prevalence of the left side traumatic and degenerative pelvic pathology that is usually seen in diverse groups of patients. A total of 253 patients were analyzed in a retrospective case-control study during a six-year period. The patients were divided into the case group of 103 patients suffering traumatic acetabular fractures and into the co...

  20. Contribution of hip joint proprioception to static and dynamic balance in cerebral palsy: a case control study

    OpenAIRE

    Diane L Damiano; Wingert, Jason R.; Stanley, Christopher J.; Curatalo, Lindsey

    2013-01-01

    Background Balance problems are common in cerebral palsy (CP) but etiology is often uncertain. The classic Romberg test compares ability to maintain standing with eyes open versus closed. Marked instability without vision is a positive test and generally indicates proprioceptive loss. From previous work showing diminished hip joint proprioception in CP, we hypothesized that static and dynamic balance without vision (positive Romberg) would be compromised in CP. Methods Force plate sway and ga...

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

    Directory of Open Access Journals (Sweden)

    Bernd Bittersohl

    2011-09-01

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

  2. 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.

  3. Power at hip, knee and ankle joints are compromised in women with mild and moderate knee osteoarthritis.

    Science.gov (United States)

    Resende, Renan Alves; Fonseca, Sérgio Teixeira; Silva, Paula Lanna; Magalhães, Claudio Marcos Bedran; Kirkwood, Renata Noce

    2012-12-01

    Analyses of the biomechanical characteristics of gait of women with mild and moderate knee osteoarthritis may identify parameters that could be targeted by physical therapy interventions. Therefore, the purpose of the present study was to compare the joint power profiles during gait between a group of elderly women with mild and moderate levels of knee osteoarthritis and a group of age-matched asymptomatic women. Thirty-nine women diagnosed with osteoarthritis at the medial compartment of the knee and 39 healthy women with no diagnosis of knee osteoarthritis participated in the study. Joint power profiles of the hip, knee and ankle joints in the sagittal plane during gait were performed using video and force data obtained using Qualisys ProReflex System synchronized with two force plates. Principal component analysis was applied to extract features from the joint power waveforms characterizing their main modes of temporal variation. The extracted features were compared between groups. Women with knee osteoarthritis absorbed and generated less energy at the hip and ankle joints, and absorbed less energy at the knee when compared to the asymptomatic group. The observed power pattern in women with knee osteoarthritis may be related to their reduced gait speed, a suboptimal strategy possibly used to reduce reaction forces at the knee. Clinical studies should investigate whether interventions designed to improve muscular resources, as a means to control the flow of forces at the knee, would optimize power patterns and gait performance in women with knee osteoarthritis. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Defining modes of failure after joint-preserving surgery of the hip.

    Science.gov (United States)

    Beaulé, P E; Bleeker, H; Singh, A; Dobransky, J

    2017-03-01

    Joint-preserving surgery of the hip (JPSH) has evolved considerably and now includes a number of procedures, including arthroscopy, surgical dislocation, and redirectional osteotomies of the femur and acetabulum. There are a number of different factors which lead to failure of JPSH. Consequently, it is of interest to assess the various modes of failure in order to continue to identify best practice and the indications for these procedures. Using a retrospective observational study design, we reviewed 1013 patients who had undergone JPSH by a single surgeon between 2005 and 2015. There were 509 men and 504 women with a mean age of 39 years (16 to 78). Of the 1013 operations, 783 were arthroscopies, 122 surgical dislocations, and 108 peri-acetabular osteotomies (PAO). We analysed the overall failure rates and modes of failure. Re-operations were categorised into four groups: Mode 1 was arthritis progression or organ failure leading to total hip arthroplasty (THA); Mode 2 was an Incorrect diagnosis/procedure; Mode 3 resulted from malcorrection of femur (type A), acetabulum (type B), or labrum (type C) and Mode 4 resulted from an unintended consequence of the initial surgical intervention. At a mean follow-up of 2.5 years, there had been 104 re-operations (10.2%) with a mean patient age of 35.5 years (17 to 64). There were 64 Mode 1 failures (6.3%) at a mean of 3.2 years following JPSH with a mean patient age of 46.8 years (18 to 64). There were 17 Mode 2 failures (1.7%) at a mean of 2.2 years post-JPSH with a mean patient age of 28.9 years (17 to 42) (2% scopes; 1% surgical dislocations). There were 19 Mode 3 failures (1.9%) at a mean of 2.0 years post-JPSH, with a mean patient age of 29.9 years (18 to 51) (2% scopes; 2% surgical dislocations; 5% PAO). There were 4 Mode 4 failures (0.4%) at a mean of 1.8 years post-JPSH with a mean patient age of 31.5 years (15 to 43). Using the modified Dindo-Clavien classification system, the overall complication rate among JPSHs

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

    Science.gov (United States)

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

    2013-02-01

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

  6. Ultrasound measurement of joint cartilage thickness in large and small joints in healthy children: a clinical pilot study assessing observer variability

    Directory of Open Access Journals (Sweden)

    Pfeiffer-Jensen Mogens

    2007-04-01

    Full Text Available Abstract Background Loss of joint cartilage is a feature of destructive disease in JIA. The cartilage of most joints can be visualized with ultrasonography (US. Our present study focuses on discriminant validity of US in children. We studied reproducibility between and within a skilled and a non-skilled investigator of US assessment of cartilage thickness in small and large joints in healthy children. Methods and results In 11 healthy children (5 girls/6 boys, aged 9.6 years (9.3–10 years, 110 joints were examined. Cartilage thickness of the right and left hip, knee, ankle, 2nd metacarpophalangeal (MCP, and 2nd proximal interphalangeal (PIP joint independently. The joints were examined twice, two days apart by a skilled and a non-skilled investigator. Mean cartilage thickness in the five joints was: hip 2.59 ± 0.41, knee 3.67 ± 0.64, ankle 1.08 ± 0.31, MCP 1.52 ± 0.27 and PIP 0.73 ± 0.15 mm. We found the same mean differences in CTh of 0.6 mm in the inter-observer part with regard of the PIP joint. Within investigators (intra-observer, the smallest mean difference of CTh was found in the MCP joint with -0.004 (skilled and 0.013 mm (non-skilled. Conclusion We found the level of agreement between observers within a 95% Confidence Interval in assessment of cartilage thickness in hip-, knee-, ankle-, MCP-, and PIP joints in healthy children. Observer variability seems not to relate to joint size but to the positioning of the joints and the transducer. These factors seem to be of major importance for reproducible US measurements. The smallest difference in measurement of cartilage thickness between observers was found in the PIP joint, and within observers in the MCP joint and it seems that using EULAR standard US guidelines is feasible for a pediatric setting. The use of US in children is promising. Studies on larger groups of children are needed to confirm the validation and variability of US in children as well as determining the smallest

  7. [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.

  8. MOTOR IMAGERY BOOSTS PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION IN THE ATTAINMENT AND RETENTION OF RANGE-OF -MOTION AT THE HIP JOINT

    Directory of Open Access Journals (Sweden)

    Michael Callaghan

    2004-09-01

    Full Text Available This study examined the effect of proprioceptive neuromuscular facilitation (PNF coupled with an internal mental imagery technique (PNFI on both the attainment and retention of increased range-of-movement (ROM at the hip joint. Twenty-four young adult subjects were randomly allocated to PNF, PNFI, and control treatments administered in fifteen sessions over a three-week period. ROM was assessed prior to training then at the completion of sessions 1 day, 3, 7, and 14 during training, then 28 days after program completion. Analysis-of-Variance with repeated measures showed both significant treatment (p < 0.01 and time effects (p < 0.05. Mean change of ROM values were always larger under the PNFI condition and significantly different (p < 0.05 at day 1 and 3 following training program completion. Thereafter, the diminution of ROM was comparable to the PNF condition. Mean ROM increment relative to baseline was 7.55 and 9.45 degrees for PNF and PNFI respectively receding to 5.86 and 6.5 degrees at twenty-eight days following treatment cessation. Motor imagery coupled with PNF to enhance and retain ROM yields superior results to physical training used alone and can benefit both athletes and those undergoing rehabilitation.

  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. The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

    2018-02-21

    In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

  11. Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

    Science.gov (United States)

    Wissig, Stephanie; van Maasakkers, Lisa; Stowell, Caleb; Ackerman, Ilana; Ayers, David; Barber, Thomas; Benzakour, Thami; Bozic, Kevin; Budhiparama, Nicolaas; Caillouette, James; Conaghan, Philip G.; Dahlberg, Leif; Dunn, Jennifer; Grady‐Benson, John; Ibrahim, Said A.; Lewis, Sally; Malchau, Henrik; Manzary, Mojieb; March, Lyn; Nassif, Nader; Nelissen, Rob; Smith, Noel; Franklin, Patricia D.

    2016-01-01

    Objective To define a minimum Standard Set of outcome measures and case‐mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients. Methods An international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus. Results The working group reached consensus on a concise set of outcome measures to evaluate patients’ joint pain, physical functioning, health‐related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were defined. Annual outcome measurement is recommended for all patients. Conclusion We have defined a Standard Set of outcome measures for monitoring the care of people with clinically diagnosed hip or knee OA that is appropriate for use across all treatment and care settings. We believe this Standard Set provides meaningful, comparable, and easy to interpret measures ready to implement in clinics and/or registries globally. We view this set as an initial step that, when combined with cost data, will facilitate value‐based health care improvements in the treatment of hip and knee OA. PMID:26881821

  12. Hip supporting device

    DEFF Research Database (Denmark)

    2011-01-01

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

  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

    2017-10-01

    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. MEASUREMENTS OF CRUCIATE LIGAMENTS OF KNEE JOINT

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    Sravanthi

    2015-06-01

    Full Text Available AIM OF STU DY: T o measure length and width of Cruciate Ligaments and to observe for any variations in the parameters. PERIOD OF STUDY : 2008 - 2011 . MATERIALS AND METHODS : 100 d isarticulated limbs were collected from department of anatomy , K akatiya M edical C ollege , Warangal. Telangana. Which were preserved in 10% formalin , 50 MRIs of Knee joint were studied and measurements were taken from Vijaya Diagnostic center , Hanamkonda , Wa rangal , Telangana. To expose cruciate ligament a systematic dissection procedure has been adopted . The cruciate ligaments were exposing and their attachments were defined on to the femur and tibia. OBSERVATIONS: Average of parameters for anterior and poste rior cruciate ligaments were calculated for all 100 limbs and 50 knee joint MRI scans. The observations were similar to the previous studies. CONCLUSION: T he parameters which were measure are help full in selection and preparation of the graft and in re co nstruction of ligaments. The aim of re - construction is not just to substitute a torn ligament , but to restore the morphology inherent in the ligament

  15. The shape of the hip joint as a risk factor for osteoarthritis

    NARCIS (Netherlands)

    Saberi Hosnijeh, F; Zuiderwijk, M; Versteeg, M; Smeele, J; Hofman, A; Uitterlinden, A G; Agricola, R; Oei, E H; Waarsing, J H; Biermae Zeinstra, S M; Van Meurs, J B

    2016-01-01

    Purpose: Cam-type femoroacetabular impingement characterized by extra bone formation at the anterolateral head-neck junction of the hip creates a non-spherical femoral head, known as a cam deformity. The cam deformity is forced into the acetabulum during flexion and internal rotation of the hip,

  16. Traumatic obturator dislocation of the hip joint: a case report and ...

    African Journals Online (AJOL)

    We describe a case of traumatic obturator hip dislocation in an adult. Closed reduction was done under general anesthesia. Post-reduction radiographs showed concentric and congruent reduction of the right hip. Traction was applied for three weeks followed by progressive mobilization and loading. Follow up for two years ...

  17. Hip joint pathology: relationship between patient history, physical tests, and arthroscopy findings in clinical practice

    NARCIS (Netherlands)

    Tijssen, M.; Cingel, R.E. van; Visser, E de; Holmich, P.; Nijhuis-Van der Sanden, M.W.G.

    2017-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18-65

  18. Prevalence of malformations of the hip joint and their relationship to sex, groin pain, and risk of osteoarthritis: a population-based survey

    DEFF Research Database (Denmark)

    Gosvig, Kasper Kjaerulf; Jacobsen, Steffen; Sonne-Holm, Stig

    2010-01-01

    , or a combination of a deep acetabular socket and a pistol grip deformity. Hip osteoarthritis was defined radiographically as a minimum joint-space width of 0.13). A deep acetabular socket was a significant risk factor for the development of osteoarthritis (risk ratio, 2.4), as was a pistol grip deformity (risk...... ratio, 2.2). Acetabular dysplasia and the subject's sex were not found to be significant risk factors for the development of hip osteoarthritis (p = 0.053 and p = 0.063, respectively). The prevalence of hip osteoarthritis was 9.5% in men and 11.2% in women. The prevalence of concomitant malformations...... was 71.0% in men with hip osteoarthritis and 36.6% in women with hip osteoarthritis. CONCLUSIONS: In our study population, a deep acetabular socket and a pistol grip deformity were common radiographic findings and were associated with an increased risk of hip osteoarthritis. The high prevalence...

  19. Less hip joint loading only during running rather than walking in elderly compared to young adults.

    Science.gov (United States)

    Giarmatzis, Georgios; Jonkers, Ilse; Baggen, Remco; Verschueren, Sabine

    2017-03-01

    Walking and running have been found to increase hip bone mass in postmenopausal women. However, the optimal speed to trigger osteogenesis is still under debate because the exact loading during different speeds is poorly characterized. Moreover, age related differences in gait kinematics/kinetics can potentially result in differences in peak hip loading, making extrapolation of results based on young populations to the elderly misleading. Using integrated 3D motion capture and musculoskeletal modeling, peak hip contact forces (HCFs) were calculated during walking and running from 3 to 9km/h in 14 female young (21.4±1.6years old) and elderly (69.8±3.4years old) participants. Peak HCFs were similar during walking in both groups, whereas elderly loaded their hip less than young during running, through reducing their stride length and hip adduction angle at peak loading. Moreover, hip adduction moment was found to best predict peak HCF during impact in walking and running whereas hip extension and external rotation moment can predict the second peak HCF during walking in the elderly and young group respectively. Comparison between same speeds in walking and running revealed that in contrast to young no additional hip loading is imposed during running in elderly. The present study offers an insight into the differences in hip loading profile in postmenopausal women during walking and running at different speeds. Such information is crucial to medical experts that target site-specific bone loading through exercise in elderly populations in order to prevent hip bone loss. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 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

    2010-02-01

    Full Text Available 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.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.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.

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

    Science.gov (United States)

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

    2010-01-01

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

  2. 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.

  3. Femoral Shaft Torsion in Injured and Uninjured Ballet Dancers and Its Association with Other Hip Measures: A Cross-sectional Study.

    Science.gov (United States)

    Hafiz, Eliza; Hiller, Claire E; Nicholson, Leslie L; Nightingale, Elizabeth J; Grimaldi, Alison; Refshauge, Kathryn M

    2016-03-01

    Low range femoral torsion, termed "lateral shaft torsion," has been associated with greater range of hip external rotation and turnout in dancers. It is also hypothesized that achieving greater turnout at the hip minimizes torsion at the knee, shank, ankle, and foot, and consequently reduces incidence of lower limb injuries. The primary aims of this study were to investigate: 1. differences in range of femoral shaft torsion between dancers with and without lower limb injuries; and 2. the relationship between femoral shaft torsion, hip external rotation range, and turnout. A secondary aim was to examine the relationship between femoral shaft torsion and other hip measures: hip strength, lower limb joint hypermobility, hip stability, and foot progression angle, as explanatory variables. Demographic, dance, and injury data were collected, along with physical measures of femoral shaft torsion, hip rotation range of motion, and turnout. Hip strength, control, lower limb hypermobility, and foot progression angle were also measured. Eighty female dancers, 50 with lower limb injury (20.7 ± 4.8 years of age) and 30 without lower limb injury (17.8 ± 4.1 years of age), participated in the study. There was no difference in range of femoral shaft torsion between the groups (p = 0.941). Femoral shaft torsion was weakly correlated with range of hip external rotation (r = -0.034, p = 0.384) and turnout (r = -0.066, p = 0.558). Injured dancers had a significantly longer training history than non-injured dancers (p = 0.001). It was concluded that femoral shaft torsion does not appear to be associated with the overall incidence of lower limb injury in dancers or to be a primary factor influencing extent of turnout in this population.

  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. Knee joint forces: prediction, measurement, and significance

    Science.gov (United States)

    D’Lima, Darryl D.; Fregly, Benjamin J.; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W.

    2011-01-01

    Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

  6. 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.

  7. 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.

  8. Open reduction and stabilisation of coxofemoral joint luxation in dogs and cats, using a stainless steel rope inserted via a ventral approach to the hip joint.

    Science.gov (United States)

    Kawamata, T; Niiyama, M; Taniyama, H

    1996-12-01

    Open reduction and stabilisation of coxofemoral joint luxation was made via a ventral approach to the hip joint in dogs and cats, using a transarticular stainless steel rope. A feature of the procedure is transarticular penetration of the rope from the pelvic cavity to the femoral neck by guidance with a guide wire which was previously inserted from the femoral neck into the pelvic cavity and by detection of the guide wire in the pelvic cavity by use of forceps connected to an alarm-ohmmeter. Forty-seven animals (37 dogs and 10 cats) with acute and simple coxofemoral luxation were treated and postoperatively maintained in cage rest without external fixation. Most of the animals regained an almost normal gait within several days.

  9. Fully automated segmentation of a hip joint using the patient-specific optimal thresholding and watershed algorithm.

    Science.gov (United States)

    Kim, Jung Jin; Nam, Jimin; Jang, In Gwun

    2018-02-01

    Automated segmentation with high accuracy and speed is a prerequisite for FEA-based quantitative assessment with a large population. However, hip joint segmentation has remained challenging due to a narrow articular cartilage and thin cortical bone with a marked interindividual variance. To overcome this challenge, this paper proposes a fully automated segmentation method for a hip joint that uses the complementary characteristics between the thresholding technique and the watershed algorithm. Using the golden section method and load path algorithm, the proposed method first determines the patient-specific optimal threshold value that enables reliably separating a femur from a pelvis while removing cortical and trabecular bone in the femur at the minimum. This provides regional information on the femur. The watershed algorithm is then used to obtain boundary information on the femur. The proximal femur can be extracted by merging the complementary information on a target image. For eight CT images, compared with the manual segmentation and other segmentation methods, the proposed method offers a high accuracy in terms of the dice overlap coefficient (97.24 ± 0.44%) and average surface distance (0.36 ± 0.07 mm) within a fast timeframe in terms of processing time per slice (1.25 ± 0.27 s). The proposed method also delivers structural behavior which is close to that of the manual segmentation with a small mean of average relative errors of the risk factor (4.99%). The segmentation results show that, without the aid of a prerequisite dataset and users' manual intervention, the proposed method can segment a hip joint as fast as the simplified Kang (SK)-based automated segmentation, while maintaining the segmentation accuracy at a similar level of the snake-based semi-automated segmentation. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Outcome measures of bipolar hip arthroplasty for atraumatic hip disorders - A preliminary report

    Directory of Open Access Journals (Sweden)

    Dudani Baldev

    2005-01-01

    Full Text Available Background: Bipolar hip arthroplasty was devised for fracture neck femur in elderly patients. Subsequently, indications have been expanded to include conditions affecting acetabulum like rheumatoid arthritis, osteoarthritis and avascular necrosis of femoral head. Materials and methods: We have studied the results of bipolar hip arthroplasty in 38 such patients, with severely involved acetabulum due to rheumatoid arthritis, avascular necrosis of femoral head and primary osteoarthritis. Acetabulum was reamed to get a tight ′equatorial′ or ′rim′ fit of the prosthesis. Prosthesis selected was 1 mm bigger than the maximum size of reamer used. Cement was used in femur whenever there was marked osteoporosis or wide medullary canal. Post operatively all patients were regularly screened for pain, range of movement, protrusio acetabuli, loosening / sinking of prosthesis and radiographic assessment of movement in the two bearings of prosthesis. Results: Overall results achieved were good to excellent in 80% of patients. Conclusions: The ultimate outcome is comparable to total hip arthroplasty. The added advantage is of low cost, simplicity of procedure and easy future revision.

  11. 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.

  12. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Michaelides, Michael, E-mail: mihalismihailidis@gmail.com [Ygia Polyclinic Hospital, MRI/CT Department (Cyprus); Papas, Stylianos, E-mail: vascular@drpapas.com [Ygia Polyclinic Hospital, Vascular Surgery Department (Cyprus); Pantziara, Maria, E-mail: mgpantziara@gmail.com; Ioannidis, Kleanthis, E-mail: aktinodiagnostis@gmail.com [Ygia Polyclinic Hospital, MRI/CT Department (Cyprus)

    2013-05-14

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

  14. High spatial resolution MRI of cystic adventitial disease of the iliofemoral vein communicating with the hip joint.

    Science.gov (United States)

    Michaelides, Michael; Papas, Stylianos; Pantziara, Maria; Ioannidis, Kleanthis

    2014-02-01

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

  15. The Investigation Of A 3-Dimensional Human Hip Joint Subjected To Distributed Load By Using Finite Element Method

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Çetin

    2012-06-01

    Full Text Available In this study, a three dimensionally modeled human hip joint was investigated by using finite element method. During this study, finite element models were prepared for three different prosthesis types namely; Charnley, Muller and Hipokrat and for two different activities as walking and stair climbing motions. Ansys Workbench commercial program was used for finite element analysis by applying distributed load condition. The von- Mises stresses and strains occurred on the cortical and trabecular layers of bone, prosthesis and bone cement which was used to assemble prosthesis into bone's intramedullary canal, were determined at the end of the finite element analysis and compared to each other.

  16. 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

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

    Science.gov (United States)

    Kim, Ju-Oh

    2014-01-01

    Association between enlarged iliopsoas bursa and hip lesions such as osteoarthritis of the hip or femoral head necrosis is infrequently seen. Enlarged iliopsoas bursa with a rapidly destructive arthropathy is claimed to be seen only in patients with rheumatoid arthritis. In this paper, we report a patient with a rapidly destructive arthropathy accompanied by an enlarged iliopsoas bursa that has been misdiagnosed as an infection. PMID:27536579

  18. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Dobson, F; Hinman, R S; Hall, M

    2012-01-01

    reviewers independently rated measurement properties using the consensus-based standards for the selection of health status measurement instrument (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings. RESULTS: Twenty-four out of 1792 publications were eligible......OBJECTIVES: To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). METHODS: Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two...... for inclusion. Twenty-one performance-based measures were evaluated including 15 single-activity measures and six multi-activity measures. Measurement properties evaluated included internal consistency (three measures), reliability (16 measures), measurement error (14 measures), validity (nine measures...

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

    Science.gov (United States)

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

    2012-05-01

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

  20. 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.)

  1. 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. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. 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.

  3. Determination of the criterion-related validity of hip joint angle test for estimating hamstring flexibility using a contemporary statistical approach.

    Science.gov (United States)

    Sainz de Baranda, Pilar; Rodríguez-Iniesta, María; Ayala, Francisco; Santonja, Fernando; Cejudo, Antonio

    2014-07-01

    To examine the criterion-related validity of the horizontal hip joint angle (H-HJA) test and vertical hip joint angle (V-HJA) test for estimating hamstring flexibility measured through the passive straight-leg raise (PSLR) test using contemporary statistical measures. Validity study. Controlled laboratory environment. One hundred thirty-eight professional trampoline gymnasts (61 women and 77 men). Hamstring flexibility. Each participant performed 2 trials of H-HJA, V-HJA, and PSLR tests in a randomized order. The criterion-related validity of H-HJA and V-HJA tests was measured through the estimation equation, typical error of the estimate (TEEST), validity correlation (β), and their respective confidence limits. The findings from this study suggest that although H-HJA and V-HJA tests showed moderate to high validity scores for estimating hamstring flexibility (standardized TEEST = 0.63; β = 0.80), the TEEST statistic reported for both tests was not narrow enough for clinical purposes (H-HJA = 10.3 degrees; V-HJA = 9.5 degrees). Subsequently, the predicted likely thresholds for the true values that were generated were too wide (H-HJA = predicted value ± 13.2 degrees; V-HJA = predicted value ± 12.2 degrees). The results suggest that although the HJA test showed moderate to high validity scores for estimating hamstring flexibility, the prediction intervals between the HJA and PSLR tests are not strong enough to suggest that clinicians and sport medicine practitioners should use the HJA and PSLR tests interchangeably as gold standard measurement tools to evaluate and detect short hamstring muscle flexibility.

  4. The prevalence of femoroacetabular impingement as an aetiologic factor for end-stage degenerative osteoarthritis of the hip joint: analysis of 1,000 cases.

    Science.gov (United States)

    Oner, Ali; Koksal, Alper; Sofu, Hakan; Aykut, Umit S; Yıldırım, Timur; Kaygusuz, Mehmet A

    2016-01-01

    The main purpose of the present study was to determine the prevalence of FAI among patients who underwent total hip arthroplasty (THA) with the diagnosis of end-stage osteoarthritis (OA) of the hip joint in a tertiary referral centre. A retrospective search of the institutional archive database for patients who had undergone THA between the years 2005 and 2010 was conducted with the analysis of the recorded radiographic images. A total of 1,004 patients including 690 (68.7%) females and 314 (31.3%) males were identified. All radiographs were reviewed by 3 of the authors. Intra- and interobserver consistencies were calculated. The prevalence of femeroacetabular impingement (FAI) as a predisposing diagnosis resulting in end-stage degenerative joint disease treated with THA was determined. The most common diagnosis was developmental dysplasia of the hip (DDH). The predisposing aetiologic factor leading to end-stage degenerative hip disease treated with THA was undetermined for 26 patients (2.6%). The number of patients who were diagnosed as cam-type FAI by all of the observers was 83, whereas it was 16 for pincer-type FAI. Interobserver agreement was very high in the evaluation of the stated ethiologies of hip osteoarthritis. The contingency coefficient for the diagnosis of FAI was 0.71 between observers. Our study may be a reference for further investigations to develop a better understanding of the underlying pathological factors in patients undergoing THA due to end-stage OA of the hip joint.

  5. 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.

  6. Alternative outcome measures in young total hip arthroplasty patients

    DEFF Research Database (Denmark)

    Klit, Jakob; Jacobsen, Steffen; Schmiegelow, Victoria

    2015-01-01

    In this prospective multicentre cohort study we studied subjects younger than 60 years of age scheduled for primary total hip arthroplasty (THA). The study assessed patients' overall satisfaction, fulfillment of preoperative expectations, the effect on socioeconomic parameters, and quality of sex...

  7. Analysis of NSTX TF Joint Voltage Measurements

    Energy Technology Data Exchange (ETDEWEB)

    R, Woolley

    2005-10-07

    This report presents findings of analyses of recorded current and voltage data associated with 72 electrical joints operating at high current and high mechanical stress. The analysis goal was to characterize the mechanical behavior of each joint and thus evaluate its mechanical supports. The joints are part of the toroidal field (TF) magnet system of the National Spherical Torus Experiment (NSTX) pulsed plasma device operating at the Princeton Plasma Physics Laboratory (PPPL). Since there is not sufficient space near the joints for much traditional mechanical instrumentation, small voltage probes were installed on each joint and their voltage monitoring waveforms have been recorded on sampling digitizers during each NSTX ''shot''.

  8. The migration of femoral components after total hip replacement surgery: accuracy and precision of software-aided measurements

    Energy Technology Data Exchange (ETDEWEB)

    Decking, J. [Dept. of Orthopaedic Surgery, Univ. of Mainz School of Medicine, Mainz (Germany); Schuetz, U.; Decking, R.; Puhl, W. [Orthopaedic Dept., Univ. of Ulm, School of Medicine (Germany)

    2003-09-01

    Objective: To assess the accuracy and precision of a software-aided system to measure migration of femoral components after total hip replacement (THR) on digitised radiographs. Design and patients: Subsidence and varus-valgus tilt of THR stems within the femur were measured on digitised anteroposterior pelvic radiographs. The measuring software (UMA, GEMED, Germany) relies on bony landmarks and comparability parameters of two consecutive radiographs. Its accuracy and precision were calculated by comparing it with the gold standard in migration measurements, radiostereometric analysis (RSA). Radiographs and corresponding RSA measurements were performed in 60 patients (38-69 years) following cementless THR surgery. Results and conclusions: The UMA software measured the subsidence of the stems with an accuracy of {+-}2.5 mm and varus-valgus tilt with an accuracy of {+-}1.8 (95% confidence interval). A good interobserver and intraobserver reliability was calculated with Cronbach's alpha ranging from 0.86 to 0.97. Measuring the subsidence of THR stems within the femur is an important parameter in the diagnosis of implant loosening. Software systems such as UMA improve the accuracy of migration measurements and are easy to use on routinely performed radiographs of operated hip joints. (orig.)

  9. Interrater reliability in finger joint goniometer measurement in Dupuytren's disease.

    Science.gov (United States)

    Engstrand, Christina; Krevers, Barbro; Kvist, Joanna

    2012-01-01

    We investigated interrater reliability of motion (ROM) measurement in the finger joints of people with Dupuytren's disease. Eight raters measured flexion and extension of the three finger joints in one affected finger of each of 13 people with different levels of severity of Dupuytren's disease, giving 104 measures of joints and motions. Reliability measures, represented by intraclass correlation coefficient (ICC), standard error of the mean (SEM), and differences between raters with the highest and lowest mean scores, were calculated. ICCs ranged from .832 to .973 depending on joint and motion. The SEM was ≤3° for all joints and motions. Differences in mean between highest and lowest raters were larger for flexion than for extension; the largest difference was in the distal interphalangeal joint. The results indicate that following these standardized guidelines, the interrater reliability of goniometer measurements is high for digital ROM in people with Dupuytren's disease.

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

    Science.gov (United States)

    Lewis, Cara L.; Ferris, Daniel P.

    2011-01-01

    Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 minutes of the powered condition and the unpowered condition. After completing three 30-minute training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed. PMID:21333995

  11. Hip Labral Tear

    Science.gov (United States)

    ... sports as ice hockey, soccer, football, golf and ballet are at higher risk of developing a hip labral tear. Structural abnormalities of the hip also ... of a hip labral tear may be: Trauma. Injury to or dislocation of the hip joint — which can occur during car accidents or ...

  12. [Hip joint development after treatment the developmental dislocation with overhead traction].

    Science.gov (United States)

    Sibińiski, Marcin; Grzegorzewski, Andrzej; Synder, Marek

    2006-01-01

    Despite the fact that ultrasound of children's hips is widely used for screening, late diagnosed cases of developmental dislocation of the hip are still a common problem in the orthopaedic practice. The aim of the study is to review final clinical and radiological outcomes of treatment of DDH with overhead traction and closed reduction after skeletal growth. Clinical records and radiograms of 107 hips (81 children) were retrospectively reviewed. All of them were treated according to the same program: overhead traction (about 2 weeks), followed by closed reduction, modified Lorenz cast (2 months) and finally cast in Lange position (3 months). Average age of children was 14.2 months at the beginning of treatment and 20.7 years at last visit. Good and very good results were found in 80% of cases according to final radiological assessment of Severin and in 91% according functional classification of Harris. Avascular necrosis of femoral head according to Bucholz-Ogden classification system was identified in one third of patients. Functional results are better than radiological, but deteriorated with time especially in hips with residual dysplasia and AVN due to development of early, secondary degenerative changes.

  13. [A robot measurement system for spacesuit joint torque].

    Science.gov (United States)

    Du, Li-Bin; Gao, Xiao-Hui; Liu, Hong; Li, Tan-qiu

    2003-06-01

    To measure the joint torque of spacesuit so as to evaluate its dynamic force/torque performance. A method for measuring the spacesuit joint torque by use of robot technology was proposed in this paper. The design of the measuring strategy and measuring robot was put forward and a mathematical model of the system was given. Then the working space of the robot was analyzed. The robot designed is light, compact, easy to operate, and has a large working space. Experimental results demonstrated the effectiveness of the measuring principle and the reliability of the measuring system. The system can satisfy the requirements of the spacesuit joint torque measurement.

  14. Trabecular mineral content of the spine in women with hip fracture: CT measurement

    Energy Technology Data Exchange (ETDEWEB)

    Firooznia, H.; Rafii, M.; Golimbu, C.; Schwartz, M.S.; Ort, P.

    1986-06-01

    The trabecular bone mineral content (BMC) of the spine was measured by computed tomography in 185 women aged 47-84 years with vertebral fracture (n = 74), hip fracture (n = 83), and both vertebral and hip fracture (n = 28). Eighty-seven percent of vertebral-fracture patients, 38% of hip-fracture patients, and 82% of vertebral- and hip-fracture patients had spinal BMC values below the fifth percentile for healthy premenopausal women and values 64%, 9%, and 68% below the fifth percentile for age-matched control subjects. No significant loss of spinal trabecular bone was seen in patients with hip fracture. If it is assumed that the rate of trabecular bone loss is the same in the spine and femoral neck, then hip fracture (unlike osteoporotic vertebral fracture) is not associated with disproportionate loss of trabecular bone. Hip fracture occurs secondary to weakening of bone and increased incidence of falls. Bone weakening may be due to disproportionate loss of trabecular or cortical bone, proportionate loss of both, or other as yet undetermined qualitative changes in bone.

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

    Science.gov (United States)

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

    2016-06-01

    Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study. Instrumented gait analysis was performed preoperatively, 13.4 (±1.7), and 28.0 (±4.4) months postoperatively. At final follow-up, the mean leg length of the involved side was reduced by 1.10 (±0.53)cm compared to the non-involved side. In addition, a significant reduction in maximum knee flexion (-26%, p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still present in the patient group compared to controls indicating a "stiff knee gait pattern". In contrast, the sagittal plane hip parameters, the ipsilateral trunk lean toward the involved stance limb, and the knee and hip joint loading during gait normalized during the postoperative period. The results of the present study should motivate further exploration if patients with LCPD stiffen their knees to compensate for leg length discrepancy. Besides the standard radiological evaluation of the surgery outcome, instrumented gait analysis is a valuable method of recording functional deficits and early recognition of the need for physiotherapeutic treatment or insole supply in patients with LCPD. Copyright © 2016. Published by Elsevier B.V.

  16. The Phan-Thien and Tanner model applied to thin film spherical coordinates: applications for lubrication of hip joint replacement.

    Science.gov (United States)

    Tichy, John; Bou-Saïd, Benyebka

    2008-04-01

    The Phan-Thien and Tanner (PTT) model is one of the most widely used rheological models. It can properly describe the common characteristics of viscoelastic non-Newtonian fluids. There is evidence that synovial fluid in human joints, which also lubricates artificial joints, is viscoelastic. Modeling the geometry of the total hip replacement, the PTT model is applied in spherical coordinates for a thin confined fluid film. A modified Reynolds equation is developed for this geometry. Several simplified illustrative problems are solved. The effect of the edge boundary condition on load-carrying normal stress is discussed. Solutions are also obtained for a simple squeezing flow. The effect of both the relaxation time and the PTT shear parameter is to reduce the load relative to a Newtonian fluid with the same viscosity. This implies that the Newtonian model is not conservative and may overpredict the load capacity. The PTT theory is a good candidate model to use for joint replacement lubrication. It is well regarded and derivable from molecular considerations. The most important non-Newtonian characteristics can be described with only three primary material parameters.

  17. Confiabilidade intra e interobservador da análise cinemática angular do quadril durante o teste sentar e alcançar para mensurar o comprimento dos isquiotibiais em estudantes universitários Intra and interobserver reliability of angular kinematic analysis of the hip joint during the sit-and-reach test to measure hamstring length in university students

    Directory of Open Access Journals (Sweden)

    JR Cardoso

    2007-04-01

    better when the hip joint angle (HJA is measured concomitantly. OBJECTIVE: To assess the intra and interobserver reliability of the SRT for measuring hamstring muscle length through angular kinematic analysis. METHOD: Fifty university students (X= 21.5 years; SD= 1.5 without musculoskeletal abnormalities took part. A standard SRT bench with a door (to assess the action of the gastrocnemius muscles and a digital photographic camera positioned on a tripod were used. Skin markers were placed on the anterosuperior iliac spine and greater trochanter. Two images were recorded: one with the door closed (DC and another with the door open (DO. To test the intra and interobserver reliability, the intraclass correlation coefficient (ICC (random effect with one factor and the Bland and Altman concordance test (d= mean difference between measurements were used, with the respective 95% confidence intervals (95% CI. RESULTS: The intraobserver reliability of the HJA test was: ICCdc= 0.97 (95% CI [0.95;0.99] and Bland and Altman d = -0.02 (95% CI [-0.11;0.07]; ICCdo = 0.98 (95% CI [0.96;0.99], d = -0.01 (95% CI [-0.11;0.08]. For the interobserver reliability: ICCdc= 0.96 (95% CI [0.94;0.98] and d = -0.07 (95% CI [-0.19;0.03]; ICCdo= 0.96 (95% CI [0.93;0.98] and d = -0.06 (95% CI [-0.19;0.52]. CONCLUSION: The intra and interobserver reliability tests (DC and DO for HJA assessment using kinematic analysis showed high reliability. The technique is easy to apply (only requiring a standard SRT bench and a photographic camera and provides a reliable method for measuring hamstring muscles using kinematic analysis in clinical practice.

  18. Isometric hip and knee torque measurements as an outcome measure in robot assisted gait training.

    Science.gov (United States)

    Galen, Sujay S; Clarke, Celia J; McLean, Alan N; Allan, David B; Conway, Bernard A

    2014-01-01

    Strength changes in lower limb muscles following robot assisted gait training (RAGT) in subjects with incomplete spinal cord injury (ISCI) has not been quantified using objective outcome measures. To record changes in the force generating capacity of lower limb muscles (recorded as peak voluntary isometric torque at the knee and hip), before, during and after RAGT in both acute and subacute/chronic ISCI subjects using a repeated measures study design. Eighteen subjects with ISCI participated in this study (Age range: 26-63 years mean age = 49.3 ± 11 years). Each subject participated in the study for a total period of eight weeks, including 6 weeks of RAGT using the Lokomat system (Hocoma AG, Switzerland). Peak torques were recorded in hip flexors, extensors, knee flexors and extensors using torque sensors that are incorporated within the Lokomat. All the tested lower limb muscle groups showed statistically significant (p torques in the acute subjects. Comparison between the change in peak torque generated by a muscle and its motor score over time showed a non-linear relationship. The peak torque recorded during isometric contractions provided an objective outcome measure to record changes in muscle strength following RAGT.

  19. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Cordtz, Rene Lindholm; Zobbe, Kristian; Højgaard, Pil

    2017-01-01

    OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients.......65-3.40)), PJI (SHR=1.61 (0.70-3.69)) nor death (HR=0.75 (0.24-2.33)) compared with non-treated. Glucocorticoid exposure (HR=2.87 (1.12-7.34)) and increasing DAS28 (HR=1.49 (1.01-2.20)) were risk factors for mortality. CONCLUSION: Patients with RA had a decreased 10-year risk of revision while the risk of death......) and the Danish Hip and Knee Arthroplasty Registers. Survival analyses were used to calculate confounder-adjusted sub-HRs (SHR) and HRs. RESULTS: In total, 3913 patients with RA with THA/TKA were compared with 120 499 patients with OA. Patients with RA had decreased risk of revision (SHR 0.71 (0...

  20. Research on static angular stiffness measurement of flexible joint

    Directory of Open Access Journals (Sweden)

    Yongchao HUANG

    2016-10-01

    Full Text Available Measurement accuracy of the angular stiffness of flexible joint is directly related to the control accuracy and sensitivity of gyro, but the traditional measurement methods have many problems. According to the principle of angular stiffness measurement of flexible joint, two static measurement methods of angular stiffness are proposed based on different loading ways, namely mechanical loading angular stiffness measurement and piezoelectric loading angular stiffness measurement. The mechanical loading angular stiffness measurement system is built by using a motor driven indexing feeding tilting table, the measure experiment if the angular stiffness of flexible joint is conducted, and the angular stiffness of flexible joint is measured. For the excessive fluctuation problem of the measure result in mechanical load test, a piezoelectric loading structure is designed and a measurement method employing piezoelectric actuator is proposed for angular stiffness measurement of flexible joint. Based on ANSYS Workbench, the displacement output of the piezoelectric loading structure is analyzed by simulations. The simulation results illustrate that the displacement output meets the requirement of static loading angular stiffness measurement of flexible joint, and the theoretical feasibility of piezoelectric loading angular stiffness measurement method is validated.

  1. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... component made of ultra-high molecular weight polyethylene with carbon fibers composite. Both components are... articulating surfaces. It has no linkage across-the-joint. This generic type of device includes prostheses that...

  2. Asymmetry in CT Scan Measures of Thigh Muscle 2 Months After Hip Fracture: The Baltimore Hip Studies.

    Science.gov (United States)

    Miller, Ram R; Eastlack, Marty; Hicks, Gregory E; Alley, Dawn E; Shardell, Michelle D; Orwig, Denise L; Goodpaster, Bret H; Chomentowski, Peter J; Hawkes, William G; Hochberg, Marc C; Ferrucci, Luigi; Magaziner, Jay

    2015-10-01

    Hip fracture is an important problem for older adults with significant functional consequences. After hip fracture, reduced muscle loading can result in muscle atrophy. We compared thigh muscle characteristics in the fractured leg to those in the nonfractured leg in participants from the Baltimore Hip Studies 7th cohort using computed tomography scan imaging. At 2 months postfracture, a single 10mm axial computed tomography scan was obtained at the midthigh level in 43 participants (23 men, 20 women) with a mean age of 79.9 years (range: 65-96 years), and thigh muscle cross-sectional area, cross-sectional area of intermuscular adipose tissue, and mean radiologic attenuation were measured. Total thigh muscle cross-sectional area was less on the side of the fracture by 9.46cm(2) (95% CI: 5.97cm(2), 12.95cm(2)) while the cross-sectional area of intermuscular adipose tissue was greater by 2.97cm(2) (95% CI: 1.94cm(2), 4.01cm(2)) on the fractured side. Mean muscle attenuation was lower on the side of the fracture by 3.66 Hounsfield Units (95% CI: 2.98 Hounsfield Units, 4.34 Hounsfield Units). The observed asymmetry is consistent with the effect of disuse and inflammation in the affected limb along with training effects in the unaffected limb due to the favoring of this leg with ambulation during the postfracture period. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Phantom studies of triple photon absorptiometry and bone mineral measurement at a hip prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Farrell, T.J.; Webber, C.E. (Chedoke McMaster Hospitals, Hamilton, ON (Canada). Dept. of Nuclear Medicine)

    1992-03-01

    The feasibility of using triple photon absorptiometry (TPA) for the measurement of bone mineral mass about a hip prosthesis was examined. A theoretical expression describing the variance of TPA measurements was verified using a triple photon source and phantom materials which simulate the soft tissue-bone mineral-metal prosthesis system. The expression for the variance was used to determine an optimized set of photon energies. It was shown that a precision of 3% could be obtained for reasonable measurement times using this optimized set of energies and that TPA should be a feasible approach for measurement of bone mineral about a hip prosthesis. (orig.).

  4. Space Suit Joint Torque Measurement Method Validation

    Science.gov (United States)

    Valish, Dana; Eversley, Karina

    2012-01-01

    In 2009 and early 2010, a test method was developed and performed to quantify the torque required to manipulate joints in several existing operational and prototype space suits. This was done in an effort to develop joint torque requirements appropriate for a new Constellation Program space suit system. The same test method was levied on the Constellation space suit contractors to verify that their suit design met the requirements. However, because the original test was set up and conducted by a single test operator there was some question as to whether this method was repeatable enough to be considered a standard verification method for Constellation or other future development programs. In order to validate the method itself, a representative subset of the previous test was repeated, using the same information that would be available to space suit contractors, but set up and conducted by someone not familiar with the previous test. The resultant data was compared using graphical and statistical analysis; the results indicated a significant variance in values reported for a subset of the re-tested joints. Potential variables that could have affected the data were identified and a third round of testing was conducted in an attempt to eliminate and/or quantify the effects of these variables. The results of the third test effort will be used to determine whether or not the proposed joint torque methodology can be applied to future space suit development contracts.

  5. Relação entre rigidez articular passiva e torque concêntrico dos rotadores laterais do quadril Relationship between joint passive stiffness and hip lateral rotator concentric torque

    Directory of Open Access Journals (Sweden)

    Diego X. Leite

    2012-10-01

    Full Text Available CONTEXTUALIZAÇÃO: Rigidez passiva adequada do quadril pode impedir movimentos excessivos dos membros inferiores no plano transverso durante a realização de atividades funcionais. O fortalecimento muscular dos rotadores laterais do quadril poderia ser utilizado na tentativa de aumentar a rigidez dessa articulação. No entanto, a relação entre rigidez passiva e força dos músculos do quadril não está documentada na literatura. OBJETIVO: Investigar a associação entre rigidez passiva do quadril durante o movimento de rotação medial e torque concêntrico dos rotadores laterais dessa articulação em indivíduos saudáveis. MÉTODO: Foram avaliados 26 indivíduos com média de idade de 24,42±2,77 anos. Para quantificação da rigidez passiva do quadril, o torque passivo de resistência durante a rotação medial dessa articulação foi mensurado por um dinamômetro isocinético. A rigidez foi determinada como a inclinação média da curva de torque passivo obtida nos primeiros 20° do movimento. Eletromiografia foi utilizada para verificar o repouso dos músculos do quadril durante esse procedimento. O dinamômetro isocinético também foi utilizado para avaliação do pico de torque e trabalho máximo dos rotadores laterais do quadril em uma amplitude de 55° de rotação. RESULTADOS: Regressões lineares demonstraram coeficientes de correlação r=0,70 (R²=0,50/pBACKGROUND: Adequate passive stiffness of the hip joint can prevent the occurrence of excessive transverse plane lower limb movement during functional activities. Strength training of the hip lateral rotator muscles can be used to increase the stiffness of this joint. However, the relationship between hip joint passive stiffness and muscle strength remains undocumented in the literature. OBJECTIVE: To investigate the association between hip passive stiffness measured during medial rotation and hip lateral rotator concentric torque in healthy young adults. METHOD: Twenty

  6. Development and initial validation of the ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    A. O. Akinpelu

    2007-02-01

    Full Text Available Background and Aim: Development of outcome measures remains a focus of health research in the 21st century. Outcome measures originally developed for the Nigerian environment are very rare. The aims of this study were to develop an outcome measure for management of hip and knee arthritic conditions, and to investigate the validity and responsiveness of it. Methods: The Ibadan Knee/Hip Osteoarthritis Measure (IKHOAMwas developed from other measures found in literature, as well as complaints of attending patients. Forty nine patients with pain from knee and/or hip osteoarthritis, the OA group (OAG and 49 individuals without knee or hip pain, the pain-free group (PFG were assessed, using the IKHOAM. The OAG was assessed on IKHOAM and the Visual Analogue Scale (VAS before and after a 6-week physiotherapy programme. Results: Significant differences between IKHOAM scores of the OAG and PFG and between IKHOAM scores of OAG pre and post 6-week physiotherapy programme, as well as the significant negative correlations between changes in IKHOAM and VAS scores of OAG before and after the 6-week physiotherapy programme were demonstrated. Conclusion: IKHOAM demonstrated initial criteria towards validity and responsiveness and may be used in a Nigerian population of OA knee/hip individuals and similar environments.

  7. [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

  8. Pose measurement of Anterior Pelvic Plane based on inertial measurement unit in total hip replacement surgeries.

    Science.gov (United States)

    Zhe Cao; Shaojie Su; Hong Chen; Hao Tang; Yixin Zhou; Zhihua Wang

    2016-08-01

    In Total Hip Replacement (THR), inaccurate measurement of Anterior Pelvic Plane (APP), which is usually used as a reference plane, will lead to malposition of the acetabular prosthesis. As a result, the risk of impingement, dislocation and wear will increase and the safe range of motion will be limited. In order to acquire the accurate pose of APP, a measurement system is designed in this paper, which includes two parts: one is used to estimate the initial pose of APP and the other is used to trail dynamic motion of APP. Both parts are composed of an Inertial Measurement Unit (IMU) and magnetometer sensors. An Extended Kalman Filter (EKF) is adopted to fuse the data from IMU and the magnetometer sensors to estimate the orientation of the pelvis. The test results show that the error angle between calculated axis and true axis of the pelvis in geodetic coordinate frame is less than 1.2 degree, which meets the requirement of the surgery.

  9. CTXA hip--an extension of classical DXA measurements using quantitative CT.

    Directory of Open Access Journals (Sweden)

    Christopher E Cann

    Full Text Available Bone mineral density (BMD estimates for the proximal femur using Dual Energy X-ray Absorptiometry (DXA are currently considered the standard for making a diagnosis of osteoporosis in an individual patient using BMD alone. We have compared BMD results from a commercial Quantitative CT (QCT BMD analysis system, "CTXA Hip", which provides clinical data for the proximal femur, to results from DXA. We have also used CTXA Hip to determine cortical and trabecular contributions to total BMD. Sixty-nine patients were scanned using 3D QCT and DXA. CTXA Hip BMD measurements for Total Hip and Femoral Neck were compared to DXA results. Twenty-two women were scanned at 0, 1, 2 years and CTXA Hip and DXA results analyzed for long-term reproducibility. Long-term reproducibility calculated as root-mean-square averages of SDs in vivo was 0.012 g/cm2 (CV = 1.8% for CTXA Total Hip and 0.011 g/cm2 (CV = 2.0% for CTXA Femoral Neck compared to 0.014 g/cm2 (CV = 2.0% and 0.016 g/cm2 (CV = 2.7%, respectively, for DXA. The correlation of Total Hip BMD CTXA vs. DXA was R = 0.97 and for Femoral Neck was R = 0.95 (SEE 0.044 g/cm2 in both cases. Cortical bone comprised 62±5% (mean ± SD of total hipbone mass in osteoporotic women. CTXA Hip provides substantially the same clinical information as conventional DXA and in addition provides estimates of BMD in separate cortical and trabecular bone compartments, which may be useful in evaluation of bone strength.

  10. The Femoro-Epiphyseal Acetabular Roof (FEAR) Index: A New Measurement Associated With Instability in Borderline Hip Dysplasia?

    Science.gov (United States)

    Wyatt, Michael; Weidner, Jan; Pfluger, Dominik; Beck, Martin

    2017-03-01

    The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making-specifically, a tool that might be associated with instability-therefore would be very helpful for this group of patients. (1) To compare a new radiographic measurement, which we call the Femoro-Epiphyseal Acetabular Roof (FEAR) index, with the lateral center-edge angle (LCEA) and acetabular index (AI), with respect to intra- and interobserver reliability; (2) to correlate AI, neck-shaft angle, LCEA, iliocapsularis volume, femoral antetorsion, and FEAR index with the surgical treatment received in stable and unstable borderline dysplastic hips; and (3) to assess whether the FEAR index is associated clinical instability in borderline dysplastic hips. We defined and validated the FEAR index in 10 standardized radiographs of asymptomatic controls using two blinded independent observers. Interrater and intrarater coefficients were calculated, supplemented by Bland-Altman plots. We compared its reliability with LCEA and AI. We performed a case-control study using standardized radiographs of 39 surgically treated symptomatic borderline radiographically dysplastic hips and 20 age-matched controls with asymptomatic hips (a 2:1 ratio), the latter were patients attending our institution for trauma unrelated to their hips but who had standardized pelvic radiographs between January 1, 2016 and March 1, 2016. Patient demographics were assessed using univariate Wilcoxon two-sample tests. There was no difference in mean age (overall: 31.5 ± 11.8 years [95% CI, 27.7-35.4 years]; stable borderline group: mean, 32.1± 13.3 years [95% CI, 25.5-38.7 years]; unstable borderline group: mean, 31.1 ± 10.7 years [95% CI, 26.2-35.9 years]; p = 0.96) among study groups. Treatment received was either a periacetabular osteotomy (if the hip was unstable) or, for patients with femoroacetabular impingement, either an open or arthroscopic

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  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. Comparison of health-related quality of life, work status, and health care utilization and costs according to hip and knee joint disease severity: a national Australian study.

    Science.gov (United States)

    Ackerman, Ilana N; Ademi, Zanfina; Osborne, Richard H; Liew, Danny

    2013-07-01

    No population-based studies have investigated how the impact of hip and knee joint disease may vary with increasing severity. The purpose of this study was to evaluate health-related quality of life (HRQoL), work status, and health service utilization and costs according to severity of hip and knee joint disease. A national cross-sectional survey was conducted. Five thousand individuals were randomly selected from the Australian electoral roll and invited to complete a questionnaire to screen for doctor-diagnosed hip arthritis, hip osteoarthritis (OA), knee arthritis, and knee OA. Severity was classified by means of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (range=0-100): hip or knee joint disease. Of these, 16% (n=37) were classified as asymptomatic, 51% (n=120) as mild-moderate, and 27% (n=64) as severe. The severe group reported very low HRQoL (adjusted mean AQoL=0.43, 95% confidence interval [95% CI]=0.38-0.47) compared with the mild-moderate group (adjusted mean AQoL=0.72, 95% CI=0.69-0.75) and the asymptomatic group (adjusted mean AQoL=0.80, 95% CI=0.74-0.86). Compared with the asymptomatic group, the severe group was >3 times less likely to undertake paid work (adjusted odds ratio=0.28, 95% CI=0.09-0.88) and >4 times less likely to undertake unpaid work (adjusted odds ratio=0.24, 95% CI=0.10-0.62). Although physical therapy services were used infrequently, primary and specialist care utilization and costs were highest for the severe group. Other costs (including physical therapy consultations) were unavailable. A clear pattern of worsening HRQoL, reduced work participation, and higher medical care utilization was seen with increasing severity of joint disease.

  15. 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.

  16. Determining material loss from the femoral stem trunnion in hip arthroplasty using a coordinate measuring machine.

    Science.gov (United States)

    Bone, Martin C; Sidaginamale, Raghavendra P; Lord, James K; Scholes, Susan C; Joyce, Thomas J; Nargol, Anthony V F; Langton, David J

    2015-01-01

    In contrast to the articulating and taper surfaces of failed total hip replacements, volumetric wear analysis of trunnions is not routinely performed. Metal wear particles from the trunnion may contribute not only to the failures of metal-on-metal total hip replacements but also to all hip replacements utilising metal trunnions. A validation study was performed with the material removed in stages from the trunnions of an Exeter V40 stem, a Corail stem and an Accolade stem to simulate different magnitudes of wear. The material loss from the trunnions was measured both volumetrically with a coordinate measuring machine and gravimetrically with a high-precision balance. A cohort of 28 ex vivo trunnions was also measured using the coordinate measuring machine. The maximum error between the two methods was found to be 0.13 mm(3). This result was comparable with the coordinate measuring machine method for the taper surface (0.2 mm(3)). The ex vivo trunnions had a median wear volume of 0.14mm(3) (range: 0.04-0.28 mm(3)). This is the first study to determine the accuracy of volumetric wear measurements of trunnions by comparing against gravimetric measurements. Volumetric wear analysis of trunnions may provide additional insights into failures of modular total hip prostheses and will be performed routinely at our centre. © IMechE 2015.

  17. 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. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. 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.

  19. 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

  20. Achieving Consensus on Total Joint Replacement Trial Outcome Reporting Using the OMERACT Filter: Endorsement of the Final Core Domain Set for Total Hip and Total Knee Replacement Trials for Endstage Arthritis.

    Science.gov (United States)

    Singh, Jasvinder A; Dowsey, Michelle M; Dohm, Michael; Goodman, Susan M; Leong, Amye L; Scholte Voshaar, Marieke M J H; Choong, Peter F

    2017-11-01

    Discussion and endorsement of the OMERACT total joint replacement (TJR) core domain set for total hip replacement (THR) and total knee replacement (TKR) for endstage arthritis; and next steps for selection of instruments. The OMERACT TJR working group met at the 2016 meeting at Whistler, British Columbia, Canada. We summarized the previous systematic reviews, the preliminary OMERACT TJR core domain set and results from previous surveys. We discussed preliminary core domains for TJR clinical trials, made modifications, and identified challenges with domain measurement. Working group participants (n = 26) reviewed, clarified, and endorsed each of the inner and middle circle domains and added a range of motion domain to the research agenda. TJR were limited to THR and TKR but included all endstage hip and knee arthritis refractory to medical treatment. Participants overwhelmingly endorsed identification and evaluation of top instruments mapping to the core domains (100%) and use of subscales of validated multidimensional instruments to measure core domains for the TJR clinical trial core measurement set (92%). An OMERACT core domain set for hip/knee TJR trials has been defined and we are selecting instruments to develop the TJR clinical trial core measurement set to serve as a common foundation for harmonizing measures in TJR clinical trials.

  1. Automatic Measurement System For Congenital Hip Dislocation Using A Computed Radiography

    Science.gov (United States)

    Komori, M.; Minato, K.; Nakano, Y.; Hirakawa, A.; Kuwahara, M.

    1988-06-01

    Acetabular angle which is a diagnostic parameter of congenital hip dislocation has been measured manually in conventional X-ray film system. Using digital image directly provided from a computed radiography, an automatic measurement system was developed for this parameter. The process of the measurement was completed within a reasonable time, and accurate enough. The system was combined with an image database, so that it would be a measurement tool of PACS.

  2. An optimization algorithm for joint mechanics estimate using inertial measurement unit data during a squat task.

    Science.gov (United States)

    Bonnet, Vincent; Mazzà, Claudia; Fraisse, Philippe; Cappozzo, Aurelio

    2011-01-01

    The use of dynamic optimization as a tool to estimate joint kinematics and kinetics, and ground reaction forces using data from a single inertial measurement unit (IMU) positioned on the lower trunk was investigated. The feasibility of this approach and its accuracy was explored for the analysis of a squat task, focusing on the ankle, knee and hip joints. An optimal motor control strategy aimed at minimizing the sum of the intersegmental couples and of their time derivatives was imposed to estimate the mechanics of a three-segment sagittal model. Moreover, in the optimization process constraints to the measured vertical acceleration, to the maximal vertical IMU excursion, and with regard to the maintenance of dynamic balance were imposed. Experiments were performed using 10 volunteers. Data were collected from the IMU, from a stereophotogrammetric system (SS) and from a force platform for validation purposes. Results showed a very good consistency of the model output with the lower limb joint trajectories, as obtained using the SS, and with the measured vertical component of the ground reaction (low root mean square differences (<10%) and high correlation coefficients (0.98)).

  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. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints.

    Science.gov (United States)

    Prieto-Alhambra, Daniel; Judge, Andrew; Javaid, M Kassim; Cooper, Cyrus; Diez-Perez, Adolfo; Arden, Nigel K

    2014-09-01

    Data on the incidence of symptomatic osteoarthritis (OA) are scarce. We estimated incidence of clinical hip, knee and hand OA, and studied the effect of prevalent OA on joint-specific incident OA. SIDIAP contains primary care records for>5 million people from Catalonia (Spain). Participants aged ≥40 years with an incident diagnosis of knee, hip or hand OA between 2006 and 2010 were identified using International Classification of Diseases (ICD)-10 codes. Incidence rates and female-to-male rate ratios (RRs) for each joint site were calculated. Age, gender and body mass index-adjusted HR for future joint-specific OA according to prevalent OA at other sites were estimated using Cox regression. 3 266 826 participants were studied for a median of 4.45 years. Knee and hip OA rates increased continuously with age, and female-to-male RRs were highest at age 70-75 years. In contrast, female hand OA risk peaked at age 60-64 years, and corresponding female-to-male RR was highest at age 50-55 years. Adjusted HR for prevalent knee OA on risk of hip OA was 1.35 (99% CI 1.28 to 1.43); prevalent hip OA on incident knee OA: HR 1.15 (1.08 to 1.23). Prevalent hand OA predicted incident knee and hip OA: HR 1.20 (1.14 to 1.26) and 1.23 (1.13 to 1.34), respectively. The effect of age is greatest in the elderly for knee and hip OA, but around the menopause for hand OA. OA clusters within individuals, with higher risk of incident knee and hip disease from prevalent lower limb and hand OA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Finite Element Analysis Examining the Effects of Cam FAI on Hip Joint Mechanical Loading Using Subject-Specific Geometries During Standing and Maximum Squat.

    Science.gov (United States)

    Ng, K C Geoffrey; Rouhi, Gholamreza; Lamontagne, Mario; Beaulé, Paul E

    2012-10-01

    Cam femoroacetabular impingement (FAI) can impose elevated mechanical loading in the hip, potentially leading to an eventual mechanical failure of the joint. Since in vivo data on the pathomechanisms of FAI are limited, it is still unclear how this deformity leads to osteoarthritis. The purpose of this study was to examine the effects of cam FAI on hip joint mechanical loading using finite element analysis, by incorporating subject-specific geometries, kinematics, and kinetics. The research objectives were to address and determine: (1) if hips with cam FAI demonstrate higher maximum shear stresses, in comparison with control hips; (2) the magnitude of the peak maximum shear stresses; and (3) the locations of the peak maximum shear stresses. Using finite element analysis, two patient models were control-matched and simulated during quasi-static positions from standing to squatting. Intersegmental hip forces, from a previous study, were applied to the subject-specific hip geometries, segmented from CT data, to evaluate the maximum shear stresses on the acetabular cartilage and underlying bone. Peak maximum shear stresses were found at the anterosuperior region of the underlying bone during squatting. The peaks at the anterosuperior acetabulum were substantially higher for the patients (15.2 ± 1.8 MPa) in comparison with the controls (4.5 ± 0.1 MPa). Peaks were not situated on the cartilage, but instead located on the underlying bone. The results correspond with the locations of initial cartilage degradation observed during surgical treatment and from MRI. These findings support the pathomechanism of cam FAI. Changes may originate from the underlying subchondral bone properties rather than direct shear stresses to the articular cartilage.

  6. Instruments to assess physical activity in patients with osteoarthritis of the hip or knee: a systematic review of measurement properties

    NARCIS (Netherlands)

    Terwee, C.B.; Bouwmeester, W.; van Elsland, S.; de Vet, H.C.W.; Dekker, J.

    2011-01-01

    Objective: There is no consensus on the best approach for measuring physical activity in patients with osteoarthritis (OA) of the hip or knee. The aims of this study were (1) to identify all physical activity measures that have been validated in patients with OA of the hip or knee and to

  7. Increased risk of joint failure in hip prostheses infected with Staphylococcus aureus treated with debridement, antibiotics and implant retention compared to Streptococcus.

    Science.gov (United States)

    Betz, Michael; Abrassart, Sophie; Vaudaux, Pierre; Gjika, Ergys; Schindler, Maximilian; Billières, Julien; Zenelaj, Besa; Suvà, Domizio; Peter, Robin; Uçkay, Ilker

    2015-03-01

    The debridement, antibiotic and implant retention (DAIR) procedure is an option for patients with prosthetic hip joint infections for whom arthroplasty removal is problematic. Unfortunately, some of the guidelines proposed for deciding on DAIR management of arthroplasty infections fail to take into consideration the role of the infecting pathogen. While Staphylococcus aureus and streptococci are major contributors to infected hip arthroplasties, their respective contributions to treatment success or failure rates with the DAIR procedure have not been thoroughly analysed from a microbiological perspective. This retrospective study included all patients who were hospitalised in Geneva University Hospitals between 1996 and 2012 and were initially treated with DAIR for prosthetic hip joint monomicrobial infection due to S. aureus or Streptococcus spp. The outcome of DAIR treatment was evaluated after a minimal follow-up of two years. A literature search was also performed to retrieve data from additional DAIR-treated cases in other institutions. In our institution, 38 DAIR-treated patients with hip arthroplasty monomicrobial infections underwent at least one surgical debridement (median two, range one to five), exchange of mobile parts and concomitant targeted antibiotic therapy for several weeks or months. A literature search identified outcome data in other institutions from 52 additional DAIR-treated cases according to our study criteria. After merging our own data with those retrieved from other reports, we found a failure rate of 21 % instead of 24 % for S. aureus-infected, DAIR-treated patients, but no failure in 14 streptococcal-infected patients. In the pooled data, the failure rate linked with S. aureus infections was significantly higher than that with Streptococcus ssp. (19/90 vs 0/14 episodes; Fisher's exact test, P = 0.07). DAIR-treated patients with prosthetic hip joint infections due to S. aureus tended to have worse outcomes than those infected with

  8. [APPLICATION OF PREPARATION OF COCARNIT FOR PATIENTS AFTER ENDOPROSTHESIS OF HIP AND KNEE JOINTS].

    Science.gov (United States)

    Korzh, N A; Filippenko, V A; Leont'eva, F S; Tulyakov, V A; Bondarenko, S E

    2015-01-01

    In the article the results of clinical researches of efficiency of preparation of Cocarnit are resulted for patients after endoprosthesis of large joints. It is routine that for patients, receiving preparation of Cocarnit after the operation period there was a decline in the amount of complaints of patients on the total somatical state. Preparation of Ccocarnit was positively estimated outside patients, meaningful by-reactions, serving reason of abolition of preparation, was not marked. At the reception preparation of Cocarnit greater part of investigational laboratory indexes (table of contents of glucose, β-lipoproteines, total chondroitisulfates, TBC-productes (malonic dyaldehyde), activity of aspartataminotransferase, alkaline phosphatase and β-glutamyltranspeptidase), the indexes of clinical blood test and leucocytar indexes during a supervision did not have reliable differences from such as the persons of the control group, that confirms good bearab leness of the indicated preparation. Application preparation of Cocarnit for patients in composition the chart of treatment of patients after endoprosthesis of large joints brought maintenance over of cholesterol to the decline, glycoproteins, TBC-products (malonic dyaldehyde), activity of alaninaminotransferase, that specifies on normalizing influence of the indicated preparation in relation to the basic types of exchange of matters.

  9. A narrative review of evidence-based recommendations for the physical examination of the lumbar spine, sacroiliac and hip joint complex.

    Science.gov (United States)

    Wong, C K; Johnson, E K

    2012-09-01

    Non-specific low back pain is a frequent complaint in primary care, but the differential diagnosis for low back pain can be complex. Despite advances in diagnostic imaging, a specific pathoanatomical source of low back pain can remain elusive in up to 85% of individuals. Best practice guidelines recommend that clinicians conduct a focused physical examination to help to identify patients with non-specific low back pain and an evidence-based course of clinical management. The use of sensitive and specific clinical methods to assess the lumbar spine, sacroiliac and hip joints is critical for effective physical examination. Psychosocial factors also play an important role in the evaluation of individuals with low back pain, but are not included in this narrative review of physical examination methods. Physical examination of the lumbar spine, sacroiliac and hip joints is presented, organized around patient position for efficient and effective clinical assessment. Copyright © 2012 John Wiley & Sons, Ltd.

  10. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled.

    Science.gov (United States)

    Vigotsky, Andrew D; Lehman, Gregory J; Beardsley, Chris; Contreras, Bret; Chung, Bryan; Feser, Erin H

    2016-01-01

    The modified Thomas test was developed to assess the presence of hip flexion contracture and to measure hip extensibility. Despite its widespread use, to the authors' knowledge, its criterion reference validity has not yet been investigated. The purpose of this study was to assess the criterion reference validity of the modified Thomas test for measuring peak hip extension angle and hip extension deficits, as defined by the hip not being able to extend to 0º, or neutral. Twenty-nine healthy college students (age = 22.00 ± 3.80 years; height = 1.71 ± 0.09 m; body mass = 70.00 ± 15.60 kg) were recruited for this study. Bland-Altman plots revealed poor validity for the modified Thomas test's ability to measure hip extension, which could not be explained by differences in hip flexion ability alone. The modified Thomas test displayed a sensitivity of 31.82% (95% CI [13.86-54.87]) and a specificity of 57.14% (95% CI [18.41-90.10]) for testing hip extension deficits. It appears, however, that by controlling pelvic tilt, much of this variance can be accounted for (r = 0.98). When pelvic tilt is not controlled, the modified Thomas test displays poor criterion reference validity and, as per previous studies, poor reliability. However, when pelvic tilt is controlled, the modified Thomas test appears to be a valid test for evaluating peak hip extension angle.

  12. The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2016-08-01

    Full Text Available The modified Thomas test was developed to assess the presence of hip flexion contracture and to measure hip extensibility. Despite its widespread use, to the authors’ knowledge, its criterion reference validity has not yet been investigated. The purpose of this study was to assess the criterion reference validity of the modified Thomas test for measuring peak hip extension angle and hip extension deficits, as defined by the hip not being able to extend to 0º, or neutral. Twenty-nine healthy college students (age = 22.00 ± 3.80 years; height = 1.71 ± 0.09 m; body mass = 70.00 ± 15.60 kg were recruited for this study. Bland–Altman plots revealed poor validity for the modified Thomas test’s ability to measure hip extension, which could not be explained by differences in hip flexion ability alone. The modified Thomas test displayed a sensitivity of 31.82% (95% CI [13.86–54.87] and a specificity of 57.14% (95% CI [18.41–90.10] for testing hip extension deficits. It appears, however, that by controlling pelvic tilt, much of this variance can be accounted for (r = 0.98. When pelvic tilt is not controlled, the modified Thomas test displays poor criterion reference validity and, as per previous studies, poor reliability. However, when pelvic tilt is controlled, the modified Thomas test appears to be a valid test for evaluating peak hip extension angle.

  13. Reproducibility of a knee and hip proprioception test in healthy older adults

    NARCIS (Netherlands)

    Arvin, M.; Hoozemans, M.J.M.; Burger, B.J.; Verschueren, S.M.; van Dieen, J.H.; Pijnappels, M.A.G.M.

    2015-01-01

    Background: Proprioception can be assessed by measuring joint position sense (JPS). Most studies have focused on JPS of the knee joint while literature for other joints especially for hip JPS is scarce. Although some studies have evaluated proprioception of the knee joint, the reproducibility of

  14. Posterior dislocation of a native hip joint associate