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Sample records for hip osteoarthritis design

  1. HIP osteoarthritis and work.

    Science.gov (United States)

    Harris, E Clare; Coggon, David

    2015-06-01

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

  2. The role of self-management in designing care for people with osteoarthritis of the hip and knee.

    Science.gov (United States)

    Brand, Caroline A

    2008-11-17

    Osteoarthritis of the hip and knee is an increasingly common condition that is managed principally with lifestyle behaviour changes. Osteoarthritis management can be complex, as it typically affects older patients with multiple comorbidities. There is evidence that opportunities exist to improve uptake of evidence-based recommendations for care, especially for non-pharmacological interventions. The National Chronic Disease Strategy (NCDS) defines key components of programs designed to meet the needs of people with chronic conditions; one component is patient self-management. NCDS principles have been effectively integrated into chronic disease management programs for other conditions, but there is limited evidence of effectiveness for osteoarthritis programs. A comprehensive osteoarthritis management model that reflects NCDS policy is needed. Barriers to implementing such a model include poor integration of decision support, a lack of national infrastructure, workforce constraints and limited funding.

  3. The effects of exercise and weight loss in overweight patients with hip osteoarthritis: design of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    van der Meer Klaas

    2009-02-01

    Full Text Available Abstract Background Hip osteoarthritis (OA is recognised as a substantial source of disability, with pain and loss of function as principal symptoms. An aging society and a growing number of overweight people, which is considered a risk factor for OA, contribute to the growing number of cases of hip OA. In knee OA patients, exercise as a single treatment is proven to be very effective towards counteracting pain and physical functionality, but the combination of weight loss and exercise is demonstrated to be even more effective. Exercise as a treatment for hip OA patients is also effective, however evidence is lacking for the combination of weight loss and exercise. Consequently, the aim of this study is to get a first impression of the potential effectiveness of exercise and weight loss in overweight patients suffering from hip OA. Methods/Design This is a prospective cohort study. Patients aged 25 or older, overweight (BMI > 25 or obese (BMI > 30, with clinical and radiographic evidence of OA of the hip and able to attend exercise sessions will be included. The intervention is an 8-month exercise and weight-loss lifestyle program. Main goal is to increase aerobic capacity, lose weight and stimulate a low-calorie and active lifestyle. Primary outcome is self-reported physical functioning. Secondary outcomes include pain, stiffness, health-related quality of life and habitual activity level. Weight loss in kilograms and percentage of fat-free mass will also be measured. Discussion The results of this study will give a first impression of potential effectiveness of exercise and weight loss as a combination program for patients with OA of the hip. Once this program is proven to be effective it may lead to postponing the moment of total hip replacement. Trial Registration number NTR1053

  4. The effects of exercise and weight loss in overweight patients with hip osteoarthritis : design of a prospective cohort study

    NARCIS (Netherlands)

    Paans, Nienke; van den Akker-Scheek, Inge; van der Meer, Klaas; Bulstra, Sjoerd K.; Stevens, Martin

    2009-01-01

    Background: Hip osteoarthritis (OA) is recognised as a substantial source of disability, with pain and loss of function as principal symptoms. An aging society and a growing number of overweight people, which is considered a risk factor for OA, contribute to the growing number of cases of hip OA. In

  5. Gait Characteristics, Symptoms, and Function in Persons With Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Eitzen, I.; Fernandes, L.; Kallerud, H.

    2015-01-01

    STUDY DESIGN: Longitudinal laboratory study. OBJECTIVES: (1) To compare gait characteristics between individuals with early-stage hip osteoarthritis who underwent total hip replacement (THR) and those who did not undergo THR, and (2) to evaluate whether gait characteristics, function, and symptoms...... declined among individuals who did not undergo THR during a 6- to 7-year follow-up. BACKGROUND: The natural history of symptoms, function, and gait changes secondary to hip osteoarthritis, including potential differences at an early stage of disease, is unknown. METHODS: Forty-three individuals (mean age......, 58.9 years) with radiographic and symptomatic hip osteoarthritis participated. Outcome measures included 3-D gait analysis; self-reported pain; stiffness, and function; hip range of motion; and the six-minute walk test. Baseline comparisons between individuals who later underwent THR and those who...

  6. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: a case series.

    NARCIS (Netherlands)

    MacDonald, C.W.; Whitman, J.M.; Cleland, J.A.; Smith, M.; Hoeksma, H.L.

    2006-01-01

    Study Design: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Case Description: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients we

  7. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: a case series.

    NARCIS (Netherlands)

    MacDonald, C.W.; Whitman, J.M.; Cleland, J.A.; Smith, M.; Hoeksma, H.L.

    2006-01-01

    Study Design: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Case Description: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients we

  8. Design and testing a web-based physical activity intervention for patients with osteoarthritis in hip and/or knee.

    NARCIS (Netherlands)

    Bossen, D.

    2012-01-01

    Purpose: Due to elevated fear of pain, catastrophizing thoughts and joint stiffness, a large group of patients with hip and/or knee osteoarthritis (OA) remain sedentary. Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we d

  9. Design and testing a web-based physical activity intervention for patients with osteoarthritis in hip and/or knee.

    NARCIS (Netherlands)

    Bossen, D.

    2012-01-01

    Purpose: Due to elevated fear of pain, catastrophizing thoughts and joint stiffness, a large group of patients with hip and/or knee osteoarthritis (OA) remain sedentary. Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we

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

    OpenAIRE

    Kim, Chan; Nevitt, Michael C.; Niu, Jingbo; Clancy, Mary M; Nancy E Lane; Link, Thomas M.; Vlad, Steven; Tolstykh, Irina; Jungmann, Pia M.; Felson, David T.; Guermazi, Ali

    2015-01-01

    Study question Is there concordance between hip pain and radiographic hip osteoarthritis? Methods In this diagnostic test study, pelvic radiographs were assessed for hip osteoarthritis in two cohorts: the Framingham Osteoarthritis Study (community of Framingham, Massachusetts) and the Osteoarthritis Initiative (a multicenter longitudinal cohort study of osteoarthritis in the United States). Using visual representation of the hip joint, participants reported whether they had hip pain on most d...

  11. Effectiveness of intramuscular corticosteroid injection versus placebo injection in patients with hip osteoarthritis: design of a randomized double-blinded controlled trial

    Directory of Open Access Journals (Sweden)

    Dorleijn Desirée MJ

    2011-12-01

    Full Text Available Abstract Background Recent international guidelines recommend intra-articular corticosteroid injections for patients with hip osteoarthritis who have moderate to severe pain and do not respond satisfactorily to oral analgesic/anti-inflammatory agents. Of the five available randomized controlled trials, four showed positive effects with respect to pain reduction. However, intra-articular injection in the hip is complex because the joint is adjacent to important neurovascular structures and cannot be palpated. Therefore fluoroscopic or ultrasound guidance is needed. The systemic effect of corticosteroids has been studied in patients with impingement shoulder pain. Gluteal corticosteroid injection was almost as effective as ultrasound-guided subacromial corticosteroid injection. Such a clinically relevant effect of a systemic corticosteroid injection offers a less complex alternative for treatment of patients with hip osteoarthritis not responsive to oral pain medication. Methods/Design This is a double-blinded, randomized controlled trial. A total of 135 patients (aged > 40 years with hip osteoarthritis and persistent pain despite oral analgesics visiting a general practitioner or orthopaedic surgeon will be included. They will be randomized to a gluteal intramuscular corticosteroid injection or a gluteal intramuscular placebo (saline injection. The randomization will be stratified for setting (general practitioner and outpatient clinics of department of orthopaedics. Treatment effect will be evaluated by questionnaires at 2, 4, 6, and 12 weeks follow-up and a physical examination at 12 weeks. Primary outcome is severity of hip pain reported by the patients at 2-week follow-up. Statistical analyses will be based on the intention-to-treat principle. Discussion This study will evaluate the effectiveness of an intramuscular corticosteroid injection on pain in patients with hip osteoarthritis. Patient recruitment has started. Trial Registration This

  12. Osteoarthritis

    Science.gov (United States)

    ... also common sites of osteoarthritis. As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint ... groin, inner thigh, buttocks, or even the knees. Osteoarthritis of the hip may limit moving and bending, making daily activities ...

  13. Pelvic Incidence in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ibrahim Raphael

    2016-04-01

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

  14. Activity Increase Despite Arthritis (AÏDA: design of a Phase II randomised controlled trial evaluating an active management booklet for hip and knee osteoarthritis [ISRCTN24554946

    Directory of Open Access Journals (Sweden)

    Edwards Rhiannon T

    2009-09-01

    Full Text Available Abstract Background Hip and knee osteoarthritis is a common cause of pain and disability, which can be improved by exercise interventions. However, regular exercise is uncommon in this group because the low physical activity level in the general population is probably reduced even further by pain related fear of movement. The best method of encouraging increased activity in this patient group is not known. A booklet has been developed for patients with hip or knee osteoarthritis. It focuses on changing disadvantageous beliefs and encouraging increased physical activity. Methods/Design This paper describes the design of a Phase II randomised controlled trial (RCT to test the effectiveness of this new booklet for patients with hip and knee osteoarthritis in influencing illness and treatment beliefs, and to assess the feasibility of conducting a larger definitive RCT in terms of health status and exercise behaviour. A computerised search of four general medical practice patients' record databases will identify patients older than 50 years of age who have consulted with hip or knee pain in the previous twelve months. A random sample of 120 will be invited to participate in the RCT comparing the new booklet with a control booklet, and we expect 100 to return final questionnaires. This trial will assess the feasibility of recruitment and randomisation, the suitability of the control intervention and outcome measurement tools, and will provide an estimate of effect size. Outcomes will include beliefs about hip and knee pain, beliefs about exercise, fear avoidance, level of physical activity, health status and health service costs. They will be measured at baseline, one month and three months. Discussion We discuss the merits of testing effectiveness in a phase II trial, in terms of intermediate outcome measures, whilst testing the processes for a larger definitive trial. We also discuss the advantages and disadvantages of testing the psychometric

  15. Cost-effectiveness of exercise therapy versus general practitioner care for osteoarthritis of the hip: design of a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2011-10-01

    Full Text Available Abstract Background Osteoarthritis (OA is the most common joint disease, causing pain and functional impairments. According to international guidelines, exercise therapy has a short-term effect in reducing pain/functional impairments in knee OA and is therefore also generally recommended for hip OA. Because of its high prevalence and clinical implications, OA is associated with considerable (healthcare costs. However, studies evaluating cost-effectiveness of common exercise therapy in hip OA are lacking. Therefore, this randomised controlled trial is designed to investigate the cost-effectiveness of exercise therapy in conjunction with the general practitioner's (GP care, compared to GP care alone, for patients with hip OA. Methods/Design Patients aged ≥ 45 years with OA of the hip, who consulted the GP during the past year for hip complaints and who comply with the American College of Rheumatology criteria, are included. Patients are randomly assigned to either exercise therapy in addition to GP care, or to GP care alone. Exercise therapy consists of (maximally 12 treatment sessions with a physiotherapist, and home exercises. These are followed by three additional treatment sessions in the 5th, 7th and 9th month after the first treatment session. GP care consists of usual care for hip OA, such as general advice or prescribing pain medication. Primary outcomes are hip pain and hip-related activity limitations (measured with the Hip disability Osteoarthritis Outcome Score [HOOS], direct costs, and productivity costs (measured with the PROductivity and DISease Questionnaire. These parameters are measured at baseline, at 6 weeks, and at 3, 6, 9 and 12 months follow-up. To detect a 25% clinical difference in the HOOS pain score, with a power of 80% and an alpha 5%, 210 patients are required. Data are analysed according to the intention-to-treat principle. Effectiveness is evaluated using linear regression models with repeated measurements. An

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

    DEFF Research Database (Denmark)

    Svege, Ida; Nordsletten, Lars; Fernandes, Linda

    2015-01-01

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

  17. Hip Osteoarthritis : symptomatic presentation and non-operative treatment

    OpenAIRE

    Dorleijn, Desirée

    2017-01-01

    markdownabstractHip osteoarthritis is a common, chronic disease characterized by pain and disability. It can have a considerable impact on a person’s activities of daily living. Because there is no treatment available that can cure osteoarthritis, the treatment consists of symptom management. This thesis describes a systematic review on the usefulness of anesthetic hip joint injection in diagnosing hip osteoarthritis. Also it reports on associations between biochemical cartilage markers and c...

  18. Osteoarthritis of the hip; MR features

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-07-01

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

  19. The association between hip fracture and hip osteoarthritis: A case-control study

    Directory of Open Access Journals (Sweden)

    Englund Martin

    2010-11-01

    Full Text Available Abstract Background There have been reports both supporting and refuting an inverse relationship between hip fracture and hip osteoarthritis (OA. We explore this relationship using a case-control study design. Methods Exclusion criteria were previous hip fracture (same side or contralateral side, age younger than 60 years, foreign nationality, pathological fracture, rheumatoid arthritis and cases were radiographic examinations were not found in the archives. We studied all subjects with hip fracture that remained after the exclusion process that were treated at Akureyri University Hospital, Iceland 1990-2008, n = 562 (74% women. Hip fracture cases were compared with a cohort of subjects with colon radiographs, n = 803 (54% women to determine expected population prevalence of hip OA. Presence of radiographic hip OA was defined as a minimum joint space of 2.5 mm or less on an anteroposterior radiograph, or Kellgren and Lawrence grade 2 or higher. Possible causes of secondary osteoporosis were identified by review of medical records. Results The age-adjusted odds ratio (OR for subjects with hip fracture having radiographic hip OA was 0.30 (95% confidence interval [95% CI] 0.12-0.74 for men and 0.33 (95% CI 0.19-0.58 for women, compared to controls. The probability for subjects with hip fracture and hip OA having a secondary cause of osteoporosis was three times higher than for subjects with hip fracture without hip OA. Conclusion The results of our study support an inverse relationship between hip fractures and hip OA.

  20. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial

    OpenAIRE

    Kirsti Uusi-Rasi; Radhika Patil; Saija Karinkanta; Kari Tokola; Pekka Kannus; Harri Sievänen

    2017-01-01

    Introduction. Osteoarthritis (OA) of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods...

  1. the Hip Joint Affected by Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Anetta Zioła-Frankowska

    2015-01-01

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

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

    Science.gov (United States)

    Sudula, S N

    2016-05-01

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

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

    Science.gov (United States)

    Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

    2016-07-25

    BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (prehabilitation program including water exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

  4. Pain distribution in primary care patients with hip osteoarthritis

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chatla

    2016-03-01

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

  6. Effectiveness of intramuscular corticosteroid injection versus placebo injection in patients with hip osteoarthritis: Design of a randomized double-blinded controlled trial

    NARCIS (Netherlands)

    D.M.J. Dorleijn (Desirée); P.A.J. Luijsterburg (Pim); M. Reijman (Max); M. Kloppenburg (Margreet); J.A.N. Verhaar (Jan); P.J.E. Bindels (Patrick); P.K. Bos (Koen); S.M. Bierma-Zeinstra (Sita)

    2011-01-01

    textabstractBackground: Recent international guidelines recommend intra-articular corticosteroid injections for patients with hip osteoarthritis who have moderate to severe pain and do not respond satisfactorily to oral analgesic/anti- inflammatory agents. Of the five available randomized controlled

  7. Prevalence of hip osteoarthritis in chiropractic practice in denmark

    DEFF Research Database (Denmark)

    Poulsen, Erik; Christensen, Henrik W; Overgaard, Søren

    2012-01-01

    The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered by the chiroprac......The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered...

  8. Hip Osteoarthritis : symptomatic presentation and non-operative treatment

    NARCIS (Netherlands)

    D.M.J. Dorleijn (Desirée)

    2017-01-01

    markdownabstractHip osteoarthritis is a common, chronic disease characterized by pain and disability. It can have a considerable impact on a person’s activities of daily living. Because there is no treatment available that can cure osteoarthritis, the treatment consists of symptom management. This

  9. Assessment of hip dysplasia and osteoarthritis: Variability of different methods

    Energy Technology Data Exchange (ETDEWEB)

    Troelsen, Anders; Elmengaard, Brian; Soeballe, Kjeld (Orthopedic Research Unit, Univ. Hospital of Aarhus, Aarhus (Denmark)), e-mail: a_troelsen@hotmail.com; Roemer, Lone (Dept. of Radiology, Univ. Hospital of Aarhus, Aarhus (Denmark)); Kring, Soeren (Dept. of Orthopedic Surgery, Aabenraa Hospital, Aabenraa (Denmark))

    2010-03-15

    Background: Reliable assessment of hip dysplasia and osteoarthritis is crucial in young adults who may benefit from joint-preserving surgery. Purpose: To investigate the variability of different methods for diagnostic assessment of hip dysplasia and osteoarthritis. Material and Methods: By each of four observers, two assessments were done by vision and two by angle construction. For both methods, the intra- and interobserver variability of center-edge and acetabular index angle assessment were analyzed. The observers' ability to diagnose hip dysplasia and osteoarthritis were assessed. All measures were compared to those made on computed tomography scan. Results: Intra- and interobserver variability of angle assessment was less when angles were drawn compared with assessment by vision, and the observers' ability to diagnose hip dysplasia improved when angles were drawn. Assessment of osteoarthritis in general showed poor agreement with findings on computed tomography scan. Conclusion: We recommend that angles always should be drawn for assessment of hip dysplasia on pelvic radiographs. Given the inherent variability of diagnostic assessment of hip dysplasia, a computed tomography scan could be considered in patients with relevant hip symptoms and a center-edge angle between 20 deg and 30 deg. Osteoarthritis should be assessed by measuring the joint space width or by classifying the Toennis grade as either 0-1 or 2-3

  10. Translation, Cross-cultural Adaptation, and Psychometric Properties of the German Version of the Hip Disability and Osteoarthritis Outcome Score

    NARCIS (Netherlands)

    Blasimann, A.; Dauphinee, S.W.; Staal, J.B.

    2014-01-01

    Study Design Clinical measurement. Objectives To translate and cross-culturally adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) from English into German, and to study its psychometric properties in patients after hip surgery. Background There is no specific hip questionnaire in Germ

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  12. The Effect of Hip Bracing on Gait in Patients with Medial Knee Osteoarthritis

    OpenAIRE

    David Wallace; Christa Barr

    2012-01-01

    Objective. Impaired hip motion has been associated with heightened medial knee joint loading in patients with knee osteoarthritis (OA). A hip external rotation strap designed to pull the femur into external rotation and abduction may serve as one protective mechanism. The primary aim of our study is to determine if the strap decreases medial knee joint loading during level walking in people with knee OA. Design. This study is a single-day repeated measures design. Methods. 15 volunteers with ...

  13. Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis.

    Science.gov (United States)

    Deasy, Margaret; Leahy, Edmund; Semciw, Adam Ivan

    2016-08-01

    Study Design Systematic review with meta-analysis. Background A complete understanding of impairments associated with knee osteoarthritis would optimize exercise interventions for people with knee osteoarthritis. Our current understanding of hip strength deficits in this population is based on studies with conflicting findings and small samples. There is a need to systematically review and pool current evidence. Objectives To determine whether hip strength deficits exist in people with symptomatic knee osteoarthritis. Methods Electronic databases (MEDLINE, CINAHL, Embase, the Cochrane Library, and PsycINFO) were searched through February 2016. Studies comparing hip strength in people diagnosed with symptomatic knee osteoarthritis to healthy control participants were included in the review. A meta-analysis with random effects was applied to relevant data from included studies and a modified Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the quality of evidence for each pooled analysis. Results Five studies were included in the review. Meta-analysis revealed moderate-quality evidence of weaker isometric and isokinetic hip abduction strength in people with knee osteoarthritis (moderate difference: 7% to 24% weaker) and very low-quality evidence of no difference in isometric hip adduction strength. There was very low- to moderate-quality evidence of weaker isokinetic hip strength in the remaining planes of motion (moderate to large differences: 14% to 55% weaker). Conclusion Significant hip strength deficits exist in people with knee osteoarthritis. Hip strength assessment should be considered in clinical practice and may assist with directing targeted management strategies. Level of Evidence Symptom prevalence, level 1a-. J Orthop Sports PhysTher 2016;46(8):629-639. Epub3 Jul 2016. doi:10.2519/jospt.2016.6618.

  14. Using hip measures to avoid misdiagnosing early rapid onset osteoarthritis for osteonecrosis.

    Science.gov (United States)

    Nelson, Fred R T; Bhandarkar, Varun S; Woods, Tammy A

    2014-06-01

    In the early phases, subchondral insufficiency fractures and rapidly destructive osteoarthritis of the hip are often mistaken for osteonecrosis of the hip. Three hip measures were used comparing combined subchondral insufficiency fractures and rapidly destructive 18 osteoarthritis patients to 18 osteonecrosis patients. Due to the rarity of these conditions there was no statistical power. Initial diagnoses for the osteoarthritis patients were recorded. The osteoarthritis group had significantly higher means for Tönnis angle (P osteoarthritis. Using hip measures will reduce the misdiagnosis of rapid onset osteoarthritis of the hip for osteonecrosis.

  15. [Quality of life in patients with knee and hip osteoarthritis].

    Science.gov (United States)

    Bernad-Pineda, M; de Las Heras-Sotos, J; Garcés-Puentes, M V

    2014-01-01

    To evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. An observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1,849 patients with knee and/or hip osteoarthritis, aged ≥ 50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. The patients were 68.5 ± 9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74 ± 8.6 and 35.21 ± 8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. This is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. These results could be considered as reference values of Spanish population aged ≥ 50 years with knee or hip osteoarthritis. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  16. Passive hip movement measurements related to dynamic motion during gait in hip osteoarthritis.

    Science.gov (United States)

    Baker, Matt; Moreside, Janice; Wong, Ivan; Rutherford, Derek J

    2016-10-01

    Reduced sagittal plane range of motion (ROM) has been reported in individuals with hip osteoarthritis (OA) both during walking and passive testing. The purpose of this study was to determine if a relationship exists between hip extension ROM recorded during gait and passive hip extension ROM in individuals with moderate and severe hip OA, in comparison to an asymptomatic group. Sagittal plane hip ROM was calculated using skin surface marker trajectories captured during treadmill walking at self-selected speed. Passive hip ROM was measured using standardized position and recording procedures with a goniometer. Sagittal plane extension, flexion, and overall ROM were measured dynamically and passively. A two-way mixed model analysis of variance determined significant differences between groups and between passive and dynamic ROM (α = 0.05). Pearson correlations determined relationships between passive and dynamic ROM. Significant group by ROM interactions were found for flexion and extension ROM (p passive ROM compared to the other groups and greater passive than dynamic ROM (p passive ROM existed between all three groups (p passive hip extension were found in the moderate (r = 0.596) and severe OA (r = 0.586) groups, and no correlation was found in the asymptomatic group (r = 0.139). Passive ROM explains variance in dynamic ROM measurements obtained during gait in individuals with moderate and severe hip OA which have implications for the design of treatment strategies targeting walking pathomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1790-1797, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  17. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement

    DEFF Research Database (Denmark)

    Nilsdotter, Anna K; Lohmander, L Stefan; Klässbo, Maria

    2003-01-01

    The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score...

  18. Reliability of the hip examination in osteoarthritis: effect of standardization.

    Science.gov (United States)

    Cibere, Jolanda; Thorne, Anona; Bellamy, Nicholas; Greidanus, Nelson; Chalmers, Andrew; Mahomed, Nizar; Shojania, Kam; Kopec, Jacek; Esdaile, John M

    2008-03-15

    To assess the reliability of the physical examination of the hip in osteoarthritis (OA) among rheumatologists and orthopedic surgeons, and to evaluate the benefits of standardization. Thirty-five physical signs and techniques were evaluated using a 6 x 6 Latin square design. Subjects with mild to severe hip OA, based on physical and radiographic signs, were examined in random order prior to and following standardization of physical examination techniques. For dichotomous signs, agreement was calculated as the prevalence-adjusted bias-adjusted kappa (PABAK), whereas for continuous and ordinal signs a reliability coefficient was calculated using analysis of variance. A PABAK >0.60 and a reliability coefficient >0.80 were considered to indicate adequate reliability. Adequate post-standardization reliability was achieved for 25 (71%) of 35 signs. The most highly reliable signs included true and apparent leg length discrepancy > or =1.5 cm; hip flexion, abduction, adduction, and extension strength; log roll test for hip pain; internal rotation and flexion range of motion; and Thomas test for flexion contracture. The standardization process was associated with substantial improvements in reliability for a number of physical signs, although minimal or no change was noted for some. Only 1 sign, Trendelenburg's sign, was highly unreliable post-standardization. With the exception of gait, a comprehensive hip examination can be performed with adequate reliability. Post-standardization reliability is improved compared with pre-standardization reliability for some physical signs. The application of these findings to future OA studies will contribute to improved outcome assessments in OA.

  19. Osteoarthritis

    Science.gov (United States)

    Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in your ... it affects your hands, knees, hips or spine. Osteoarthritis breaks down the cartilage in your joints. Cartilage ...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Vossinakis, I.C. [General Hospital of Volos, Orthopaedic Department, Volos (Greece); Georgiades, G. [General Hospital of Tripoli, Tripoli Greece, Orthopaedic Department, Athens (Greece); Hartofilakidis, G. [University of Athens Medical School, Department of Orthopaedics, Athens (Greece); Kafidas, D.

    2008-10-15

    The objective of this study was to define, in unilateral hip osteoarthritis (OA), factors predicting the outcome of the other hip. We examined the anteroposterior radiographs of the pelvis of 95 white patients with unilateral idiopathic (56 patients) or secondary to congenital hip diseases (39 patients) OA. The other hip was free from symptoms (pain or limping) at the initial examination and without radiographic evidence of OA; it was what we call a ''normal'' hip. Two parameters were evaluated: (1) the type of osteoarthritis of the involved hip and (2) the range of four radiographic indices of the contralateral hip: the sourcil inclination (weight-bearing surface), the acetabular angle, the Wiberg's center-edge angle, and the neck-shaft angle. Follow-up radiographs for the hips that remained OA-free were available for 10 to 35 years and for those that developed OA, at the time of initial symptoms, range 2 to 31 years. Logistic regression analysis showed that the presence of idiopathic OA in one hip had a statistically significant effect on the development of OA on the other hip (p<0.001). Minor deviations of radiographic indices of the contralateral hip is not a predictive factor for its outcome. When the radiographic indices are examined together with the pathology of the involved hip, only WBS was shown to have a significant effect to the development of OA and its type (p < 0.001). The following conclusions can be drawn from this study: 1. Patient with idiopathic OA of one hip is at increased risk of developing OA in the other hip. 2. The outcome of the other hip cannot be predicted only on the basis of the evaluation of its radiographic indices. 3. Among the different indices, WBS seems to have a strong influence toward the development of OA. (orig.)

  3. Investigation of association between hip morphology and prevalence of osteoarthritis.

    Science.gov (United States)

    Zeng, Wei-Nan; Wang, Fu-You; Chen, Cheng; Zhang, Ying; Gong, Xiao-Yuan; Zhou, Kai; Chen, Zhi; Wang, Duan; Zhou, Zong-Ke; Yang, Liu

    2016-03-22

    The cause of hip osteoarthritis (OA) remains unclear, morphologic abnormality of hip was thought to be a contributing factor to hip OA. The hypothesis was that there were subtle anatomical morphology differences of the hip between normal and OA subjects; the objective of this study was to explore these anatomical differences which are predisposing to hip OA based on CT 3D reconstruction. Ninety-three normal subjects (186 hips) and 66 mild-to-moderate hip OA subjects (132 hips) were recruited in this study. Three parameters of the head-neck relationship were assessed: translation, rotation and concavity. Translation was the potential translational movements of femoral head related to the neck's axis. Rotation was described by the physeal scar to evaluate the rotation tendency of femoral head related to the neck at the head-neck junction. Concavity was used to assess the sphericity of the head as it joins the neck. The femoral neck anteversion angle and some parameters of the acetabulum: anteversion, inclination and CE angle were measured too. By comparison, it was found that OA subjects had less femoral head sphericity, head-neck junction concavity, acetabular and femoral neck anteversion angle; but greater acetabular coverage. These characteristics increased the risk of hip OA in OA subjects.

  4. The effect of education and supervised exercise vs. education alone on the time to total hip replacement in patients with severe hip osteoarthritis. A randomized clinical trial protocol

    DEFF Research Database (Denmark)

    Jensen, Carsten; Roos, Ewa M.; Kjærsgaard-Andersen, Per

    2013-01-01

    measures are the five subscales of the Hip disability and Osteoarthritis Outcome Score, physical activity (UCLA activity score), and patient’s global perceived effect. Other measures include pain after exercise, joint-specific adverse events, exercise adherence, general health status (EQ-5D-5L), mechanical...... muscle function and performance in physical tests. A cost-effectiveness analysis will also be performed. Discussion: To our knowledge, this is the first randomized clinical trial comparing a patient education plus supervised exercise program to patient education alone in hip osteoarthritis patients...... replacement is considered. We hypothesize that the time to hip replacement can be postponed in patients with severe hip osteoarthritis following participation in a patient education and supervised exercise program when compared to patients receiving patient education alone. Methods/design: A prospective...

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

    Directory of Open Access Journals (Sweden)

    McMurtrie A

    2008-01-01

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

  6. Osteoarthritis and bone: Osteologic types of osteoarthritis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Oettmeier, R.; Abendroth, K.

    1989-05-01

    To assess prognosis and indications for allografting articular surfaces, osteological examination is of increasing importance. In this study 93 femoral heads of patients with primary osteoarthritis could be differentiated into three osteologic types using histomorphometry: (1) the osteosclerotic type (77% of cases), (2) the hyperostotic type, with excessive neogenesis of bone all over the femoral head and increased formation of osteophytes (10% of cases), and (3) the osteopenic type, with decreased bone mass and features of bone remodelling, a greater occurrence of subchondral cysts, and small osteophytes (8% of cases). Radiological and clinical features to distinguish these groups are given. The consequences for pathogenesis and clinical practice are discussed. (orig.).

  7. Total hip arthroplasty for patients with osteoarthritis secondary to hip pyogenic infection

    Institute of Scientific and Technical Information of China (English)

    GAO Xiang; HE Rong-xin; YAN Shi-gui

    2010-01-01

    Background Pyogenic hip arthritis occurs most often in young patients. Delayed treatment causes significant anatomical deformation of bony and soft tissue structures leading to premature onset of secondary osteoarthritis. Total hip arthroplasty (THA) in patients who had osteoarthritis secondary to hip pyogenic infection has been associated with high complication rates. Methods We analyzed 19 THAs performed from April 2003 to July 2008 in adults with osteoarthritis secondary to hip pyogenic infection (average age 40.7 years; range 34-52 years). There were 7 males and 12 females, the average age of infection was 10.6 years (range 7-13 years) and the average quiescent period of infection was 29.5 years (range 22-41 years). The count of white blood cell (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were examined routinely before surgery. The duration of followup was 34 months (range 6-52 months). Conclusions It is safe and efficient to perform THA in patients who had osteoarthritis secondary to pyogenic hip arthritis when the infection is quiescent. The key points of successful surgery are exclusion of active infection preoperatively, quiescent period of infection more than ten years and adequate intraoperative soft tissue releases.

  8. Biomechanical gait features associated with hip osteoarthritis: Towards a better definition of clinical hallmarks.

    Science.gov (United States)

    Meyer, Christophe A G; Corten, Kristoff; Fieuws, Steffen; Deschamps, Kevin; Monari, Davide; Wesseling, Mariska; Simon, Jean-Pierre; Desloovere, Kaat

    2015-10-01

    Critical appraisal of the literature highlights that the discriminative power of gait-related features in patients with hip osteoarthritis (OA) has not been fully explored. We aimed to reduce the number of gait-related features and define the most discriminative ones comparing the three-dimensional gait analysis of 20 patients with hip osteoarthritis (OA) with those of 17 healthy peers. First, principal component analysis was used to reduce the high-dimensional gait data into a reduced set of interpretable variables for further analysis, including tests for group differences. These differences were indicative for the selection of the top 10 variables to be included into linear discriminant analysis models (LDA). Our findings demonstrated the successful data reduction of hip osteoarthritic-related gait features with a high discriminatory power. The combination of the top variables into LDA models clearly separated groups, with a maximum misclassification error rate of 19%, estimated by cross-validation. Decreased hip/knee extension, hip flexion and internal rotation moment were gait features with the highest discriminatory power. This study listed the most clinically relevant gait features characteristics of hip OA. Moreover, it will help clinicians and physiotherapists understand the movement pathomechanics related to hip OA useful in the management and design of rehabilitation intervention.

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

    Science.gov (United States)

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

    2006-12-01

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

  10. The Effect of Hip Bracing on Gait in Patients with Medial Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    David Wallace

    2012-01-01

    Full Text Available Objective. Impaired hip motion has been associated with heightened medial knee joint loading in patients with knee osteoarthritis (OA. A hip external rotation strap designed to pull the femur into external rotation and abduction may serve as one protective mechanism. The primary aim of our study is to determine if the strap decreases medial knee joint loading during level walking in people with knee OA. Design. This study is a single-day repeated measures design. Methods. 15 volunteers with medial knee OA underwent motion analysis data collection during two randomly assigned walking conditions: (1 wearing the strap and (2 control (no strap. Primary outcome measures were peak pelvis, hip and knee joint motions, and torques. These outcomes were averaged across five trials for each condition. Results. Hip abduction (<0.01, trunk lean towards the stance limb (=0.04 and pelvic tilt (=0.02 significantly increased with the strap versus control trials. Knee adduction loading did not significantly change with the strap (=0.33. Conclusion. The use of the hip external rotation strap resulted in angular changes at the hip and pelvis which may be beneficial for patients with medial knee osteoarthritis.

  11. Effect of passive muscle stretching in osteoarthritis of the hip.

    Science.gov (United States)

    Leivseth, G; Torstensson, J; Reikerås, O

    1989-01-01

    1. Twenty-five minute daily muscle stretching, perpendicular to the fibre direction of the adductor muscles without movement of the hip, was performed in patients with osteoarthritis of the hip. 2. Before and after treatment hip abduction was measured and muscle biopsies were taken for analysis of fibre cross-sectional areas of type 1 and type 2 fibres as well as adenosine 5'-triphosphate, creatine phosphate and glycogen contents. 3. From the results it is concluded that passive muscle stretching leads to a significant increase in hip abduction of 8.3 degrees (P less than 0.05). There was also a significant increase of type 1 and type 2 fibre cross-sectional area and of glycogen content after the treatment period (P less than 0.05), but the concentrations of adenosine 5'-triphosphate and creatine phosphate did not change significantly.

  12. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Scott J Dos Santos

    2016-12-01

    Full Text Available Objectives: Pelvic congestion syndrome (PCS is associated with pelvic vein reflux (PVR, occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE. The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. Methods: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain. Both had previously been investigated for the hip pain and diagnosed as osteoarthritis despite minimal arthritic changes on pelvic X-rays. During investigation for lower limb varicose veins, both showed a pelvic origin for their leg veins and hence underwent transvaginal duplex ultrasound. This revealed PVR, and PVE was planned in both patients. Results: Both patients underwent PVE and reported ‘miraculous’ resolution of left hip pain and also PCS symptoms including pelvic pain, irritable bowel issues and the disappearance of pelvic dragging, with almost immediate disappearance of vulval and vaginal varicosities. One patient also noted reduced clitoral sensitivity. Conclusion: Manifestations of PCS may vary in terms of intra- or extra-pelvic signs. PCS and PVR should be considered in the differential diagnosis of patients with arthritic symptoms in the hip without evident radiographic evidence.

  13. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    Science.gov (United States)

    Mella, Claudio; Villalón, Ignacio E.; Núñez, Álvaro; Paccot, Daniel; Díaz-Ledezma, Claudio

    2015-01-01

    The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI) and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage. PMID:27163082

  14. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    Directory of Open Access Journals (Sweden)

    Mella Claudio

    2015-01-01

    Full Text Available The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage.

  15. Aquatic exercise for the treatment of knee and hip osteoarthritis

    DEFF Research Database (Denmark)

    Bartels, Else Marie; Juhl, Carsten B; Christensen, Robin

    2016-01-01

    BACKGROUND: Osteoarthritis is a chronic disease characterized by joint pain, tenderness, and limitation of movement. At present, no cure is available. Thus only treatment of the person's symptoms and treatment to prevent further development of the disease are possible. Clinical trials indicate...... that aquatic exercise may have advantages for people with osteoarthritis. This is an update of a published Cochrane review. OBJECTIVES: To evaluate the effects of aquatic exercise for people with knee or hip osteoarthritis, or both, compared to no intervention. SEARCH METHODS: We searched the following...... databases up to 28 April 2015: the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library Issue 1, 2014), MEDLINE (from 1949), EMBASE (from 1980), CINAHL (from 1982), PEDro (Physiotherapy Evidence Database), and Web of Science (from 1945). There was no language restriction. SELECTION...

  16. Aquatic exercise for the treatment of knee and hip osteoarthritis

    DEFF Research Database (Denmark)

    Bartels, Else Marie; Juhl, Carsten B; Christensen, Robin

    2016-01-01

    participants) and disability (SMD -0.32, 95% CI -0.47 to -0.17; 12 trials, 1059 participants). Ten trials showed a small effect on quality of life (QoL) (SMD -0.25, 95% CI -0.49 to -0.01; 10 trials, 971 participants). These effects on pain and disability correspond to a five point lower (95% CI three to eight...... were reported in the included trials with relation to aquatic exercise. AUTHORS' CONCLUSIONS: There is moderate quality evidence that aquatic exercise may have small, short-term, and clinically relevant effects on patient-reported pain, disability, and QoL in people with knee and hip OA...... that aquatic exercise may have advantages for people with osteoarthritis. This is an update of a published Cochrane review. OBJECTIVES: To evaluate the effects of aquatic exercise for people with knee or hip osteoarthritis, or both, compared to no intervention. SEARCH METHODS: We searched the following...

  17. Probability and heritability estimates on primary osteoarthritis of the hip leading to total hip arthroplasty

    DEFF Research Database (Denmark)

    Skousgaard, Søren Glud; Hjelmborg, Jacob; Skytthe, Axel;

    2015-01-01

    INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk and heritab......INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk...... and heritability of primary osteoarthritis of the hip leading to a total hip arthroplasty, and if this heritability increased with increasing age. METHODS: In a nationwide population-based follow-up study 118,788 twins from the Danish Twin Register and 90,007 individuals from the Danish Hip Arthroplasty Register...... not have had a total hip arthroplasty at the time of follow-up. RESULTS: There were 94,063 twins eligible for analyses, comprising 835 cases of 36 concordant and 763 discordant twin pairs. The probability increased particularly from 50 years of age. After sex and age adjustment a significant additive...

  18. Association between biochemical cartilage markers and clinical symptoms in patients with hip osteoarthritis: Cohort study with 2-year follow-up

    NARCIS (Netherlands)

    D.M.J. Dorleijn (Desirée); P.A.J. Luijsterburg (Pim); A.C. Bay-Jensen (Anne); A.S. Siebuhr (Anne Sofie); M.A. Karsdal (Ma); R.M. Rozendaal (Rianne); P.K. Bos (Koen); S.M. Bierma-Zeinstra (Sita)

    2015-01-01

    textabstractTo assess associations between uCTX-II or uCIIM and severity of hip pain in patients with mild-moderate hip osteoarthritis (OA) over a 2-year period, and establish whether the level of these biomarkers at baseline could estimate a specific trajectory of hip pain. Design: A cohort study w

  19. Mesenchymal stem cell therapy in the treatment of hip osteoarthritis

    Science.gov (United States)

    Mardones, Rodrigo; Jofré, Claudio M.; Tobar, L.

    2017-01-01

    Abstract This study was performed to investigate the safety and efficacy of the intra-articular infusion of ex vivo expanded autologous bone marrow-derived mesenchymal stem cells (BM-MSC) to a cohort of patients with articular cartilage defects in the hip. The above rationale is sustained by the notion that MSCs express a chondrocyte differential potential and produce extracellular matrix molecules as well as regulatory signals, that may well contribute to cure the function of the damaged hip joint. A cohort of 10 patients with functional and radiological evidences of hip osteoarthritis, either in one or both legs, was included in the study. BM-MSC (the cell product) were prepared and infused into the damaged articulation(s) of each patient (60 × 106 cells in 3 weekly/doses). Before and after completion of the cell infusion scheme, patients were evaluated (hip scores for pain, stiffness, physical function, range of motion), to assess whether the infusion of the respective cell product was beneficial. The intra-articular injection of three consecutive weekly doses of ex vivo expanded autologous BM-MSC to patients with articular cartilage defects in the hip and proved to be a safe and clinically effective treatment in the restoration of hip function and range of motion. In addition, the statistical significance of the above data is in line with the observation that the radiographic scores (Tönnis Classification of Osteoarthritis) of the damaged leg(s) remained without variation in 9 out of 10 patients, after the administration of the cell product. PMID:28630737

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

    Science.gov (United States)

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

    2007-12-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

  3. Pain management in the elderly: transdermal fentanyl for the treatment of pain caused by osteoarthritis of the knee and hip.

    Science.gov (United States)

    Mordarski, Sylwester

    2014-01-01

    This study was designed to evaluate the utility of transdermal fentanyl (transdermal fentanyl, TDF) for the treatment of pain due to osteoarthritis (osteoarthritis, OA) of the knee and hip, which was not adequately controlled by nonopioid analgesics or weak opioids. WOMAC is a reliable, valid, and responsive multidimensional, self-administrated outcome measure designed specifically to evaluate patients with OA of the knee or hip. TDF significantly increased pain control and improved functioning and quality of life. Metoclopramide appeared to be of limited value in preventing nausea and vomiting.

  4. Differential genetic regulation of canine hip dysplasia and osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Zhengkui Zhou

    Full Text Available BACKGROUND: Canine hip dysplasia (HD is a common polygenic trait characterized by hip malformation that results in osteoarthritis (OA. The condition in dogs is very similar to developmental dysplasia of the human hip which also leads to OA. METHODOLOGY/PRINCIPAL FINDINGS: A total of 721 dogs, including both an association and linkage population, were genotyped. The association population included 8 pure breeds (Labrador retriever, Greyhounds, German Shepherd, Newfoundland, Golden retriever, Rottweiler, Border Collie and Bernese Mountain Dog. The linkage population included Labrador retrievers, Greyhounds, and their crosses. Of these, 366 dogs were genotyped at ∼22,000 single nucleotide polymorphism (SNP loci and a targeted screen across 8 chromosomes with ∼3,300 SNPs was performed on 551 dogs (196 dogs were common to both sets. A mixed linear model approach was used to perform an association study on this combined association and linkage population. The study identified 4 susceptibility SNPs associated with HD and 2 SNPs associated with hip OA. CONCLUSION/SIGNIFICANCE: The identified SNPs included those near known genes (PTPRD, PARD3B, and COL15A1 reported to be associated with, or expressed in, OA in humans. This suggested that the canine model could provide a unique opportunity to identify genes underlying natural HD and hip OA, which are common and debilitating conditions in both dogs and humans.

  5. A morphological descriptors-based pattern recognition system for the characterization of hip osteoarthritis severity from X-ray images

    Energy Technology Data Exchange (ETDEWEB)

    Boniatis, I.; Costaridou, L. [Department of Medical Physics, University of Patras, School of Medicine, 26500 Patras (Greece); Cavouras, D. [Department of Medical Instrumentation Technology, Technological Educational Institute of Athens, 12210 Athens (Greece); Panagiotopoulos, E. [Department of Orthopaedics, University of Patras, School of Medicine, 26500 Patras (Greece); Panayiotakis, G. [Department of Medical Physics, University of Patras, School of Medicine, 26500 Patras (Greece)], E-mail: panayiot@upatras.gr

    2007-10-01

    A pattern recognition system is proposed for the characterization of hip osteoarthritis (OA) severity. Sixty-four (64) hips, corresponding to 32 unilateral and bilateral OA patients were studied. Employing the Kellgren and Lawrence scale, hips were grouped into three OA severity categories: 'Normal', 'Mild/Moderate', and 'Severe'. Utilizing custom-developed software, 64 ROIs, corresponding to patients' radiographic Hip Joint Spaces (HJSs), were determined on digitized radiographs. A Probabilistic Neural Network classifier was designed employing morphological descriptors of the HJS-ROIs. The classifier discriminated successfully between (i) normal and OA hips (92.2% accuracy) and (ii) hips of 'Mild/Moderate' OA and of 'Severe' OA (91.3% accuracy). The proposed system could contribute in assessing hip OA severity.

  6. A morphological descriptors-based pattern recognition system for the characterization of hip osteoarthritis severity from X-ray images

    Science.gov (United States)

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

    2007-10-01

    A pattern recognition system is proposed for the characterization of hip osteoarthritis (OA) severity. Sixty-four (64) hips, corresponding to 32 unilateral and bilateral OA patients were studied. Employing the Kellgren and Lawrence scale, hips were grouped into three OA severity categories: "Normal", "Mild/Moderate", and "Severe". Utilizing custom-developed software, 64 ROIs, corresponding to patients' radiographic Hip Joint Spaces (HJSs), were determined on digitized radiographs. A Probabilistic Neural Network classifier was designed employing morphological descriptors of the HJS-ROIs. The classifier discriminated successfully between (i) normal and OA hips (92.2% accuracy) and (ii) hips of "Mild/Moderate" OA and of "Severe" OA (91.3% accuracy). The proposed system could contribute in assessing hip OA severity.

  7. Hip osteoarthritis: What the radiologist wants to know

    Energy Technology Data Exchange (ETDEWEB)

    Karachalios, Theofilos [Department of Orthopaedic Surgery, School of Health Sciences, University of Thessaly, Papakiriazi 22, Larissa 41222 (Greece)]. E-mail: kar@med.uth.gr; Karantanas, Apostolos H. [Department of Radiology, Medical School, University of Crete, Heraklion (Greece); Malizos, Konstantinos [Department of Orthopaedic Surgery, School of Health Sciences, University of Thessaly, Papakiriazi 22, Larissa 41222 (Greece)

    2007-07-15

    Osteoarthritis (OA) is the most common disease of the hip joint seen in adults. The diagnosis of OA is based on a combination of radiographic findings of joint degeneration and characteristic subjective symptoms. The lack of a radiographic consensus definition has resulted in a variation of the published incidences and prevalence of OA. The chronological sequence of degeneration includes the following plain radiographic findings: joint space narrowing, development of osteophytes, subchondral sclerosis, and cyst formation. There are cases though, that plain radiographs show minor changes and the clinical suspicion of early disease can be confirmed with more sophisticated imaging methods, such as multi-detector computed tomography and MR imaging. The present article will review all the clinical information on the hip OA together with an updated radiological approach, with emphasis on the early depiction and the differential diagnosis of the disease.

  8. Cross-cultural adaptation and validation of the French version of the Hip disability and Osteoarthritis Outcome Score (HOOS) in hip osteoarthritis patients

    DEFF Research Database (Denmark)

    Ornetti, P; Parratte, S; Gossec, L

    2010-01-01

    OBJECTIVE: To translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into French and to evaluate the psychometric properties of this new version, by testing feasibility, internal consistency, construct validity, reliability and responsiveness, in patients with hip osteoart......OBJECTIVE: To translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into French and to evaluate the psychometric properties of this new version, by testing feasibility, internal consistency, construct validity, reliability and responsiveness, in patients with hip...... osteoarthritis (OA). METHODS: The French version of the HOOS was developed according to published international guidelines to ensure content validity. The new version was then evaluated in two symptomatic hip OA populations, one with no indication for joint replacement (medical group), and the other waiting...

  9. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial

    Directory of Open Access Journals (Sweden)

    Kirsti Uusi-Rasi

    2017-01-01

    Full Text Available Introduction. Osteoarthritis (OA of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods. 13 women aged ≥ 65 years with hip OA were recruited in this 12-week pilot study. Results. Pain declined significantly over 30% from baseline, and joint function and health-related quality of life improved slightly. Objective assessment of physical functioning showed statistically significant improvement in the maximal isometric leg extensor strength by 20% and in the hip extension range of motion by 30%. Conclusions. The exercise program was found to be safe and feasible. The present evidence indicates that the exercise program is effective in the short term. However, adequate powered RCTs are needed to determine effects of long-term exercise therapy on pain and progression of hip OA.

  10. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial.

    Science.gov (United States)

    Uusi-Rasi, Kirsti; Patil, Radhika; Karinkanta, Saija; Tokola, Kari; Kannus, Pekka; Sievänen, Harri

    2017-01-01

    Introduction. Osteoarthritis (OA) of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods. 13 women aged ≥ 65 years with hip OA were recruited in this 12-week pilot study. Results. Pain declined significantly over 30% from baseline, and joint function and health-related quality of life improved slightly. Objective assessment of physical functioning showed statistically significant improvement in the maximal isometric leg extensor strength by 20% and in the hip extension range of motion by 30%. Conclusions. The exercise program was found to be safe and feasible. The present evidence indicates that the exercise program is effective in the short term. However, adequate powered RCTs are needed to determine effects of long-term exercise therapy on pain and progression of hip OA.

  11. Hip and Knee Osteoarthritis Affects Younger People, Too.

    Science.gov (United States)

    Ackerman, Ilana N; Kemp, Joanne L; Crossley, Kay M; Culvenor, Adam G; Hinman, Rana S

    2017-02-01

    Synopsis Although osteoarthritis (OA) has traditionally been considered a disease of older age, hip and knee OA can and does affect younger adults, with a profound impact on psychosocial well-being and work capacity. Obesity and a history of traumatic knee injury (eg, anterior cruciate ligament rupture and/or meniscal tear) are key risk factors for the accelerated development of knee OA, while structural hip deformities (including those contributing to femoroacetabular impingement syndrome) are strong predictors of early-onset hip OA. In view of these associations, rising rates of obesity and sports injuries are concerning, and may signal a future surge in OA incidence among younger people. Assessment of hip and knee OA in younger people should focus on a patient-centered history, comprehensive physical examination, performance-based measures, and patient-reported outcome measures to enable monitoring of symptoms and function over time. Referral for imaging should be reserved for people presenting with atypical signs or symptoms that may indicate diagnoses other than OA. Nonpharmacological approaches are core strategies for the management of hip and knee OA in younger people, and these include appropriate disease-related education, activity modification (including for work-related tasks), physical therapist- prescribed exercise programs to address identified physical impairments, and weight control or weight loss. High-quality evidence has shown no benefit of arthroscopy for knee OA, and there are no published clinical trials to support the use of hip arthroscopy for OA. Referral for joint-conserving or joint replacement surgery should be considered when nonpharmacological and pharmacological management strategies are no longer effective. J Orthop Sports Phys Ther 2017;47(2):67-79. doi:10.2519/jospt.2017.7286.

  12. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials

    Directory of Open Access Journals (Sweden)

    Barker Karen L

    2009-08-01

    Full Text Available Abstract Background Physiotherapy has long been a routine component of patient rehabilitation following hip joint replacement. The purpose of this systematic review was to evaluate the effectiveness of physiotherapy exercise after discharge from hospital on function, walking, range of motion, quality of life and muscle strength, for osteoarthritic patients following elective primary total hip arthroplasty. Methods Design: Systematic review, using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions and the Quorom Statement. Database searches: AMED, CINAHL, EMBASE, KingsFund, MEDLINE, Cochrane library (Cochrane reviews, Cochrane Central Register of Controlled Trials, DARE, PEDro, The Department of Health National Research Register. Handsearches: Physiotherapy, Physical Therapy, Journal of Bone and Joint Surgery (Britain Conference Proceedings. No language restrictions were applied. Selection: Trials comparing physiotherapy exercise versus usual/standard care, or comparing two types of relevant exercise physiotherapy, following discharge from hospital after elective primary total hip replacement for osteoarthritis were reviewed. Outcomes: Functional activities of daily living, walking, quality of life, muscle strength and range of hip joint motion. Trial quality was extensively evaluated. Narrative synthesis plus meta-analytic summaries were performed to summarise the data. Results 8 trials were identified. Trial quality was mixed. Generally poor trial quality, quantity and diversity prevented explanatory meta-analyses. The results were synthesised and meta-analytic summaries were used where possible to provide a formal summary of results. Results indicate that physiotherapy exercise after discharge following total hip replacement has the potential to benefit patients. Conclusion Insufficient evidence exists to establish the effectiveness of physiotherapy exercise following primary hip replacement for osteoarthritis. Further

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

    Science.gov (United States)

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

    2017-09-01

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

  14. Quantitative assessment of hip osteoarthritis based on image texture analysis.

    Science.gov (United States)

    Boniatis, I S; Costaridou, L I; Cavouras, D A; Panagiotopoulos, E C; Panayiotakis, G S

    2006-03-01

    A non-invasive method was developed to investigate the potential capacity of digital image texture analysis in evaluating the severity of hip osteoarthritis (OA) and in monitoring its progression. 19 textural features evaluating patterns of pixel intensity fluctuations were extracted from 64 images of radiographic hip joint spaces (HJS), corresponding to 32 patients with verified unilateral or bilateral OA. Images were enhanced employing custom developed software for the delineation of the articular margins on digitized pelvic radiographs. The severity of OA for each patient was assessed by expert orthopaedists employing the Kellgren and Lawrence (KL) scale. Additionally, an index expressing HJS-narrowing was computed considering patients from the unilateral OA-group. A textural feature that quantified pixel distribution non-uniformity (grey level non-uniformity, GLNU) demonstrated the strongest correlation with the HJS-narrowing index among all extracted features and utilized in further analysis. Classification rules employing GLNU feature were introduced to characterize a hip as normal or osteoarthritic and to assign it to one of three severity categories, formed in accordance with the KL scale. Application of the proposed rules resulted in relatively high classification accuracies in characterizing a hip as normal or osteoarthritic (90.6%) and in assigning it to the correct KL scale category (88.9%). Furthermore, the strong correlation between the HJS-narrowing index and the pathological GLNU (r = -0.9, p<0.001) was utilized to provide percentages quantifying hip OA-severity. Texture analysis may contribute in the quantitative assessment of OA-severity, in the monitoring of OA-progression and in the evaluation of a chondroprotective therapy.

  15. Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial.

    Science.gov (United States)

    Beselga, Carlos; Neto, Francisco; Alburquerque-Sendín, Francisco; Hall, Toby; Oliveira-Campelo, Natália

    2016-04-01

    Mobilization with movement (MWM) has been shown to reduce pain, increase range of motion (ROM) and physical function in a range of different musculoskeletal disorders. Despite this evidence, there is a lack of studies evaluating the effects of MWM for hip osteoarthritis (OA). To determine the immediate effects of MWM on pain, ROM and functional performance in patients with hip OA. Randomized controlled trial with immediate follow-up. Forty consenting patients (mean age 78 ± 6 years; 54% female) satisfied the eligibility criteria. All participants completed the study. Two forms of MWM techniques (n = 20) or a simulated MWM (sham) (n = 20) were applied. pain recorded by numerical rating scale (NRS). hip flexion and internal rotation ROM, and physical performance (timed up and go, sit to stand, and 40 m self placed walk test) were assessed before and after the intervention. For the MWM group, pain decreased by 2 points on the NRS, hip flexion increased by 12.2°, internal rotation by 4.4°, and functional tests were also improved with clinically relevant effects following the MWM. There were no significant changes in the sham group for any outcome variable. Pain, hip flexion ROM and physical performance immediately improved after the application of MWM in elderly patients suffering hip OA. The observed immediate changes were of clinical relevance. Future studies are required to determine the long-term effects of this intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    L. Di Lorenzo

    2013-10-01

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

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

    Science.gov (United States)

    Di Lorenzo, L

    2013-10-31

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

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

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

    OBJECTIVES: The aim of this cross-sectional survey of 2232 women and 1336 men (age range 20-91 yr) was to investigate individual risk factors for hip joint osteoarthritis (OA). METHODS: Standardized, weight-bearing pelvic radiographs were evaluated. Radiological hip joint OA was defined as minimu...

  19. Does hip osteoarthritis have a protective effect against proximal femoral fractures? A retrospective study.

    Science.gov (United States)

    Calderazzi, Filippo; Groppi, Giulia; Ricotta, Agostino; Ceccarelli, Francesco

    2014-01-01

    The inverse relationship between proximal femoral fracture incidence and hip osteoarthritis remains controversial. However, femoral neck fractures rarely occur in patients with hip osteoarthritis, suggesting a protective effect of osteoarthritis. We sought to determine if the severity of osteoarthritis influenced fracture type. We examined the radiographs of 190 consecutive patients treated at our institution after hip trauma. They were divided into three groups according to the outcome of the trauma: femoral neck fracture; trochanteric fracture; and no fracture. We then analysed the severity of osteoarthritis within these groups. No relationship between the grade of hip osteoarthritis and the presence of a proximal femoral fracture was found. However, the grade of osteoarthritis was related both to the outcome of the trauma (posteoarthritis of the hip had a three-fold increased likelihood of trochanteric fracture compared to femoral neck fracture. Osteoarthritis does not protect against proximal femoral fractures, but strongly affects the location of the fracture in the proximal femur, increasing the possibility of a trochanteric location.

  20. Seasonal variation in adult hip disease secondary to osteoarthritis and developmental dysplasia of the hip

    Science.gov (United States)

    Sueyoshi, Tatsuya; Ritter, Merrill A; Davis, Kenneth E; Loder, Randall T

    2016-01-01

    AIM To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis (OA) or sequelae of developmental dysplasia of the hip (DDH). METHODS The total hip registry from the author’s institution for the years 1969 to 2013 was reviewed. The month of birth, age, gender, and ethnicity was recorded. Differences between number of births observed and expected in the winter months (October through February) and non-winter mo (March through September) were analyzed with the χ2 test. Detailed temporal variation was mathematically assessed using cosinor analysis. RESULTS There were 7792 OA patients and 60 DDH patients who underwent total hip arthroplasty. There were more births than expected in the winter months for both the DDH (P < 0.0001) and OA (P = 0.0052) groups. Cosinor analyses demonstrated a peak date of birth on 1st October. CONCLUSION These data demonstrate an increased prevalence of DDH and OA in those patients born in winter. PMID:28032035

  1. Improving care for people with osteoarthritis of the hip and knee: how has national policy for osteoarthritis been translated into service models in Australia?

    Science.gov (United States)

    Brand, Caroline; Hunter, David; Hinman, Rana; March, Lyn; Osborne, Richard; Bennell, Kim

    2011-05-01

    There is strong rationale for improving care for people with chronic conditions, including osteoarthritis (OA). Successful implementation of healthcare reform requires new concepts and directions that are strongly supported by policy, new models of care (service redesign) and changes in day-to-day practice (healthcare provider and patient practice). In this paper we discuss the extent to which policy about management of OA of the hip and knee has been translated into new service models in Australia. A structured search of government and other key health websites in Australia was performed to identify policy, funding initiatives and new services models for managing OA of the hip and knee. This search was supported by a literature review. Musculoskeletal conditions were designated a National Health Priority in Australia in 2002. Under the Better Arthritis and Osteoporosis Care initiative, Australia has developed a national policy for OA care and national evidence-based clinical practice guidelines for management of OA of the hip and knee. Only two well-described examples of new chronic disease management service models, the Osteoarthritis Clinical Pathway (OACP) model and the Osteoarthritis Hip and Knee Service (OAHKS) were identified. Primarily focused within acute care public hospital settings, these have been shown to be feasible and acceptable but have limited data on clinical impact and cost-effectiveness. While policy is extant, implementation has not been systematic and comprehensive. Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently.

  2. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Fernandes, Linda; Hagen, Kare B.; Bijlsma, Johannes W.J.

    2013-01-01

    The objective was to develop evidence -based recommendations and a research and educational agenda for the non-pharmacological management of hip and knee osteoarthritis (OA). The multidisciplinary task force comprised 21 experts: nurses, occupational therapists, physiotherapists, rheumatologists,...

  3. Osteoarthritis of the hip in children at the Lome´ Teaching Hospital

    African Journals Online (AJOL)

    features, treatment, and outcome of osteoarthritis. Results A total of 30 children were included in this study, of whom .... dilemma. The association between fever and hip pain ... Poverty of parents and lack of technical equipment often hamper ...

  4. Intra-rater reliability and agreement of muscle strength, power and functional performance measures in patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Bieler, Theresa; Magnusson, S Peter; Kjær, Michael;

    2014-01-01

    OBJECTIVE: To investigate the reliability and agreement of measures of lower extremity muscle strength, power and functional performance in patients with hip osteoarthritis at different time intervals, and to compare these with the same measures in healthy peers. DESIGN: Intra-rater test...... extensor power, and functional performance (8-foot Up & Go, stair climbing, chair stand and 6-min walk) were measured in patients, and quadriceps strength, leg extensor power and functional performance were measured in healthy peers. Systematic error, reliability and agreement were calculated. RESULTS......-retest separated by 1, 2, or 2.5 weeks in patients, and 1 week in healthy peers. SUBJECTS: Patients with hip osteoarthritis (age range 61-83 years) with 1 (n = 37), 2 (n = 35), or 2.5 weeks (n = 15) between tests, and 35 healthy peers (age range 63-82 years). METHODS: Maximal isometric hip and thigh strength, leg...

  5. Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index.

    Science.gov (United States)

    Klässbo, Maria; Larsson, Eva; Mannevik, Eva

    2003-01-01

    To further develop the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC LK 3.0) for people with hip disability with or without hip osteoarthritis (OA), 52 subjects (median age 64 yrs, 35 women) answered a version of the Index with additional dimensions, twice, with a one-week interval. Reproducibility, percentage of zero scores (best possible scores), mean score of symptoms, and importance, were analyzed. This resulted in the Hip disability and osteoarthritis outcome score (HOOS LK 1.1), a 39-item questionnaire with five separate sub-scales. There were higher median scores (more symptoms) for three of HOOS sub-scales Pain, Activity limitations--sport and recreation, and Hip-related Quality of life compared to those in the WOMAC, improving the ability to assess change in patients over time. The HOOS appears to be an evaluative instrument for assessing important self-rated hip problems for people with hip disability with/without hip OA, but additional studies are needed.

  6. Predictors of patient relevant outcome after total hip replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Nilsdotter, A-K; Petersson, I F; Roos, Ewa M.

    2003-01-01

    To investigate prospectively long term patient relevant outcomes after unilateral total hip replacement (THR) for osteoarthritis (OA). To identify non-responders to this intervention and patient related predictors of unsatisfactory outcome.......To investigate prospectively long term patient relevant outcomes after unilateral total hip replacement (THR) for osteoarthritis (OA). To identify non-responders to this intervention and patient related predictors of unsatisfactory outcome....

  7. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis.

    LENUS (Irish Health Repository)

    Atchia, Ismaël

    2011-01-01

    Intra-articular injection is effective for osteoarthritis, but the best single injection strategy is not known, nor are there established predictors of response. The objectives of this study were to assess and predict response to a single ultrasound-guided injection in moderate to severe hip osteoarthritis.

  8. Group education and exercise is feasible in knee and hip osteoarthritis

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Odgaard, Anders; Rasmussen, Jens Ole

    2012-01-01

    Clinical practice does not reflect current clinical guidelines recommending an early multimodal non-surgical treatment for knee and hip osteoarthritis (OA). The purpose of this study was to examine the feasibility of such an initiative (Good Life with osteoArthritis in Denmark (GLA:D) in persons ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-20

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

  10. Long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip.

    Science.gov (United States)

    Ohsawa, Suguru

    2017-01-01

    Pauwels' femoral osteotomy is a classical and joint-preserving method for osteoarthritis of the hip caused by acetabular dysplasia and/or subluxation. However, its application for terminal-stage osteoarthritis of the hip, and the long-term results, have not yet been reported. We herein aim to investigate the long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip. Eighty-two hips of 75 patients (74 women and 1 man, mean age: 48.1 years) classified as having terminal-stage osteoarthritis by Kellgren and Laurence were indicated for valgus osteotomy from 1984 to 1993. Sixty-three hips of 57 patients were followed for more than 20 years (mean: 298 months). Follow-up rate was 77%. Preoperative mean hip score (Harris Hip Score) was 46.4 points. Thirty-two hips were later converted to total hip arthroplasty (THA) (mean: 185 months after surgery). Of the hips without conversion to THA, 31 hips scored 72.8 points on average, and 21 hips scored 70 or more points at the final follow-up. Kaplan-Meier survivorship analysis revealed that 40% of the hips, classified as non-atrophic type (according to Bombelli's classification) at the time of operation, maintained their joint space width for 20 years (endpoint: less than 1 mm at the weight-bearing segment, i.e., recurrence of osteoarthritis) and also revealed that 60% of the hips were not converted for 20 years after the initial operation (endpoint: conversion to THA). Cox's proportional hazard model revealed that those with the atrophic type had a hazard risk 24 times greater than those with the non-atrophic type of osteoarthritis. This is the first report of the long-term results of osteotomy for terminal-stage osteoarthritis of the hip showing satisfactory results with a lengthy follow-up period. Pauwels' valgus femoral osteotomy for terminal-stage osteoarthritis, excluding atrophic type, could be an acceptable alternative to THA.

  11. Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis.

    Science.gov (United States)

    Allen, Kelli D; Sanders, Linda L; Olsen, Maren K; Bowlby, Lynn; Katz, Jeffrey N; Mather, Richard C; Williams, John W

    2016-06-01

    Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA). Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test. Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time (p John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Ultrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Erik S Anderson

    2013-09-01

    Full Text Available Ultrasound-guided intraarticular hip corticosteroid injections may be useful for emergency care providers treating patients with painful exacerbations of osteoarthritis of the hip. Corticosteroid injection is widely recommended as a first-line treatment for painful osteoarthritis of the hip. Bedside ultrasound is readily available in most emergency departments; however, using ultrasound to guide therapeutic hip injections has not yet been described in emergency practice. Herein, we present the first description of a successful emergency physician-performed ultrasound-guided hip injection of local anesthetic and corticosteroid for pain control in a patient with an acute exacerbation of osteoarthritis. [West J Emerg Med. 2013;14(5:505–508.

  13. The design and feasibility of a web-based physical activity program for patients with osteoarthritis in hip and/or knee.

    NARCIS (Netherlands)

    Bossen, D.; Veenhof, C.; Dekker, J.; Bakker, D. de

    2012-01-01

    Background: A large proportion of patients with osteoarthritis (OA) do not meet the recommended levels of physical activity (PA). Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we developed a web-based intervention that p

  14. Cost-effectiveness of exercise therapy versus general practitioner care for osteoarthritis of the hip: Design of a randomised clinical trial

    NARCIS (Netherlands)

    P. van Es (Pauline); P.A.J. Luijsterburg (Pim); J. Dekker (Joost); M.A. Koopmanschap (Marc); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2011-01-01

    textabstractBackground: Osteoarthritis (OA) is the most common joint disease, causing pain and functional impairments. According to international guidelines, exercise therapy has a short-term effect in reducing pain/functional impairments in knee OA and is therefore also generally recommended for hi

  15. Impact of Rehabilitation on Health Related Quality of Life in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Divjak Ana

    2017-06-01

    Full Text Available Hip osteoarthritis (OA is a degenerative, progressive musculoskeletal system disease in adult individuals. Both genders demonstrate a similar prevalence at 11.5% for men and 11.6% for women. During the initial stage of hip OA, conservative treatments may significantly decrease pain, provide functional improvement and enhance health related quality of life (HRQoL.

  16. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

    NARCIS (Netherlands)

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

    2004-01-01

    OBJECTIVE: To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip. METHODS: A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of

  17. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

    NARCIS (Netherlands)

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

    2004-01-01

    OBJECTIVE: To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip. METHODS: A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of

  18. Osteoarthritis of the hip or knee: which coexisting disorders are disabling?

    NARCIS (Netherlands)

    Reeuwijk, K.G.; Rooij, M. de; Dijk, G.M. van; Veenhof, C.; Steultjens, M.P.; Dekker, J.

    2010-01-01

    Exercise therapy is generally recommended in osteoarthritis (OA) of the hip or knee. However, coexisting disorders may bring additional impairments, which may necessitate adaptations to exercise for OA of the hip or knee. For the purpose of developing an adapted protocol for exercise therapy in OA

  19. Osteoarthritis of the hip or knee: which coexisting disorders are disabling?

    NARCIS (Netherlands)

    Reeuwijk, K.G.; Rooij, M. de; Dijk, G.M. van; Veenhof, C.; Steultjens, M.P.; Dekker, J.

    2010-01-01

    Exercise therapy is generally recommended in osteoarthritis (OA) of the hip or knee. However, coexisting disorders may bring additional impairments, which may necessitate adaptations to exercise for OA of the hip or knee. For the purpose of developing an adapted protocol for exercise therapy in OA p

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

    Science.gov (United States)

    Maezaki, Nobutaka; Ezumi, Tsutomu; Hachiya, Masashi

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

  1. Primary osteoarthritis of the hip: a genetic disease caused by European genetic variants.

    Science.gov (United States)

    Hoaglund, Franklin T

    2013-03-06

    Primary osteoarthritis of the hip is a separate phenotype that occurs at a rate of 3% to 6% in the populations of the world with European ancestry. In all non-European populations, there is a consistent rarity of primary osteoarthritis that suggests a different etiology for these few patients. Family, sibling, and twin studies prove primary osteoarthritis to be a genetic disease with a 50% heritability caused by European genetic variants. The genetic basis is reinforced by the lower rate of primary osteoarthritis in American minorities consistent with their degree of European gene admixture. Whether the mechanism of degeneration of primary osteoarthritis may be secondary through a morphologic deformity, such as femoroacetabular impingement, remains unknown. The virtual absence of the disease in non-Europeans indicates that the European gene component is necessary for the expression of this separate phenotype of osteoarthritis.

  2. Curved versus Straight Stem Uncemented Total Hip Arthroplasty Osteoarthritis Multicenter trial (CUSTOM): Design of a prospective blinded randomised controlled multicentre trial

    NARCIS (Netherlands)

    Beers, L.W.A.H. (Loes) van; Van Oldenrijk, J. (Jakob); V.A. Scholtes (Vanessa); Geerdink, C.H. (Carel H.); Niers, B.B.A.M. (Bob B. A. M.); Runne, W. (Wouter); M. Bhandari (Mohit); R.W. Poolman (Rudolf)

    2016-01-01

    textabstractIntroduction: Answering the demands of an increasingly young and active patient population, recent developments in total hip arthroplasty (THA) have shifted towards minimising tissue damage. The Collum Femoris Preserving (CFP) stem was developed to preserve the trochanteric region of the

  3. Total hip arthroplasty with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    吴立东; 金礼斌; 严世贵; 杨泉森; 戴雪松; 王祥华

    2004-01-01

    Objective:To evaluate the outcome of total hip arthroplasty (THA) with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis.Methods: Between 1995 and 2002, we implanted 23cementless cups and femoral head autografts in 20 patients with hip dysplasia and osteoarthritis. In this study, a retrospective study was made on 21 hips in 20 patients (18females and 2 males, aged 50 years on an average) with developmental hip dysplasia treated by THA with acementless cup and femoral head autograft. The acetabular cup was placed at the level of the true acetabuinm and all the patients required autogenous femoral head grafts due to acetabular deficiency. The average rate of the acetabular cup covered by the femoral head autograft was 31%(ranging from 10% to 45%). Eight hips had less than 25%cup coverage and thirteen between 25% and 50%. The average follow-up period was 4.7 years (range, 1-8 years).The replacing outcome was evaluated by modified Harris hip score. Preoperative and follow-up radiographs were made.Results: All the autografts were united to the host bones. No autograft was collapsed or no component from the hip was loosed in all the patients. According to the modified Harris hip score, the average hip score increased from 46 before operation to 89 at the final review. Before operation, the leg-length discrepancy was greater than 2 cm in all the patients except one with bilateral hip dysplasia.After operation, only 2 out of 20 patients had a leg-length discrepancy greater than 1 cm. Three hips showed minor bone resorption in the lateral portion of the graft, which did not support the cup. Three hips developed Grade 1Brooker heterotopic ossification and one developed Grade 2.Conclusions: THA with a cementless cup and a femoral head autograft for patients with osteoarthritis resulted from hip dysplasia can result in favorable outcomes. This method can provide reliable acetabular fixation and restore the acetabular bone stock in

  4. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Dobson, F; Hinman, R S; Roos, Ewa M.

    2013-01-01

    To recommend a consensus-derived set of performance-based tests of physical function for use in people diagnosed with hip or knee osteoarthritis (OA) or following joint replacement.......To recommend a consensus-derived set of performance-based tests of physical function for use in people diagnosed with hip or knee osteoarthritis (OA) or following joint replacement....

  5. Application of uncemented Zweymüller hip prosthesis in adult patients with hip osteoarthritis secondary to developmental dysplasia

    Institute of Scientific and Technical Information of China (English)

    XU Yong-sheng; WANG Yan; LU Long; WEI Bao-gang

    2012-01-01

    Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ‘high-riding' hip.It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty (THA) for coxarthrosis.The aim of this study was to evaluate efficiency and safety of THA using Zweymüller hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip (DDH) in adults.Methods From January 2000 to February 2008,35 patients (40 hips) with developmental dysplasia of the hip were included.Five were male and 30 were female,with ages ranging from 26 to 65 years and an average age of 45 years.According to Hartofilakidis classification,there were type Ⅰ in 5 hips,type Ⅱ in 20 hips,type Ⅲ in 15 hips.All the patients were performed the THA using the Zweymüller hip implant.The preoperative average Harris score was 44.The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients.The patients mainly suffered from pain and claudication.Clinical and radiological results were analyzed.The Harris score was used for outcome measurement.Results Thirty five patients (40 hips) were followed and the mean follow-up period was 46 months (ranged from 24 months to 96 months).The latest follow-up average Harris score was 88.9 (97.1% of good rate).All the patients were pain-free and there was no sign of infection,aseptic loosening and subsidence.Conclusions In summary,THA using Zweymüller hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults.The key techniques for the total hip replacement are as follows:good preoperative plan,firmly placing the acetabular component in the true acetabulum,proper preparation of proximal femur,suitable femoral component choosing and improving the techniques of the bone graft.

  6. A morphological index for assessing hip osteoarthritis severity from radiographic images.

    Science.gov (United States)

    Boniatis, I; Costaridou, L; Cavouras, D; Kalatzis, I; Panagiotopoulos, E; Panayiotakis, G

    2008-02-01

    A new method is proposed for assessing the severity of hip osteoarthritis (OA) based on radiographic hip joint space (HJS) morphology. 64 hips of patients with verified unilateral OA or bilateral OA were studied by digitizing the corresponding pelvic radiographs. Radiographic OA severity was assessed employing the Kellgren and Lawrence (KL) scale. Using custom-developed software, radiographs were enhanced, the margins of both HJSs were outlined, and 64 regions of interest (ROIs), corresponding to the delineated HJSs, were obtained. Employing custom-developed algorithms, an index ("joint space morphological index" - JSMI) evaluating alterations in the shape and size of HJS was introduced, calculated and normalized with respect to each patient's individual anatomy. The JSMI values were used to introduce classification rules concerning the characterization of a hip in accordance with the KL scale. For each patient in the unilateral OA group, the OA severity was expressed as the percentage of the HJS area difference between the patient's osteoarthritic and contralateral normal hip. The per cent HJS area difference and the JSMI values were used in the design of a regression model for providing a quantitative estimation of OA severity. The per cent HJS area difference correlated highly with the pathological JSMI values (r = -0.83, p0.05), and to be strongly correlated with (r = 0.96, p<0.001), the corresponding ones obtained by the computerized approach. Additionally, the implementation of classification rules based on JSMI simplified resulted in classification accuracies identical to the corresponding ones obtained for the JSMI-based rules. The proposed method may be utilized for evaluating OA and monitoring OA progression.

  7. Adult hip dysplasia and osteoarthritis. Studies in radiology and clinical epidemiology

    DEFF Research Database (Denmark)

    Jacobsen, Steffen

    2006-01-01

    Osteoarthritis (OA) presupposes the interaction of systemic and/or local factors. In hip joint OA, congenital or developmental malformation is believed to constitute an individual risk factor for premature degeneration. Hip dysplasia (HD) is such a malformation. The radiological and epidemiological...... subjects. In a computerized tomographic study of severely dysplastic hips we found a close relationship between insufficient anterior, acetabular containment and proximal femoral anteversion. The primary area of degeneration in dysplastic hips was in the antero-lateral quadrant of the joint....

  8. Gait biomechanics and hip muscular strength in patients with patellofemoral osteoarthritis.

    Science.gov (United States)

    Pohl, Michael B; Patel, Chirag; Wiley, J Preston; Ferber, Reed

    2013-03-01

    A significant number of patients with patellofemoral osteoarthritis (PFOA) have described a history of patellofemoral pain syndrome (PFPS). This leads to speculation that the underpinning mechanical causes of PFPS and PFOA may be similar. Although alterations in gait biomechanics and hip strength have been reported in PFPS, this relationship has not yet been explored in PFOA. Therefore the purpose of this study was compare gait biomechanics and hip muscular strength between PFOA patients and a healthy control group. Fifteen patients with symptomatic, radiographic PFOA and 15 controls participated. All patients underwent a walking gait analysis and maximal hip strength testing. Biomechanical variables of interest included the peak angular values of contra-lateral pelvic drop, hip adduction and hip internal rotation during the stance phase. Hip abduction and external rotation strength were assessed using maximal voluntary isometric contractions. The PFOA group demonstrated significantly lower hip abduction strength compared to controls but no difference in hip external rotation strength. There were no statistical differences between the PFOA and control groups for contra-lateral pelvic drop, hip adduction and hip internal rotation angles during walking. Despite patients with PFOA exhibiting weaker hip abductor muscle strength compared to their healthy counterparts they did not demonstrate alterations in pelvis or hip biomechanics during gait. These preliminary data suggests that weaker hip abductor strength does not result in biomechanical alterations during gait in this population.

  9. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    OBJECTIVE: Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. METHODS: This was a randomized controlled assessor-blinded trial...... and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  11. Neuromuscular exercise improves functional performance in patients with severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Larsen, Anders Holsgaard

    Purpose. Exercise is regarded a cornerstone in the treatment of mild to moderate osteoarthritis (OA). However, little is known of the effects in patients with advanced and end-stage OA. The purpose was to evaluate the effect of neuromuscular exercise in patients with severe hip OA. Methods. Design...... to an eight-week neuromuscular exercise (NEMEX-TJR) intervention or care-as-usual (verbal and written preoperative information). Intervention was supervised and offered twice a week with each session lasting one hour. The program is considered feasible and safe in this patient group and previously described...... in detail. Assessments were carried out at baseline and within one week after the intervention. Outcomes. Functional performance: 20-m walk at maximal pace and 5 repeated chair stands timed. Muscle power: Unilateral multi-joint leg extension power and unilateral single-joint knee extension power evaluated...

  12. Risk factors for osteoarthritis and total hip replacement in Legg-Calvé-Perthes disease

    DEFF Research Database (Denmark)

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

    2009-01-01

    replacement (THR) compared with a sex- and age-matched control group. From 1941 to 1962, 167 patients (191 hips) with LCP presented to The Community of Disabled in Kolding, Denmark. All hips were treated conservatively by a Thomas splint. At follow-up weight-bearing AP pelvis radiographs were obtained......This study has three purposes A) to determine if Legg-Calvé-Perthes disease (LCP) is a risk factor for developing secondary hip osteoarthritis (OA), B) to determine the inter-relationship between Stulberg class and radiographic OA and C) to investigate the risk for insertion of total hip...... and patients with previous operation at pelvis/lower limbs. Fifty-two patients (55 hips) were enrolled in the study. The follow-up period was 47 years. In study C emigrated persons, persons lost to follow-up and patients with previous operation at pelvis/lower limb were excluded. 135 patients (156 hips) were...

  13. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis-A Cross-Sectional Study

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren;

    2016-01-01

    BACKGROUND: The Gait Deviation Index summarizes overall gait 'quality', based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study......) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...

  14. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren

    2016-01-01

    was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2......BACKGROUND: The Gait Deviation Index summarizes overall gait 'quality', based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study......) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...

  15. 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

    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...

  16. Osteoarthritis of the hip and/or knee in Dutch general practice and physiotherapy practice.

    NARCIS (Netherlands)

    Barten, D.J.; Swinkels, I.C.; Dorsman, S.A.; Veenhof, C.

    2012-01-01

    Purpose: To describe demographic characteristics and the treatment process of patients with hip osteoarthritis (OA) or knee OA treated in Dutch general practice (GP) and/or physiotherapy practice. Additionally, to investigate whether there are differences in characteristics between referred and non-

  17. Quality indicators for physiotherapy care in hip and knee osteoarthritis: development and clinimetric properties

    NARCIS (Netherlands)

    Peter, W.F.; Wees, P.J. van der; Hendriks, E.J.; Bie, R.A. de; Verhoef, J.; Jong, Z. de; Bodegom-Vos, L. van; Hilberdink, W.K.H.A.; Vlieland, T.P.

    2013-01-01

    OBJECTIVE: The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA). METHODS: Guideline recommendations were rated for their relevance by an expert panel, transf

  18. Which patients with osteoarthritis of hip and/or knee benefit most from behavorial graded activity?

    NARCIS (Netherlands)

    Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Köke, A.J.A.; Oostendorp, R.A.; Bijlsma, J.W.J.

    2007-01-01

    Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized cli

  19. ICF linked Dutch physiotherapy guidelines concerning initial assessment, treatment and evaluation in hip and knee osteoarthritis.

    NARCIS (Netherlands)

    Peter, W.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, E.M.; Vos, I. de; Schoones, J.W.; Vliet Vlieland, T.P.

    2011-01-01

    Purpose: In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published. Relevance: An update of the physi

  20. ICF linked Dutch physiotherapy guidelines concerning initial assessment, treatment and evaluation in hip and knee osteoarthritis.

    NARCIS (Netherlands)

    Peter, W.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, E.M.; Vos, I. de; Schoones, J.W.; Vliet Vlieland, T.P.

    2011-01-01

    Purpose: In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published. Relevance: An update of the physi

  1. Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Jaremko, Jacob L; Lambert, Robert G W; Zubler, Veronika

    2014-01-01

    As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring ...

  2. Genome-wide association and functional studies identify a role for IGFBP3 in hip osteoarthritis

    NARCIS (Netherlands)

    D.S. Evans (Daniel); F. Cailotto (Frederic); N. Parimi (Neeta); A.M. Valdes (Ana Maria); M.C. Castaño Betancourt (Martha); Y. Liu (Youfang); R.C. Kaplan (Robert); M. Bidlingmaier (Martin); R.S. Vasan (Ramachandran Srini); A. Teumer (Alexander); G.J. Tranah (Gregory); M.C. Nevitt (Michael); S. Cummings; E.S. Orwoll (Eric); E. Barrett-Connor (Elizabeth); J.B. Renner (Jordan); J.M. Jordan (Joanne); M. Doherty (Michael); S. Doherty (Sally); A.G. Uitterlinden (André); J.B.J. van Meurs (Joyce); T.D. Spector (Timothy); R.J. Lories (Rik); N.E. Lane

    2014-01-01

    textabstractObjectives To identify genetic associations with hip osteoarthritis (HOA), we performed a meta-analysis of genome-wide association studies (GWAS) of HOA. Methods The GWAS meta-analysis included approximately 2.5 million imputed HapMap single nucleotide polymorphisms (SNPs). HOA cases and

  3. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013

    DEFF Research Database (Denmark)

    Ackerman, Ilana N; Bohensky, Megan A; de Steiger, Richard

    2017-01-01

    OBJECTIVE: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. METHODS: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland...

  4. CHECKing biochemical markers in early-stage knee and hip osteoarthritis, a critical appraisal

    NARCIS (Netherlands)

    van Spil, W.E.

    2012-01-01

    Osteoarthritis (OA) is the most common joint disease and poses a large social and financial burden for societies worldwide. OA is characterized by symptoms of pain, stiffness, and incidental soft tissue swelling of synovial joints. Synovial joints, such as knees and hips, unite bone ends covered by

  5. Which patients with osteoarthritis of hip and/or knee benefit most from behavioral graded activity?

    NARCIS (Netherlands)

    Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Kiike, A.J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    2007-01-01

    Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized cli

  6. ICF linked Dutch physiotherapy guidelines concerning initial assessment, treatment and evaluation in hip and knee osteoarthritis.

    NARCIS (Netherlands)

    Peter, W.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, E.M.; Vos, I. de; Schoones, J.W.; Vliet Vlieland, T.P.

    2011-01-01

    Purpose: In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published. Relevance: An update of the

  7. Reasons for Treatment Choices in Knee and Hip Osteoarthritis: A Qualitative Study

    NARCIS (Netherlands)

    Selten, E.M.H.; Vriezekolk, J.E.; Geenen, R.; Laan, W.H. van der; Meulen-Dilling, R.G. van der; Nijhof, M.W.; Schers, H.J.; Ende, C.H.M. van den

    2016-01-01

    OBJECTIVE: Conservative treatment modalities in osteoarthritis (OA) of the hip or knee are underused, whereas the demand for surgery is rising substantially. To improve the use of conservative treatment modalities, a more in-depth understanding of the reasons for patients' treatment choices is requi

  8. Reasons for treatment choices in knee and hip osteoarthritis: a qualitative study

    NARCIS (Netherlands)

    Selten, E.M.H.; Vriezekolk, J.E.; Geenen, R.; Van der Laan, W.H.; Van der Meulen-Dilling, R.G.; Nijhof, M.W.; Schers, H.J.; van den Ende, C.H.M.

    2016-01-01

    Objective Conservative treatment modalities in osteoarthritis (OA) of the hip or knee are underused, whereas the demand for surgery is rising substantially. To improve the use of conservative treatment modalities, a more in-depth understanding of the reasons for patients’ treatment choices is requir

  9. Cam deformity and acetabular dysplasia as risk factors for hip osteoarthritis.

    NARCIS (Netherlands)

    Hosnijeh, Fatemeh Saberi; Zuiderwijk, Maria E; Versteeg, Mathijs; Smeele, Hieronymus T W; Hofman, Albert; Uitterlinden, André G; Agricola, Rintje; Oei, Edwin H G; Waarsing, Jan H; Bierma-Zeinstra, Sita M; van Meurs, Joyce B J

    2017-01-01

    Objective: Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these

  10. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study

    NARCIS (Netherlands)

    E. Odding (Else); H.A. Valkenburg (Hans); D. Algra; F.A. Vandenouweland; D.E. Grobbee (Diederick); A. Hofman (Albert)

    1998-01-01

    textabstractOBJECTIVE: To assess the contribution of radiological osteoarthritis of the hips and knees to disabilities in the activities of daily living related to lower limb function. METHODS: During a home interview 1156 men and 1739 women, randomly chosen from the

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

    NARCIS (Netherlands)

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

    2000-01-01

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

  12. Associations of educational attainment, occupation, and community poverty with hip osteoarthritis.

    Science.gov (United States)

    Cleveland, Rebecca J; Schwartz, Todd A; Prizer, Lindsay P; Randolph, Randy; Schoster, Britta; Renner, Jordan B; Jordan, Joanne M; Callahan, Leigh F

    2013-06-01

    To examine cross-sectional baseline data from the Johnston County Osteoarthritis Project for the association between individual and community socioeconomic status (SES) measures with hip osteoarthritis (OA) outcomes. We analyzed data on 3,087 individuals (68% white and 32% African American). Educational attainment and occupation were used as individual measures of SES. Census block group household poverty rate was used as a measure of community SES. Hip OA outcomes included radiographic OA and symptomatic OA in one or both hip joints. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association of each hip OA outcome with each SES variable separately, and then with all SES measures simultaneously. Associations between hip OA outcomes and SES variables were evaluated for effect modification by race and sex. Living in a community of high household poverty rate showed independent associations with hip radiographic OA in one or both hips (OR 1.50, 95% CI 1.18-1.92) and bilateral (both hips) radiographic OA (OR 1.87, 95% CI 1.32-2.66). Similar independent associations were found between low educational attainment among those with symptomatic OA in one or both hips (OR 1.44, 95% CI 1.09-1.91) or bilateral symptomatic OA (OR 1.91, 95% CI 1.08-3.39), after adjusting for all SES measures simultaneously. No significant associations were observed between occupation and hip OA outcomes, nor did race or sex modify the associations. Our data provide evidence that hip OA outcomes are associated with both education and community SES measures, associations that remained after adjustment for covariates and all SES measures. Copyright © 2013 by the American College of Rheumatology.

  13. Outcome of arthroscopy in patients with advanced osteoarthritis of the hip.

    Science.gov (United States)

    Daivajna, Sachin; Bajwa, Ali; Villar, Richard

    2015-01-01

    Hip arthroscopy has continued to expand its horizons in treating many conditions other than femoroacetabular impingement (FAI). However, the results of hip arthroscopy are known to be poor if the degree of articular cartilage damage is significant. We wanted to assess, whether the procedure might have a role in the management of young and active patients with advanced osteoarthritis (OA) and whether it should be offered as a treatment modality. 77 consecutive patients with Tönnis grade 2 and 3 osteoarthritis of the hip who had undergone hip arthroscopy were included in the study. Patients' medical notes, plain radiographs and outcome scores (modified Harris hip score (mHHS), non-arthritic hip score (NAHS)) preoperatively and postoperatively at six weeks, six months, one year and annually thereafter, were analysed. 77 patients consisted of 63 men and 14 women with mean follow-up of 2.8 years (2.2 to 4.2) and mean age at surgery of 43 years (19 to 64). The mean preoperative mHHS and NAHS scores were 58 (28 to 87) and 64 (27 to 93) respectively. The mean improvements in both the mHHS and NAHS scores were significant (p = 0.003 and p = 0.0001 for mHHS at one and two years, p = 0.002 and p = 0.0003 for NAHS at one and two years, respectively). There were 34 patients (44%) who required a total hip replacement at mean of 18 months (6 to 48) after hip arthroscopy. We conclude that hip arthroscopy improves outcome scores in 56% of patients with severe OA of the hip (Tönnis grade 2 and 3) for at least two years after surgery. We thus consider the procedure to be a reasonable option for patients with hip OA, although success of the procedure will be less than if undertaken for certain other conditions.

  14. Total Hip Arthroplasty in Patients with Cerebral Palsy: A Cohort Study Matched to Patients with Osteoarthritis.

    Science.gov (United States)

    Houdek, Matthew T; Watts, Chad D; Wyles, Cody C; Trousdale, Robert T; Milbrandt, Todd A; Taunton, Michael J

    2017-03-15

    The spasticity and increased muscle tone observed in patients with cerebral palsy can lead to hip degeneration, subluxation, and pain. Currently, there is hesitation to perform total hip arthroplasty in patients with cerebral palsy because of fears of early wear and dislocation. The purpose of this study was to review the outcomes of total hip arthroplasty in patients with cerebral palsy and to compare outcomes with those of matched patients with a diagnosis of osteoarthritis. Over a 24-year period, 39 patients undergoing a total hip arthroplasty with a diagnosis of cerebral palsy were identified. The cohort included 26 male patients (67%), and the mean patient age was 49 years. The mean follow-up was 7 years. Patients with cerebral palsy were matched 1:2 with a group of patients undergoing total hip arthroplasty for osteoarthritis. There was no difference in the rate of reoperation, implant survival, or complications, specifically dislocation. Prior to the surgical procedure, all patients had severe or moderate pain, and postoperatively no patient had moderate or severe pain. Twenty-three patients had an improvement in their ability to independently walk, and all preoperative hip flexion contractures were corrected (n = 9). There was also a significant improvement (p cerebral palsy. Total hip arthroplasty is a durable treatment option and provides clinically important pain relief and functional improvement in patients with cerebral palsy. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  15. Anticipatory postural adjustments during lateral step motion in patients with hip osteoarthritis.

    Science.gov (United States)

    Tateuchi, Hiroshige; Ichihashi, Noriaki; Shinya, Masahiro; Oda, Shingo

    2011-02-01

    Patients with hip osteoarthritis (OA) have difficulty with mediolateral postural control. Since the symptom of hip OA includes joint pain, which mostly occurs upon initial movement, patients with hip OA might have disabling problems with movement initiation. This study aimed to identify the movement strategy during the anticipatory postural adjustments in the lateral step motion in patients with hip OA. We studied 18 female subjects with unilateral hip OA and 10 healthy subjects, and measured temporal, kinetic, and kinematic variables. Patients with hip OA required a longer duration of anticipation phase than the control subjects, the total duration of lateral stepping was not different between the groups. Displacement of the center of mass to the supporting (affected) side during the anticipation phase was not different between the two groups. These findings suggest that, in patients with hip OA, the center of mass slowly moved to the affected side. Furthermore, patients with hip OA showed greater shift of the trunk to the supporting side than did the control subjects. These movement characteristics might contribute to the achievement of both protection of the affected hip joint and quickness in the subsequent lateral step in patients with hip OA.

  16. Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population.

    Science.gov (United States)

    Park, Jung-Ho; Hong, Jae-Young; Han, Kyungdo; Suh, Seung-Woo; Park, Si-Young; Yang, Jae-Hyuk; Han, Seung-Woo

    2017-03-01

    Osteoarthritis is prominent among the elderly, with symptoms originating from multiple parts of the body. A cross-sectional study of a nationwide survey was performed to describe the prevalence of and identify factors related to symptomatic hip, knee, and spine osteoarthritis.This cross-sectional study collected data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-5; 2010-2012). After excluding ineligible subjects, there were 8976 subjects in this study (3830 males and 5146 females). All subjects reported symptoms and disabilities related to osteoarthritis. Plain radiographs of the spine, hip, and knee were taken in all subjects.Overall, 9.3% of male participants and 28.5% of female participants were diagnosed with symptomatic osteoarthritis according to survey criteria. Women showed a significantly higher prevalence in all age groups (P osteoarthritis was diagnosed in 10.8% of male patients and 22.8% of female patients with osteoarthritis. Several demographic and lifestyle variables were related to osteoarthritis morbidity. Anthropometric and laboratory measurements were also related to osteoarthritis morbidity. In addition, mental distress and quality of life were significantly compromised in osteoarthritis. There were more significant relationships for these factors among women with a higher prevalence of multijoint osteoarthritis.A significant proportion of the elderly with single- or multiple-joint osteoarthritis had a variety of pain origins that were closely related. Osteoarthritis was also significantly related to several factors, including mental distress and quality of life.

  17. [Update on current care guidelines: knee and hip osteoarthriti].

    Science.gov (United States)

    2012-01-01

    The goal of OA (osteoarthritis) treatment is to relieve pain and maintain/improve patient's functional capacity. First line medication is paracetamol and topical NSAIDs, and oral NSAIDs when needed. Tramadol and codeine may be considered in most severe cases. Glucosamine and chondroitin do not differ from placebo, but intra-articular glucocorticoids and hyaluronate may be useful. Supervised exercise is recommended especially for knee osteoarthritis. Cold, TENS and ultrasound therapies may offer short-term benefits in knee OA. Arthroscopic debridement does not alleviate OA symptoms. Arthroplasty is indicated if pain is not otherwise manageable.

  18. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: A case series.

    Science.gov (United States)

    MacDonald, Cameron W; Whitman, Julie M; Cleland, Joshua A; Smith, Marcia; Hoeksma, Hugo L

    2006-08-01

    Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients were treated with manual physical therapy followed by exercises to maximize strength and range of motion. Six of 7 patients completed a Harris Hip Score at initial examination and discharge from physical therapy, and 1 patient completed a Global Rating of Change Scale at discharge. Three males and 4 females with a median age of 62 years (range, 52-80 years) and median duration of symptoms of 9 months (range, 2-60 months) participated in this case series. The median number of physical therapy sessions attended was 5 (range, 4-12). The median increase in total passive range of motion of the hip was 82 degrees (range, 70 degrees-86 degrees). The median improvement on the Harris Hip Score was 25 points (range, 15-38 points). The single patient who completed the Global Rating of Change Scale at discharge reported being "a great deal better." Numeric pain rating scores decreased by a mean of 5 points (range, 2-7 points) on 0-to-10-point scale. All patients exhibited reductions in pain and increases in passive range of motion, as well as a clinically meaningful improvement in function. Although we can not infer a cause and effect relationship from a case series, the outcomes with these patients are similar to others reported in the literature that have demonstrated superior clinical outcomes associated with manual physical therapy and exercise for hip osteoarthritis compared to exercise alone.

  19. A blended intervention for patients with knee and hip osteoarthritis in the physical therapy practice: Development and a pilot study

    National Research Council Canada - National Science Library

    Bossen, Daniël; Kloek, C.J.J; Snippe, Harm Wouter; Dekker, Joost; de Bakker, D.H; Veenhof, Cindy

    2016-01-01

    .... The first aim was to develop a blended exercise therapy intervention for patients with knee and hip osteoarthritis that matches the values of the users and that can be implemented in the daily...

  20. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    NARCIS (Netherlands)

    Peter, W.F.H.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, H.M.; Vos, R.J. de; Schoones, J.W.; Vliet Vlieland, T.P.M.

    2011-01-01

    BACKGROUND: An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial

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

    Science.gov (United States)

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

    2000-11-01

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

  2. Positive outcomes following gait therapy intervention for hip osteoarthritis: A longitudinal study.

    Science.gov (United States)

    Solomonow-Avnon, Deborah; Herman, Amir; Levin, Daniel; Rozen, Nimrod; Peled, Eli; Wolf, Alon

    2017-01-04

    Footwear-generated biomechanical manipulation of lower-limb joints was shown to beneficially impact gait and quality of life in knee osteoarthritis patients, but has not been tested in hip osteoarthritis patients. We examined a customized gait treatment program using a biomechanical device shown in previous investigations to be capable of manipulating hip biomechanics via foot center of pressure (COP) modulation. The objective of this study was to assess the treatment program for hip osteoarthritis patients, enrolled in a 1-year prospective investigation, by means of objective gait and spatiotemporal parameters, and subjective quality of life measures. Gait analysis and completion of questionnaires were performed at the start of the treatment (baseline), and after 3, 6, and 12 months. Outcome parameters were evaluated over time using linear mixed effects models, and association between improvement in quality of life measures and change in objective outcomes was tested using mixed effect linear regression models. Quality of life measures improved compared to baseline, accompanied by increased gait speed and cadence. Sagittal-plane hip joint kinetics, kinematics, and spatiotemporal parameters changed throughout the study compared to baseline, in a manner suggesting improvement of gait. The most substantial improvement occurred within 3 months after treatment initiation, after which improvement approximately plateaued, but was sustained at 12 months. Speed and cadence, as well as several sagittal-plane gait parameters, were significant predictors of improvement in quality of life.

  3. Vitality and the course of limitations in activities in osteoarthritis of the hip or knee

    Directory of Open Access Journals (Sweden)

    van Dijk Gabriella M

    2011-11-01

    Full Text Available Abstract Background The objective of the study was to determine whether psychological and social factors predict the course of limitations in activities in elderly patients with osteoarthritis of the hip or knee, in addition to established somatic and cognitive risk factors. Methods A longitudinal cohort study with a follow-up period of three years was conducted. Patients (N = 237 with hip or knee osteoarthritis were recruited from rehabilitation centers and hospitals. Body functions, comorbidity, cognitive functioning, limitations in activities and psychological and social factors (mental health, vitality, pain coping and perceived social support were assessed. Statistical analyses included univariate and multivariate regression analyses. Psychological and social factors were added to a previously developed model with body functions, comorbidity and cognitive functioning. Results In knee OA, low vitality has a negative impact on the course of self-reported and performance-based limitations in activities, after controlling for somatic and cognitive factors. In hip OA, psychological and social factors had no additional contribution to the model. Conclusion Low vitality predicts deterioration of limitations in activities in elderly patients with osteoarthritis of the knee, in addition to established somatic and cognitive risk factors. However, the contribution of vitality is relatively small. Results of this study are relevant for the group of patients with knee or hip OA, attending hospitals and rehabilitation centers.

  4. Does running cause osteoarthritis in the hip or knee?

    Science.gov (United States)

    Hansen, Pamela; English, Michael; Willick, Stuart E

    2012-05-01

    Running is an excellent activity to promote general health and well-being. However, running injuries are common, and concern is sometimes raised that running might lead to osteoarthritis in weight-bearing joints. This article reviews the relevant in vitro and in vivo literature that looks at possible associations between running and the development of osteoarthritis. Also reviewed is the limited literature on running barefoot and with minimalist footwear. Low- and moderate-volume runners appear to have no more risk of developing osteoarthritis than nonrunners. The existing literature is inconclusive about a possible association between high-volume running and the development of osteoarthritis. The early literature on running barefoot and running with minimalist footwear has primarily focused on biomechanics but has not yet focused on any effect on cartilage health. Experienced and beginner runners should be encouraged to allow the body adequate time to adapt to changes in gait biomechanics caused by changing footwear, which can be done by slowly increasing running mileage in the new footwear. Clinicians can improve the health of runners by encouraging appropriate treatment of musculoskeletal injuries, encouraging maintenance of an optimal body mass index, and correcting gait abnormalities caused by deficits in flexibility, strength, or motor control along the kinetic chain.

  5. A meta-analysis of genome-wide association studies identifies novel variants associated with osteoarthritis of the hip

    DEFF Research Database (Denmark)

    Evangelou, Evangelos; Kerkhof, Hanneke J; Styrkarsdottir, Unnur

    2014-01-01

    Osteoarthritis (OA) is the most common form of arthritis with a clear genetic component. To identify novel loci associated with hip OA we performed a meta-analysis of genome-wide association studies (GWAS) on European subjects.......Osteoarthritis (OA) is the most common form of arthritis with a clear genetic component. To identify novel loci associated with hip OA we performed a meta-analysis of genome-wide association studies (GWAS) on European subjects....

  6. Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Forbes Andrew

    2010-10-01

    Full Text Available Abstract Background Hip osteoarthritis (OA is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatment in reducing pain and improving physical function. Methods The trial will be conducted at the University of Melbourne Centre for Health, Exercise and Sports Medicine. 128 participants with hip pain greater or equal to 40/100 on visual analogue scale (VAS and evidence of OA on x-ray will be recruited. Treatment will be provided by eight community physiotherapists in the Melbourne metropolitan region. The active physiotherapy treatment will comprise a semi-structured program of manual therapy and exercise plus education and advice. The placebo treatment will consist of sham ultrasound and the application of non-therapeutic gel. The participants and the study assessor will be blinded to the treatment allocation. Primary outcomes will be pain measured by VAS and physical function recorded on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC immediately after the 12 week intervention. Participants will also be followed up at 36 weeks post baseline. Conclusions The trial design has important strengths of reproducibility and reflecting contemporary physiotherapy practice. The findings from this randomised trial will provide evidence for the efficacy of a physiotherapy program for painful hip OA. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12610000439044

  7. 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.

  8. The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Hammer, Nanna Maria; Bieler, Theresa; Beyer, Nina Ann-Marie

    2016-01-01

    Purpose: Understanding motivational factors related to physical activity (PA) maintenance is essential in promoting long-term exercise benefits. This study explored the impact of self-efficacy (SE) on post-intervention PA maintenance in patients with hip osteoarthritis. Method: An SE-theory based...... mixed-methods sub-study of a trial investigating the effects of 4 months supervised exercise in patients with hip osteoarthritis. Questionnaire data (n = 52; baseline and 12 months) on PA and SE (Arthritis Self-Efficacy Scale, ASES, score-range 10–100) were analysed (Mann–Whitney test) for differences...... from incorporating the self-efficacy theory in the planning and execution of exercise interventions to promote post-intervention physical activity maintenance and long term health benefits. •Post-intervention physical activity maintenance may be increased by focussing on the patients’ exercise self...

  9. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Directory of Open Access Journals (Sweden)

    Elaine W Chong

    Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

  10. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Science.gov (United States)

    Chong, Elaine W; Wang, Yuanyuan; Robman, Liubov D; Aung, Khin Zaw; Makeyeva, Galina A; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M; Guymer, Robyn H

    2015-01-01

    Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be

  11. Analysis of the acetabulum by CT scan in Japanese with osteoarthritis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Masanori [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    The morphology of the acetabulum was analyzed by CT scan in 66 Japanese patients with osteoarthritis of the hip mainly following congenital dislocation or dysplasia. The CT scan data was analyzed to standardize the pelvic inclination in all directions. In these patients, the acetabular floor had thickened and the acetabulum was located in the anterolateral portion. The bilateral difference in the acetabular anteversion angle was not different between patients and normal individuals, but the acetabular sector angle in patients was smaller than in the normal subjects. As the stage of osteoarthritis of the hip advanced, the thickness of the acetabular floor in the center and posterior portions and the anterior sector angle increased, and the lateralization of the acetabulum advanced, but the anteversion angle decreased. A bone-forming change is characteristic of the anterior acetabulum and acetabular fossa in the center and posterior portions in Japanese patients with osteoarthritis of the hip. In comparison with data obtained by standard radiography, these changes detected by CT scan corresponded to an increase of the width of a tear drop, the lateralization of the femoral head and the lack of the support of the femoral head from the acetabulum. (author)

  12. In hip osteoarthritis Nordic Walking is superior to strength training and home based exercise for improving function

    DEFF Research Database (Denmark)

    Bieler, T; Siersma, Volkert Dirk; Magnusson, P

    2017-01-01

    in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self...

  13. Physiotherapy in hip and knee osteoarthritis : evidence and daily practice

    NARCIS (Netherlands)

    Peter, Willem Frederik Hendrik (Wilfred)

    2015-01-01

    In the first part an update of a guideline for the physiotherapy treatment of patients with hip and knee OA is described. Then a set of quality indicators for the physiotherapy management is developed to be used as an instrument to measure guideline adherence. Subsequently the effect of educational

  14. Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial.

    Science.gov (United States)

    Hinman, Rana S; Heywood, Sophie E; Day, Anthony R

    2007-01-01

    Aquatic physical therapy is frequently used in the management of patients with hip and knee osteoarthritis (OA), yet there is little research establishing its efficacy for this population. The purpose of this study was to evaluate the effects of aquatic physical therapy on hip or knee OA. A total of 71 volunteers with symptomatic hip OA or knee OA participated in this study. The study was designed as a randomized controlled trial in which participants randomly received 6 weeks of aquatic physical therapy or no aquatic physical therapy. Outcome measures included pain, physical function, physical activity levels, quality of life, and muscle strength. The intervention resulted in less pain and joint stiffness and greater physical function, quality of life, and hip muscle strength. Totals of 72% and 75% of participants reported improvements in pain and function, respectively, compared with only 17% (each) of control participants. Benefits were maintained 6 weeks after the completion of physical therapy, with 84% of participants continuing independently. Compared with no intervention, a 6-week program of aquatic physical therapy resulted in significantly less pain and improved physical function, strength, and quality of life. It is unclear whether the benefits were attributable to intervention effects or a placebo response.

  15. Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol

    OpenAIRE

    Forbes Andrew; Wrigley Tim V; McManus Fiona; Metcalf Ben; Sims Kevin; Abbott J Haxby; Pua Yong-Hao; Egerton Thorlene; Bennell Kim L; Harris Anthony; Buchbinder Rachelle

    2010-01-01

    Abstract Background Hip osteoarthritis (OA) is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatmen...

  16. Physiotherapy in hip and knee osteoarthritis: evidence and daily practice

    OpenAIRE

    Peter, Willem Frederik Hendrik (Wilfred)

    2015-01-01

    In the first part an update of a guideline for the physiotherapy treatment of patients with hip and knee OA is described. Then a set of quality indicators for the physiotherapy management is developed to be used as an instrument to measure guideline adherence. Subsequently the effect of educational strategies to enhance their uptake by physiotherapists in daily clinical practice is investigated. An interactive approach with patient colaboration and following a proces of clinical reasoning has...

  17. Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis

    DEFF Research Database (Denmark)

    Bieler, Theresa; Magnusson, Stig Peter; Christensen, Helle Elisabeth;

    2016-01-01

    : The symptomatic extremity in patients was significantly (p extremity for five hip muscles (8-17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p ... in patients, but had no asymmetry in leg extensor power. CONCLUSIONS: Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate...... that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis. Implications for Rehabilitation Even in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening...

  18. Correlation between mechanical stress by finite element analysis and 18F-fluoride PET uptake in hip osteoarthritis patients.

    Science.gov (United States)

    Hirata, Yasuhide; Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Yukizawa, Yohei; Fujimaki, Hiroshi; Tezuka, Taro; Tateishi, Ukihide; Inoue, Tomio; Saito, Tomoyuki

    2015-01-01

    18F-fluoride positron emission tomography (18F-fluoride PET) is a functional imaging modality used primarily to detect increased bone metabolism. Increased 18F-fluoride PET uptake suggests an association between increased bone metabolism and load stress at the subchondral level. This study therefore examined the relationship between equivalent stress distribution calculated by finite element analysis and 18F-fluoride PET uptake in patients with hip osteoarthritis. The study examined 34 hips of 17 patients who presented to our clinic with hip pain, and were diagnosed with osteoarthritis or pre-osteoarthritis. The hips with trauma, infection, or bone metastasis of cancer were excluded. Three-dimensional models of each hip were created from computed tomography data to calculate the maximum equivalent stress by finite element analysis, which was compared with the maximum standardized uptake value (SUVmax) examined by 18F-fluoride PET. The SUVmax and equivalent stress were correlated (Spearman's rank correlation coefficient ρ=0.752), and higher equivalent stress values were noted in higher SUVmax patients. The correlation between SUVmax and maximum equivalent stress in osteoarthritic hips suggests the possibility that 18F-fluoride PET detect increased bone metabolism at sites of stress concentration. This study demonstrates the correlation between mechanical stress and bone remodeling acceleration in hip osteoarthritis.

  19. Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Deshmukh, Ajit J.; Rodriguez, Jose A. [North Shore LIJ Lenox Hill Hospital, Department of Orthopaedic Surgery, New York, NY (United States); Panagopoulos, Georgia [North Shore LIJ Lenox Hill Hospital, Department of Research, New York, NY (United States); Alizadeh, Ahmadreza; Klein, Devon A. [North Shore LIJ Lenox Hill Hospital, Department of Radiology, New York, NY (United States)

    2011-11-15

    Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration. This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren-Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient. Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80, p < 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief. Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty. (orig.)

  20. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity.

    Science.gov (United States)

    Taşoğlu, Özlem; Şahin, Ali; Karataş, Gülşah; Koyuncu, Engin; Taşoğlu, İrfan; Tecimel, Osman; Özgirgin, Neşe

    2017-02-01

    Osteoarthritis (OA) is a low grade systemic inflammatory disease in which many inflammatory mediators are known to be elevated in the peripheric blood. Blood platelet lymphocyte ratio (PLR) and mean platelet volume (MPV) are accepted as novel markers in many of the systemic inflammatory disorders, but have not been investigated in synovitis-free radiographic OA yet.The aim of this study was to evaluate the levels of blood PLR and MPV in radiographic hip OA. A total of 880 patients were evaluated retrospectively and after certain exclusion criteria, 237 of them who have primary hip OA were included. Age, sex, height, weight, body mass index, neutrophil, lymphocyte and platelet counts, erythrocyte sedimentation rate (ESR), PLR, and MPV levels were recorded, Kellgren-Lawrence (KL) grading of the hip joints were performed. Patients were then divided into 2 groups as KL grades 1 to 2 (mild-moderate) and KL grades 3 to 4 (severe) hip OA.Mean age, mean neutrophil, lymphocyte and platelet counts, mean MPV, mean PLR, and mean ESR were statistically significantly different between mild/moderate hip OA group and severe hip OA group. In univariate analysis, older age and higher MPV, PLR, and ESR were severely associated with severe hip OA. In multiple logistic regression analysis, MPV, PLR, and ESR emerged as independent predictors of severe hip OA.The results of the present study, for the first time in the literature, suggest blood PLR and MPV as novel inflammatory markers predicting the radiographic severity of hip OA in the daily practice.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

  2. A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Tomoya Takasago

    2015-01-01

    Full Text Available A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA, secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient’s hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.

  3. Correlation between radiologic and ultrasonographic patterns and clinical manifestations in symptomatic hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    A. Alimonti

    2011-09-01

    Full Text Available Increasing amounts of data have recenlty been published regarding ultrasonographic (US findings of osteoarthritic joints, but very few data concern hip joints. In the current study we described US patterns concerning 490 patients affected by symptomatic hip osteoarthritis (OA who underwent to intra-articular injections of hyaluronic products under US guidance. All patients were studied by US and X-ray of hip, clinical evaluation was assessed by the followings indexes: Lequesne, pain VAS, ICED, Global Physician Assessment and Global Patient Assessment. US findings were summarized in four main patterns, effusion and synovial proliferation were also detected. The aim of this study was to correlate US findings with clinical assessment and radiographic findings (according to Kellegren- Lawrence classification. Pearson’s r correlation coefficient were computed and come out significant and positive between X ray and US patterns and between clinical indexes and US patterns. Also the correlation between K-L score and US patterns showed a significant positive correlation indicating that higher K-L scores are associated with increasing abnormal US findings. Our data suggest that ultrasonography of the hip may give useful information about the state of synovial membrane, synovial fluid, joint margins and bone profile in hip OA. Further studies are needed to evaluate their prevalence in hip OA symptomatic and not-symptomatic patients and their correlation to treatment outcome.

  4. Association between Dairy Product Consumption and Incidence of Total Hip Arthroplasty for Osteoarthritis.

    Science.gov (United States)

    Hussain, Sultana Monira; Cicuttini, Flavia M; Giles, Graham G; Graves, Stephen E; Wluka, Anita E; Wang, Yuanyuan

    2017-07-01

    The aim of this prospective cohort study was to determine whether dairy product consumption was associated with the incidence of total hip arthroplasty for osteoarthritis (OA). There were 38,924 participants from the Melbourne Collaborative Cohort Study who had dairy product consumption recorded in 1990-1994. The incidence of total hip arthroplasty for OA during 2001-2013 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Over an average of 11.8 years of followup, 1505 total hip arthroplasties for OA were identified (524 in men, 981 in women). In men, a 1 SD increase in dairy product consumption was associated with a 21% increased incidence of total hip arthroplasty for OA (HR 1.21, 95% CI 1.10-1.33), with a dose-response relationship observed for quartiles of dairy product consumption (p for trend = 0.001). These results were independent of age, body mass index, country of birth, education, smoking status, vigorous physical activity, calcium supplementation, energy consumption, circulating 25-hydroxy vitamin D, hypertension, and diabetes. No significant association was observed for women (HR 1.02, 95% CI 0.95-1.09). Increasing dairy product consumption was associated with an increased risk of total hip arthroplasty for men with OA, with no significant association observed for women. Understanding the mechanisms may help identify strategies to prevent hip OA, particularly for men.

  5. Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Hideki Higashi

    Full Text Available BACKGROUND: Osteoarthritis constitutes a major musculoskeletal burden for the aged Australians. Hip and knee replacement surgeries are effective interventions once all conservative therapies to manage the symptoms have been exhausted. This study aims to evaluate the cost-effectiveness of hip and knee replacements in Australia. To our best knowledge, the study is the first attempt to account for the dual nature of hip and knee osteoarthritis in modelling the severities of right and left joints separately. METHODOLOGY/PRINCIPAL FINDINGS: We developed a discrete-event simulation model that follows up the individuals with osteoarthritis over their lifetimes. The model defines separate attributes for right and left joints and accounts for several repeat replacements. The Australian population with osteoarthritis who were 40 years of age or older in 2003 were followed up until extinct. Intervention effects were modelled by means of disability-adjusted life-years (DALYs averted. Both hip and knee replacements are highly cost effective (AUD 5,000 per DALY and AUD 12,000 per DALY respectively under an AUD 50,000/DALY threshold level. The exclusion of cost offsets, and inclusion of future unrelated health care costs in extended years of life, did not change the findings that the interventions are cost-effective (AUD 17,000 per DALY and AUD 26,000 per DALY respectively. However, there was a substantial difference between hip and knee replacements where surgeries administered for hips were more cost-effective than for knees. CONCLUSIONS/SIGNIFICANCE: Both hip and knee replacements are cost-effective interventions to improve the quality of life of people with osteoarthritis. It was also shown that the dual nature of hip and knee OA should be taken into account to provide more accurate estimation on the cost-effectiveness of hip and knee replacements.

  6. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

    Directory of Open Access Journals (Sweden)

    Arwert Henk

    2008-06-01

    Full Text Available Abstract Background This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i to describe the prevalence of comorbidity and (ii to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. Methods A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test and pain (VAS was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA. Results Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain. Conclusion The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients.

  7. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

    Science.gov (United States)

    van Dijk, Gabriella M; Veenhof, Cindy; Schellevis, Francois; Hulsmans, Harry; Bakker, Jan PJ; Arwert, Henk; Dekker, Jos HM; Lankhorst, Guus J; Dekker, Joost

    2008-01-01

    Background This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. Methods A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test) and pain (VAS) was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA. Results Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain. Conclusion The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients. PMID:18582362

  8. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee.

    Science.gov (United States)

    Bennell, Kim L; Hinman, Rana S

    2011-01-01

    Osteoarthritis (OA) is a chronic joint disease with the hip and knee being commonly affected lower limb sites. Osteoarthritis causes pain, stiffness, swelling, joint instability and muscle weakness, all of which can lead to impaired physical function and reduced quality of life. This review of evidence provides recommendations for exercise prescription in those with hip or knee OA. A narrative review was performed. Conservative non-pharmacological strategies, particularly exercise, are recommended by all clinical guidelines for the management of OA and meta-analyses support these exercise recommendations. Aerobic, strengthening, aquatic and Tai chi exercise are beneficial for improving pain and function in people with OA with benefits seen across the range of disease severities. The optimal exercise dosage is yet to be determined and an individualized approach to exercise prescription is required based on an assessment of impairments, patient preference, co-morbidities and accessibility. Maximising adherence is a key element dictating success of exercise therapy. This can be enhanced by the use of supervised exercise sessions (possibly in class format) in the initial exercise period followed by home exercises. Bringing patients back for intermittent consultations with the exercise practitioner, or attendance at "refresher" group exercise classes may also assist long-term adherence and improved patient outcomes. Few studies have evaluated the effects of exercise on structural disease progression and there is currently no evidence to show that exercise can be disease modifying. Exercise plays an important role in managing symptoms in those with hip and knee OA.

  9. Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis - treatment effects of neuromuscular exercise and total joint replacement

    DEFF Research Database (Denmark)

    Kosek, E; Roos, Ewa M.; Ageberg, E

    2013-01-01

    To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters.......To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters....

  10. Is a long leg a risk for hip or knee osteoarthritis?

    Science.gov (United States)

    Tallroth, Kaj; Ristolainen, Leena; Manninen, Mikko

    2017-10-01

    Background and purpose - 7% of the asymptomatic population has leg-length inequality (LLI) greater than 12 mm. It has been proposed that LLI of >5 mm can be associated with an increased risk of osteoarthritis (OA) of the knee and hip. We studied a possible association between LLI and OA of the knee and hip joint. Patients and methods - We followed 193 individuals (97 women, 96 men) for 29 years. The initial mean age of the participants was 43 (34-54) years, and they had no clinical histories or signs of leg symptoms. The initial standing radiographs of their hips were re-examined and measured for LLI and signs of OA. None had any signs of OA. At the follow-up, data on performed hip or knee arthroplasties were obtained. Results - 24 (12%) of the subjects had no discernible leg-length difference, 62 (32%), had LLIs of 1-4 mm, 74 (38%) of 5-8 mm, 21 (11%) of 9-12 mm, and 12 (6%) of over 12 mm. 16 (8%) of the subjects had undergone arthroplasty for primary OA during follow-up, and of those, 8 for both hip and knee OA. 10 individuals had undergone an arthroplasty of the longer leg and only 3 of the shorter leg. In the group of equal leg length, 3 had had an arthroplasty of hip or knee. Interpretation - We noted that hip or knee arthroplasty due to primary OA had been done 3 times more often to the longer leg than to the shorter.

  11. Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study.

    Science.gov (United States)

    Bieler, Theresa; Magnusson, Stig Peter; Christensen, Helle Elisabeth; Kjaer, Michael; Beyer, Nina

    2017-07-01

    To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers. Seventy-two patients (60-87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63-82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy. The symptomatic extremity in patients was significantly (p muscles (8-17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p power. Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis. Implications for Rehabilitation Even in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present. Between-leg differences in leg extensor power (force × velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry. Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity. Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip

  12. Development and preliminary testing of a computerized Animated Activity Questionnaire (AAQ) in patients with hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Peter, Wf; Loos, M; de Vet, Hcw

    2015-01-01

    Objective To develop an Animated Activity Questionnaire (AAQ), based on video animations, for assessing activity limitations in patients with hip/knee osteoarthritis (OA), which combines the advantages of self-reported questionnaires and performance-based tests, without many of their limitations......, 4) existing measurement instruments, and 5) focus groups of patients. Test-retest reliability was assessed in 30/110 patients. In 110 patients correlations were calculated between AAQ and self-reported Hip disability and Knee injury Osteoarthritis Outcome ADL subscale (H/KOOS). In 45/110 patients...

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

    DEFF Research Database (Denmark)

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

    2004-01-01

    OBJECTIVES: (1) To evaluate the effect of pelvic orientation on measurements of hip joint space widths (JSW) in cadaver pelvic radiographs, thereby validating the pelvic radiographs of the Copenhagen City Heart Study: The Osteoarthritis Substudy (CCHS III) cohort of 4.152 subjects, and (2) to inv...

  14. Italian consensus on EULAR recommendations 2005 for the management of hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    R. Ramonda

    2011-09-01

    Full Text Available The recommendations for the management of osteoarthritis (OA of the hip were proposed by EULAR in 2005. Among the most important objectives of the expert charged to provide these recommendations were their wide dissemination and implementation. Thus, the information generated can be used by each individual country to produce their own set of management guidelines and algorithms for treatment in primary care. According with that previously executed for the EULAR recommendation 2003 for the knee, the Italian Society of Rheumatology (SIR has organised a Consensus on the EULAR recommendations 2005 for the management of hip OA. To obtain an acceptability as large as possible, the group of experts was composed by many physicians interested in the management of hip OA, including Orthopaedics, Rheumatologists, Physiatrists, and General Practitioners. Main aim of the Consensus was to analyse the acceptability and applicability of the recommendations according to own experience and local situations in the Italy. The results of this Consensus have demonstrated that a large majority of the EULAR recommendations are endorsed by the Italian experts. Furthermore, the final document of the Italian Consensus clearly indicated the need that the specialists involved in the management of hip OA strongly encourage the dissemination of the EULAR 2005 recommendations also in Italy.

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

    Science.gov (United States)

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

    2009-10-01

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

  16. Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee

    Directory of Open Access Journals (Sweden)

    Renata Alqualo Costa

    2010-01-01

    Full Text Available OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

  17. Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life.

    Science.gov (United States)

    Pereira, Duarte; Severo, Milton; Santos, Rui A; Barros, Henrique; Branco, Jaime; Lucas, Raquel; Costa, Lúcia; Ramos, Elisabete

    2016-06-01

    The association between radiographic osteoarthritis (OA) and symptoms is inconsistent and variable according to each joint. The purpose of this study is to understand the relation between radiographic OA features, pain, function and quality of life, in knee and hip joints. A cross-sectional study was performed using information from EPIPorto cohort. Data was obtained by interview using a structured questionnaire on social, demographic, behavioural and clinical data. Pain was assessed using a pain frequency score (regarding ever having knee pain, pain in the last year, in the last 6 months and in the last month). Quality of life was evaluated with Short Form 36 (SF-36) and function disability with the Lequesne knee and hip indexes. Radiographic knees and hips were classified using the Kellgren-Lawrence score (KL 0-4). Linear regression and proportional odds ratios estimated the association between radiographic features, pain, function and quality of life. In our study, symptomatic OA (KL ≥ 2 plus joint pain) was 26.0 % in knee and 7.0 % hip joints. In knee, the increase on radiographic score increased the odds to have a higher pain frequency score [1.58 (95 % CI = 1.27, 1.97)] and was associated [adjusted β (95 % CI)] with worst general health [-3.05 (-5.00, -1.09)], physical function [-4.92 (-7.03, -2.80)], role-physical [-4.10 (-8.08, -0.11)], bodily pain [-2.96 (-5.45, -0.48)] and limitations in activities of daily living [0.48 (0.08, 0.89)]. Regarding hip, no significant associations were found between the severity of radiographic lesions and these measures. Radiographic lesions in knee were associated with higher complaints, as far as pain and functional limitations are concerned, compared with hip.

  18. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Directory of Open Access Journals (Sweden)

    Yasuhiro Homma

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  19. Analgesic effect and side effects of celecoxib and meloxicam in canine hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    Víctor Molina D.

    2014-09-01

    Full Text Available Objective. To evaluate the pharmacological, clinical and toxicological effects of celecoxib and meloxicam for analgesia for 30 days in dogs with hip osteoarthritis. Materials and methods. Twenty-four patients were evaluated, 75% were females with an average age of 7.16 ± 2.06 years and twenty five percent were males with an average age of 7.83 ± 2.22 years. All patients had hip osteoarthritis and they were randomized into two groups; one group received oral celecoxib 5 mg/kg every 12 hours during one month and the second group received oral meloxicam 0.2 mg/kg every 24 hours during 1 month. The patients were evaluated for analgesia, and hematological, renal, liver, and coagulation tests on days 0, 10th and 30th after treatment initiation, and a gastric endoscopy on day 30. Statistical analysis was performed using a HSD Tukey test and c2 with a 5% level of statistical significance. Results. Both drugs reduced articular pain according to the Melbourne scale during the 30 days of treatment (p≤0.05. Hematological, renal, hepatic and coagulation tests were normal in both treatment groups. All patients presented chronic gastritis on endoscopy on day 30th. Conclusions. Both drugs decreased pain at day 30th without causing alterations in hematological, renal, hepatic or coagulation tests after 30 days of treatment. However, both drugs induced chronic gastritis.

  20. HIP JOINT OSTEOARTHRITIS IN LEGG-CALVÉ-PERTHES DISEASE - A LONG-TIME FOLLOW-UP CASE-CONTROL STUDY

    DEFF Research Database (Denmark)

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

    2009-01-01

    compared to one hip of 107 hips in the control group. One patient out of 41 in Stulberg class I/II had OA compared to three out of nine in Stulberg class III/IV/V. CONCLUSION LCP patients have a significant higher risk of having hip OA compared to a sex- and age-matched control group, p=0.04 [OR=8.5 (CI=0.......8-428.8)]. Patients in Stulberg class III, IV or V have a significantly increases risk of hip OA compared to patients in Stulberg class I or II, p=0.03 [OR=13.7 (CI 1.9-97.1)].......INTRODUCTION The purposes of this study are to investigate the inter-relationship between Stulberg class and radiographic hip osteoarthritis (OA) in patients with Legg-Calvé-Perthes disease (LCP) and to determine whether LCP patients develop hip OA more often than sex- and age-matched individuals...

  1. 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.

  2. Epidemiological evidence for work load as a risk factor for osteoarthritis of the hip: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sandra I Sulsky

    Full Text Available OBJECTIVE: Osteoarthritis of the hip (OA is a common degenerative disorder of the joint cartilage that presents a major public health problem worldwide. While intrinsic risk factors (e.g, body mass and morphology have been identified, external risk factors are not well understood. In this systematic review, the evidence for workload as a risk factor for hip OA is summarized and used to derive recommendations for prevention and further research. METHODS: Epidemiological studies on workload or occupation and osteoarthritis of the hip were identified through database and bibliography searches. Using pre-defined quality criteria, 30 studies were selected for critical evaluation; six of these provided quantitative exposure data. RESULTS: Study results were too heterogeneous to develop pooled risk estimates by specific work activities. The weight of evidence favors a graded association between long-term exposure to heavy lifting and risk of hip OA. Long-term exposure to standing at work might also increase the risk of hip OA. CONCLUSIONS: It is not possible to estimate a quantitative dose-response relationship between workload and hip OA using existing data, but there is enough evidence available to identify job-related heavy lifting and standing as hazards, and thus to begin developing recommendations for preventing hip OA by limiting the amount and duration of these activities. Future research to identify specific risk factors for work-related hip OA should focus on implementing rigorous study methods with quantitative exposure measures and objective diagnostic criteria.

  3. Long-term effectiveness of exercise therapy in patients with Osteoarthritis of the hip or knee : a systematic review

    NARCIS (Netherlands)

    Pisters, Martijn F.; Veenhof, Cindy; Van Meeteren, Nico L. U.; Ostelo, Raymond W.; De Bakker, Dinny H.; Schellevis, Franicois G.; Dekkers, Joost

    2007-01-01

    Objective. To determine the long-term effectiveness (>= 6 months after treatment) of exercise therapy on pain, physical function, and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. Methods. We conducted an extensive literature search in PubMed

  4. Effectiveness of behavioral graded activity in patients with osteoarthritis of hip and/or knee: a randomized clinical trial.

    NARCIS (Netherlands)

    Veenhof, C.; Köke, A.J.A.; Dekker, J.; Oostendorp, R.A.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

    2006-01-01

    Objective: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to incr

  5. Effectiveness of exercise therapy added to general practitioner care in patients with hip osteoarthritis: A pragmatic randomized controlled trial

    NARCIS (Netherlands)

    C.H. Teirlinck (Carolien H.); P.A.J. Luijsterburg (Pim); J.H.M. Dekker (Joost); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); M.A. Koopmanschap (Marc); P. van Es (Pauline); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2016-01-01

    textabstractObjective: To assess the effectiveness of exercise therapy added to general practitioner (GP) care compared with GP care alone, in patients with hip osteoarthritis (OA) during 12 months follow-up. Methods: We performed a multi-center parallel pragmatic randomized controlled trial in 120

  6. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    NARCIS (Netherlands)

    Peter, W.F.H.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, H.M.; Vos, R.J. de; Schoones, J.W.; Vliet Vlieland, T.P.M.

    2011-01-01

    BACKGROUND: An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial as

  7. Physical activity and exercise adherence in physical therapy exercise treatment in patients with osteoarthritis of hip or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2008-01-01

    Purpose: a lack of regular physical activity in patients with osteoarthritis (OA) of the hip and/or knee is an important risk factor for functional decline. The ultimate goal of exercise therapy is to improve the overall physical function and to help individuals meet the demands of daily living. Ear

  8. Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice : an observational study

    NARCIS (Netherlands)

    Barten, Di-Janne J A; Swinkels, Llse C S; Dorsman, Sara A; Dekker, Joost; Veenhof, Cindy; de Bakker, Dinny H

    2015-01-01

    BACKGROUND: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as

  9. Long-term effectiveness of exercise therapy in patients with Osteoarthritis of the hip or knee : a systematic review

    NARCIS (Netherlands)

    Pisters, Martijn F.; Veenhof, Cindy; Van Meeteren, Nico L. U.; Ostelo, Raymond W.; De Bakker, Dinny H.; Schellevis, Franicois G.; Dekkers, Joost

    2007-01-01

    Objective. To determine the long-term effectiveness (>= 6 months after treatment) of exercise therapy on pain, physical function, and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. Methods. We conducted an extensive literature search in PubMed

  10. A blended intervention for patients with knee and hip osteoarthritis in the physical therapy practice: development and a pilot study.

    NARCIS (Netherlands)

    Bossen, D.; Kloek, C.; Snippe, H.W.; Dekker, J.; Bakker, D. de; Veenhof, C.

    2016-01-01

    Background Exercise therapy in patients with hip and/or knee osteoarthritis is effective in reducing pain, increasing physical activity and physical functioning, but costly and a burden for the health care budget. A web-based intervention is cheap in comparison to face-to-face exerci

  11. Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Schellevis, F.G.; Twisk, J.W.; Dekker, J.; Bakker, D.H. de

    2010-01-01

    OBJECTIVE: To determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patients' outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or kn

  12. Long-term effectiveness of exercise therapy in patients with osteoarthritis of hip or knee: a systematic review.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Meeteren, N.L.U. van; Ostelo, R.W.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2007-01-01

    PURPOSE: To determine the long-term effectiveness (= 6 months after treatment) of exercise therapy on pain, physical function and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. METHODS: An extensive literature search in PubMed, Embase, CINAHL,

  13. Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study.

    NARCIS (Netherlands)

    Barten, D.J.A.; Swinkels, I.C.S.; Dorsman, S.A.; Dekker, J.; Veenhof, C.; Bakker, D.H. de

    2015-01-01

    Background: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as

  14. A meta-analysis of genome-wide association studies identifies novel variants associated with osteoarthritis of the hip

    NARCIS (Netherlands)

    E. Evangelou (Evangelos); J.M. Kerkhof (Hanneke); U. Styrkarsdottir (Unnur); E.E. Ntzani (Evangelia); S.D. Bos (Steffan); T. Esko (Tõnu); D.S. Evans (Daniel); S. Metrustry (Sarah); K. Panoutsopoulou (Kalliope); Y.F.M. Ramos (Yolande); G. Thorleifsson (Gudmar); K.K. Tsilidis (Konstantinos); N.K. Arden (Nigel); N. Aslam (Nadim); N. Bellamy (Nicholas); F. Birrell (Fraser); F.J. Blanco; A.J. Carr (Andrew Jonathan); K. Chapman (Kay); A.G. Day-Williams (Aaron); P. Deloukas (Panagiotis); M. Doherty (Michael); G. Engström; H.T. Helgadottir (Hafdis); A. Hofman (Albert); T. Ingvarsson (Torvaldur); H. Jonsson (Helgi); A. Keis (Aime); J.C. Keurentjes (J. Christiaan); M. Kloppenburg (Margreet); P.A. Lind (Penelope); A. McCaskie (Andrew); N.G. Martin; A.L. Milani (Alfredo); G.W. Montgomery; R.G.H.H. Nelissen (Rob); M.C. Nevitt (Michael); P. Nilsson (Peter); W.E.R. Ollier (William); N. Parimi (Neeta); A. Rai (Ashok); S.H. Ralston; M.R. Reed (Mike); J.A. Riancho (José); F. Rivadeneira Ramirez (Fernando); C. Rodriguez-Fontenla (Cristina); L. Southam (Lorraine); U. Thorsteinsdottir (Unnur); A. Tsezou (Aspasia); G.A. Wallis (Gillian); J.M. Wilkinson (Mark); A. Gonzalez (Antonio); N.E. Lane; L.S. Lohmander (Stefan); J. Loughlin (John); A. Metspalu (Andres); A.G. Uitterlinden (André); I. Jonsdottir (Ingileif); J-A. Zwart (John-Anker); P.E. Slagboom (Eline); E. Zeggini (Eleftheria); I. Meulenbelt (Ingrid); J.P.A. Ioannidis (John); T.D. Spector (Timothy); J.B.J. van Meurs (Joyce); A.M. Valdes (Ana Maria)

    2013-01-01

    textabstractObjectives: Osteoarthritis (OA) is the most common form of arthritis with a clear genetic component. To identify novel loci associated with hip OA we performed a meta-analysis of genome-wide association studies (GWAS) on European subjects. Methods: We performed a two-stage meta-analysis

  15. Validity of Cyriax's concept capsular pattern for the diagnosis of osteoarthritis of hip and/or knee.

    NARCIS (Netherlands)

    Bijl, D.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Lemmens, A.M.; Bijlsma, J.W.J.; Voorn, TH.B.

    1998-01-01

    To analyse the validity of Cyriax's concept of the 'capsular pattern' in the diagnosis of osteoarthritis (OA) of hip and knee, data on 200 patients were analysed. The capsular pattern with limitations of medial rotation, flexion, and abduction, was not present in a distinct pattern in patients with

  16. Course and predictors of pain and physical functioning in patients with hip osteoarthritis : Systematic review and meta-analysis

    NARCIS (Netherlands)

    de Rooij, Mariëtte; van der Leeden, Marike; Heymans, Martijn W; Holla, Jasmijn F M; Häkkinen, Arja; Lems, Willem F; Roorda, Leo D; Veenhof, Cindy; Sanchez-Ramirez, Diana C; de Vet, Henrica C W; Dekker, Joost

    2016-01-01

    OBJECTIVE: To systematically summarize the literature on: (i) the course of pain and physical functioning; and (ii) predictors of deterioration of pain and physical functioning in patients with osteoarthritis of the hip. METHODS: A literature search was conducted in PubMed, CINAHL, Embase, PsychINFO

  17. Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice : an observational study

    NARCIS (Netherlands)

    Barten, Di-Janne J A; Swinkels, Llse C S; Dorsman, Sara A; Dekker, Joost; Veenhof, Cindy; de Bakker, Dinny H

    2015-01-01

    BACKGROUND: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as

  18. Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study.

    NARCIS (Netherlands)

    Barten, D.J.A.; Swinkels, I.C.S.; Dorsman, S.A.; Dekker, J.; Veenhof, C.; Bakker, D.H. de

    2015-01-01

    Background: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as

  19. Long-term effectiveness of exercise therapy in patients with osteoarthritis of hip or knee: a systematic review.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Meeteren, N.L.U. van; Ostelo, R.W.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2007-01-01

    PURPOSE: To determine the long-term effectiveness (= 6 months after treatment) of exercise therapy on pain, physical function and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. METHODS: An extensive literature search in PubMed, Embase, CINAHL,

  20. Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics.

    NARCIS (Netherlands)

    Baar, M.E. van; Dekkers, J.; Lemmens, J.A.M.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    1998-01-01

    Objective: To determine to what extent articular, kinesiological, and psychological factors each contribute to pain and disability in patients with osteoarthritis (OA), after controlling for other factors. Methods: Cross sectional study among 200 patients with OA of the hip or knee. Dependent variab

  1. Exercise adherence improves long-term patient outcome in patients with osteoarthritis of the hip and/or knee.

    NARCIS (Netherlands)

    Pisters, M.; Veenhof, C.; Schellevis, F.; Twisk, J.; Dekker, J.; Bakker, D. de

    2011-01-01

    Purpose: To determine the effect of patient exercise adherence, within the prescribed physiotherapy treatment period and after discharge, on patients’ outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. Relevance: The p

  2. Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee: A randomized clinical trial.

    NARCIS (Netherlands)

    Veenhof, C.; Koke, A.J.; Dekker, J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

    2006-01-01

    OBJECTIVE: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to incr

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  4. Weight-bearing asymmetries during Sit-To-Stand in patients with mild-to-moderate hip osteoarthritis

    DEFF Research Database (Denmark)

    Eitzen, Ingrid; Fernandes, Linda; Nordsletten, Lars

    2014-01-01

    The Sit-To-Stand (STS) transition is a mechanically demanding task that may pose particular challenges for individuals with lower limb osteoarthritis (OA). Biomechanical features of STS have been investigated in patients with OA, but not in patients with early stage hip OA. The purpose of this st...

  5. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review.

    NARCIS (Netherlands)

    Veenhof, C.; Huisman, P.A.; Barten, J.A.; Takken, T.; Pisters, M.F.

    2012-01-01

    OBJECTIVE: To give an overview of factors related to the level of physical activity in patients with hip or knee osteoarthritis (OA). METHODS: An extensive systematic literature search was conducted in PubMed, CINAHL and Embase. Inclusion criteria were: studies on patients with a diagnosis of OA of

  6. Physical activity and exercise adherence in physical therapy exercise treatment in patients with osteoarthritis of hip or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2008-01-01

    Purpose: a lack of regular physical activity in patients with osteoarthritis (OA) of the hip and/or knee is an important risk factor for functional decline. The ultimate goal of exercise therapy is to improve the overall physical function and to help individuals meet the demands of daily living. Ear

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  8. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review.

    NARCIS (Netherlands)

    Veenhof, C.; Huisman, P.A.; Barten, J.A.; Takken, T.; Pisters, M.F.

    2012-01-01

    OBJECTIVE: To give an overview of factors related to the level of physical activity in patients with hip or knee osteoarthritis (OA). METHODS: An extensive systematic literature search was conducted in PubMed, CINAHL and Embase. Inclusion criteria were: studies on patients with a diagnosis of OA of

  9. Compensatory Trunk Movements in Patients with Hip Osteoarthritis Accuracy and Reproducibility of a Body-Fixed Sensor-Based Assessment

    NARCIS (Netherlands)

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

    2011-01-01

    Reininga IHF, Stevens M, Wagenmakers R, Boerboom AL, Groothoff JW, Bulstra SK, Zijlstra W: Compensatory trunk movements in patients with hip osteoarthritis; Accuracy and reproducibility of a body-fixed sensor-based assessment. Am J Phys Med Rehabil 2011;90:681-687. This study examined the accuracy a

  10. Exercise adherence improves long-term patient outcome in patients with osteoarthritis of the hip and/or knee.

    NARCIS (Netherlands)

    Pisters, M.; Veenhof, C.; Schellevis, F.; Twisk, J.; Dekker, J.; Bakker, D. de

    2011-01-01

    Purpose: To determine the effect of patient exercise adherence, within the prescribed physiotherapy treatment period and after discharge, on patients’ outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. Relevance: The

  11. Low validity of the Sensewear Pro3 activity monitor compared to indirect calorimetry during simulated free living in patients with osteoarthritis of the hip

    DEFF Research Database (Denmark)

    Hermann, Andreas; Ried-Larsen, Mathias; Jensen, Andreas Emil Kryger

    2014-01-01

    BACKGROUND: To validate physical activity estimates by the Sensewear Pro3 activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty. METHODS: Twenty patients diagnosed with hip osteoarth...

  12. Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics.

    Science.gov (United States)

    Schmitt, Daniel; Vap, Alexander; Queen, Robin M

    2015-09-01

    This study tested the hypothesis that the presence of isolated ankle (A-OA; N=30), knee (K-OA; N=20), or hip (H-OA; N=30) osteoarthritis (OA) compared to asymptomatic controls (N=15) would lead to mechanical changes in the affected joint but also in all other lower limb joints and gait overall. Stride length, stance and swing times, as well as joint angles and moments at the hip, knee, and ankle were derived from 3-D kinematic and kinetic data collected from seven self-selected speed walking trial. Values were compared across groups using a 1×4 ANCOVA, covarying for walking speed. With walking speed controlled, the results indicated a reduction in hip and knee extension and ankle plantar flexion in accordance with the joint affected. In addition, OA in one joint had strong effects on other joints. In both H-OA and K-OA groups the hip never passed into extension, and A-OA subjects significantly changed hip kinematics to compensate for lack of plantar flexion. Finally, OA in any joint led to lower peak vertical forces as well as extension and plantar flexion moments compared to controls. The presence of end-stage OA at various lower extremity joints results in compensatory gait mechanics that cause movement alterations throughout the lower extremity. This work reinforces our understanding of the complex interaction of joints of the lower limb and the importance of focusing on the mechanics of the entire lower limb when considering gait disability and potential interventions in patients with isolated OA.

  13. Predictors of response to physical therapy intervention in patients with primary hip osteoarthritis.

    Science.gov (United States)

    Wright, Alexis A; Cook, Chad E; Flynn, Timothy W; Baxter, G David; Abbott, J Haxby

    2011-04-01

    Few studies have investigated or identified common clinical tests and measures as being associated with progression of hip osteoarthritis (OA); fewer still are longitudinal studies exploring prognostic variables associated with long-term outcome following physical therapy treatment. The purpose of this study was to determine a set of prognostic factors that maximize the accuracy of identifying patients with hip osteoarthritis (OA) likely to demonstrate a favorable response to physical therapy intervention. This was a prognostic study. Ninety-one patients with a clinical diagnosis of hip OA were analyzed to determine which clinical measures, when clustered together, were most predictive of a favorable response to physical therapy intervention. Responders were determined based on OMERACT-OARSI response criteria, which included percent and absolute changes in pain, function, and global rating of change over 1 year. These data served as the reference standard for determining the predictive validity of baseline clinical examination variables. Using multivariate regression analyses and calculations for sensitivity, specificity, and positive and negative likelihood ratios, a cluster was identified. Five baseline variables (unilateral hip pain, age of ≤58 years, pain of ≥6/10 on a numeric pain rating scale, 40-m self-paced walk test time of ≤25.9 seconds, and duration of symptoms of ≤1 year) were retained in the final model. Failure to exhibit a condition of 1 of the 5 predictor variables decreased the posttest probability of responding favorably to physical therapy intervention from 32% to physical therapy intervention from 32% to 65% (positive likelihood ratio=3.99, 95% confidence interval=2.66-4.48), and having 3 or more of 5 predictor variables increased the posttest probability of success to 99% or higher. A comparison with a control group that did not receive physical therapy further substantiated the cluster. The small sample size and the number of variables

  14. Osteoarthritis of the hip in fibrous dysplasia of the proximal femur.

    Science.gov (United States)

    Kim, H-S; Im, S B; Han, I

    2015-07-01

    Deformity of the proximal femur in fibrous dysplasia leads to deviation of the mechanical axis of the hip, which may lead to the development of secondary osteoarthritis (OA). This study investigated the prevalence and predisposing factors for the development of OA in patients with fibrous dysplasia of the proximal femur. We reviewed the records of 209 patients from our institutional database with fibrous dysplasia of the proximal femur, investigating possible predisposing factors including patient demographics, the extent of the coxa vara deformity, the presence of peri-articular disease, and the overall burden of skeletal disease. Of the 209 patients, 24 (12%) had radiological evidence of OA in the ipsilateral hip. The prevalence was significantly higher in patients with polyostotic fibrous dysplasia compared with those with monostotic disease (p dysplasia have a high risk of developing secondary OA of the hips. This risk is higher in patients with peri-articular disease, and those with a more severe deformity of proximal femur. ©2015 The British Editorial Society of Bone & Joint Surgery.

  15. Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Dongquan Shi

    2014-01-01

    Full Text Available Objective. Ankylosing spondylitis (AS, an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients’ quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P=0.89. The patients of AS group were much younger (P<0.0001 and thinner (P=0.018 compared with those of OA group. AS patients had higher ejection fraction (EF (P=0.016, higher platelet counts (P<0.0001, and lower hypertension rate (P=0.0004. The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P<0.0001. The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients.

  16. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials

    OpenAIRE

    Barker Karen L; Minns Lowe Catherine; Dewey Michael E; Sackley Catherine M

    2009-01-01

    Abstract Background Physiotherapy has long been a routine component of patient rehabilitation following hip joint replacement. The purpose of this systematic review was to evaluate the effectiveness of physiotherapy exercise after discharge from hospital on function, walking, range of motion, quality of life and muscle strength, for osteoarthritic patients following elective primary total hip arthroplasty. Methods Design: Systematic review, using the Cochrane Collaboration Handbook for System...

  17. EULAR recommendations for knee and hip osteoarthritis: a critique of the methodology

    Science.gov (United States)

    Zhang, W; Doherty, M

    2006-01-01

    The quality of the EULAR recommendations for the management of hip and knee osteoarthritis (OA) was evaluated using a validated instrument. The quality and methods were compared with other guidelines and recommendations. EULAR recommendations were found to be among the best for overall quality. They show strengths with respect to scope, rigour of development, and clarity, but weaknesses with respect to stakeholder involvement, applicability, and editorial independence. However, a principal strength is their attempt to fill the gap between guidelines based solely on either research evidence or expert opinion. The methods used to synthesise research evidence (systematic review) and expert opinion (Delphi exercise) are robust. Strength of recommendation, based on combined consideration of research evidence, clinical expertise, and perceived patient preference, is valid and approaches the true essence of “evidence based practice” that considers each of these different forms of evidence. PMID:16864563

  18. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis of the hip or knee: protocol of a prospective randomised controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Deutsch Tobias

    2009-08-01

    Full Text Available Abstract Background The increasing age of the population, especially in the western world, means that the prevalence of osteoarthritis is also increasing, with corresponding socioeconomic consequences. Although there is no curative intervention at present, in accordance with US and European guidelines, pharmacotherapeutic and non-pharmacological approaches aim at pain control and the reduction of functional restriction. It has been established that hydrotherapy for osteoarthritis of the hip or knee joint using serial cold and warm water stimulation not only improves the range of movement but also reduces pain significantly and increases quality of life over a period of up to three months. Weight reduction is important for patients with osteoarthritis of the hip or knee. In addition, conventional physiotherapy and exercise therapy have both been shown, at a high level of evidence, to be cost-effective and to have long-term benefits for pain relief, movement in the affected joint, and patient quality of life. Methods/design The study design consists of a prospective randomised controlled three-armed clinical trial, which will be carried out at a specialist clinic for integrative medicine, to investigate the clinical effects of hydrotherapy on osteoarthritis of the knee or hip joint, in comparison with conventional physiotherapy. One hundred and eighty patients diagnosed with osteoarthritis of hip or knee will be randomly assigned to one of three intervention groups: hydrotherapy, physiotherapy, and both physiotherapy and hydrotherapy of the affected joint. In the first group, patients will receive Kneipp hydrotherapy daily, with water applied in the form of alternate cold and warm thigh affusions (alternating cold and warm water stimulation is particularly relevant to the knee and hip regions. Patients in the second group will receive physiotherapy of the hip or knee joint three times a week. Patients in the physiotherapy-hydrotherapy combination

  19. Transdermal fentanyl for the treatment of pain caused by osteoarthritis of the knee or hip: an open, multicentre study

    Directory of Open Access Journals (Sweden)

    Pavelka Karel

    2005-06-01

    Full Text Available Abstract Background This study was designed to evaluate the utility of transdermal fentanyl (TDF, Durogesic® for the treatment of pain due to osteoarthritis (OA of the knee or hip, which was not adequately controlled by non-opioid analgesics or weak opioids. The second part of the trial, investigating TDF in patients with rheumatoid arthritis (RA is reported separately. Methods Current analgesia was optimised during a 1-week run-in. Patients then received 28 days treatment with TDF starting at 25 μg/hr, with the option to increase the dose until adequate pain control was achieved. Metoclopramide was taken during the first week and then as needed. Results Of the 159 patients recruited, 75 with OA knee and 44 with OA hip completed the treatment phase, 30 knee and 18 hip patients entered the one-week taper-off phase. The most frequently used maximum dose of TDF was 25 μg/hr. The number of patients with adequate pain control increased during the run-in period from 4% to 27%, and further increased during TDF treatment to 88% on day 28. From baseline to endpoint, there were significant reductions in pain (p Conclusion TDF significantly increased pain control, and improved functioning and quality of life. Metoclopramide appeared to be of limited value in preventing nausea and vomiting; more effective anti-emetic treatment may enable more people to benefit from strong opioids such as TDF. This study suggests that four weeks is a reasonable period to test the benefit of adding TDF to improve pain control in OA patients and that discontinuing therapy in cases of limited benefit creates no major obstacles.

  20. Prediction of three-dimensional femoral offset from AP pelvis radiographs in primary hip osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Merle, C., E-mail: christian.merle@med.uni-heidelberg.de [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford (United Kingdom); Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg (Germany); Waldstein, W., E-mail: wwaldstein@gmail.com [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford (United Kingdom); Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg (Germany); Pegg, E.C., E-mail: elise.pegg@ndorms.ox.ac.uk [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford (United Kingdom); Streit, M.R., E-mail: marcus.streit@med.uni-heidelberg.de [Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg (Germany); Gotterbarm, T., E-mail: tobias.gotterbarm@med.uni-heidelberg.de [Department of Orthopaedic and Trauma Surgery, University Hospital Heidelberg (Germany); Aldinger, P.R., E-mail: peter.aldinger@diak-stuttgart.de [Department of Orthopaedic Surgery, Paulinenhilfe, Diakonieklinikum, Stuttgart (Germany); Murray, D.W., E-mail: david.murray@ndorms.ox.ac.uk [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford (United Kingdom); Gill, H.S., E-mail: r.gill@bath.ac.uk [Department of Mechanical Engineering, University of Bath (United Kingdom)

    2013-08-15

    Background: In pre-operative planning for total hip arthroplasty (THA), femoral offset (FO) is frequently underestimated on AP pelvis radiographs as a result of inaccurate patient positioning, imprecise magnification, and radiographic beam divergence. The aim of the present study was to evaluate the accuracy and reliability of predicting three-dimensional (3-D) FO from standardised AP pelvis radiographs. Methods: In a retrospective cohort study, pre-operative AP pelvis radiographs, AP hip radiographs and CT scans of a consecutive series of 345 patients (345 hips, 146 males, 199 females, mean age 60 (range: 40–79) years, mean body-mass-index 27 (range: 19–57) kg/m{sup 2}) with primary end-stage hip OA were reviewed. Patients were positioned according to a standardised protocol and all images were calibrated. Using validated custom programmes, FO was measured on corresponding radiographs and CT scans. Measurement reliability was evaluated using intra-class-correlation-coefficients. To predict 3-D FO from AP pelvis measurements and to assess the accuracy compared to CT, the entire cohort was randomly split into subgroups A and B. Gender specific regression equations were derived from group A (245 patients) and the accuracy of prediction was evaluated in group B (100 patients) using Bland–Altman plots. Results: In the entire cohort, mean FO was 39.2 mm (95%CI: 38.5–40.0 mm) on AP pelvis radiographs, 44.1 mm (95%CI: 43.4–44.9 mm) on AP hip radiographs and 44.6 mm (95%CI: 44.0–45.2 mm) on CT scans. In group B, we observed no significant difference between gender specific predicted FO (males: 48.0 mm, 95%CI: 47.1–48.8 mm; females: 42.0 mm, 95%CI: 41.1–42.8 mm) and FO as measured on CT (males: 47.7 mm, 95%CI: 46.1–49.4 mm, p = 0.689; females: 41.6 mm, 95%CI: 40.3–43.0 mm, p = 0.607). Conclusions: The present study suggests that FO can be accurately and reliably predicted from AP pelvis radiographs in patients with primary end-stage hip osteoarthritis

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

    Directory of Open Access Journals (Sweden)

    Reininga Inge HF

    2012-01-01

    Full Text Available Abstract Background Compensatory trunk movements during gait, such as a Duchenne limp, are observed frequently in subjects with osteoarthritis of the hip, yet angular trunk movements are seldom included in clinical gait assessments. Hence, the objective of this study was to quantify compensatory trunk movements during gait in subjects with hip osteoarthritis, outside a gait laboratory, using a body-fixed-sensor based gait analysis. Frontal plane angular movements of the pelvis and thorax and spatiotemporal parameters of persons who showed a Duchenne limp during gait were compared to healthy subjects and persons without a Duchenne limp. Methods A Body-fixed-sensor based gait analysis approach was used. Two body-fixed sensors were positioned at the dorsal side of the pelvis and on the upper thorax. Peak-to-peak frontal plane range of motion (ROM and spatiotemporal parameters (walking speed, step length and cadence of persons with a Duchenne limp during gait were compared to healthy subjects and persons without a Duchenne limp. Participants were instructed to walk at a self-selected low, preferred and high speed along a hospital corridor. Generalized estimating equations (GEE analyses were used to assess group differences between persons with a Duchenne limp, without a Duchenne limp and healthy subjects. Results Persons with a Duchenne limp showed a significantly larger thoracic ROM during walking compared to healthy subjects and to persons without a Duchenne limp. In both groups of persons with hip osteoarthritis, pelvic ROM was lower than in healthy subjects. This difference however only reached significance in persons without a Duchenne limp. The ratio of thoracic ROM relative to pelvic ROM revealed distinct differences in trunk movement patterns. Persons with hip osteoarthritis walked at a significantly lower speed compared to healthy subjects. No differences in step length and cadence were found between patients and healthy subjects, after

  2. The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis : Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment

    NARCIS (Netherlands)

    Rienstra, Wietske; Blikman, Tim; Mensink, Frans B.; van Raay, Jos J. A. M.; Dijkstra, Baukje; Bulstra, Sjoerd K.; Stevens, Martin; van den Akker-Scheek, Inge

    2015-01-01

    There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to

  3. Leg length discrepancy and osteoarthritis in the knee, hip and lumbar spine.

    Science.gov (United States)

    Murray, Kelvin J; Azari, Michael F

    2015-09-01

    Osteoarthritis (OA) is an extremely common condition that creates substantial personal and health care costs. An important recognised risk factor for OA is excessive or abnormal mechanical joint loading. Leg length discrepancy (LLD) is a common condition that results in uneven and excessive loading of not only knee joints but also hip joints and lumbar motion segments. Accurate imaging methods of LLD have made it possible to study the biomechanical effects of mild LLD (LLD of 20mm or less). This review examines the accuracy of these methods compared to clinical LLD measurements. It then examines the association between LLD and OA of the joints of the lower extremity. More importantly, it addresses the largely neglected association between LLD and degeneration of lumbar motion segments and the patterns of biomechanical changes that accompany LLD. We propose that mild LLD may be an important instigator or contributor to OA of the hip and lumbar spine, and that it deserves to be rigorously studied in order to decrease OA's burden of disease.

  4. Differences in Gait Characteristics of Patients with Lumbar Spinal Canal Stenosis (L4 Radiculopathy) and Those with Osteoarthritis of the Hip.

    Science.gov (United States)

    Yokogawa, Noriaki; Toribatake, Yasumitsu; Murakami, Hideki; Hayashi, Hiroyuki; Yoneyama, Takeshi; Watanabe, Tetsuyou; Tsuchiya, Hiroyuki

    2015-01-01

    It is important to differentially diagnose thigh pain from lumbar spinal stenosis (particularly lumbar fourth nerve root radiculopathy) and osteoarthritis of the hip. In this study, using a treadmill and a motion analysis method, gait characteristics were compared between these conditions. Patients with lumbar fourth nerve root radiculopathy had increased physiological knee flexion immediately after foot-ground contact, possibly owing to a slight decrease in the muscle strength of the quadriceps femoris muscle. Patients with osteoarthritis of the hip had decreased range of motion of the hip joint probably due to anatomically limited mobility as well as gait strategy to avoid pain resulting from increased internal pressure on the hip joint during its extension. Our facile and noninvasive method can be useful for the differential diagnosis of lumbar spinal canal stenosis from osteoarthritis of the hip.

  5. The effect of posterior and lateral approach on patient-reported outcome measures and physical function in patients with osteoarthritis, undergoing total hip replacement

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Jensen, Carsten

    2014-01-01

    BACKGROUND: Total hip replacement provides pain relief and improves physical function and quality of life in patients with end-stage hip osteoarthritis. The incidence of hip replacement operations is expected to increase due to the growing elderly population. Overall, the posterior approach...... and lateral approach are the two most commonly used approaches for hip replacement operations. The posterior approach is associated with an increased risk of revision due to dislocations, and some studies have shown that the lateral approach is associated with reduced patient-reported outcomes, including...... is a prospective, double blinded, parallel-group controlled trial with balanced randomisation [1: 1]. Patients with hip osteoarthritis scheduled for hip replacement surgery, aged 45-70 years, will be consecutively recruited and randomised into two groups. Group A will receive hip replacement using the posterior...

  6. Factors associated with functional limitations in the daily living activities of Japanese hip osteoarthritis patients.

    Science.gov (United States)

    Kondo, Kyoko; Jingushi, Seiya; Ohfuji, Satoko; Sofue, Muroto; Itoman, Moritoshi; Matsumoto, Tadami; Hamada, Yoshiki; Shindo, Hiroyuki; Takatori, Yoshio; Yamada, Harumoto; Yasunaga, Yuji; Ito, Hiroshi; Mori, Satoshi; Owan, Ichiro; Fujii, Genji; Ohashi, Hirotsugu; Fukushima, Wakaba; Maeda, Akiko; Inui, Miki; Takahashi, Shinji; Hirota, Yoshio

    2016-12-10

    As society ages, there is a vast number of elderly people with locomotive syndrome. In this study, the factors associated with functional limitations in daily living activities evaluated by female hip osteoarthritis (OA) patients were investigated. This study was a cross-sectional study. The subjects were 353 female patients who were newly diagnosed with hip OA at an orthopedic clinic with no history of hip joint surgery. Outcome indices were functional limitations in two daily living activities obtained from a questionnaire completed by the patients: (i) standing up (standing from a crouched position) and (ii) stair-climbing (climbing and/or descending stairs). The odds ratios (ORs) and 95% confidence intervals (CIs) were computed for explanatory variables using the proportional odds model in logistic regression to evaluate their associations with functional limitations. Functional limitations in standing up were associated with heavy weight (third tertile vs. first tertile: 1.91, 1.11-3.27), participation in sports at school (0.62, 0.40-0.98), parity (vs. nullipara: 1.96, 1.08-3.56), old age and OA stage. Associations with functional limitations in stair-climbing were seen with short height (weight, parity, shorter height and bilateral OA were associated with functional limitations in standing up and/or stair-climbing, whereas participation in sports such as club activities in school maintained standing up. © 2016 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  7. Cam Deformity and Acetabular Dysplasia as Risk Factors for Hip Osteoarthritis.

    Science.gov (United States)

    Saberi Hosnijeh, Fatemeh; Zuiderwijk, Maria E; Versteeg, Mathijs; Smeele, Hieronymus T W; Hofman, Albert; Uitterlinden, André G; Agricola, Rintje; Oei, Edwin H G; Waarsing, Jan H; Bierma-Zeinstra, Sita M; van Meurs, Joyce B J

    2017-01-01

    Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these associations differs according to sex, body mass index (BMI), and age. Participants in the Rotterdam Study cohort including men and women ages 55 years or older without OA at baseline (n = 4,438) and a mean follow-up of 9.2 years were included in the study. Incident radiographic OA was defined as a Kellgren/Lawrence grade of ≥2 or a total hip replacement at follow-up. Alpha and center-edge angles were measured to determine the presence of cam deformity and acetabular dysplasia/pincer deformity, respectively. Odds ratios (ORs) were calculated to assess the associations between both deformities and the development of OA. Subjects with cam deformity (OR 2.11, 95% confidence interval [95% CI] 1.55-2.87) and those with acetabular dysplasia (OR 2.19, 95% CI 1.50-3.21) had a 2-fold increased risk of developing OA compared with subjects without deformity, while pincer deformity did not increase the risk of OA. Stratification analyses showed that the associations of cam deformity and acetabular dysplasia with OA were driven by younger individuals, whereas BMI did not influence the associations. Female sex appears to modify the risk of hip OA related to acetabular dysplasia. Individuals with cam deformity and those with acetabular dysplasia are predisposed to OA; these associations were independent of other well-known risk factors. Interestingly, both deformities predisposed to OA only in relatively young individuals. Therefore, early identification of these conditions is important. © 2016, American College of Rheumatology.

  8. Hip osteoarthritis: influence of work with heavy lifting, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting.

    Science.gov (United States)

    Jensen, L K

    2008-01-01

    The aim of the study was to evaluate the evidence for an association between hip osteoarthritis (OA) and physical work demands. Systematic searches were made and epidemiological studies on hip OA and heavy lifting, including farming and construction work and climbing stairs, were reviewed for the period 1966-2007 inclusive. The quality of the studies was assessed and best-evidence syntheses of a causal relation between hip OA and physical demanding work have been made using specific criteria of the different degrees of evidence of causality. Limitations of the studies include few participants, use of different diagnostic criteria, and a poor description of the exposure. It is concluded that moderate to strong evidence was found for a relation between heavy lifting and hip OA. The burdens have to be at least 10-20 kg and the duration at least 10-20 years to give a clearly increased risk of hip OA. For farmers the risk of hip OA seems doubled after approximately 10 years of farming and the evidence is considered as moderate to strong. The evidence for a relation between hip OA for construction workers is limited and there is insufficient or no evidence that climbing stairs or ladders causes hip OA.

  9. Inversion of the acetabular labrum triggers rapidly destructive osteoarthritis of the hip: representative case report and proposed etiology.

    Science.gov (United States)

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami

    2014-12-01

    The pathophysiology of rapidly destructive osteoarthritis (OA) of the hip is unknown. This study documented cases of inversion of the acetabular labrum, which has clinicoradiologic features similar to those of initial-stage rapidly destructive hip OA. Our study was based on a prospective review of data for 9 patients with rapidly destructive hip OA. Intraoperative findings showed that the anterosuperior portion of the acetabular labrum had inverted into the articular space, along with many fragments of articular cartilage, in all patients. Subchondral insufficiency fractures of the femoral heads were seen just under the inverted labra in 8 of the 9 patients. Inversion of the acetabular labrum may be involved in rapid joint-space narrowing and subchondral insufficiency fracture in rapidly destructive hip OA.

  10. Analgesic use in patients with knee and/or hip osteoarthritis referred to an outpatient center: a cross-sectional study within the Amsterdam Osteoarthritis Cohort.

    Science.gov (United States)

    Knoop, Jesper; van Tunen, Joyce; van der Esch, Martin; Roorda, Leo D; Dekker, Joost; van der Leeden, Marike; Lems, Willem F

    2017-08-18

    Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted. Self-reported use of analgesic (yes/no) was administered and subdivided into acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, including coxibs) and opioids. Logistic regression analyses were performed to analyze the association between analgesic use and disease-related, predisposing and enabling factors. Analgesic use was reported by 63% of the patients, with acetaminophen, NSAIDs and opioid use reported by 50, 30 and 12%, respectively. Factors related to analgesic use were higher pain severity, longer duration of symptoms, higher radiographic hip OA severity, overweight/obesity and psychological distress. These factors explained 21% of the variance of analgesic use. More than one-third of patients with established knee and/or hip OA referred to an outpatient center did not use any analgesics. Although multiple, mostly disease-related associated factors were found, analgesic use remained predominantly unexplained. Our study seems to indicate that prescription of analgesics should be guided more dominantly by clinical symptoms and needs, and preceded by a thorough shared decision-making process between patient and physician.

  11. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial

    Directory of Open Access Journals (Sweden)

    Hunter David J

    2007-12-01

    Full Text Available Abstract Background Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis (OA. Strengthening the hip abductor and adductor muscles may influence joint loading and/or OA-related symptoms, but no study has evaluated these hypotheses directly. The aim of this randomised, single-blind controlled trial is to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with medial compartment knee OA. Methods/Design 88 participants with painful, radiographically confirmed medial compartment knee OA and varus alignment will be recruited from the community and randomly allocated to a hip strengthening or control group using concealed allocation stratified by disease severity. The hip strengthening group will perform 6 exercises to strengthen the hip abductor and adductor muscles at home 5 times per week for 12 weeks. They will consult with a physiotherapist on 7 occasions to be taught the exercises and progress exercise resistance. The control group will be requested to continue with their usual care. Blinded follow up assessment will be conducted at 12 weeks after randomisation. The primary outcome measure is the change in the peak external knee adduction moment measured during walking. Questionnaires will assess changes in pain and physical function as well as overall perceived rating of change. An intention-to-treat analysis will be performed using linear regression modelling and adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effect of hip strengthening on knee loads and symptoms in people with medial compartment knee OA. If shown to reduce the knee adduction moment, hip strengthening has the potential to slow disease progression. Trial Registration Australia New Zealand Clinical Trials Registry ACTR12607000001493

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

    DEFF Research Database (Denmark)

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

    2004-01-01

    degrees). At each 3 degrees increment an anteroposterior radiograph was recorded. Measurements of JSW were performed. (2) Self reported recurrent pain in or around the hip joint during 12 months prior to baseline examinations, and minimum JSW in pelvic radiographs of the cohort were registered......OBJECTIVES: (1) To evaluate the effect of pelvic orientation on measurements of hip joint space widths (JSW) in cadaver pelvic radiographs, thereby validating the pelvic radiographs of the Copenhagen City Heart Study: The Osteoarthritis Substudy (CCHS III) cohort of 4.152 subjects, and (2......) to investigate the relationship between minimal JSW and self reported hip pain of the cohort. METHODS: (1) Cadaver pelves and proximal femora of one male and one female donor were mounted in holding devices permitting independent rotation (total arc of 42 degrees), and inclination/reclination (total arc of 24...

  13. Exercise and Manual therapy Arthritis Research Trial (EMPART) for osteoarthritis of the hip: A Multicentre Randomised Controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2012-10-16

    OBJECTIVE: To determine the effectiveness of exercise therapy (ET) compared to ET with adjunctive manual therapy (ET+MT) for people with hip osteoarthritis (OA). A secondary aim was to identify if immediate commencement of ET or ET+MT was more beneficial than a 9 week waiting period for either intervention. DESIGN: Assessor-blind randomised controlled trial with 9 and 18 week follow-ups. SETTING: Four academic teaching hospitals, Dublin, Ireland. PARTICIPANTS: 131 patients with hip OA recruited from general practitioners, rheumatologists, orthopaedic surgeons, and other hospital consultants were randomised to one of three groups: ET (n=45), ET+MT (n=43) and wait-list control (n=43). INTERVENTIONS: Participants in both ET and ET+ MT groups received up to 8 treatments over 8 weeks. Control group participants were re-randomised into either ET or ET+MT group after 9 week follow-up. Their data were pooled with original treatment group data: ET (n=66) and ET+MT (n=65). MAIN OUTCOME MEASURES: The primary outcome was the WOMAC physical function (PF) subscale. Secondary outcomes included physical performance, pain, hip range of motion (HROM), anxiety\\/depression, quality of life, medication usage, patient-perceived change and patient satisfaction. RESULTS: There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean diff 0.09 (95% CI -4.41, 5.25)) or at 18 weeks (mean diff 0.42 (95% CI -3.98, 6.83)), or other outcomes, except \\'patient satisfaction with outcome\\' which was higher in the ET+MT group (p=0.02). Improvements in WOMAC, HROM and patient-perceived change occurred in both treatment groups compared with the control group. CONCLUSION: Self-reported function, HROM and patient-perceived improvement occurred after an 8 week programme of ET for patients with hip OA MT as an adjunct provided no further benefit, except for higher patient satisfaction.

  14. Self-Reported Functional Status as Predictor of Observed Functional Capacity in Subjects with Early Osteoarthritis of the Hip and Knee : A Diagnostic Study in the CHECK Cohort

    NARCIS (Netherlands)

    Bieleman, H. J.; Reneman, M. F.; van Ittersum, M. W.; van der Schans, C. P.; Groothoff, J. W.; Oosterveld, F. G. J.

    2009-01-01

    Objectives Patients with hip or knee osteoarthritis (OA) may experience functional limitations in work settings. In the Cohort Hip and Cohort Knee study (CHECK) physical function was both self-reported and measured performance-based, using Functional Capacity Evaluation (FCE). Relations between self

  15. ASSESSMENT OF IN VIVO MECHANICAL MUSCLE FUNCTION IN PATIENTS WITH OSTEOARTHRITIS (OA) OF THE HIP; RELIABILITY

    DEFF Research Database (Denmark)

    Jensen, Carsten; Overgaard, Søren; Aagaard, Per

    2009-01-01

    -joint strength and power a novel setup. MATERIAL AND METHODS Isokinetic contractions for both knee and hip muscles were performed. Reliability for isometric muscle contractions in vivo was recorded and evaluated by use of within subject variability (CVW-S), Spearman correlation and Limits of Agreement (Lo......INTRODUCTION Muscle function in patients with hip OA is not well-studied. We established a new setup of tests in order to monitor patients before and after surgery with total hip arthroplasty (THA). A test-retest protocol was designed to evaluate the reproducibility of single- and multi......A). Both explosive muscle force characteristics (Rate of force development) and maximal isometric force (MVC) were obtained for the affected (aff) and non-affected (n-aff) leg (only data MVC for affected side in this abstract). 20 patients, (age 55.9 ± 4.8; height 174 ± 8; BMI 27.1 ± 4.5) with unilateral...

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

    Science.gov (United States)

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

    2016-10-01

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

  17. Characteristics of sagittal spine-pelvis-leg alignment in patients with severe hip osteoarthritis.

    Science.gov (United States)

    Weng, Wen-Jie; Wang, Wei-Jun; Wu, Ming-Da; Xu, Zhi-Hong; Xu, Lei-Lei; Qiu, Yong

    2015-06-01

    The interaction between the sagittal alignment of the spine and pelvis and the compensatory mechanism in patients suffering from spinal disorders has been well documented. However, in patients with hip osteoarthritis (HOA), few studies have explored how the hip joint pathology could affect the sagittal alignment of the hip, pelvis and spine, and no reports have investigated whether these changes are involved in the pathogenesis of low back pain in these patients. The aims of this case-control study were to investigate the sagittal spine-pelvis-leg alignment in patients suffering from severe HOA and to understand whether the alignment was related to the occurrence of low back pain and the health-related quality of life in these patients. Fifty-eight patients with severe HOA and 64 asymptomatic controls were studied. Digital lateral X-rays of the spine, pelvis and proximal femur were obtained with the patients placed in upright positions. The following radiographic parameters were measured to examine the sagittal alignment of the pelvis, hip and spine: pelvic incidence (PI), pelvic tilting (PT), sacral slope (SS), pelvic femoral angle (PFA), femoral inclination (FI), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T) and T1 spinal-pelvic inclination (T1-SPI). The global balance patterns of spinal-pelvic alignment were classified as normal balance, slight unbalance and severe unbalance according to the relative position of the C7 plumb line to the sacrum and femoral heads. Short Form-36 questionnaire was carried out in the patients. Comparisons were carried out between the patients with HOA and the controls and between the HOA patients with or without low back pain. Correlation analysis was used to measure relationships between the HOA patients' parameters. There were no significant differences in the age and gender distribution between the HOA patients and control. Compared with the controls, the patients with HOA showed significantly higher SS and lower

  18. Developing a minimum standard of care for treating people with osteoarthritis of the hip and knee.

    Science.gov (United States)

    March, Lyn; Amatya, Bhasker; Osborne, Richard H; Brand, Caroline

    2010-02-01

    We reviewed three recently published guidelines for the management of osteoarthritis (OA) and considered the evidence and potential for implementation. From this we propose a minimum standard of care, or a 'core set' of interventions, that should be offered to all patients with OA of the hip and/or knee. Eight core recommendations emerged where it is recommended that health-care professionals: Provide advice about, and offer access to appropriate information for OA self-management and lifestyle change; Provide advice about weight loss if patient is overweight or obese and refer to services as required; Provide advice for land-based exercises incorporating aerobic and strengthening components and refer to services as required; Recommend adequate paracetamol for pain relief; Make patients aware that non-steroid anti-inflammatory drugs (NSAIDs) or coxibs can improve symptoms in majority but this comes with potential for harm and that risk potential varies--be aware of and minimise the individual's risk potential; Offer intra-articular steroids for short-term relief of a flare or acute deterioration in symptoms; Offer stronger analgesic relief if prolonged severe symptoms; Offer access to assessment for arthroplasty for consumers with severe symptomatic OA not responding to conservative therapy. An integrated, chronic disease model of care is proposed to best implement OA management and a check list of clinical indicators/performance measures is provided.

  19. The Lawrence D. Dorr Surgical Techniques & Technologies Award: Differences in Postoperative Outcomes Between Total Hip Arthroplasty for Fracture vs Osteoarthritis.

    Science.gov (United States)

    Qin, Charles D; Helfrich, Mia M; Fitz, David W; Hardt, Kevin D; Beal, Matthew D; Manning, David W

    2017-09-01

    Hip fracture is an increasingly common expanded indication for total hip arthroplasty (THA) and warrants outcome analysis so as to best inform risk assessment models, public reporting of outcome, and value-based reimbursement schemes. The National Surgical Quality Improvement Program data file from 2011 to 2014 was used to identify all patients undergoing THA via current procedural terminology code 27130. Propensity score matching in a 1:5 fashion was used to compare 2 cohorts: THA for osteoarthritis and THA for fracture. Primary outcomes included Centers for Medicare and Medicaid Services (CMS) reportable complications, unplanned readmission, postsurgical length of stay, and discharge destination. χ(2) tests for categorical variables and Student t test for continuous variables were used to compare the 2 cohorts and adjusted linear regression analysis used to determine the association between hip fracture and THA outcomes of interest. A total of 58,302 patients underwent elective THA for osteoarthritis and 1580 patients underwent THA for hip fracture. Rates of CMS-reported complications (4.0% vs 10.7%; P < .001), non-homebound discharge (39.8% vs 64.7%; P < .001), readmission (4.7% vs 8.0%; P < .001), and mean days of postsurgical hospital stay (3.2 vs 4.4; P < .001) were greater in the hip fracture cohort. THA for hip fracture was significantly associated with increased risk of CMS-reportable complications (odds ratio [OR], 2.67; 95% confidence interval [CI], 2.17-3.28), non-homebound discharge (OR, 1.73; 95% CI, 1.39-2.15), and readmission (OR, 2.78; 95% CI, 2.46-3.12). Our findings support recent advocacy for the exclusion of THA for fracture from THA bundled pricing methodology and public reporting of outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Eitzen Ingrid

    2012-12-01

    Full Text Available Abstract Background Existent biomechanical studies on hip osteoarthritic gait have primarily focused on the end stage of disease. Consequently, there is no clear consensus on which specific gait parameters are of most relevance for hip osteoarthritis patients with mild to moderate symptoms. The purpose of this study was to explore sagittal plane gait characteristics during the stance phase of gait in hip osteoarthritis patients not eligible for hip replacement surgery. First, compared to healthy controls, and second, when categorized into two subgroups of radiographic severity defined from a minimal joint space of ≤/>2 mm. Methods Sagittal plane kinematics and kinetics of the hip, knee and ankle joint were calculated for total joint excursion throughout the stance phase, as well as from the specific events initial contact, midstance, peak hip extension and toe-off following 3D gait analysis. In addition, the Western Ontario and McMaster Universities Osteoarthritis Index, passive hip range of motion, and isokinetic muscle strength of hip and knee flexion and extension were included as secondary outcomes. Data were checked for normality and differences evaluated with the independent Student’s t-test, Welch’s t-test and the independent Mann–Whitney U-test. A binary logistic regression model was used in order to control for velocity in key variables. Results Fourty-eight hip osteoarthritis patients and 22 controls were included in the final material. The patients walked significantly slower than the controls (p=0.002, revealed significantly reduced joint excursions of the hip (pp=0.011, and a reduced hip flexion moment at midstance and peak hip extension (p2 mm suggested that the observed deviations were more pronounced in patients with greater radiographic severity. The biomechanical differences were, however, not reflected in self-reported symptoms or function. Conclusions Reduced gait velocity, reduced sagittal plane joint excursion, and

  1. Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty

    DEFF Research Database (Denmark)

    Hermann, A; Holsgaard-Larsen, A; Zerahn, B;

    2016-01-01

    pain (VAS score ≤ 5) reported in 83% of sessions and no adverse events. Changes in HOOS 'function' was 10.0 points 95%CI [4.7; 15.3] higher in IG compared to CG (P leg extension muscle power (P ... in the Hip Osteoarthritis Outcome Score (HOOS) (primary endpoint; ADL function), and leg muscle power at post intervention follow-up immediate before surgery. Intention-to-treat analyses were performed in a multilevel regression model adjusting for baseline, sex, age and weight. Feasibility was reported.......0001) compared to CG. CONCLUSION: Progressive explosive-type RT was feasible in the included group of hip OA patients scheduled for THA and resulted in significant improvement in self-reported outcomes and increased leg muscle power....

  2. Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Ageberg, Eva; Nilsdotter, Anna; Kosek, Eva

    2013-01-01

    The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled bef...... before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee.......The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled...

  3. The relationship of bone properties using high resolution peripheral quantitative computed tomography to radiographic components of hip osteoarthritis.

    Science.gov (United States)

    Edwards, M H; Paccou, J; Ward, K A; Jameson, K A; Moss, C; Woolston, J; Javaid, M K; Cooper, C; Dennison, E M

    2017-09-01

    Positive associations between radiographic osteoarthritis (OA) and areal bone mineral density (BMD) have been demonstrated and appear strongest when bony features of OA are considered. To date, these associations have not been assessed using HRpQCT. A total of 318 participants (170 men and 148 women), aged 72.1-81.4 years from a non-selected cohort, underwent HRpQCT of the distal radius and tibia along with hip radiography. Differences in bone microarchitecture were assessed between those with and without osteophytes, sclerosis or joint space narrowing (JSN) in either hip. Men with osteophytes alone had significantly higher radial trabecular volumetric BMD (Tb.vBMD) and radial and tibial trabecular thickness (Tb.Th). Men with both sclerosis and osteophytes had significantly higher cortical volumetric BMD (Ct.vBMD) and cortical thickness (Ct.Th) at the distal tibia than those with osteophytes alone (P < 0.05). These relationships were maintained after adjustment for age and Body Mass Index (BMI), and were not replicated in women. Bone microarchitecture did not differ significantly in those with JSN from those without it in men or women. Our findings suggest higher Tb.vBMD and Tb.Th in men with osteophytosis but higher tibial Ct.vBMD and Ct.Th in men with hip joint sclerosis. These results do however require replication in other cohorts. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  4. Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Baxter G David

    2009-02-01

    Full Text Available Abstract Background Non-pharmacological, non-surgical interventions are recommended as the first line of treatment for osteoarthritis (OA of the hip and knee. There is evidence that exercise therapy is effective for reducing pain and improving function in patients with knee OA, some evidence that exercise therapy is effective for hip OA, and early indications that manual therapy may be efficacious for hip and knee OA. There is little evidence as to which approach is more effective, if benefits endure, or if providing these therapies is cost-effective for the management of this disorder. The MOA Trial (Management of OsteoArthritis aims to test the effectiveness of two physiotherapy interventions for improving disability and pain in adults with hip or knee OA in New Zealand. Specifically, our primary objectives are to investigate whether: 1. Exercise therapy versus no exercise therapy improves disability at 12 months; 2. Manual physiotherapy versus no manual therapy improves disability at 12 months; 3. Providing physiotherapy programmes in addition to usual care is more cost-effective than usual care alone in the management of osteoarthritis at 24 months. Methods This is a 2 × 2 factorial randomised controlled trial. We plan to recruit 224 participants with hip or knee OA. Eligible participants will be randomly allocated to receive either: (a a supervised multi-modal exercise therapy programme; (b an individualised manual therapy programme; (c both exercise therapy and manual therapy; or, (d no trial physiotherapy. All participants will continue to receive usual medical care. The outcome assessors, orthopaedic surgeons, general medical practitioners, and statistician will be blind to group allocation until the statistical analysis is completed. The trial is funded by Health Research Council of New Zealand Project Grants (Project numbers 07/199, 07/200. Discussion The MOA Trial will be the first to investigate the effectiveness and cost

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

    Science.gov (United States)

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

    2008-03-01

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

  6. Preferences for Disease-Related Education and Support Among Younger People With Hip or Knee Osteoarthritis.

    Science.gov (United States)

    Ackerman, Ilana N; Bucknill, Andrew; Page, Richard S; Broughton, Nigel S; Roberts, Carol; Cavka, Bernarda; Schoch, Peter; Brand, Caroline A

    2017-04-01

    To explore the usefulness and accessibility of different delivery modes of disease-related education and support, as perceived by younger people with osteoarthritis (OA). People ages 20-55 years with hip or knee OA were recruited from 3 major Australian public hospitals and the community (n = 147). Data were collected on use of disease-related education and support services, as well as perceived usefulness and accessibility of delivery modes including group-based programs, online resources, telephone helplines, mailed information, social media, and mobile applications (rated on visual analog scales from 1-10; higher scores indicate greater usefulness or accessibility). Very few participants had used social media (5%), group self-management programs (3%), or telephone helplines (2%) to obtain OA information. Mailed information packs and online education programs were considered the most useful (median usefulness scores 8.0 and 7.0, respectively) and accessible methods (median accessibility scores 10.0 and 9.0, respectively) for providing OA education and support. Social media was perceived as least useful (median usefulness score 2.0) and least accessible; 45% of participants considered it "not at all useful," while 35% reported it would be "very difficult" to access OA education and support by this means. Less educational attainment was associated with greater perceived difficulty in accessing online/electronic delivery modes, while people in paid work perceived easier access. These data highlight the value of mailed information and online education to younger people with OA and can be used to develop targeted resources for individuals of working age. Social media was not a highly valued source of disease-related education and support. © 2016, American College of Rheumatology.

  7. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review

    Directory of Open Access Journals (Sweden)

    A. Romeo

    2013-05-01

    Full Text Available This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA. Two independent reviewers (AR, CV searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012 and publication language (English or Italian. Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid- and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.

  8. A Blended Intervention for Patients With Knee and Hip Osteoarthritis in the Physical Therapy Practice: Development and a Pilot Study.

    Science.gov (United States)

    Bossen, Daniël; Kloek, Corelien; Snippe, Harm Wouter; Dekker, Joost; de Bakker, Dinny; Veenhof, Cindy

    2016-02-24

    Blended care, a combination of online and face-to-face care, is seen as a promising treatment option. However, actual use of blended interventions in practice is disappointing. The objective of this study was two folded. The first aim was to develop a blended exercise therapy intervention for patients with knee and hip osteoarthritis that matches the values of the users and that can be implemented in the daily routine of physical therapists. The second aim was to investigate the feasibility through interviews and a pilot study. In this paper, we employed the first 3 steps of the CeHRes road map to develop a blended intervention for patients with knee and hip osteoarthritis. We used interviews, a focus group and discussions with stakeholders to explore the needs, values, and requirements with respect to our to-be-developed blended intervention, which we called e-Exercise. The first version of e-Exercise was tested in a pilot study. Feasibility outcomes, including recruitment rates within each practice, website usage (assignments completed and website visits), and user satisfaction, were measured. In addition, therapists and patients from the pilot study were interviewed to investigate users' experiences. The study captured important information about stakeholders' needs and perspectives. Based on our findings, we created a first version and attuned the application's content, functionality, and structure. Patients and, to lesser extent, physical therapists were satisfied with the e-Exercise intervention. Eight patients were recruited by 8 physical therapists. Of the 8 patients, 6 completed more than 7 of 12 modules. This study outlines the development and feasibility of a blended exercise therapy intervention for patients with knee and hip osteoarthritis. E-Exercise offers an alternative approach in the physical therapy treatment of knee and hip osteoarthritis. This study provides valuable information to conduct a further trial to evaluate the (cost) effectiveness of

  9. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis

    DEFF Research Database (Denmark)

    Wandel, Simon; Jüni, Peter; Tendal, Britta;

    2010-01-01

    visual analogue scale. DATA SOURCES: Electronic databases and conference proceedings from inception to June 2009, expert contact, relevant websites. Eligibility criteria for selecting studies Large scale randomised controlled trials in more than 200 patients with osteoarthritis of the knee or hip...... that compared glucosamine, chondroitin, or their combination with placebo or head to head. Results 10 trials in 3803 patients were included. On a 10 cm visual analogue scale the overall difference in pain intensity compared with placebo was -0.4 cm (95% credible interval -0.7 to -0.1 cm) for glucosamine, -0...

  10. Proximal femoral canal shape is more accurately assessed on AP hip radiographs than AP pelvis radiographs in primary hip osteoarthritis.

    Science.gov (United States)

    Merle, Christian; Waldstein, Wenzel; Gregory, Jennifer S; Goodyear, Simon R; Aspden, Richard M; Aldinger, Peter R; Murray, David W; Gill, Harinderjit S

    2013-01-01

    The objectives of the present study were to determine whether differences in the radiographic appearance of the of the proximal femoral canal exist on corresponding AP pelvis and AP hip radiographs, and whether radiographic assessment of canal shape is accurate with reference to computed tomography (CT). In a retrospective study, corresponding radiographs and CT scans of 100 consecutive patients with primary hip OA were evaluated. Active shape modelling (ASM) was performed to assess the variation in proximal femoral canal shape and to identify differences between AP hip and AP pelvis views. Differences in the medial cortical flare between radiographs and CT were quantified using least squares curve fitting. ASM identified significant differences in the assessment of canal shape on corresponding AP hip and AP pelvis views. Curve fitting demonstrated a good agreement between AP hip radiographs and CT. Agreement between AP pelvis radiographs and CT was less good. In contrast to AP pelvis radiographs, AP hip radiographs allow a more accurate and reliable assessment of proximal femoral canal shape in the frontal plane in primary hip OA. Our findings may improve stem fit in total hip arthroplasty without the routine use of CT.

  11. Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis – an interrater study

    DEFF Research Database (Denmark)

    Poulsen, Erik; Christensen, Henrik Wulff; Penny, Jeannette Østergaard

    2012-01-01

    .) with a standard two-arm goniometer and muscle strength in Newton (N) using a hand-held dynamometer. Reproducibility is reported as agreement and reliability between paired raters of the same profession. Agreement is reported as limits of agreement (LoA) and reliability is reported with intraclass correlation......ABSTRACT: BACKGROUND: Assessment of range of motion (ROM) and muscle strength is fundamental in the clinical diagnosis of hip osteoarthritis (OA) but reproducibility of these measurements has mostly involved clinicians from secondary care and has rarely reported agreement parameters. Therefore......, the primary objective of the study was to determine the inter-rater reproducibility of ROM and muscle strength measurements. Furthermore, the reliability of the overall assessment of clinical hip OA was evaluated. Reporting is in accordance with proposed guidelines for the reporting of reliability...

  12. Short- and long-term mortality following primary total hip replacement for osteoarthritis: a Danish nationwide epidemiological study

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Baron, J A; Overgaard, S

    2011-01-01

    -term mortality in subjects under 60 years old, and among THR patients without comorbidity. Long-term mortality was lower among THR patients than in controls (mortality rate ratio 0.7; 95% confidence interval 0.7 to 0.7). Overall, THR was associated with lower short- and long-term mortality among patients......We evaluated the short-term of 0 to 90 days and the longer term, up to 12.7 years, mortality for patients undergoing primary total hip replacement (THR) in Denmark in comparison to the general population. Through the Danish Hip Arthroplasty Registry we identified all primary THRs undertaken...... for osteoarthritis between 1 January 1995 and 31 December 2006. Each patient (n = 44 558) was matched at the time of surgery with three people from the general population (n = 133 674). We estimated mortality rates and mortality rate ratios with 95% confidence intervals for THR patients compared with the general...

  13. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty : design of a randomized controlled trial

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; Bos, Nanne; van Raaij, Jos J. A. M.

    2008-01-01

    Background: Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyet

  14. Differences in characteristics and patient-reported questionnaire responses in patients who choose non-surgical versus surgical treatment for severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Have, Mads; Overgaard, Søren; Jensen, Carsten

    Background: Preoperative patient characteristics may influence patient choice for participating in RCT’s. Purpose / Aim of Study: This study aimed to compare patient characteristics, level of pain, physical function and joint space width in patients with severe hip osteoarthritis (OA) who accepted...... or refused to participate in a RCT. Materials and Methods: In this prospective cohort study a total of 137 patients with primary hip OA were asked to choose between surgical or non- surgical treatment. We then compared the characteristics of each patient cohort (demographics, pain level and duration......, analgesic use, exercise habits), the radiographic hip OA state and their responses to Hip dysfunction and Osteoarthritis Outcome Score (HOOS, 0-100) and European Quality of Life Scale (EQ-5D-5L) questionnaires. Findings / Results: The between-group HOOS scores were significantly different in three out...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-15

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

  16. Comparative analysis of gene expression profiles of hip articular cartilage between non-traumatic necrosis and osteoarthritis.

    Science.gov (United States)

    Wang, Wenyu; Liu, Yang; Hao, Jingcan; Zheng, Shuyu; Wen, Yan; Xiao, Xiao; He, Awen; Fan, Qianrui; Zhang, Feng; Liu, Ruiyu

    2016-10-10

    Hip cartilage destruction is consistently observed in the non-traumatic osteonecrosis of femoral head (NOFH) and accelerates its bone necrosis. The molecular mechanism underlying the cartilage damage of NOFH remains elusive. In this study, we conducted a systematically comparative study of gene expression profiles between NOFH and osteoarthritis (OA). Hip articular cartilage specimens were collected from 12 NOFH patients and 12 controls with traumatic femoral neck fracture for microarray (n=4) and quantitative real-time PCR validation experiments (n=8). Gene expression profiling of articular cartilage was performed using Agilent Human 4×44K Microarray chip. The accuracy of microarray experiment was further validated by qRT-PCR. Gene expression results of OA hip cartilage were derived from previously published study. Significance Analysis of Microarrays (SAM) software was applied for identifying differently expressed genes. Gene ontology (GO) and pathway enrichment analysis were conducted by Gene Set Enrichment Analysis software and DAVID tool, respectively. Totally, 27 differently expressed genes were identified for NOFH. Comparing the gene expression profiles of NOFH cartilage and OA cartilage detected 8 common differently expressed genes, including COL5A1, OGN, ANGPTL4, CRIP1, NFIL3, METRNL, ID2 and STEAP1. GO comparative analysis identified 10 common significant GO terms, mainly implicated in apoptosis and development process. Pathway comparative analysis observed that ECM-receptor interaction pathway and focal adhesion pathway were enriched in the differently expressed genes of both NOFH and hip OA. In conclusion, we identified a set of differently expressed genes, GO and pathways for NOFH articular destruction, some of which were also involved in the hip OA. Our study results may help to reveal the pathogenetic similarities and differences of cartilage damage of NOFH and hip OA.

  17. Exercise for people with hip or knee osteoarthritis: a comparison of land-based and aquatic interventions

    Directory of Open Access Journals (Sweden)

    Ann E Rahmann

    2010-07-01

    Full Text Available Ann E RahmannDivision of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, AustraliaAbstract: Expert opinion considers the referral of people with osteoarthritis (OA for physiotherapy to be a core component of managing the functional disability and pain of the disease. Clinical guidelines for the physiotherapy management of people with OA focus on three main areas: exercise, pain relief, and specific manual therapy techniques. Land-based group and individual physiotherapy exercise programs, as well as manual therapy, have demonstrated a distinct benefit in favor of physiotherapy intervention. Similarly, both general and specific aquatic physiotherapy exercise programs have shown positive outcomes for people with OA. This review will focus primarily on therapeutic exercise to improve strength and fitness and reduce pain in people with hip or knee OA. An overview of the principles of hydrodynamics relevant to aquatic exercise is also included to facilitate an understanding of effective aquatic exercise programs. The issue of compliance with exercise programs will also be discussed. Clinicians will, therefore, gain an understanding of the benefits of land-based and aquatic exercise for people with OA.Keywords: exercise, physical therapy, aquatic therapy, hip and knee osteoarthritis, strength, pain, aerobic exercise

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

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

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

  19. Effect of physical therapy on pain and function in patients with hip osteoarthritis: a randomized clinical trial.

    Science.gov (United States)

    Bennell, Kim L; Egerton, Thorlene; Martin, Joel; Abbott, J Haxby; Metcalf, Ben; McManus, Fiona; Sims, Kevin; Pua, Yong-Hao; Wrigley, Tim V; Forbes, Andrew; Smith, Catherine; Harris, Anthony; Buchbinder, Rachelle

    2014-05-21

    There is limited evidence supporting use of physical therapy for hip osteoarthritis. To determine efficacy of physical therapy on pain and physical function in patients with hip osteoarthritis. Randomized, placebo-controlled, participant- and assessor-blinded trial involving 102 community volunteers with hip pain levels of 40 or higher on a visual analog scale of 100 mm (range, 0-100 mm; 100 indicates worst pain possible) and hip osteoarthritis confirmed by radiograph. Forty-nine patients in the active group and 53 in the sham group underwent 12 weeks of intervention and 24 weeks of follow-up (May 2010-February 2013) INTERVENTIONS: Participants attended 10 treatment sessions over 12 weeks. Active treatment included education and advice, manual therapy, home exercise, and gait aid if appropriate. Sham treatment included inactive ultrasound and inert gel. For 24 weeks after treatment, the active group continued unsupervised home exercise while the sham group self-applied gel 3 times weekly. Primary outcomes were average pain (0 mm, no pain; 100 mm, worst pain possible) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, 0 no difficulty to 68 extreme difficulty) at week 13. Secondary outcomes were these measures at week 36 and impairments, physical performance, global change, psychological status, and quality of life at weeks 13 and 36. Ninety-six patients (94%) completed week 13 measurements and 83 (81%) completed week 36 measurements. The between-group differences for improvements in pain were not significant. For the active group, the baseline mean (SD) visual analog scale score was 58.8 mm (13.3) and the week-13 score was 40.1 mm (24.6); for the sham group, the baseline score was 58.0 mm (11.6) and the week-13 score was 35.2 mm (21.4). The mean difference was 6.9 mm favoring sham treatment (95% CI, -3.9 to 17.7). The function scores were not significantly different between groups. The baseline mean (SD) physical function score

  20. Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres

    Directory of Open Access Journals (Sweden)

    Puhl Wofhart

    2009-02-01

    Full Text Available Abstract Background Total hip joint replacement (THR is a high volume, effective intervention for hip osteoarthritis (OA. However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. Methods A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC – Likert version 3.1. Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L grading and Osteoarthritis Research Society International (OARSI atlas features. Regression analyses were carried out. Results Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4% than men. Most (79% were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common. Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score; the mean total WOMAC score was 59.2 (SD 16.1. The radiographic severity showed no correlation with WOMAC scores. Significantly higher WOMAC scores (worse disease were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. Conclusion 1. Clinical disease severity

  1. Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres.

    Science.gov (United States)

    Dieppe, Paul; Judge, Andrew; Williams, Susan; Ikwueke, Ifeoma; Guenther, Klaus-Peter; Floeren, Markus; Huber, Joerg; Ingvarsson, Thorvaldur; Learmonth, Ian; Lohmander, L Stefan; Nilsdotter, Anna; Puhl, Wofhart; Rowley, David; Thieler, Robert; Dreinhoefer, Karsten

    2009-02-10

    Total hip joint replacement (THR) is a high volume, effective intervention for hip osteoarthritis (OA). However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC - Likert version 3.1). Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA) status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L) grading and Osteoarthritis Research Society International (OARSI) atlas features. Regression analyses were carried out. Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4%) than men. Most (79%) were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common.Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score); the mean total WOMAC score was 59.2 (SD 16.1). The radiographic severity showed no correlation with WOMAC scores.Significantly higher WOMAC scores (worse disease) were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. 1. Clinical disease severity varies widely at the time of THR for OA. 2. In advanced hip OA

  2. Recent patents and designs on hip replacement prostheses.

    Science.gov (United States)

    Derar, H; Shahinpoor, M

    2015-01-01

    Hip replacement surgery has gone through tremendous evolution since the first procedure in 1840. In the past five decades the advances that have been made in technology, advanced and smart materials innovations, surgical techniques, robotic surgery and methods of fixations and sterilization, facilitated hip implants that undergo multiple design revolutions seeking the least problematic implants and a longer survivorship. Hip surgery has become a solution for many in need of hip joint remedy and replacement across the globe. Nevertheless, there are still long-term problems that are essential to search and resolve to find the optimum implant. This paper reviews several recent patents on hip replacement surgery. The patents present various designs of prostheses, different materials as well as methods of fixation. Each of the patents presents a new design as a solution to different issues ranging from the longevity of the hip prostheses to discomfort and inconvenience experienced by patients in the long-term.

  3. Effectiveness of an interactive postgraduate educational intervention with patient participation on the adherence to a physiotherapy guideline for hip and knee osteoarthritis: a randomised controlled trial

    NARCIS (Netherlands)

    Peter, W.; Wees, P.J. van der; Verhoef, J.; Jong, Z. de; Bodegom-Vos, L. van; Hilberdink, W.K.; Fiocco, M.; Vlieland, T.P.

    2015-01-01

    PURPOSE: To determine the effectiveness of an interactive educational intervention on a physiotherapy guideline for hip and knee osteoarthritis. METHOD: Physiotherapists were randomly allocated to a 3-h interactive educational course with the collaboration of three patient partners or no interventio

  4. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: a cross-sectional study

    NARCIS (Netherlands)

    Smink, A.J.; Bierma-Zeinstra, S.M.; Dekker, J.; Vlieland, T.P.; Bijlsma, J.W.J.; Swierstra, B.A.; Kortland, J.H.; Voorn, T.B.; Ende, C.H.M. van den; Schers, H.J.

    2013-01-01

    BACKGROUND: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in

  5. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: A cross-sectional study

    NARCIS (Netherlands)

    E. Smink (Enna); S.M. Bierma-Zeinstra (Sita); J. Dekker (Joost); T.P.M.V. Vlieland (Thea P. M. Vliet); J.W.J. Bijlsma (Hans); B.A. Swierstra (Bart); J.H. Kortland (Joke); T.B. Voorn (Theo); C.H.M. van den Ende (C. H M); H.J. Schers (Henk)

    2013-01-01

    textabstractBackground: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of

  6. An Implementation Study of Two Evidence-Based Exercise and Health Education Programmes for Older Adults with Osteoarthritis of the Knee and Hip

    Science.gov (United States)

    de Jong, O. R. W.; Hopman-Rock, M.; Tak, E. C. M. P.; Klazinga, N. S.

    2004-01-01

    Implementation studies are recommended to assess the feasibility and effectiveness in real-life of programmes which have been tested in randomized controlled trials (RCTs). We report on an implementation study of two evidence-based exercise and health education programmes for older adults with osteoarthritis (OA) of the knee or hip. Three types of…

  7. Prognostic Factors for Sustained Work Participation in Early Osteoarthritis : A Follow-Up Study in the Cohort Hip and Cohort Knee (CHECK)

    NARCIS (Netherlands)

    Bieleman, Hendrik J.; Reneman, Michiel F.; Drossaers-Bakker, K. Wiepke; Groothoff, Johan W.; Oosterveld, Frits G. J.

    Objective To identify prognostic factors for the 2-year course of work participation in early osteoarthritis (OA) of hips or knees. Methods In this prospective cohort study, questionnaire data from 925 subjects was analyzed. Rate ratios were calculated to compare work participation with the general

  8. Hip Osteoarthritis: Genetics, epidemiological risk factors and burden of the disease

    NARCIS (Netherlands)

    M.C. Castaño Betancourt (Martha)

    2015-01-01

    markdownabstract__Abstract__ Osteoarthritis (OA) is the most common degenerative joint disease, characterized by progressive damage of the articular cartilage, osteophyte formation and alterations in the subchondral bone. OA is associated with an extremely high burden in terms of health

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

    Institute of Scientific and Technical Information of China (English)

    Wei YANG; Can-jun YANG‡; Ting XU

    2016-01-01

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

  10. The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis: Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment.

    Science.gov (United States)

    Rienstra, Wietske; Blikman, Tim; Mensink, Frans B; van Raay, Jos J A M; Dijkstra, Baukje; Bulstra, Sjoerd K; Stevens, Martin; van den Akker-Scheek, Inge

    2015-01-01

    There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to offer such patients education and additional treatment options besides conventional pain treatment. The painDETECT Questionnaire is a self-report questionnaire developed to discriminate between nociceptive and neuropathic pain. This questionnaire was modified to fit patients suffering from knee osteoarthritis. The aim of this study was to translate and cross-culturally adapt the modified painDETECT Questionnaire to the Dutch language and to provide a modified version to fit patients with hip osteoarthritis. Reliability for internal consistency, repeatability and floor and ceiling effects were subsequently assessed. A total of 278 patients were included in the reliability study and 123 patients in the repeatability analysis. The Dutch modified painDETECT Questionnaire shows good internal consistency and small relative measurement errors, represented by a good intraclass correlation coefficient. Absolute measurement error, represented by the Standard Error of Measurement, was acceptable. However, a measurement bias might be present when it comes to repeatability. To our knowledge, this study is the first to provide a Dutch modified painDETECT Questionnaire to fit hip and knee osteoarthritis patients and to assess internal consistency, reliability and agreement. International guidelines were followed in the translation process and this study has ample sample size with an adequate time interval for repeatability. Based on this study, the Dutch modified painDETECT Questionnaire seems to be fit as a discriminative tool to identify knee and hip osteoarthritis patients with a neuropathic pain profile. Whether it is also suitable as an evaluative tool to record changes over time

  11. The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis: Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment.

    Directory of Open Access Journals (Sweden)

    Wietske Rienstra

    Full Text Available There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to offer such patients education and additional treatment options besides conventional pain treatment. The painDETECT Questionnaire is a self-report questionnaire developed to discriminate between nociceptive and neuropathic pain. This questionnaire was modified to fit patients suffering from knee osteoarthritis. The aim of this study was to translate and cross-culturally adapt the modified painDETECT Questionnaire to the Dutch language and to provide a modified version to fit patients with hip osteoarthritis. Reliability for internal consistency, repeatability and floor and ceiling effects were subsequently assessed. A total of 278 patients were included in the reliability study and 123 patients in the repeatability analysis. The Dutch modified painDETECT Questionnaire shows good internal consistency and small relative measurement errors, represented by a good intraclass correlation coefficient. Absolute measurement error, represented by the Standard Error of Measurement, was acceptable. However, a measurement bias might be present when it comes to repeatability. To our knowledge, this study is the first to provide a Dutch modified painDETECT Questionnaire to fit hip and knee osteoarthritis patients and to assess internal consistency, reliability and agreement. International guidelines were followed in the translation process and this study has ample sample size with an adequate time interval for repeatability. Based on this study, the Dutch modified painDETECT Questionnaire seems to be fit as a discriminative tool to identify knee and hip osteoarthritis patients with a neuropathic pain profile. Whether it is also suitable as an evaluative tool to

  12. 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.

  13. The association of disability and pain with individual and community socioeconomic status in people with hip osteoarthritis.

    Science.gov (United States)

    Knight, Joshua B; Callahan, Leigh F; Luong, My-Linh N; Shreffler, Jack; Schoster, Britta; Renner, Jordan B; Jordan, Joanne M

    2011-01-01

    To examine associations between disability and socioeconomic status (SES) in persons with hip radiographic OA (rOA) or symptomatic OA (sxOA) in the Johnston County Osteoarthritis Project. Cross-sectional analyses were conducted on individuals with hip rOA (708) or sxOA (251). rOA was defined as Kellgren-Lawrence ≥ 2. Educational attainment (Disability was measured by the HAQ-DI and the WOMAC (function, pain, total). Covariates included age, gender, race, BMI, and presence of knee symptoms. Analyses examined associations of disability with each SES effect separately, followed by multivariable analyses using all SES variables, adjusting for covariates. In models with single SES variables adjusted for covariates, WOMAC scores were associated significantly (peducational attainment and non-managerial occupation in rOA and sxOA. HAQ was significantly associated with low educational attainment in rOA and sxOA and with high community poverty in rOA. In models including all SES variables, the patterns of association were similar although with diminished significance. There was indication that education was more strongly associated with HAQ and WOMAC function, while occupation was more strongly associated with WOMAC pain. Our data provide evidence that individual SES is an important factor to consider when examining disability and pain outcomes in older adults with hip OA.

  14. Hip Osteoarthritis in Dogs: A Randomized Study Using Mesenchymal Stem Cells from Adipose Tissue and Plasma Rich in Growth Factors

    Directory of Open Access Journals (Sweden)

    Belen Cuervo

    2014-07-01

    Full Text Available Purpose: The aim of this study was to compare the efficacy and safety of a single intra-articular injection of adipose mesenchymal stem cells (aMSCs versus plasma rich in growth factors (PRGF as a treatment for reducing symptoms in dogs with hip osteoarthritis (OA. Methods: This was a randomized, multicenter, blinded, parallel group. Thirty-nine dogs with symptomatic hip OA were assigned to one of the two groups, to receive aMSCs or PRGF. The primary outcome measures were pain and function subscales, including radiologic assessment, functional limitation and joint mobility. The secondary outcome measures were owners’ satisfaction questionnaire, rescue analgesic requirement and overall safety. Data was collected at baseline, then, 1, 3 and 6 months post-treatment. Results: OA degree did not vary within groups. Functional limitation, range of motion (ROM, owner’s and veterinary investigator visual analogue scale (VAS, and patient’s quality of life improved from the first month up to six months. The aMSCs group obtained better results at 6 months. There were no adverse effects during the study. Our findings show that aMSCs and PRGF are safe and effective in the functional analysis at 1, 3 and 6 months; provide a significant improvement, reducing dog’s pain, and improving physical function. With respect to basal levels for every parameter in patients with hip OA, aMSCs showed better results at 6 months.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  16. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  17. Can a disease-specific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Buchbinder Rachelle

    2006-11-01

    Full Text Available Abstract Background Patient education and self-management programs are offered in many countries to people with chronic conditions such as osteoarthritis (OA. The most well-known is the disease-specific Stanford Arthritis Self-Management Program (ASMP. While Australian and international clinical guidelines promote the concept of self-management for OA, there is currently little evidence to support the use of the ASMP. Several meta-analyses have reported that arthritis self-management programs had minimal or no effect on reducing pain and disability. However, previous studies have had methodological shortcomings including the use of outcome measures which do not accurately reflect program goals. Additionally, limited cost-effectiveness analyses have been undertaken and the cost-utility of the program has not been explored. Methods/design This study is a randomised controlled trial to determine the efficacy (in terms of Health-Related Quality of Life and self-management skills and cost-utility of a 6-week group-based Stanford ASMP for people with hip or knee OA. Six hundred participants referred to an orthopaedic surgeon or rheumatologist for hip or knee OA will be recruited from outpatient clinics at 2 public hospitals and community-based private practices within 2 private hospital settings in Victoria, Australia. Participants must be 18 years or over, fluent in English and able to attend ASMP sessions. Exclusion criteria include cognitive dysfunction, previous participation in self-management programs and placement on a waiting list for joint replacement surgery or scheduled joint replacement. Eligible, consenting participants will be randomised to an intervention group (who receive the ASMP and an arthritis self-management book or a control group (who receive the book only. Follow-up will be at 6 weeks, 3 months and 12 months using standardised self-report measures. The primary outcome is Health-Related Quality of Life at 12 months, measured

  18. Long-Term Effect of Exercise Therapy and Patient Education on Impairments and Activity Limitations in People With Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Svege, Ida; Fernandes, L.; Nordsletten, L

    2016-01-01

    Background. The effect of exercise on specific impairments and activity limitations in people with hip osteoarthritis (OA) is limited. Objective. The study objective was to evaluate the long-term effect of exercise therapy and patient education on range of motion (ROM), muscle strength, physical...... allocated to receive both exercise therapy and patient education (exercise group) or patient education only (control group). Intervention. All participants attended a patient education program consisting of 3 group meetings led by 2 physical therapists. Two other physical therapists were responsible...... results for ROM, muscle strength, physical fitness, and walking capacity, but exercise in addition to patient education resulted in less pain during walking in the long term. © 2016 American Physical Therapy Association....

  19. An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Rubak, Tine Steen; Svendsen, Susanne Wulff; Andersen, Johan Hviid;

    2014-01-01

    in population studies of the work-relatedness of hip and knee osteoarthritis. METHODS: Based on all 2227 occupational titles in the Danish version of the International Standard Classification of Occupations (D-ISCO 88), we constructed 121 job groups comprising occupational titles with expected homogeneous......BACKGROUND: When conducting large scale epidemiologic studies, it is a challenge to obtain quantitative exposure estimates, which do not rely on self-report where estimates may be influenced by symptoms and knowledge of disease status. In this study we developed a job exposure matrix (JEM) for use...... exposure patterns in addition to a minimally exposed job group, which was not included in the JEM. The job groups were allocated the mean value of five experts' ratings of daily duration (hours/day) of standing/walking, kneeling/squatting, and whole-body vibration as well as total load lifted (kg...

  20. Quantitative analysis of the muscle atrophy in osteoarthritis of the hip by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tajiri, Masahiro; Hieda, Hiroshi (Kurume Univ., Fukuoka (Japan). School of Medicine)

    1984-06-01

    Twenty normal hips and 30 cases of the unilateral osteoarthritic hips were examined by computed tomography in order to measure the atrophy of the muscles around the hip. We discussed the relationship among the muscle atrophy, stages of the osteoarthritic hip, and the clinical score of the JOA's criteria. The results were as follows: 1. There is no difference between the muscle volume of both sides in normal hips. 2. Atrophy of the gluteus maximus and the gluteus medius were already observed at the preosteoarthritic stage and the gluteus minimus, the tensor fasciae latae, iliopsoas revealed atrophy at the late stage. 3. There was a negative correlation between the percentage of atrophy of the gluteus maximus and the clinical score of the JOA's criteria. 4. In cases of normal position of the greater trochanter, artophy of the gluteus medius was more distinguished in cases of abductors of grade 4 by MMT than in those of normal grade.

  1. Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial: a pilot study

    Science.gov (United States)

    Kovács, Csaba; Bozsik, Ágnes; Pecze, Mariann; Borbély, Ildikó; Fogarasi, Andrea; Kovács, Lajos; Tefner, Ildikó Katalin; Bender, Tamás

    2016-11-01

    The effects of balneotherapy were evaluated in patients with osteoarthritis of the hip. This randomized, controlled, investigator-blinded study enrolled outpatients with hip osteoarthritis according to ACR criteria. In addition to home exercise therapy, one patient group received balneotherapy for 3 weeks on 15 occasions. The mineral water used in this study is one of the mineral waters with the highest sulfide ion content (13.2 mg/L) in Hungary. The control group received exercise therapy alone. The WOMAC Likert 3.1 index and the EQ-5D quality of life self-administered questionnaire were completed three times during the study: prior to first treatment, at the end of the 3-week treatment course, and 12 weeks later. The main endpoint was achievement of Minimal Clinically Important Improvement (MCII) at 12 weeks, defined as ≥7.9 points in a normalized WOMAC function score. The intention to treat analysis included 20 controls and 21 balneotherapy patients. At 12 weeks, 17 (81 %) balneotherapy group patients had Minimal Clinically Important Improvement and 6 (30 %) of controls ( p = 0.001). Comparing the results of the two groups at the end of treatment, there was a significant difference in the WOMAC stiffness score only, whereas after 12 weeks, the WOMAC pain, stiffness, function, and total scores also showed a significant difference in favor of the balneotherapy group. The difference between the two groups was significant after 12 weeks in point of EQVAS score, too. The results of our study suggest that the combination of balneotherapy and exercise therapy achieves more sustained improvement of joint function and decreases in pain than exercise therapy alone.

  2. A new classification for 'Pistol Grip Deformity'. Correlation between the severity of the deformity and the grade of osteoarthritis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Ipach, Ingmar; Mittag, F.; Sachsenmaier, S.; Kluba, T. [Tuebingen Univ. (Germany). Dept. of Orthopaedic Surgery; Heinrich, P. [Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany). Inst. fuer Medizinische Statistik und Epidemiologie

    2011-04-15

    Purpose: Two types of femoroacetabular impingement (FAI) are described as reasons for the early development of osteoarthritis of the hip. Cam impingement develops from contact between an abnormal head-neck junction and the acetabular rim. Pincer impingement is characterized by local or general overcoverage of the femoral head by the acetabular rim. Both forms might cause early osteoarthritis of the hip. A decreased head/neck offset has been recognized on AP pelvic views and labeled as 'pistol grip deformity'. The aim of the study was to develop a classification for this deformity with regard to the stage of osteoarthritis of the hip. Materials and Methods: 76 pelvic and axial views were analyzed for alpha angle and head ratio. 22 of them had a normal shape in the head-neck region and no osteoarthritis signs, 27 had a 'pistol grip deformity' and osteoarthritis I and 27 had a 'pistol grip deformity' and osteoarthritis II -IV . The CART method was used to develop a classification. Results: There was a statistically significant correlation between alpha angle and head ratio. A statistically significant difference in alpha angle and head ratio was seen between the three groups. Using the CART method, we developed a three-step classification system for the 'pistol grip deformity' with very high accuracy. This deformity was aggravated by increasing age. Conclusion: Using this model it is possible to differentiate between normal shapes of the head-neck junction and different severities of the pistol grip deformity. (orig.)

  3. Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis.

    Science.gov (United States)

    Ishidou, Yasuhiro; Matsuyama, Kanehiro; Sakuma, Daisuke; Setoguchi, Takao; Nagano, Satoshi; Kawamura, Ichiro; Maeda, Shingo; Komiya, Setsuro

    2017-12-01

    As elderly patients with hip osteoarthritis aged, acetabular dysplasia parameters decreased (Sharp's angle, acetabular roof obliquity angle, and acetabular head index) and the incidence of the atrophic type increased. Vertebral body fracture was more frequent in the atrophic type, suggesting the involvement of osteoporosis at the onset of hip osteoarthritis. Osteoarthritis (OA) is associated with increased bone formation at a local site. However, excessive bone resorption has also been found to occur in the early stages of OA. Osteoporosis may be involved in the onset of OA in elderly patients. We conducted a cross-sectional radiographic study of patients with hip OA and examined the association between age and factors of acetabular dysplasia (Sharp's angle, acetabular roof obliquity angle, and acetabular head index) as well as the osteoblastic response to determine the potential involvement of osteoporosis. This study included 366 patients (58 men, 308 women) who had undergone total hip arthroplasty for the diagnosis of hip OA. We measured the parameters of acetabular dysplasia using preoperative frontal X-ray images and evaluated each patient according to Bombelli classification of OA (hypertrophic, normotrophic, or atrophic type). As the patients aged, the parameters of acetabular dysplasia decreased. The incidence of the atrophic type of OA was significantly higher in older patients. Vertebral body fractures were more frequent in the atrophic type than in the other types. Additionally, the index of acetabular dysplasia was lower in the atrophic type. By contrast, the hypertrophic type was present in relatively younger patients and was associated with an increased index of acetabular dysplasia. In elderly patients with hip OA, the parameters of acetabular dysplasia decreased and the incidence of the atrophic type increased as the patients aged. The frequency of vertebral body fracture was high in patients with the atrophic type, suggesting the involvement of

  4. Randomised, controlled trial of avocado–soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study

    Science.gov (United States)

    Maheu, Emmanuel; Cadet, Christian; Marty, Marc; Moyse, Dominique; Kerloch, Isabelle; Coste, Philippe; Dougados, Maxime; Mazières, Bernard; Spector, Tim D; Halhol, Hafid; Grouin, Jean-Marie; Lequesne, Michel

    2014-01-01

    Objective To assess the ability of avocado–soybean unsaponifiable—Expanscience (ASU-E) to slow radiographic progression in symptomatic hip osteoarthritis (OA). Methods Prospective, randomised, double blind, parallel group, placebo controlled 3 year trial. Patients with symptomatic (painful ≥1 year, Lequesne Index between 3 and 10) hip OA (American College of Rheumatology criteria) and a minimum joint space width (JSW) of the target hip between 1 and 4 mm on a pelvic radiograph were randomly assigned to 300 mg/day ASU-E or placebo. Standing pelvis, target hip anteroposterior (AP) and oblique views were taken annually. The primary outcome was JSW change at year 3, measured at the narrowest point on pelvic or target hip AP view (manual measure using a 0.1 mm graduated magnifying glass). The full analysis dataset (FAS) included all patients having at least two successive radiographs. An analysis of covariance Mixed Model for Repeated Measurements with Missing at Random (for missing data) was performed to compare adjusted 3 year JSW changes (primary outcome) and the percentages of ‘progressors’ (JSW loss≥0.5 mm) between groups. Results 399 patients were randomised (345 kept in the FAS), aged 62 (35–84) years, 54% women, mean body mass index 27 (SD 4) kg/m2, mean symptom duration 4 (SD 5) years, 0–100 normalised Lequesne Index 30 (SD 9) and global pain visual analogue scale 37 (SD 23) mm. Mean baseline JSW was 2.8 (0.9) mm. There was no significant difference on mean JSW loss (−0.638 mm vs −0.672 mm, p=0.72, in the ASU-E and placebo groups, respectively) but there were 20% less progressors in the ASU-E than in the placebo group (40% vs 50%, respectively, p=0.040). No difference was observed on clinical outcomes. Safety was excellent. Conclusions 3 year treatment with ASU-E reduces the percentage of JSW progressors, indicating a potential structure modifying effect in hip OA to be confirmed, and the clinical relevance requires

  5. Patient information and emotional needs across the hip osteoarthritis continuum: a qualitative study

    NARCIS (Netherlands)

    Brembo, E.A.; Kapstad, H.; Eide, T.; Mansson, L.; Dulmen, S. van; Eide, H.

    2016-01-01

    BACKGROUND: Osteoarthritis (OA) is the most common form of arthritis worldwide, affecting a growing number of people in the ageing populations. Currently, it affects about 50 % of all people over 65 years of age. There are no disease-modifying treatments for OA; hence preference-sensitive treatment

  6. Patient information and emotional needs across the hip osteoarthritis continuum: a qualitative study.

    NARCIS (Netherlands)

    Brembo, E.A.; Kapstad, H.; Eide, T.; Mansson, L.; Dulmen, S. van; Eide, H.

    2016-01-01

    Background: Osteoarthritis (OA) is the most common form of arthritis worldwide, affecting a growing number of people in the ageing populations. Currently, it affects about 50 % of all people over 65 years of age. There are no disease-modifying treatments for OA; hence preference-sensitive treatment

  7. Hip Osteoarthritis: Genetics, epidemiological risk factors and burden of the disease

    NARCIS (Netherlands)

    M.C. Castaño Betancourt (Martha)

    2015-01-01

    markdownabstract__Abstract__ Osteoarthritis (OA) is the most common degenerative joint disease, characterized by progressive damage of the articular cartilage, osteophyte formation and alterations in the subchondral bone. OA is associated with an extremely high burden in terms of health and economi

  8. The Rise and Fall of the Hip: From Skeletal Development to Osteoarthritis

    NARCIS (Netherlands)

    R. Agricola (Rintje)

    2015-01-01

    markdownabstract__Abstract__ Osteoarthritis is a common disease and accounts for a detrimental impact on the quality of life. The etiology of the disease is largely unknown and hence its treatment is limited to pain management until the patient can undergo total joint replacement. In this thesis,

  9. Cumulative years in occupation and the risk of hip or knee osteoarthritis in men and women

    DEFF Research Database (Denmark)

    Andersen, Susan; Thygesen, Lau Caspar; Davidsen, Michael

    2012-01-01

    Occupational workload has been associated with an increased risk of osteoarthritis (OA), but only little research has been conducted among female workers. The objective of this study was to analyse if men and women in farming, construction or healthcare work have increased risk of developing OA...

  10. The Incidence of Primary Hip Osteoarthritis in Active Duty US Military Servicemembers

    Science.gov (United States)

    2009-04-15

    Goldie I, Hogstedt C. Sports and osteoarthrosis of the hip: an epidemiologic study. Am J Sports Med 1993;21:195–200. 42. Puranen J, Ala-Ketola L...physical activity and osteoarthrosis in ageing women. Public Health 1993;107:459–70. 46. Axmacher B, Lindberg H. Coxarthrosis in farmers. Clin Or- thop...Malchau H. Osteoarthrosis of the hip in women and its relation to physical load at work and in the home. Ann Rheum Dis 1997;56:293–8. Primary Hip OA Incidence in US Military Servicemembers 475

  11. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis

    DEFF Research Database (Denmark)

    Kroman, S L; Roos, Ewa M.; Bennell, K L;

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA).......To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA)....

  12. Cross-cultural validation of the ICOAP and physical function short forms of the HOOS and KOOS in a multi-country study of patients with hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Mehta, S P; Sankar, A; Venkataramanan, V;

    2016-01-01

    OBJECTIVE: To evaluate the internal consistency and construct validity of the Physical Function short-forms for the Hip and Knee Injury Osteoarthritis Outcome Scores (HOOS-PS/KOOS-PS) and the Intermittent and Constant Osteoarthritis Pain (ICOAP) in a nine country study of patients consulting for ...

  13. The Hip Impact Protection Project: design and methods.

    Science.gov (United States)

    Barton, Bruce A; Birge, Stanley J; Magaziner, Jay; Zimmerman, Sheryl; Ball, Linda; Brown, Kathleen M; Kiel, Douglas P

    2008-01-01

    Nearly 340,000 hip fractures occur each year in the U.S. With current demographic trends, the number of hip fractures is expected to double at least in the next 40 years. The Hip Impact Protection Project (HIP PRO) was designed to investigate the efficacy and safety of hip protectors in an elderly nursing home population. This paper describes the innovative clustered matched-pair research design used in HIP PRO to overcome the inherent limitations of clustered randomization. Three clinical centers recruited 37 nursing homes to participate in HIP PRO. They were randomized so that the participating residents in that home received hip protectors for either the right or left hip. Informed consent was obtained from either the resident or the resident's responsible party. The target sample size was 580 residents with replacement if they dropped out, had a hip fracture, or died. One of the advantages of the HIP PRO study design was that each resident was his/her own case and control, eliminating imbalances, and there was no confusion over which residents wore pads (or on which hip). Generalizability of the findings may be limited. Adherence was higher in this study than in other studies because of: (1) the use of a run-in period, (2) staff incentives, and (3) the frequency of adherence assessments. The use of a single pad is not analogous to pad use in the real world and may have caused unanticipated changes in behavior. Fall assessment was not feasible, limiting the ability to analyze fractures as a function of falls. Finally, hip protector designs continue to evolve so that the results generated using this pad may not be applicable to other pad designs. However, information about factors related to adherence will be useful for future studies. The clustered matched-pair study design avoided the major problem with previous cluster-randomized investigations of this question - unbalanced risk factors between the experimental group and the control group. Because each

  14. 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.

  15. Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

    Science.gov (United States)

    Carapeba, Gabriel O. L.; Cavaleti, Poliana; Brinholi, Rejane B.

    2016-01-01

    The purpose of this study was to compare the efficacy of the intra-articular (IA) hyaluronic acid injection to traditional conservative treatment (TCT) in dogs with osteoarthritis (OA) induced by hip dysplasia. Sixteen dogs were distributed into two groups: Hyal: IA injection of hyaluronic acid (5–10 mg), and Control: IA injection with saline solution (0.5–1.0 mL) in combination with a TCT using an oral nutraceutical (750–1000 mg every 12 h for 90 days) and carprofen (2.2 mg/kg every 12 h for 15 days). All dogs were assessed by a veterinarian on five occasions and the owner completed an assessment form (HCPI and CPBI) at the same time. The data were analyzed using unpaired t test, ANOVA, and Tukey's test (P < 0.05). Compared with baseline, lower scores were observed in both groups over the 90 days in the veterinarian evaluation, HCPI, and CPBI (P < 0.001). The Hyal group exhibited lower scores from 15 to 90 and 60 to 90 days, in the CBPI and in the veterinarian evaluation, respectively, compared to the Control group. Both treatments reduced the clinical signs associated with hip OA. However, more significant results were achieved with intra-articular hyaluronic acid injection. PMID:27847523

  16. Validity and internal consistency of a Hausa version of the Ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    Akinpelu Aderonke O

    2008-10-01

    Full Text Available Abstract Background The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM was developed for measuring end results of care in patients with knee or hip OA in Nigeria. The purpose of this study was to validate a Hausa translation of IKHOAM in order to promote its use among the Hausa populations of Nigeria and other West African countries. Methods Sixty-seven patients with knee OA, literate in Hausa and English, recruited consecutively from all government hospitals in Kano were assessed on both English and Hausa versions of IKHOAM. The order of assessment with the versions was randomized and separated by 24 hours. Participants also rated their pain intensity on the Visual Analogue Scale. Data was analyzed using the Spearman Rank Order correlation and Cronbach's alpha. Results The participants (17 males, 50 females were aged 55.7 ± 13.4 years. Participants' scores on the Hausa version correlated significantly with the original version (r = 0.67, p = 0.000 and with pain intensity scores on the Visual Analogue Scale (r = -0.24, p = 0.005. The Cronbach's alpha for correlation on the different parts of the Hausa version ranged between 0.28 and 0.95. Conclusion The Hausa version of IKHOAM meets the criteria for validity and internal consistency and may be used in the Hausa speaking parts of Nigeria and other West African countries.

  17. Philosophies of stem designs in cemented total hip replacement.

    NARCIS (Netherlands)

    Verdonschot, N.J.J.

    2005-01-01

    Stem designs, which have different design features, may produce similar clinical survival curves. Alteratively, some designs that are considered to be similar in design produce different survival rates. In this paper, design aspects of cemented femoral total hip replacement stems, how they can be gr

  18. The effect of glucosamine sulphate on osteoarthritis: design of a long-term randomised clinical trial [ISRCTN54513166

    Directory of Open Access Journals (Sweden)

    Ginai Abida Z

    2005-04-01

    Full Text Available Abstract Background Pharmacological treatment for osteoarthritis (OA can be divided into two groups: symptom-modifying drugs and disease-modifying drugs. Symptom-modifying drugs are currently the prescription of choice for patients with OA, as disease-modifying drugs are not yet available in usual care. However, there has recently been a lot of debate about glucosamine sulphate (GS, a biological agent that is thought to have both symptom-modifying and disease-modifying properties. This assumption has yet to be proved. The objective of this article is to present the design of a blind randomised clinical trial that examines the long-term symptom-modifying and disease-modifying effectiveness of GS in patients with hip OA. This trial is ongoing and will finish in March 2006. Methods/design Patients with hip OA meeting the ACR-criteria are randomly allocated to either 1500 mg of oral GS or placebo for the duration of two years. The primary outcome measures, which are joint space narrowing (JSN, and change in the pain and function score of the Western Ontario McMaster Universities Osteoarthritis index (WOMAC, are determined at baseline and after two years of follow-up during the final assessment. Intermediate measures at three-month intervals throughout the trial are used to study secondary outcome measures. Secondary outcome measures are changes in WOMAC stiffness score, quality of life, medical consumption, side effects and differences in biomarker CTX-II.

  19. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

    Science.gov (United States)

    Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

    2017-12-01

    A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P  0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

  20. Rose Hip Powder That Contains the Natural Amount of Shells and Seeds Alleviates Pain in Osteoarthritis of the Dominant Hand—A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Clinical Trial

    DEFF Research Database (Denmark)

    Winther, Kaj; Campbell-Tofte, Joan I A; Hansen, Peter

    2013-01-01

    Aim: A standardized preparation of seeds and shells of selected sub-species of Rosa canina L, trade name Hyben Vital, reduces discomfort from osteoarthritis of the knee and hip. This study aims to investigate the impact of the same rose-hip powder (RHP) on discomfort and the consumption of rescue...... medication, in patients with osteoarthritis of the hand. Methods: The double blind, placebo-controlled, crossover trial included 30 patients with osteoarthritis of the dominant hand. Patients were randomly allocated to treatment with either five gram encapsulated RHP or placebo, for three months (Phase 1...

  1. Identification of cut-points in commonly used hip osteoarthritis-related outcome measures that define the patient acceptable symptom state (PASS).

    Science.gov (United States)

    Emerson Kavchak, Alicia J; Cook, Chad; Hegedus, Eric J; Wright, Alexis A

    2013-11-01

    To determine patient acceptable symptom state (PASS) estimates in outcome measures commonly used in hip osteoarthritis (OA). Identification of cut-points on commonly used outcome measures associated with patient satisfaction with their current state of health. As part of a randomized controlled trial, 70 patients with a clinical diagnosis of hip OA undergoing a 9-session physiotherapy treatment program completed four physical performance measures and three self-report measures at 9 weeks and 1 year. Upon completion of treatment, patients assessed their current health status according to the PASS question. Cut-points were estimated using receiver operating characteristic curves (anchor-based method), based on the patient's response to the PASS question. At 9 weeks and 1 year, identified cut-points were, respectively, ≤10 and ≤11 for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale; ≤35 and ≤40 on the WOMAC physical function subscale; ≥+5 and ≥+6 on the global rating of change score; ≤6.05 and ≤5.30 s for the timed-up-and-go; ≤28.3 and ≤24.9 for the 40-m self-paced walk test; ≥11 and ≥12 repetitions for the 30-s chair stand test; and ≥46 repetitions for the 20-cm step test. Initial target cut-points signaling patient satisfaction with their current symptom state following physiotherapy in patients with hip osteoarthritis were determined for seven outcome measures over 1 year.

  2. The association between symptoms, pain coping strategies, and physical activity among people with symptomatic knee and hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    Susan L Murphy

    2012-09-01

    Full Text Available Effective use of coping strategies by people with chronic pain conditions is associated with better functioning and adjustment to chronic disease. Although the effects of coping on pain have been well studied, less is known about how specific coping strategies relate to actual physical activity patterns in daily life. The purpose of this study was to evaluate how different coping strategies relate to symptoms and physical activity patterns in a sample of adults with knee and hip osteoarthritis (N = 44. Physical activity was assessed by wrist-worn accelerometry; coping strategy use was assessed by the Chronic Pain Coping Inventory. We hypothesized that the use of coping strategies that reflect approach behaviors (e.g., Task Persistence, would be associated with higher average levels of physical activity, whereas avoidance coping behaviors (e.g., Resting, Asking for Assistance, Guarding and Pacing would be associated with lower average levels of physical activity. We also evaluated whether coping strategies moderated the association between momentary symptoms (pain and fatigue and activity. We hypothesized that higher levels of approach coping would be associated with a weaker association between symptoms and activity compared to lower levels of this type of coping. Multilevel modeling was used to analyze the momentary association between coping and physical activity. We found that higher body mass index, fatigue, and the use of Guarding were significantly related to lower activity levels, whereas Asking for Assistance was significantly related to higher activity levels. Only Resting moderated the association between pain and activity. Guarding, Resting, Task Persistence, and Pacing moderated the association between fatigue and activity. This study provides an initial understanding of how people with osteoarthritis cope with symptoms as they engage in daily life activities using ecological momentary assessment and objective physical activity

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  4. Manual therapy in osteoarthritis of the hip: outcome in subgroups of patients

    NARCIS (Netherlands)

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

    2005-01-01

    OBJECTIVE: To investigate whether manual therapy has particular benefit in subgroups of patients defined on the basis of hip function, range of joint motion, pain and radiological deterioration. METHODS: The study was performed in the out-patient clinic of physical therapy of a large hospital. Data

  5. Manual therapy in osteoarthritis of the hip: outcome in specific subgroups of patients.

    NARCIS (Netherlands)

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

    2005-01-01

    OBJECTIVE: To investigate whether manual therapy has particular benefit in subgroups of patients defined on the basis of hip function, range of joint motion, pain and radiological deterioration. METHODS: The study was performed in the out-patient clinic of physical therapy of a large hospital. Data

  6. Manual therapy in osteoarthritis of the hip: outcome in subgroups of patients

    NARCIS (Netherlands)

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

    2005-01-01

    OBJECTIVE: To investigate whether manual therapy has particular benefit in subgroups of patients defined on the basis of hip function, range of joint motion, pain and radiological deterioration. METHODS: The study was performed in the out-patient clinic of physical therapy of a large hospital. Data

  7. Manual therapy in osteoarthritis of the hip: outcome in specific subgroups of patients.

    NARCIS (Netherlands)

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

    2005-01-01

    OBJECTIVE: To investigate whether manual therapy has particular benefit in subgroups of patients defined on the basis of hip function, range of joint motion, pain and radiological deterioration. METHODS: The study was performed in the out-patient clinic of physical therapy of a large hospital. Data

  8. Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series

    Science.gov (United States)

    Hando, Ben R; Gill, Norman W; Walker, Michael J; Garber, Mathew

    2012-01-01

    Objectives: Describe short- and long-term outcomes observed in individuals with hip osteoarthritis (OA) treated with a pre-selected, standardized set of best-evidence manual therapy and therapeutic exercise interventions. Methods: Fifteen consecutive subjects (9 males, 6 females; mean age: 52±7.5 years) with unilateral hip OA received an identical protocol of manual therapy and therapeutic exercise interventions. Subjects attended 10 treatment sessions over an 8-week period for manual therapy interventions and performed the therapeutic exercise as a home program. Results: Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60.3(±10.4) to 80.7(±10.5), Numerical Pain Rating Scale (NPRS) scores improved from 4.3(±1.9) to 2.0(±1.9), hip flexion range of motion (ROM) improved from 99 degrees (±10.6) to 127 degrees (±6.3) and hip internal rotation ROM improved from 19 degrees (±9.1) to 31 degrees (±11.5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (Ptherapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches. Discussion: PMID:24179327

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

    Science.gov (United States)

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

    2012-11-21

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

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

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2012-11-01

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

  11. Identifying compositional and structural changes in spongy and subchondral bone from the hip joints of patients with osteoarthritis using Raman spectroscopy

    Science.gov (United States)

    Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Mirosław; Siatkowski, Marcin; Krauss, Hanna

    2012-01-01

    Raman microspectroscopy was used to examine the biochemical composition and molecular structure of extracellular matrix in spongy and subchondral bone collected from patients with clinical and radiological evidence of idiopathic osteoarthritis of the hip and from patients who underwent a femoral neck fracture, as a result of trauma, without previous clinical and radiological evidence of osteoarthritis. The objectives of the study were to determine the levels of mineralization, carbonate accumulation and collagen quality in bone tissue. The subchondral bone from osteoarthritis patients in comparison with control subject is less mineralized due to a decrease in the hydroxyapatite concentration. However, the extent of carbonate accumulation in the apatite crystal lattice increases, most likely due to deficient mineralization. The alpha helix to random coil band area ratio reveals that collagen matrix in subchondral bone is more ordered in osteoarthritis disease. The hydroxyapatite to collagen, carbonate apatite to hydroxyapatite and alpha helix to random coil band area ratios are not significantly changed in the differently loaded sites of femoral head. The significant differences also are not visible in mineral and organic constituents' content in spongy bone beneath the subchondral bone in osteoarthritis disease.

  12. In hip osteoarthritis, Nordic Walking is superior to strength training and home-based exercise for improving function.

    Science.gov (United States)

    Bieler, T; Siersma, V; Magnusson, S P; Kjaer, M; Christensen, H E; Beyer, N

    2017-08-01

    This observer-blinded, randomized controlled trial compared the short- and long-term effects of 4 months of supervised strength training (ST) in a local fitness center, supervised Nordic Walking (NW) in a local park, and unsupervised home-based exercise (HBE, control) on functional performance in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self-efficacy, and health-related quality of life) were measured at baseline and at 2, 4, and 12 months. Based on intention-to-treat-analyses improvements [mean (95% CI)] after intervention in number of chair stands were equal in all three groups at 4 months [ST: 0.9 (0.2-1.6), NW: 1.9 (0.8-3.0), HBE: 1.1 (0.1-2.0)] but greater in the NW group [1.4 (0.02-2.8)] than in the ST group at 12 months. Generally, improvements in functional performance were greater (P superior (P < 0.01) to HBE for improving vigorous physical activity and to both ST and HBE for improving (P < 0.01) mental health. These data suggest that NW is the recommended exercise modality compared with ST and HBE. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Building the rationale and structure for a complex physical therapy intervention within the context of a clinical trial: a multimodal individualized treatment for patients with hip osteoarthritis.

    Science.gov (United States)

    Bennell, Kim L; Egerton, Thorlene; Pua, Yong-Hao; Abbott, J Haxby; Sims, Kevin; Buchbinder, Rachelle

    2011-10-01

    Evaluating the efficacy of complex interventions such as multimodal, impairment-based physical therapy treatments in randomized controlled trials is essential to inform practice and compare relative benefits of available treatment options. Studies of physical therapy interventions using highly standardized intervention protocols, although methodologically rigorous, do not necessarily reflect "real-world" clinical practice, and in many cases results have been disappointing. Development of a complex intervention that includes multiple treatment modalities and individualized treatment technique selection requires a systematic approach to designing all aspects of the intervention based on theory, evidence, and practical constraints. This perspective article outlines the development of the rationale and structure of a multimodal physical therapy program for painful hip osteoarthritis to be assessed in a clinical trial. The resulting intervention protocol comprises a semi-structured program of exercises and manual therapy, advice, physical activity, and optional prescription of a gait aid that is standardized, yet can be individualized according to physical assessment and radiographic findings. The program is evidence based and reflects contemporary physical therapist practice, while also being reproducible and reportable. This perspective article aims to encourage physical therapy researchers involved in evaluation of complex interventions to better document their own intervention development, as well as the outcomes, thus generating a body of knowledge about the development processes and protocols that is generalizable to the real-world complexity of providing physical therapy to individual patients.

  14. Fatigue in knee and hip osteoarthritis: the role of pain and physical function.

    Science.gov (United States)

    Snijders, Gijs F; van den Ende, Cornelia H M; Fransen, Jaap; van Riel, Piet L C M; Stukstette, Mirelle J P M; Defoort, Koen C; Arts-Sanders, Marianne A; van den Hoogen, Frank H J; den Broeder, Alfons A

    2011-10-01

    It is suggested that serious levels of fatigue are present in nearly half of patients with OA. However, it is unclear which dimensions of fatigue are involved, if fatigue is related to pain and physical function, and if fatigue is influenced by therapy. The aims of this study were to measure levels of different dimensions of fatigue before and after evidenced-based conservative treatment and to investigate the association between fatigue and pain and physical function in patients with knee or hip OA. In this observational cohort study, levels of different dimensions of fatigue were measured in knee and/or hip OA patients before and after 12 weeks of conservative treatment. Cross-sectional and longitudinal relations between (change in) fatigue dimensions and (change in) pain or physical function were studied using association models, controlling for predefined possible confounders. A total of 231 patients was included, with 47% experiencing severe fatigue. A small decrease in levels of fatigue was seen after standardized treatment. The level of fatigue severity was cross-sectionally and longitudinally associated with physical function, whereas the level of physical fatigue was cross-sectionally and longitudinally associated with pain and physical function. No confounders were identified. Important levels of fatigue are common in knee and hip OA patients. After evidence-based tailored conservative treatment targeted to improve pain and physical function, a small decrease in fatigue levels was found. Reduction in levels of different fatigue dimensions were related to the change in physical function and pain.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-12-15

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

  16. Exercise for people with hip or knee osteoarthritis: a comparison of land-based and aquatic interventions.

    Science.gov (United States)

    Rahmann, Ann E

    2010-07-23

    Expert opinion considers the referral of people with osteoarthritis (OA) for physiotherapy to be a core component of managing the functional disability and pain of the disease. Clinical guidelines for the physiotherapy management of people with OA focus on three main areas: exercise, pain relief, and specific manual therapy techniques. Land-based group and individual physiotherapy exercise programs, as well as manual therapy, have demonstrated a distinct benefit in favor of physiotherapy intervention. Similarly, both general and specific aquatic physiotherapy exercise programs have shown positive outcomes for people with OA. This review will focus primarily on therapeutic exercise to improve strength and fitness and reduce pain in people with hip or knee OA. An overview of the principles of hydrodynamics relevant to aquatic exercise is also included to facilitate an understanding of effective aquatic exercise programs. The issue of compliance with exercise programs will also be discussed. Clinicians will, therefore, gain an understanding of the benefits of land-based and aquatic exercise for people with OA.

  17. Using hierarchical linear modeling to explore predictors of pain after total hip and knee arthroplasty as a consequence of osteoarthritis.

    Science.gov (United States)

    Halket, Ashley; Stratford, Paul W; Kennedy, Deborah M; Woodhouse, Linda J

    2010-02-01

    Hierarchical linear modeling was used to establish differences in, and the average pattern of, recovery of the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 2 composite performance-specific measures of pain as well as to determine if significant individual variations exist in the growth curves for each measure. Predictors of postoperative pain were also of interest. One hundred forty-seven patients undergoing unilateral primary hip or knee arthroplasty completed 4 performance measures-self-paced 40-m walk, timed up and go, stair test, and 6-minute walk-and the WOMAC prearthroplasty and at multiple points in time between 2 and 27 weeks postarthroplasty. Although patients reported different levels of postoperative pain initially, similar recovery patterns were noted. Predictive variables were found to be site of joint arthroplasty and WOMAC prearthroplasty pain scores for the WOMAC pain subscale, the site of joint arthroplasty and sex for the first composite pain score, and sex for the second composite. 2010 Elsevier Inc. All rights reserved.

  18. Exercise for people with hip or knee osteoarthritis: a comparison of land-based and aquatic interventions

    Science.gov (United States)

    Rahmann, Ann E

    2010-01-01

    Expert opinion considers the referral of people with osteoarthritis (OA) for physiotherapy to be a core component of managing the functional disability and pain of the disease. Clinical guidelines for the physiotherapy management of people with OA focus on three main areas: exercise, pain relief, and specific manual therapy techniques. Land-based group and individual physiotherapy exercise programs, as well as manual therapy, have demonstrated a distinct benefit in favor of physiotherapy intervention. Similarly, both general and specific aquatic physiotherapy exercise programs have shown positive outcomes for people with OA. This review will focus primarily on therapeutic exercise to improve strength and fitness and reduce pain in people with hip or knee OA. An overview of the principles of hydrodynamics relevant to aquatic exercise is also included to facilitate an understanding of effective aquatic exercise programs. The issue of compliance with exercise programs will also be discussed. Clinicians will, therefore, gain an understanding of the benefits of land-based and aquatic exercise for people with OA. PMID:24198550

  19. Total hip replacement in treatment of hip dysplasia and osteoarthritis%全髋关节置换术治疗髋关节发育不良并骨性关节炎

    Institute of Scientific and Technical Information of China (English)

    龚春柱; 张卫红; 赫明堂

    2013-01-01

    Objective To investigate clinical effect of total hip arthroplasty( THA ) in treatment of hip dysplasia and osteoarthritis. Methods 19 patients ( 22 hips ) with hip dysplasia and osteoarthritis were treated by THA, The operation time, bleeding volume, the function of hip joint was analyzed and deformity correction. Results The operative time was 60 ~ 110( 85. 2 ± 11. 8 )min, the blood loss 300 ~ 1 200( 650. 3 ± 157. 7 )ml, Harris hip score improved from preoperative average of 47. 65 ±7. 85 points to 86. 54 ±6. 30 points. Shortening limbs were extended 1.5 ~4. 0 cm. 19 cases received follow-up 14 ~ 42 months, Follow-up imaging showed position of the prosthesis was normal; Joint activity was satisfied. 2 patients were still left slightly limp. Conclusions THA for hip dysplasia and osteoarthritis can significantly improve hip function, correct the deformity, and the short term effect is satisfactory.%目的 探讨全髋关节置换技术治疗髋关节发育不良并骨性关节炎的临床效果.方法 对19例(22髋)髋关节发育不良并骨性关节炎患者进行全髋关节置换术.对手术时间、术中出血量、髋关节功能及畸形矫正情况进行分析.结果 手术时间60~110(85.2±11.8)min,术中出血量300~1 200(650.3±157.7)ml.髋关节Harris评分由术前平均47.65±7.85分提高至86.54±6.30分.短缩肢体延长1.5~4.0 cm.19例均获随访,时间14~42个月,随访期内影像学显示假体位置正常;关节活动度满意.2例患者仍遗留轻度跛行.结论 全髋关节置换技术治疗髋关节发育不良并骨性关节炎能显著改善髋关节功能,纠正髋关节畸形,近期疗效满意.

  20. Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study.

    Science.gov (United States)

    Barten, Di-Janne J A; Swinkels, Llse C S; Dorsman, Sara A; Dekker, Joost; Veenhof, Cindy; de Bakker, Dinny H

    2015-06-27

    A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as well as the sequence of care. Furthermore, there is a lack of clarity regarding the role of different health care providers in the performance of OA care according to the SCS. Therefore, the main purpose of this study is to describe the content of primary care in patients with hip/knee OA, including the compliance to the SCS and taking into account the introduction of patient self-referral to physical therapy. Data were used from NIVEL Primary Care Database. In total, 12.118 patients with hip/knee OA who visited their GP or physical therapist were selected. Descriptive statistics were used to compare the content of care in GP-referred and self-referred patients to physical therapy. Content of care performed by GPs mostly concerned consultations, followed by NSAID prescriptions and referrals to secondary care. Both prescriptions of acetaminophen and referrals to physical therapy respectively dietary therapy were rarely mentioned. Nevertheless, still 65% of the patients in physical therapy practice were referred by their GP. Compared to GP-referred patients, self-referred patients more often presented recurrent complaints and were treated less often by activity-related exercise therapy. Education was rarely registered as singular intervention, neither in GP-referred nor in self-referred patients. In accordance with the SCS, less advanced interventions are more often applied than more advanced interventions. To optimize the adherence to the SCS, GPs could reconsider the frequent use of NSAIDs instead of analgesics and the low referral rate to allied health care. Self-referral to physical therapy partially distorts both the low referral rate in general practice and the low application

  1. Hip Replacement

    Science.gov (United States)

    ... The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven't helped, hip ...

  2. 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

    Score Physical function Short-form, 0-100). Analyses: Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR. RESULTS......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...

  3. The diagnostic performance of radiography for detection of osteoarthritis-associated features compared with MRI in hip joints with chronic pain

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Li [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Beijing Jishuitan Hospital, Department of Radiology, Beijing (China); Hayashi, Daichi; Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Hunter, David J. [University of Sydney, Department of Medicine, Sydney (Australia); Li, Ling [New England Baptist Hospital, Division of Research, Boston, MA (United States); Winterstein, Anton; Bohndorf, Klaus [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Klinikum Augsburg, Department of Radiology, Augsburg (Germany); University of Erlangen, Department of Radiology, Erlangen (Germany)

    2013-10-15

    To evaluate the diagnostic performance of radiography for the detection of MRI-detected osteoarthritis-associated features in various articular subregions of the hip joint. Forty-four patients with chronic hip pain (mean age, 63.3 {+-} 9.5 years), who were part of the Hip Osteoarthritis MRI Scoring (HOAMS) cohort, underwent both weight-bearing anteroposterior pelvic radiography and 1.5 T MRI. The HOAMS study was a prospective observational study involving 52 subjects, conducted to develop a semiquantitative MRI scoring system for hip osteoarthritis features. In the present study, eight subjects were excluded because of a lack of radiographic assessment. On radiography, the presence of superior and medial joint space narrowing, superior and inferior acetabular/femoral osteophytes, acetabular subchondral cysts, and bone attrition of femoral head was noted. On MRI, cartilage, osteophytes, subchondral cysts, and bone attrition were evaluated in the corresponding locations. Diagnostic performance of radiography was compared with that of MRI, and the area under curve (AUC) was calculated for each pathological feature. Compared with MRI, radiography provided high specificity (0.76-0.90) but variable sensitivity (0.44-0.78) for diffuse cartilage damage (using JSN as an indirect marker), femoral osteophytes, acetabular subchondral cysts and bone attrition of the femoral head, and a low specificity (0.42 and 0.58) for acetabular osteophytes. The AUC of radiography for detecting overall diffuse cartilage damage, marginal osteophytes, subchondral cysts and bone attrition was 0.76, 0.78, 0.67, and 0.82, respectively. Diagnostic performance of radiography is good for bone attrition, fair for marginal osteophytes and cartilage damage, but poor for subchondral cysts. (orig.)

  4. Planetary Suit Hip Bearing Model for Predicting Design vs. Performance

    Science.gov (United States)

    Cowley, Matthew S.; Margerum, Sarah; Harvil, Lauren; Rajulu, Sudhakar

    2011-01-01

    Designing a planetary suit is very complex and often requires difficult trade-offs between performance, cost, mass, and system complexity. In order to verifying that new suit designs meet requirements, full prototypes must eventually be built and tested with human subjects. Using computer models early in the design phase of new hardware development can be advantageous, allowing virtual prototyping to take place. Having easily modifiable models of the suit hard sections may reduce the time it takes to make changes to the hardware designs and then to understand their impact on suit and human performance. A virtual design environment gives designers the ability to think outside the box and exhaust design possibilities before building and testing physical prototypes with human subjects. Reductions in prototyping and testing may eventually reduce development costs. This study is an attempt to develop computer models of the hard components of the suit with known physical characteristics, supplemented with human subject performance data. Objectives: The primary objective was to develop an articulating solid model of the Mark III hip bearings to be used for evaluating suit design performance of the hip joint. Methods: Solid models of a planetary prototype (Mark III) suit s hip bearings and brief section were reverse-engineered from the prototype. The performance of the models was then compared by evaluating the mobility performance differences between the nominal hardware configuration and hardware modifications. This was accomplished by gathering data from specific suited tasks. Subjects performed maximum flexion and abduction tasks while in a nominal suit bearing configuration and in three off-nominal configurations. Performance data for the hip were recorded using state-of-the-art motion capture technology. Results: The results demonstrate that solid models of planetary suit hard segments for use as a performance design tool is feasible. From a general trend perspective

  5. Total hip replacement rate in a cohort of patients affected by symptomatic hip osteoarthritis following intra-articular sodium hyaluronate (MW 1,500-2,000 kDa) ORTOBRIX study.

    Science.gov (United States)

    Migliore, Alberto; Bella, Antonino; Bisignani, Massimariano; Calderaro, Michele; De Amicis, Daniele; Logroscino, Giandomenico; Mariottini, Fabio; Moreschini, Oreste; Massafra, Umberto; Bizzi, Emanuele; Laganà, Bruno; Piscitelli, Prisco; Tormenta, Sandro

    2012-08-01

    Hip osteoarthritis is very common and costly. The European League Against Rheumatology Committee agenda asks for research to investigate treatments able to slow down the progression of hip osteoarthritis (OA), to delay joint replacement, and to determine the comparative effectiveness and cost-effectiveness of non-surgical and surgical treatment modalities as well as criteria relating to the indications for and timing of total hip replacement (THR). After publishing the results of a randomized controlled trial and a cohort study on the efficacy of Intra-articular sodium hyaluronate (MW 1,500-2,000 kDa) on symptomatic hip OA, we performed this retrospective study in patients suffering from hip OA treated with ultrasound-guided intra-articular injections of HyalOne (Hyalubrix 60 Italian brand name) involving a group of THR expert orthopedic surgeons to appraise whether or not considered eligible for THR and the frequency and timing of THR. Six orthopedists, not routinely performing hip intra-articular injections, each independently assessed whether 176 patients suffering from hip OA and treated with ultrasound-guided intra-articular injections of sodium hyaluronate (MW 1,500-2,000 kDa) were candidates for THR according to the clinical data (age, body mass index, Pain Visual Analog Scale, Lequesne Algofunctional Index, global patient assessment, global physician assessment, nonsteroidal anti-inflammatory drug intake, and hip X-ray) collected at the first intra-articular sodium hyaluronate injection visit and provided as anonymous electronic data. At 24 months, 159 out of 76 (90 %) patients did not undergo to THR. At 48 months, 82 % (N = 144) of the study population treated with intra-articular hyaluronic acid avoided THR. In the group of 93 patients considered candidates for THR (that is, in which 4, 5, or 6 orthopedic surgeons agreed that the patient was a suitable candidate for THR), only 17 had undergone THR, with survival results of 82 % at 24 months. At 48 months

  6. Understanding total hip replacement recovery towards the design of a context-aware system

    NARCIS (Netherlands)

    Jimenez Garcia, Juan

    2011-01-01

    Total Hip Replacement (THR) is a common procedure to improve the mobility of elderly with osteoarthritis. Presently information about the recovery process after discharge is unclear. As consequence patients and physiotherapists face uncertainties to follow an adequate trajectory for recovery. Curren

  7. Risk of severe knee and hip osteoarthritis in relation to level of physical exercise: a prospective cohort study of long-distance skiers in Sweden.

    Directory of Open Access Journals (Sweden)

    Karl Michaëlsson

    Full Text Available BACKGROUND: To complete long-distance ski races, regular physical exercise is required. This includes not only cross-country skiing but also endurance exercise during the snow-free seasons. The aim of this study was to determine whether the level of physical exercise is associated with future risk of severe osteoarthritis independent of previous diseases and injuries. METHODOLOGY/PRINCIPAL FINDINGS: We used a cohort that consisted of 48 574 men and 5 409 women who participated in the 90 km ski race Vasaloppet at least once between 1989 and 1998. Number of performed races and finishing time were used as estimates of exercise level. By matching to the National Patient Register we identified participants with severe osteoarthritis, defined as arthroplasty of knee or hip due to osteoarthritis. With an average follow-up of 10 years, we identified 528 men and 42 women with incident osteoarthritis. The crude rate was 1.1/1000 person-years for men and 0.8/1000 person-years for women. Compared with racing once, participation in ≥ 5 races was associated with a 70% higher rate of osteoarthritis (multivariable-adjusted hazard ratio (HR 1.72, 95% confidence interval (CI 1.33 to 2.22. The association was dose-dependent with an adjusted HR of 1.09, 95% CI 1.05 to 1.13 for each completed race. A faster finishing time, in comparison with a slow finishing time, was also associated with an increased rate (adjusted HR 1.51, 95% CI 1.14 to 2.01. Contrasting those with 5 or more ski races and a fast finish time to those who only participated once with a slow finish time, the adjusted HR of osteoarthritis was 2.73, 95% CI 1.78 to 4.18. CONCLUSIONS/SIGNIFICANCE: Participants with multiple and fast races have an increased risk of subsequent arthroplasty of knee and hip due to osteoarthritis, suggesting that intensive exercise may increase the risk.

  8. Slide track analysis of eight contemporary hip simulator designs.

    Science.gov (United States)

    Calonius, Olof; Saikko, Vesa

    2002-11-01

    In an earlier paper, the authors presented a new method of computation of slide tracks in the relative motion between femoral head and acetabular cup of total hip prostheses. For the first time, computed tracks were verified experimentally and with an alternative method of computation. Besides being an efficient way to illustrate hip kinematics, the shapes of the slide tracks are known to be of fundamental importance regarding the wear behaviour of prostheses. The verified method was now applied to eight contemporary hip simulator designs. The use of correct motion waveforms and an Euler sequence of rotations in each case was again found to be essential. Considerable differences were found between the simulators. For instance, the shapes of the tracks drawn by the resultant contact force included a circle, ellipse, irregular oval, leaf, twig, and straight line. Computation of tracks correctly for the most widely used hip simulator, known as biaxial, was made possible by the insight that the device is actually three-axial. Slide track patterns have now been computed for virtually all contemporary hip simulators, and both for the heads and for the cups. This comparative analysis forms a valuable basis for studies on the relationship between the type of multidirectional motion and wear. These studies can produce useful information for the design of joint simulators, and improve the understanding of wear phenomena in prosthetic joints.

  9. 全髋关节置换术治疗27例髋关节发育不良合并骨性关节炎%Total Hip Arthroplasty for 27 Cases with Hip Dysplasia and Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    罗育润

    2014-01-01

    Objective To explore the clinical effect of total hip arthroplasty on 27 cases with hip dysplasia and osteoarthritis. Methods 27 patients (33 hips) with hip dysplasia and osteoarthritis admitted in our hospital including 9 patients with Crowe type IV (12 hips), 12 patients with Crowe type Ⅲ (15 hips), 6 patients with Crowe typeⅡ(6 hips), were given total hip arthroplasty. The surgery time, hip function and corrective recovery were counted and analyzed; all the patients were followed for 3 years. Results All the operations of the patients were conducted successfully. The operation time was 65~120min; the bilateral difference in leg length was 0.5~3cm after the operation; X-ray showed that artificial acetabulums were located in the true hip socket, no prosthesis loosening;the result of the last visit showed that Harris hip score was significantly higher than the preoperative score (preoperative score was 45.15 ± 8.81; the score at 36-month visit was 87.88 ± 6.33); the range of motion was improved to some extent and the patients were satisfied with the treatment effect. Conclusion Total hip arthroplasty is an effective way for treating hip dysplasia complicated by osteoarthritis, which can correct the joint deformities, improve the joint function, and is worthy of popularization and application.%目的:探讨全髋关节置换术对髋关节发育不良合并骨性关节炎的临床疗效。方法对该院27例(33髋)髋关节发育不良合并骨性关节炎的患者施行全髋关节置换术,其中Crowe IV型患者9例(12髋),Crowe Ⅲ型患者12例(15髋),CroweⅡ型患者6例(6髋),对手术时间、髋关节功能、矫正恢复情况进行统计分析,所有患者随访3年。结果患者全部顺利完成手术,手术时间在65~120 min,术后双侧下肢长度差在0.5~3 cm,X片示人工髋臼均位于真髋关节窝内,假体无松动移位,末次回访髋关节Harris评分明显高于术前评分[分别为术前评分(45.15±8.81);36

  10. Duration of symptom relief after intra-articular injection of hyaluronic acid combined with sorbitol (anti-ox-vs) in symptomatic hip osteoarthritis.

    Science.gov (United States)

    Migliore, A; Massafra, U; Bizzi, E; Tormenta, S; Cassol, M; Granata, M

    2014-01-01

    The intra-articular administration of hyaluronic acid (HA) in hip osteoarthritis (OA) has been recently increased following the use of ultrasound guidance to perform an accurate delivery of the injected product. Viscosupplementation in hip OA seems to show similar results to those obtained by viscosupplementation in knee OA. However, an unmet need is the duration of symptomatic relief, therefore several new products are proposed to prolong and increase symptomatic effects. Among these, an innovative viscosupplement has been produced from high a concentration of HA combined with a high concentration of sorbitol as a free radical scavenger. The aim of this study is to evaluate the mid-term pain-relief effect of an ultrasound-guided injection of SynolisV-A (ANTI-OX-VS) in patients suffering from symptomatic hip osteoarthritis. Lequesne index, Health Assessment Questionnaire (HAQ), pain reduction, Global Patient Assessment (GPA), Global Medical Assessment (GMA) and reduction in monthly analgesic consumption were assessed during the 12-month follow-up after the injection. A total of 20 patients were enrolled in the study and received one IA US-guided injection of two syringes of ANTI-OX-VS into the target hip. Eleven drop-out patients were registered, of whom 2 were for loss of efficacy at 6 months, 1 for loss of efficacy at 9 months and 8 patients for severe comorbilities. Mean scores of all clinical parameters evaluated at each control visit were significantly different when compared with baseline mean value. No systemic adverse events were observed. Even though the sample size of this study is limited, the results suggest a durable good efficacy of a 4-ml single injection of ANTI-OX-VS in hip OA, at least for the patients who completed the study. A larger number of patients and an RCT are needed to confirm these data, investigating also the predictive factors of clinical response to ANTI-OX-VS.

  11. Regeneration of human bones in hip osteonecrosis and human cartilage in knee osteoarthritis with autologous adipose-tissue-derived stem cells: a case series

    Directory of Open Access Journals (Sweden)

    Pak Jaewoo

    2011-07-01

    Full Text Available Abstract Introduction This is a series of clinical case reports demonstrating that a combination of percutaneously injected autologous adipose-tissue-derived stem cells, hyaluronic acid, platelet rich plasma and calcium chloride may be able to regenerate bones in human osteonecrosis, and with addition of a very low dose of dexamethasone, cartilage in human knee osteoarthritis. Case reports Stem cells were obtained from adipose tissue of abdominal origin by digesting lipoaspirate tissue with collagenase. These stem cells, along with hyaluronic acid, platelet rich plasma and calcium chloride, were injected into the right hip of a 29-year-old Korean woman and a 47-year-old Korean man. They both had a history of right hip osteonecrosis of the femoral head. For cartilage regeneration, a 70-year-old Korean woman and a 79-year-old Korean woman, both with a long history of knee pain due to osteoarthritis, were injected with stem cells along with hyaluronic acid, platelet rich plasma, calcium chloride and a nanogram dose of dexamethasone. Pre-treatment and post-treatment MRI scans, physical therapy, and pain score data were then analyzed. Conclusions The MRI data for all the patients in this series showed significant positive changes. Probable bone formation was clear in the patients with osteonecrosis, and cartilage regeneration in the patients with osteoarthritis. Along with MRI evidence, the measured physical therapy outcomes, subjective pain, and functional status all improved. Autologous mesenchymal stem cell injection, in conjunction with hyaluronic acid, platelet rich plasma and calcium chloride, is a promising minimally invasive therapy for osteonecrosis of femoral head and, with low-dose dexamethasone, for osteoarthritis of human knees.

  12. All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study.

    Directory of Open Access Journals (Sweden)

    Gillian A Hawker

    Full Text Available BACKGROUND: Because individuals with osteoarthritis (OA avoid physical activities that exacerbate symptoms, potentially increasing risk for cardiovascular disease (CVD and death, we assessed the relationship between OA disability and these outcomes. METHODS: In a population cohort aged 55+ years with at least moderately severe symptomatic hip and/or knee OA, OA disability (Western Ontario McMaster Universities (WOMAC OA scores; Health Assessment Questionnaire (HAQ walking score; use of walking aids and other covariates were assessed by questionnaire. Survey data were linked to health administrative data to determine the relationship between baseline OA symptom severity to all-cause mortality and occurrence of a composite CVD outcome (acute myocardial infarction, coronary revascularization, heart failure, stroke or transient ischemic attack over a median follow-up of 13.2 and 9.2 years, respectively. RESULTS: Of 2156 participants, 1,236 (57.3% died and 822 (38.1% experienced a CVD outcome during follow-up. Higher (worse baseline WOMAC function scores and walking disability were independently associated with a higher all-cause mortality (adjusted hazard ratio, aHR, per 10-point increase in WOMAC function score 1.04, 95% confidence interval, CI 1.01-1.07, p = 0.004; aHR per unit increase in HAQ walking score 1.30, 95% CI 1.22-1.39, p<0.001; and aHR for those using versus not using a walking aid 1.51, 95% CI 1.34-1.70, p<0.001. In survival analysis, censoring on death, risk of our composite CVD outcome was also significantly and independently associated with greater baseline walking disability ((aHR for use of a walking aid = 1.27, 95% CI 1.10-1.47, p = 0.001; aHR per unit increase in HAQ walking score = 1.17, 95% CI 1.08-1.27, p<0.001. CONCLUSIONS: Among individuals with hip and/or knee OA, severity of OA disability was associated with a significant increase in all-cause mortality and serious CVD events after controlling for multiple confounders

  13. Effects of administration of adipose-derived stromal vascular fraction and platelet-rich plasma to dogs with osteoarthritis of the hip joints.

    Science.gov (United States)

    Upchurch, David A; Renberg, Walter C; Roush, James K; Milliken, George A; Weiss, Mark L

    2016-09-01

    OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressure-sensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS AND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group.

  14. Hip fracture surgery

    Science.gov (United States)

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

  15. [Evaluation of general health status by SF-36 tool in Hip Osteoarthritis].

    Science.gov (United States)

    Angulo Tabernero, María; Fernández Letamendi, Teresa; Aguilar Ezquerra, Andres; Ungria Murillo, Julia; Panisello Sebastia, Juan José; Agudo, Jesús Mateo

    2014-01-01

    Objetivo: Determinar el estado de salud general percibida por los pacientes sometidos a artroplastia total de cadera con mini-vástago. Material y Método: Se ha administrado el cuestionario de salud SF-36 para evaluar el estado de salud percibido por 13 pacientes varones con una edad media de 46,62 (34-53) años en los que se implantó una artroplastia total de cadera no cementada tipo MiniHip® (CorinMedical) tras un seguimiento medio de 23,2 (12-47) meses. Los resultados obtenidos se compararon con los valores de referencia de la población española en varones de 45 a 54 años. Resultados: Se hallaron diferencias en aspectos como rol físico y emocional, función física, función social y dolor; mientras que en el resto de los ítems la puntuación fue similar a la de la población de referencia. Discusión: Existe la necesidad de conocer en qué grado afectan nuestras intervenciones a la calidad de vida del paciente y la manera en que es percibida por él mismo para complementar los resultados de nuestras intervenciones. Conclusión: Es necesaria una nueva perspectiva para la valoración funcional y de calidad de vida de los pacientes jóvenes sometidos a una artroplastia total de cadera.

  16. Effect of Comorbid Knee and Hip Osteoarthritis on Longitudinal Clinical and Health Care Use Outcomes in Older Adults With New Visits for Back Pain.

    Science.gov (United States)

    Rundell, Sean D; Goode, Adam P; Suri, Pradeep; Heagerty, Patrick J; Comstock, Bryan A; Friedly, Janna L; Gold, Laura S; Bauer, Zoya; Avins, Andrew L; Nedeljkovic, Srdjan S; Nerenz, David R; Kessler, Larry; Jarvik, Jeffrey G

    2017-01-01

    To examine if a comorbid diagnosis of knee or hip osteoarthritis (OA) in older adults with new back pain visits is associated with long-term patient-reported outcomes and back-related health care use. Prospective cohort study. Three integrated health systems forming the Back pain Outcomes using Longitudinal Data cohort. Participants (N=5155) were older adults (≥65y) with a new visit for back pain and a complete electronic health record data. Not applicable; we obtained OA diagnoses using diagnostic codes in the electronic health record 12 months prior to the new back pain visit. The Roland-Morris Disability Questionnaire (RDQ) and the EuroQol-5D (EQ-5D) were key patient-reported outcomes. Health care use, measured by relative-value units (RVUs), was summed for the 12 months after the initial visit. We used linear mixed-effects models to model patient-reported outcomes. We also used generalized linear models to test the association between comorbid knee or hip OA and total back-related RVUs. Of the 5155 participants, 368 (7.1%) had a comorbid knee OA diagnosis, and 94 (1.8%) had a hip OA diagnosis. Of the participants, 4711 (91.4%) had neither knee nor hip OA. In adjusted models, the 12-month RDQ score was 1.23 points higher (95% confidence interval [CI], 0.72-1.74) for patients with knee OA and 1.26 points higher (95% CI, 0.24-2.27) for those with hip OA than those without knee or hip OA, respectively. A lower EQ-5D score was found among participants with knee OA (.02 lower; 95% CI, -.04 to -.01) and hip OA diagnoses (.03 lower; 95% CI, -.05 to -.01) compared with those without knee or hip OA, respectively. Comorbid knee or hip OA was not significantly associated with total 12-month back-related resource use. Comorbid knee or hip OA in older adults with a new back pain visit was associated with modestly worse long-term disability and health-related quality of life. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All

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

    Energy Technology Data Exchange (ETDEWEB)

    Taljanovic, Mihra S.; Schwartz, Stephanie A. [The University of Arizona HSC, Department of Radiology, Tucson, AZ (United States); Graham, Anna R. [The University of Arizona HSC, Department of Pathology, Tucson, AZ (United States); Benjamin, James B. [University Orthopaedic Specialists, Tucson, AZ (United States); Gmitro, Arthur F.; Krupinski, Elizabeth A.; Hunter, Tim B. [The University of Arizona, Department of Radiology, Tucson, AZ (United States); Resnick, Donald L. [University of California, Veterans Affairs Medical Center, San Diego, CA (United States)

    2008-05-15

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

  18. Effectiveness of diclofenac versus acetaminophen in primary care patients with knee osteoarthritis: [NTR1485], DIPA-Trial: design of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Bohnen Arthur M

    2010-01-01

    Full Text Available Abstract Background Osteoarthritis is the most frequent chronic joint disease which causes pain and disability of especially hip and knee. According to international guidelines and the Dutch general practitioners guidelines for non-traumatic knee symptoms, acetaminophen should be the pain medication of first choice for osteoarthritis. However, of all prescribed pain medication in general practice, 90% consists of non-steroidal anti-inflammatory drugs compared to 10% of acetaminophen. Because general practitioners may lack evidence showing a similar efficacy of acetaminophen and non-steroidal anti-inflammatory drugs, we present the design of a randomized open-label trial to investigate the efficacy of a non-steroidal anti-inflammatory drug (diclofenac compared with acetaminophen in new consulters with knee osteoarthritis in general practice. Methods/Design Patients aged 45 years or older consulting their general practitioner with non-traumatic knee pain, meeting the clinical American College of Rheumatology criteria, and with a pain severity score of 2 or higher (on a 0-10 scale, will be randomly allocated to either diclofenac (maximum daily dose of 150 mg or acetaminophen (maximum daily dose of 3000 mg for 2 weeks and, if required, an additional 1-2 weeks, with a total follow-up period of 12 weeks. The primary outcomes are knee pain measured with a daily diary, and pain and function measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS at baseline, and at 3, 6, 9, and 12-weeks follow-up. Secondary outcomes are patients' perceived recovery, quality of life, medical, patient, and productivity costs, compliance to therapy, co-interventions, and adverse reactions. Discussion The successful completion of this trial would lead to a better understanding of which medication should be used in the treatment of primary care patients with mild knee osteoarthritis. Trial registration Dutch trial registry NTR1485.

  19. Diagnostic and prognostic value of delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) in early osteoarthritis of the hip.

    Science.gov (United States)

    Palmer, A; Fernquest, S; Rombach, I; Park, D; Pollard, T; Broomfield, J; Bangerter, N; Carr, A; Glyn-Jones, S

    2017-09-01

    Delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) can detect glycosaminoglycan loss in the acetabular cartilage of asymptomatic individuals with cam morphology. The aims of this study were to explore the relationship between cam morphology and dGEMRIC values, and to explore whether baseline dGEMRIC can predict the development of radiographic hip osteoarthritis. Prospective cohort (SibKids) study with clinical, radiographic, and MRI assessment at baseline and five-year follow-up (n = 34). The dGEMRIC values of cartilage regions were correlated with measures of cam morphology. Receiver operating characteristic (ROC) analysis was applied to baseline variables to predict radiographic loss of joint space width. Superolateral acetabular cartilage dGEMRIC values were significantly lower in participants with cam morphology (P < 0.001), defined as an alpha angle greater than 60°. There was a negative correlation between alpha angle and the dGEMRIC value of adjacent acetabular cartilage. This relationship was strongest superoanteriorly (r = -0.697 P < 0.001). There was a positive correlation between baseline dGEMRIC and the magnitude of joint space width narrowing (r = 0.398 P = 0.030). ROC analysis of combined baseline variables (positive impingement test, alpha angle, dGEMRIC ratio) gave an Area Under the Curve (AUC) of 0.75 for predicting joint space width narrowing greater than 0.5 mm within 5 years. The size and position of cam morphology determines the severity and location of progressive cartilage damage, supporting the biomechanical aetiology of femoroacetabular impingement. Baseline dGEMRIC is able to predict the development of radiographic osteoarthritis. Compositional MRI offers the potential to identify patients who may benefit from early intervention to prevent the development of osteoarthritis. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Hillmann Axel

    2010-10-01

    Full Text Available Abstract Background Degenerative musculoskeletal disorders are among the most frequent diseases occurring in adulthood, often impairing patients' functional mobility and physical activity. The aim of the present study was to investigate and compare the impact of three frequent degenerative musculoskeletal disorders -- knee osteoarthritis (knee OA, hip osteoarthritis (hip OA and lumbar spinal stenosis (LSS -- on patients' walking ability. Methods The study included 120 participants, with 30 in each patient group and 30 healthy control individuals. A uniaxial accelerometer, the StepWatch™ Activity Monitor (Orthocare Innovations, Seattle, Washington, USA, was used to determine the volume (number of gait cycles per day and intensity (gait cycles per minute of walking ability. Non-parametric testing was used for all statistical analyses. Results Both the volume and the intensity of walking ability were significantly lower among the patients in comparison with the healthy control individuals (p 50 gait cycles/min, which was significantly lower in comparison with patients with knee and hip OA at 2.5 (IQR 4.4 and 3.4 (IQR 16.1 min/day, respectively (p Conclusions Patients with degenerative musculoskeletal disorders suffer limitations in their walking ability. Objective assessment of walking ability appeared to be an easy and feasible tool for measuring such limitations as it provides baseline data and objective information that are more precise than the patients' own subjective estimates. In everyday practice, objective activity assessment can provide feedback for clinicians regarding patients' performance during everyday life and the extent to which this confirms the results of clinical investigations. The method can also be used as a way of encouraging patients to develop a more active lifestyle.

  1. Design of a biomimetic polymer-composite hip prosthesis.

    Science.gov (United States)

    Bougherara, Habiba; Bureau, Martin; Campbell, Melissa; Vadean, Aurelian; Yahia, L'Hocine

    2007-07-01

    A new biomimetic composite hip prosthesis (stem) was designed to obtain properties similar to those of the contiguous bone, in particular stiffness, to allow normal loading of the surrounding femoral bone. This normal loading would reduce excessive stress shielding, known to result in bone loss, and micromotions at the bone-implant interface, leading to aseptic prosthetic loosening. The design proposed is based on a hollow substructure made of hydroxyapatite-coated, continuous carbon fiber (CF) reinforced polyamide 12 (PA12) composite with an internal soft polymer-based core. Different composite configurations were studied to match the properties of host tissue. Nonlinear three-dimensional analysis of the hip prosthesis was carried out using a three-dimensional finite element bone model based on the composite femur. The performance of composite-based hip and titanium alloy-based (Ti-6Al-4V) stems embedded into femoral bone was compared. The effect of core stiffness and ply configuration was also analyzed. Results show that stresses in composite stem are lower than those in Ti stem, and that the femoral bone implanted with composite structure sustains more load than the one implanted with Ti stem. Micromotions in the composite stem are significantly smaller than those in Ti stem over the entire bone-implant surface because of the favorable interfacial stress distribution.

  2. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis.

    Science.gov (United States)

    Fitzgerald, G K; Hinman, R S; Zeni, J; Risberg, M A; Snyder-Mackler, L; Bennell, K L

    2015-05-01

    A Task Force of the Osteoarthritis Research Society International (OARSI) has previously published a set of guidelines for the conduct of clinical trials in osteoarthritis (OA) of the hip and knee. Limited material available on clinical trials of rehabilitation in people with OA has prompted OARSI to establish a separate Task Force to elaborate guidelines encompassing special issues relating to rehabilitation of OA. The Task Force identified three main categories of rehabilitation clinical trials. The categories included non-operative rehabilitation trials, post-operative rehabilitation trials, and trials examining the effectiveness of devices (e.g., assistive devices, bracing, physical agents, electrical stimulation, etc.) that are used in rehabilitation of people with OA. In addition, the Task Force identified two main categories of outcomes in rehabilitation clinical trials, which include outcomes related to symptoms and function, and outcomes related to disease modification. The guidelines for rehabilitation clinical trials provided in this report encompass these main categories. The report provides guidelines for conducting and reporting on randomized clinical trials. The topics include considerations for entering patients into trials, issues related to conducting trials, considerations for selecting outcome measures, and recommendations for statistical analyses and reporting of results. The focus of the report is on rehabilitation trials for hip, knee and hand OA, however, we believe the content is broad enough that it could be applied to rehabilitation trials for other regions as well.

  3. Sensor of total hip arthoplasty wear designed on principle of scanning profilometry

    Science.gov (United States)

    Rössler, Tomas; Mandat, Dusan; Gallo, Jiri; Hrabovsky, Miroslav; Pochmon, Michal; Havranek, Vitezslav

    2008-12-01

    Total hip arthroplasty significantly improves the quality of life in majority of patients with osteoarthritis. However, prosthetic wear is a problem because of inducing the development of aseptic loosening and periprosthetic osteolysis which needs the revision surgery. Thus, the polyethylene wear measurement is the central to contemporary orthopaedics and this interesting has encouraged the development and improvement of both radiologic (in vivo) and non-radiologic (in vitro) methods for polyethylene wear quantification. The principles of polyethylene liner wear measurements are predominantly geometric; nevertheless, the realization of individual types of in vivo measurements brings with it the necessity of many simplifications and compromising steps to acquire approximately accurate values. In fact, the volumetric wear can be obtained by mathematical conversion based on the most linear shift of femoral head in the cup. However, such approach is understood to be somewhat insufficient. Our ongoing research pointed to the development of optical non-contact method for wear measurement and its results are introduced in this paper including the methodology designed for the usability validation of the method for the given purpose and the description of sensor, its principle, technical realization, design and parameters.

  4. Comparative, double-blind, controlled study of intra-articular hyaluronic acid (Hyalubrix®) injections versus local anesthetic in osteoarthritis of the hip

    Science.gov (United States)

    2009-01-01

    Introduction Comparison of intra-articular bacterial-derived hyaluronic acid (Hyalubrix®) (HA) with local analgesia (mepivacaine) for osteoarthritis (OA) of the hip. Methods A pilot prospective, double-blind, 6-month randomized trial of 42 patients with hip OA. HA or mepivacaine was administered twice (once a month) under ultrasound guidance. Efficacy measurements included the Lequesne's algofunctional index, a visual analog scale for pain, concomitant use of analgesia, patient and physician global measurement, and safety. Results Patients in the HA group exhibited a significantly reduced Lequesne's algofunctional index 3 and 6 months after treatment (P < 0.001) and significantly reduced visual analog scale pain scores 3 and 6 months after treatment (P < 0.05) compared with the local anesthetic group. All primary and secondary measures were significantly improved versus baseline, but other than the above were not different from each other at 3 or 6 months. Adverse effects were minimal. Conclusions This comparative study suggests a beneficial effect and safety of intra-articular HA in the management of hip OA. Trial registration number ISRCTN39397064. PMID:20003205

  5. Cross-cultural validity of the animated activity questionnaire (AAQ) that assesses activity limitations in patients with hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Peter, W. F.; De Vet, R.; Boers, M.

    2015-01-01

    Background: The Animated Activity Questionnaire (AAQ) measures activity limitations in hip and knee osteoarthritis (HKOA), and demonstrated good validity and reliability [1]. The AAQ shows stylized video animations of different levels of activity performance. Patients are asked to choose which....... Objectives: To evaluate cross-cultural validity of the AAQ. Methods: In 7 European countries patients were asked to complete the AAQ. An example of an item of the AAQ is shown on: http://kmin-vumc.nl/-14-0.html. Ordinal logistic regression was used to evaluate DIF across languages (Dutch versus 6 other...... languages). As a criterion for uniform DIF we used an odds ratio outside the interval 0.53-1.89. An significant interaction term (p-value...

  6. Cartilage collagen damage in hip osteoarthritis similar to that seen in knee osteoarthritis; a case–control study of relationship between collagen, glycosaminoglycan and cartilage swelling

    Directory of Open Access Journals (Sweden)

    Hosseininia Shahrzad

    2013-01-01

    Full Text Available Abstract Background It remains to be shown whether OA shares molecular similarities between different joints in humans. This study provides evidence for similarities in cartilage molecular damage in osteoarthritic (OA joints. Methods Articular cartilage from osteoarthritic hip joints were analysed and compared to non-OA controls regarding collagen, glycosaminoglycan and water content. Femoral heads from 16 osteoarthritic (OA and 20 reference patients were obtained from hip replacement surgery due to OA and femoral neck fracture, respectively. Cartilage histological changes were assessed by Mankin grading and denatured collagen type II immunostaining and cartilage was extracted by α-chymotrypsin. Hydroxyproline and Alcian blue binding assays were used to measure collagen and glycosaminoglycan (GAG content, respectively. Results Mankin and immunohistology scores were significantly higher in hip OA samples than in reference samples. Cartilage water content was 6% higher in OA samples than in references. 2.5 times more collagen was extracted from OA than from reference samples. There was a positive association between water content and percentage of extractable collagen pool (ECP in both groups. The amounts of collagen per wet and dry weights did not differ statistically between OA and reference cartilage. % Extractable collagen was not related to collagen per dry weight in either group. However when collagen was expressed by wet weight there was a negative correlation between % extractable and collagen in OA cartilage. The amount of GAG per wet weight was similar in both groups but the amount of GAG per dry weight was higher in OA samples compared to reference samples, which suggests a capacity for GAG biosynthesis in hip OA cartilage. Neither of the studied parameters was related to age in either group. Conclusions Increased collagen extractability and water content in human hip cartilage is associated with OA pathology and can be observed at

  7. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature.

    Science.gov (United States)

    Springer, Bryan D; Carter, Jonathan T; McLawhorn, Alexander S; Scharf, Keith; Roslin, Mitchell; Kallies, Kara J; Morton, John M; Kothari, Shanu N

    2017-01-01

    Obesity accelerates the development of osteoarthritis of the knee and hip by exerting deleterious effects on joints through both biomechanical and also systemic inflammatory changes. The objective of this review was to evaluate the impact of obesity on lower limb biomechanics and total joint arthroplasty outcomes, as well as weight changes after joint arthroplasty and the role of bariatric surgery among patients requiring joint arthroplasty. The currently published data indicate that weight loss increases swing time, stride length, gait speed, and lower extremity range of motion. Total joint arthroplasty improves pain and joint function, but does not induce significant weight loss in the majority of patients. Bariatric surgery improves gait biomechanics, and in the severely obese patient with osteoarthritis improves pain and joint function. The evidence for supporting bariatric surgery before total joint arthroplasty is limited to retrospective reports with conflicting results. Fundamental clinical questions remain regarding the optimal management of morbid obesity and lower extremity arthritis, which should be the focus of future collaborations across disciplines providing care to patients with both conditions.

  8. Arthroscopic Management of Osteoarthritis.

    Science.gov (United States)

    Pitta, Michael; Davis, William; Argintar, Evan H

    2016-02-01

    Arthroscopic surgery is commonly performed in the knee, shoulder, elbow, and hip. However, the role it plays in the management of osteoarthritis is controversial. Routine arthroscopic management of osteoarthritis was once common, but this practice has been recently scrutinized. Although some believe that there is no role for arthroscopic treatment in the management of osteoarthritis, it may be appropriate and beneficial in certain situations. The clinical success of such treatment may be rooted in appropriate patient selection and adherence to a specific surgical technique. Arthroscopy may serve as an effective and less invasive option than traditional methods of managing osteoarthritis.

  9. Minimally Invasive Total Hip and Knee Arthroplasty-Implications for the Elderly Patient

    NARCIS (Netherlands)

    Reininga, Inge H. F.; Stevens, Martin; Wagenmakers, Robert; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2012-01-01

    Total hip arthroplasty and total knee arthroplasty have proven to be effective surgical procedures for the treatment of hip and knee osteoarthritis. In recent decades, there have been considerable efforts to improve the component designs, modes of fixation, and surgical techniques. Minimally invasiv

  10. Preoperative Predictors of Ambulation Ability at Different Time Points after Total Hip Arthroplasty in Patients with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura

    2014-01-01

    Full Text Available The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS; and the Timed Up and Go (TUG test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength (β=-0.379,R2=0.409 at 3 weeks, hip abductor strength (β=-0.572,R2=0.570 at 4 months, and age (β=0.758,R2= 0.561 at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56 Nm/kg for knee extensor strength, 0.24 Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA.

  11. Serum and urinary biochemical markers for knee and hip-osteoarthritis: a systematic review applying the consensus BIPED criteria

    NARCIS (Netherlands)

    Spil, W.E. van; Groot, J. de; Lems, W.F.; Oostveen, J.C.M.; Lafeber, F.P.J.G.

    2010-01-01

    Context: Molecules that are released into biological fluids during matrix metabolism of articular cartilage, subchondral bone, and synovial tissue could serve as biochemical markers of the process of osteoarthritis (OA). Unfortunately, actual breakthroughs in the biochemical OA marker field are limi

  12. OMERACT/OARSI initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Gossec, Laure; Hawker, Gillian; Davis, Aileen M

    2007-01-01

    OBJECTIVE: Time to theoretical indication of joint replacement surgery has been proposed as a primary outcome for potential structure-modifying interventions for osteoarthritis (OA). The objectives of this OMERACT/OARSI Working Group were to identify pain, physical function, and structure states ...

  13. The relationship between ultra-short telomeres, aging of articular cartilage and the development of human hip osteoarthritis

    DEFF Research Database (Denmark)

    Harbo, M; Delaisse, J M; Kjaersgaard-Andersen, P;

    2013-01-01

    Ultra-short telomeres caused by stress-induced telomere shortening are suggested to induce chondrocyte senescence in human osteoarthritic knees. Here we have further investigated the role of ultra-short telomeres in the development of osteoarthritis (OA) and in aging of articular cartilage in human...

  14. Comorbidity and functioning in elderly (potential) rehabilitation patients with osteoarthritis of hip or knee: results from the CARPA-study.

    NARCIS (Netherlands)

    Dijk, G.M. van; Veenhof, C.; Dekker, J.

    2006-01-01

    Objective: Osteoarthritis is one of the most common diseases in older people. It also is one of the diseases with the highest rate of comorbidity. Only few studies have concentrated on comorbidity in OA. These studies vary with regard to study population, prevalence of comorbidity and comorbidity me

  15. Agreement and Reliability of Functional Performance and Muscle Power in Patients with Advanced Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Roos, Ewa M; Overgaard, Søren;

    2012-01-01

    assessed for test-retest reliability and agreement on two occasions 1 wk apart. The outcomes were maximal single-joint muscle power (hip extension/abduction and knee extension/flexion), maximal muscle power during multijoint leg extension press, and functional performance measures (20-m walk, five......, single-joint knee extension, chair stands, and knee bending) to good (CVws, 0.81, single-joint knee extension, knee flexion, hip abduction, 20-m walk, and chair stands) reliability. CONCLUSIONS: Isolated muscle power over the hip and knee can safely be evaluated with poor to good agreement and good...

  16. Hip Injuries and Disorders

    Science.gov (United States)

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

  17. Dual-energy X-ray absorptiometric densitometry in osteoarthritis of the hip. Influence of secondary bone remodeling of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Preidler, K.W. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); White, L.S. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Tashkin, J. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); McDaniel, C.O. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Brossmann, J. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Andresen, R. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Sartoris, D. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States)

    1997-07-01

    Purpose: The aim of this study was to evaluate the influence of buttressing on bone densitometry measurements in the femoral neck, in Ward`s triangle, and in the greater trochanter. In addition, we attempted to establish the length of the femoral axis (FAL) and the true length of the femoral neck (FNL) as potential correlates with osteoarthritis (OA) or with buttressing. Material and Methods: Our study comprised 101 hips in 68 adult patients. Conventional radiographs of the hip joints were obtained in order to assess the presence and extent of OA by means of the 6-step grading system introduced in 1990 by CROFT et al., and in order to measure the cortical thickness at the medial aspect of the femoral neck. In addition, FAL and FNL were measured. All patients underwent dual energy X-ray absorptiometry so that bone density could be assessed in the femoral neck, in Ward`s triangle, and in the greater trochanter. The Spearman rank correlation was used to compare the measurements. Results: Statistical analysis showed a significant positive correlation between cortical thickness and bone density in the femoral neck and in Ward`s triangle. No correlation was found between cortical thickness and bone density in the greater trochanter, nor between cortical thickness and OA, FNL, and FAL, nor between OA and bone density, FNL, and FAL. (orig.).

  18. Barriers and Facilitators to Exercise Participation in People with Hip and/or Knee Osteoarthritis: Synthesis of the Literature Using Behavior Change Theory.

    Science.gov (United States)

    Dobson, Fiona; Bennell, Kim L; French, Simon D; Nicolson, Philippa J A; Klaasman, Remco N; Holden, Melanie A; Atkins, Lou; Hinman, Rana S

    2016-05-01

    Exercise is recommended for hip and knee osteoarthritis (OA). Patient initiation of, and adherence to, exercise is key to the success of managing symptoms. This study aimed to (1) identify modifiable barriers and facilitators to participation in intentional exercise in hip and/or knee OA, and (2) synthesize findings using behavior change theory. A scoping review with systematic searches was conducted through March 2015. Two reviewers screened studies for eligibility. Barriers and facilitators were extracted and synthesized according to the Theoretical Domains Framework (TDF) by two independent reviewers. Twenty-three studies (total of 4633 participants) were included. The greatest number of unique barriers and facilitators mapped to the Environmental Context and Resources domain. Many barriers were related to Beliefs about Consequences and Beliefs about Capabilities, whereas many facilitators were related to Reinforcement. Clinicians should take a proactive role in facilitating exercise uptake and adherence, rather than trusting patients to independently overcome barriers to exercise. Strategies that may be useful include a personalized approach to exercise prescription, considering environmental context and available resources, personalized education about beneficial consequences of exercise and reassurance about exercise capability, and use of reinforcement strategies. Future research should investigate the effectiveness of behavior change interventions that specifically target these factors.

  19. Influence of the experience of the reader on reliability of joint space width measurement. A cross-sectional multiple reading study in hip osteoarthritis.

    Science.gov (United States)

    Ornetti, Paul; Maillefert, Jean-Francis; Paternotte, Simon; Dougados, Maxime; Gossec, Laure

    2011-10-01

    The objectives were to evaluate improvement in reliability of joint space width (JSW) measurements, according to the previous experience of the readers in hip osteoarthritis (OA). Fifty radiographs in hip OA patients from a randomized controlled trial (ECHODIAH) were read 12 times by two readers with different levels of experience in radiographic interpretation. Intra-reader reliability and inter-reader reliability were assessed through calculation of the smallest detectable difference (SDD) and the intra-class correlation coefficient (ICC). Intra-reader reliability: for the experienced reader, no significant change in SDD was observed with repeated JSW measurements. For the junior reader, the SDD decreased significantly from 0.90 mm to 0.65 mm (P=0.002). A plateau of SDD was reached after reading 200 to 300 radiographs, with a value close to the mean SDD of the experienced reader (0.67 mm). ICCs were high (>0.88) for both the senior and the junior readers. Inter-reader reliability: no improvement in inter-reader reliability was noted with repeated measurements of JSW (SDD=0.81 mm). However, no additional training sessions were performed. ICCs were high (>0.85). This study indicated for the first time a learning curve in analyzing JSW in hip OA for an inexperienced reader. After analyzing 200 to 300 radiographs, the junior reader reached an intra-reader reliability similar to the experienced reader. Moreover, the information brought by the ICC was not sufficient, suggesting that the SDD should be systematically reported in studies evaluating OA radiographic progression, on top of the ICC, to help in interpreting the JSW reliability. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  20. Normalisation method can affect gluteus medius electromyography results during weight bearing exercises in people with hip osteoarthritis (OA): a case control study.

    Science.gov (United States)

    French, Helen P; Huang, Xiaoli; Cummiskey, Andrew; Meldrum, Dara; Malone, Ailish

    2015-02-01

    Surface electromyography (sEMG) is used to assess muscle activation during therapeutic exercise, but data are significantly affected by inter-individual variability and requires normalisation of the sEMG signal to enable comparison between individuals. The purpose of this study was to compare two normalisation methods, a maximal method (maximum voluntary isometric contraction (MVIC)) and non-maximal peak dynamic method (PDM), on gluteus medius (GMed) activation using sEMG during three weight-bearing exercises in people with hip osteoarthritis (OA) and healthy controls. Thirteen people with hip OA and 20 controls performed three exercises (Squat, Step-Up, Step-Down). Average root-mean squared EMG amplitude based on MVIC and PDM normalisation was compared between groups for both involved and uninvolved hips using Mann-Whitney tests. Using MVIC normalisation, significantly higher normalised GMed EMG amplitudes were found in the OA group during all Step-up and down exercises on the involved side (p=0.02-0.001) and most of the Step exercises on the uninvolved side (p=0.03-0.04), but not the Squat (p>0.05), compared to controls. Using PDM normalisation, significant between-group differences occurred only for Ascending Squat (p=0.03) on the involved side. MVIC normalisation demonstrated higher inter-trial relative reliability (ICCs=0.78-0.99) than PDM (ICCs=0.37-0.84), but poorer absolute reliability using Standard Error of Measurement. Normalisation method can significantly affect interpretation of EMG amplitudes. Although MVIC-normalised amplitudes were more sensitive to differences between groups, there was greater variability using this method, which raises concerns regarding validity. Interpretation of EMG data is strongly influenced by the normalisation method used, and this should be considered when applying EMG results to clinical populations.

  1. Exercise for people with hip or knee osteoarthritis: a comparison of land-based and aquatic interventions

    OpenAIRE

    Ann E Rahmann

    2010-01-01

    Ann E RahmannDivision of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, AustraliaAbstract: Expert opinion considers the referral of people with osteoarthritis (OA) for physiotherapy to be a core component of managing the functional disability and pain of the disease. Clinical guidelines for the physiotherapy management of people with OA focus on three main areas: exercise, pain relief, and specific manual therapy techniques. La...

  2. Responsiveness of the OARSI-OMERACT osteoarthritis pain and function measures

    DEFF Research Database (Denmark)

    Bond, M; Davis, A; Lohmander, Stefan

    2012-01-01

    To assess the responsiveness of the Intermittent and Constant Osteoarthritis Pain (ICOAP) measure, Hip Disability and Osteoarthritis Outcome Score Physical Function Short Form (HOOS-PS), and the Knee Disability and Osteoarthritis Outcome Score Physical Function Short Form (KOOS...

  3. Total hip arthroplasty for osteoarthritis secondary to hip sequelae of pyogenic infection%全髋置换术治疗化脓性髋关节炎后遗畸形继发骨关节炎

    Institute of Scientific and Technical Information of China (English)

    章军辉; 徐荣明; 凌晶; 刘华; 陶昆; 曾智敏; 章云峰; 何志勇; 狄正林; 冯建翔

    2012-01-01

    Objective To discuss the surgery complications and short-term effectiveness of total hip arthroplasty (THA) for osteoarthritis secondary to hip sequelae of pyogenic infection. Methods From 2004 to 2010, THA was carried out on 20 cases with osteoarthritis secondary to hip sequelae of pyogenic infection in our division. Eight cases were male and 12 cases were female. The average age was 48. 5 years. The average age of infection was 10. 2 years. The interval between active infection and arthroplasty was 34. 5 years. The average follow-up period was 3. 8 years. The direct lateral approach ( Hardinge's approach) was applied in 10 cases and posterolateral approach in the other 10 cases. According to X-ray the acetabular and femoral deformities were classified by Kim's classification system and the implant stability and peri-prosthetic osteolysis were evaluated. The clinical effect was measured with Harris hip scoring system pre-operatively and post-operatively. The heterotopic ossification was judged by Brooker method. Results According to Kim's classification, nine cases (45% ) were type Ⅰ , four cases (20% ) were type Ⅱ and seven cases (35% ) were type Ⅲ. Femoral fracture occurred in three cases intra-operatively and sciatic nerve palsy occurred in one patient with 4cm leg lengthening post-operatively. No hip dislocation, deep vein thrombosis or infection occurred. From X-ray view, no acetabular implant displacement ( > 2 mm) or abduction angle change was tested. The cyst formation ( > 2 mm) in the acetabular side occurred in two cases, which indicated osteolysis. The stem subsidence beyond 2.5 mm occurred in two cases. The cyst formation ( > 2 mm) in Gruen 2 area of the femoral stem occurred in one case. All cases abone had no clinical appearance and were closely observed. The average Harris hip score pre-operatively and post-operatively were 46. 8 and 88. 5 respectively, which was statistically significantly different (t = 12.32, P <0. 01). According to Brooker

  4. Public opinion on community-based education and exercise programs for managing hip and knee osteoarthritis-like symptoms: results of a survey

    Directory of Open Access Journals (Sweden)

    Davis AM

    2016-03-01

    Full Text Available Aileen M Davis,1–5 Marvilyn Palaganas,1 Linda C Li6,7 1Division of Health Care and Outcomes Research, 2Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, 3Department of Physical Therapy, Institute of Health Policy, 4Management and Evaluation, 5Institute of Rehabilitation Science, University of Toronto, Toronto, ON, 6Arthritis Research Canada, Richmond, 7Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada Introduction: In North America, delivery of targeted exercise and education programs by health professionals for people with hip and knee osteoarthritis (OA poses challenges related to cost and access. Linking the wellness and health sectors could increase program availability. We evaluated if people with OA were willing to participate in programs delivered by trainers in community centers/gyms. Methods: We conducted an online survey of the general public in Canada over a period of 2 months. Participants included those aged ≥30 years with self-reported chronic OA-like knee or hip pain. We evaluated access to community/fitness centers, exercise frequency, interest in attending an evidence-based program twice a week for 6 weeks, and willingness to pay. Analyses included descriptive statistics with 95% confidence intervals and chi-square tests to evaluate factors associated with willingness to attend the program. Results: After removing duplicate records, 751 respondents completed the survey with 408 likely having hip and/or knee OA and never having received a joint replacement. These 408 respondents had an age range of 30 to ≥75 years and 86% were female. Of the 408, (63.7% were between 45 and 64 years of age. Only two respondents reported that a community center was >1 hour away. One hundred and fifty-six (38% reported a current membership, and 203 (50.4% reported exercise 3 days/wk, 120 (29.8% <3 days, and 80 (19.9% reported no exercise. Two

  5. Responsiveness and Minimal Important Changes of the Western Ontario and McMaster Universities Osteoarthritis Index in Subjects Undergoing Rehabilitation Following Hip Fracture.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Secci, Claudio; Rocca, Barbara; Ferrante, Simona; Capone, Antonio

    2017-05-01

    To evaluate the responsiveness and minimal important changes (MICs) for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and its subscales in subjects with hip fractures. At the beginning and end of a 2-month rehabilitation program, 106 patients completed the WOMAC. After the program, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the WOMAC and its subscales were calculated by distribution (effect size; standardized response mean) and anchor-based methods (receiver operating characteristic curves; correlations between change scores of the WOMAC and its subscales and GPE). Receiver operating characteristic curves were also used in order to compute the best cutoff levels between improved and stable subjects (MICs). The effect size ranged from 0.64 to 11.10 and the standardized response mean from 0.79 to 2.65. The receiver operating characteristic analyses revealed an MIC value (area under the curve, sensitivity, specificity) for the WOMAC of 29 (0.817, 92, 78); values of 35 (0.820, 77, 76) 44 (0.625, 25, 95), and 24 (0.707, 100, 76) were found for pain, stiffness, and physical function subscales, respectively. Correlations between change scores of the WOMAC and its subscales and GPE were low (0.240, for stiffness subscale) to moderate (0.438-0.570 for the other subscales and the WOMAC). The WOMAC and its subscales (all but stiffness) were sensitive in detecting clinical changes in subjects with hip fracture undergoing rehabilitation. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in this clinical context.

  6. [Evaluation of the adhesion to the EULAR and OARSI recommendations for the treatment of knee and hip osteoarthritis in current practice].

    Science.gov (United States)

    Van Linthoudt, D

    2009-12-02

    Recommendations for the treatment of hip and knee osteoarthritis (OA) have been recently published by international scientific societies (EULAR, OARSI). The aim of this study was to evaluate, in real life, the acceptance of these recommendations in the two districts of the Neuchâtel mountains. In March 2008, a questionnaire was sent to all the general practitioners (GP = 23), internists (IM = 22), orthopedic surgeons (ORTHO = 8) and rheumatologists (RHEUMATO = 3) of the districts of Le Locle and La Chaux-de-Fonds (population of 55000 people). The anonymous questionnaire, presenting the 10 EULAR and 25 OARSI recommendations for the treatment of hip and knee OA, asked for some demographic data of the physicians and for the knowledge and acceptance of the presented recommendations. Results were expressed as a (SoA), based on a semi-quantitative evaluation (15 to 55) and expressed in percent for comparison to the (SoR) reported by EULAR and OARSI. Twenty-three questionnaires (41%) were returned. Seven of the ten GP, one of the six IM, one of the four ORTHO who responded and the three RHEUMATO knew and applied some of the EULAR recommendations. Only one GP, one ORTHO and one RHEUMATO knew the OARSI recommendations. The SoA was a little less for the primary care physicians (PCP = GP + IM) than for the specialists in the musculo-skeletal diseases (SMD = ORTHO + RHEUMATO) for the EULAR (85 versus 89%) and for the OARSI (73 versus 78%) recommendations. None of the EULAR or OARSI recommendations gained a full SoA by the PCP although two EULAR and one OARSI recommendations obtained a complete SoA by the SMD. In this sample of physicians, most IM and ORTHO ignored the EULAR and OARSI recommendations for the treatment of hip or knee OA. Nonetheless, a majority of PCP and SMD adhered to the most of them with occasionally a greater SoA than the proposed SoR. An effort for a better diffusion of these recommendations is justified among IM and ORTHO.

  7. Effectiveness of diclofenac versus acetaminophen in primary care patients with knee osteoarthritis: [NTR1485], DIPA-Trial: Design of a randomized clinical trial

    NARCIS (Netherlands)

    S.P.J. Verkleij (Saskia ); P.A.J. Luijsterburg (Pim); B.W. Koes (Bart); A.M. Bohnen (Arthur); S.M. Bierma-Zeinstra (Sita)

    2010-01-01

    textabstractBackground. Osteoarthritis is the most frequent chronic joint disease which causes pain and disability of especially hip and knee. According to international guidelines and the Dutch general practitioners guidelines for non-traumatic knee symptoms, acetaminophen should be the pain

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

    Science.gov (United States)

    Gill, Simeon; Parker, Christopher J

    2016-11-15

    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.

  9. Current Concepts in the Management of Ankle Osteoarthritis: A Systematic Review.

    Science.gov (United States)

    Bloch, Benjamin; Srinivasan, Suresh; Mangwani, Jitendra

    2015-01-01

    Ankle osteoarthritis is less common than hip or knee osteoarthritis; however, it is a relatively common presentation and is predominantly related to previous trauma. Treatments have traditionally consisted of temporizing measures such as analgesia, physiotherapy, and injections until operative treatment in the form of arthrodesis is required. More recently, interest has been increasing in both nonoperative and alternative operative options, including joint-sparing surgery, minimal access arthrodesis, and new arthroplasty designs. The present systematic instructional review has summarized the current evidence for the treatment options available for ankle osteoarthritis.

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

    Directory of Open Access Journals (Sweden)

    Haviv Barak

    2010-07-01

    Full Text Available Abstract Objective To assess the incidence of total hip arthroplasty (THA in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA. Design Retrospective clinical series Methods Follow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years. The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis. Results Ninety (16% of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA. Conclusions In our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures.

  11. Osteoarthritis 2012 year in review

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Juhl, C B

    2012-01-01

    Recent scientific advances in the treatment of hip and knee osteoarthritis (OA) relating to education, exercise, weight control and passive non-pharmacological and non-surgical treatments such as manual therapy, orthoses/orthotics and other aids are described. METHODS: A systematic literature...... search was performed in Medline from July 2011 to 10 April 2012 using the terms 'osteoarthritis, knee', 'osteoarthritis, hip' rehabilitation, physical therapy, exercise therapy and preoperative intervention; both as text words and as MeSH terms where possible. Trials evaluating rehabilitation...

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

    Institute of Scientific and Technical Information of China (English)

    DAI Min; NIE Tao

    2010-01-01

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

  13. Effect of sociodemographic factors on surgical consultations and hip or knee replacements among patients with osteoarthritis in British Columbia, Canada.

    Science.gov (United States)

    Rahman, M Mushfiqur; Kopec, Jacek A; Sayre, Eric C; Greidanus, Nelson V; Aghajanian, Jaafar; Anis, Aslam H; Cibere, Jolanda; Jordan, Joanne M; Badley, Elizabeth M

    2011-03-01

    To quantify the effect of demographic variables and socioeconomic status (SES) on surgical consultation and total joint arthroplasty (TJA) rates among patients with osteoarthritis (OA), using population-based administrative data. A cohort study was conducted in British Columbia using population data from 1991 to 2004. From April 1996 to March 1998, we documented 34,420 new patients with OA and these patients were followed to March 2004 for their first surgical consultation and TJA. Effects of age, sex, and SES were evaluated by Cox proportional hazards models after adjusting for comorbidities and pain medication used. During a mean 5.5-year followup period, 7475 patients with OA had their first surgical consultations and 2814 patients received TJA within a 6-year mean followup period. Crude hazards ratio (HR) for men compared to women was 1.25 (95% CI 1.20-1.31) for surgical consultation and was 1.14 (95% CI 1.06-1.23) for TJA. The interaction between sex and SES was significant. Stratified analysis showed among men an HR of 1.42 (95% CI 1.27-1.58) and 1.52 (95% CI 1.26-1.83) for surgical consultations and TJA, respectively, for the highest SES compared with the lowest SES quintiles. Similarly significant results were observed among women. Differential access to the healthcare system exists among patients with OA. Women with OA were less likely than men to see an orthopedic surgeon as well as to obtain TJA. Patients with higher SES consulted orthopedic surgeons more frequently and received more TJA than those with the lowest SES.

  14. Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

    OpenAIRE

    Williamson, Wilby; Kluzek, Stefan; Roberts, Nia; Richards,Justin; Arden, Nigel; Leeson, Paul; Newton, Julia; Foster, Charlie

    2015-01-01

    Objective To assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change. Design A systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/). Study selection Randomised controlled trials (RCTs) comparing physical activity interventions with placebo, no/or minimal intervention in community-dwelling adults with symptomatic knee or hip osteoarthritis. Primary outcomes were change in p...

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

    Institute of Scientific and Technical Information of China (English)

    张勇

    2012-01-01

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

  16. Barriers to implementing the "2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis" in primary healthcare practice.

    Science.gov (United States)

    Loyola-Sanchez, Adalberto; Richardson, Julie; Pelaez-Ballestas, Ingris; Sánchez, José Guadalupe; González, Martha Alicia; Sánchez-Cruz, Juan; Jiménez-Baez, María Valeria; Nolasco-Alonso, Nancy; Alvarado, Idolina; Rodríguez-Amado, Jacqueline; Alvarez-Nemegyei, José; Wilson, Mike G

    2014-01-01

    To evaluate the implementability of the "2008 Mexican Clinical Practice Guideline for the management of hip and knee osteoarthritis at the primary level of care" within primary healthcare of three Mexican regions using the Guideline Implementability Appraisal methodology version 2 (GLIA.v2). Six family physicians, representing the South, North, and Central Mexico, and one Mexican physiatrist evaluated the 45 recommendations stated by the Mexican guideline. The GLIA.v2 methodology includes the execution of qualitative and semi-quantitative techniques. Reviewers' agreement was between moderate to near complete in most cases. Sixty-nine percent of the recommendations were considered difficult to implement within clinical practice. Eight recommendations did not have an appropriate format. Only 6 recommendations were judged as able to be consistently applied to clinical practice. Barriers related to the context of one or more institutions/regions were identified in 25 recommendations. These barriers are related to health providers/patients' beliefs, processes of care within each institution, and availability of some treatments recommended by the guideline. The guideline presented problems of conciseness and clarity that negatively affect its application within the Mexican primary healthcare context. We identified individual, organizational and system characteristics, which are common to the 3 institutions/regions studied and constitute barriers for implementing the guideline to clinical practice. It is recommended that the 2008-Mexican-CPG-OA be thoroughly revised and restructured to improve the clarity of the actions implied by each recommendation. We propose some strategies to accomplish this and to overcome some of the identified regional/institutional barriers. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  17. Patients with severe radiographic osteoarthritis have a better prognosis in physical functioning after hip and knee replacement: a cohort-study.

    Directory of Open Access Journals (Sweden)

    J Christiaan Keurentjes

    Full Text Available INTRODUCTION: Although Total Hip and Knee Replacements (THR/TKR improve Health-Related Quality of Life (HRQoL at the group level, up to 30% of patients are dissatisfied after surgery due to unfulfilled expectations. We aimed to assess whether the pre-operative radiographic severity of osteoarthritis (OA is related to the improvement in HRQoL after THR or TKR, both at the population and individual level. METHODS: In this multi-center observational cohort study, HRQoL of OA patients requiring THR or TKR was measured 2 weeks before surgery and at 2-5 years follow-up, using the Short-Form 36 (SF36. Additionally, we measured patient satisfaction on a 11-point Numeric Rating Scale (NRSS. The radiographic severity of OA was classified according to Kellgren and Lawrence (KL by an independent experienced musculoskeletal radiologist, blinded for the outcome. We compared the mean improvement and probability of a relevant improvement (defined as a patients change score ≥ Minimal Clinically Important Difference between patients with mild OA (KL Grade 0-2 and severe OA (KL Grade 3+4, whilst adjusting for confounders. RESULTS: Severe OA patients improved more and had a higher probability of a relevant improvement in physical functioning after both THR and TKR. For TKR patients with severe OA, larger improvements were found in General Health, Vitality and the Physical Component Summary Scale. The mean NRSS was also higher in severe OA TKR patients. DISCUSSION: Patients with severe OA have a better prognosis after THR and TKR than patients with mild OA. These findings might help to prevent dissatisfaction after THR and TKR by means of patient selection or expectation management.

  18. The prevalence of predisposing deformity in osteoarthritic hip joints

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  19. Epidemiology of osteoarthritis in Australia.

    Science.gov (United States)

    March, Lynette M; Bagga, Hanish

    2004-03-01

    Arthritis affects around 3 million people in Australia, representing about 15% of the population. Osteoarthritis is the leading cause of pain and disability among the elderly. Osteoarthritis is the third leading cause of life-years lost due to disability. Obesity and joint injury are important potentially modifiable risk factors for the development of osteoarthritis. Obesity is also an important predictor of progression of osteoarthritis. Currently, about 19000 hip and 20000 knee replacements are performed for osteoarthritis in Australia each year. Prevalence of osteoarthritis and the need for total joint replacement surgery are likely to increase because of a combination of increasing risk factors (age, obesity, injury), increasing expectations for improved quality of life, and improved surgical and anaesthetic techniques making surgery possible for more people. Services to provide these cost-effective procedures need to be increased. Primary and secondary prevention programs aimed at reducing obesity, preventing injury and improving rehabilitation and physical activity are urgently required.

  20. Tai Chi for treating knee osteoarthritis: Designing a long-term follow up randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rones Ramel

    2008-07-01

    Full Text Available Abstract Background Knee Osteoarthritis (KOA is a major cause of pain and functional impairment among elders. Currently, there are neither feasible preventive intervention strategies nor effective medical remedies for the management of KOA. Tai Chi, an ancient Chinese mind-body exercise that is reported to enhance muscle function, balance and flexibility, and to reduce pain, depression and anxiety, may safely and effectively be used to treat KOA. However, current evidence is inconclusive. Our study examines the effects of a 12-week Tai Chi program compared with an attention control (wellness education and stretching on pain, functional capacity, psychosocial variables, joint proprioception and health status in elderly people with KOA. The study will be completed by July 2009. Methods/Design Forty eligible patients, age > 55 yr, BMI ≤ 40 kg/m2 with tibiofemoral osteoarthritis (American College of Rheumatology criteria are identified and randomly allocated to either Tai Chi (10 modified forms from classical Yang style Tai Chi or attention control (wellness education and stretching. The 60-minute intervention sessions take place twice weekly for 12 weeks. The study is conducted at an urban tertiary medical center in Boston, Massachusetts. The primary outcome measure is the Western Ontario and McMaster Universities (WOMAC pain subscale at 12 weeks. Secondary outcomes include weekly WOMAC pain, function and stiffness scores, patient and physician global assessments, lower-extremity function, knee proprioception, depression, self-efficacy, social support, health-related quality of life, adherence and occurrence of adverse events after 12, 24 and 48 weeks. Discussion In this article, we present the challenges of designing a randomized controlled trial with long-term follow up. The challenges encountered in this design are: strategies for recruitment, avoidance of selection bias, the actual practice of Tai Chi, and the maximization of adherence

  1. Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: a cross-sectional study.

    Science.gov (United States)

    Smink, Agnes J; Bierma-Zeinstra, Sita M A; Dekker, Joost; Vliet Vlieland, Thea P M; Bijlsma, Johannes W J; Swierstra, Bart A; Kortland, Joke H; Voorn, Theo B; van den Ende, Cornelia H M; Schers, Henk J

    2013-03-11

    To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in the general practice may be hampered by the negative attitude of general practitioners (GPs) towards the strategy. In order to develop a tailored implementation plan, we assessed the GPs' views regarding specific recommendations in the SCS and their working procedures with regard to OA. A survey was conducted among a random sample of Dutch GPs. Questions included the GP's demographical characteristics and the practice setting as well as how the management of OA was organized and whether the GPs supported the SCS recommendations. In particular, we assessed GP's views regarding the effectiveness of 14 recommended and non-recommended treatment modalities. Furthermore, we calculated their agreement with 7 statements based on the SCS recommendations regarding the sequence for care. With a linear regression model, we identified factors that seemed to influence the GPs' agreement with the SCS recommendations. Four hundred fifty-six GPs (37%) aged 30-65 years, of whom 278 males (61%), responded. Seven of the 11 recommended modalities (i.e. oral Non-Steroidal Anti-Inflammatory Drugs, physical therapy, glucocorticoid intra-articular injections, education, lifestyle advice, acetaminophen, and tramadol) were considered effective by the majority of the GPs (varying between 95-60%). The mean agreement score, based on a 5-point scale, with the recommendations regarding the sequence for care was 2.8 (SD = 0.5). Ten percent of the variance in GPs' agreement could be explained by the GPs' attitudes regarding the effectiveness of the recommended and non-recommended non-surgical treatment modalities and the type of practice. In general, GPs support the recommendations in the SCS. Therefore, we expect

  2. Changes in Gait symmetry, Gait velocity and self-reported function following total hip replacement

    OpenAIRE

    Hodt-Billington, Caroline; Jorunn L. Helbostad; Vervaat, Willemijn; Rognsvåg, Turid; Moe-Nilssen, Rolf

    2011-01-01

    Objective: To investigate the magnitude of change at different time points in measures of gait symmetry, gait velocity and self-reported function following total hip replacement. Design: Longitudinal with test occasions pre-surgery and 3, 6 and 12 months post-surgery. Subjects: Thirty-four patients with hip osteoarthritis (mean age 63 years, standard deviation 11 years). Methods: Subjects walked back and forth along a 7-m walkway at slow, preferred and fast speed. Ante...

  3. 人工全髋关节置换术治疗成人髋关节骨性关节炎的临床分析%Analysis on the Clinical Efficacy of Artificial Total Hip Replacement Therapy for Adult Hip Osteoar-thritis

    Institute of Scientific and Technical Information of China (English)

    王伟

    2015-01-01

    目的:分析人工全髋关节置换术治疗成人髋关节骨性关节炎的临床疗效,并探讨人工全髋关节置换术的方法及其安全性。方法选取2007年4月至2011年6月高要市人民医院确诊为成人髋关节骨性关节炎行人工全髋关节置换术治疗的84例患者为研究对象,对其行人工全髋关节置换术后的临床效果进行中期随访,采用Hariss评分及X 线对临床结果进行评估。结果随访84例患者,采用Hariss 进行髋关节评分,术后评分较术前评分显著提高[(90.4±4.4)分比(51.4± 6.5)分,P<0.05]。综和评定结果示,优57例78髋,良24例27髋,中3例3髋,优良率为96.4%。结论成人髋关节骨性关节炎患者行人工全髋关节置换术治疗,临床疗效好,安全性高,但是熟练的手术技术与完善的术后康复训练是治疗成功的关键。%Objective To analyze on the clinical efficacy of artificial total hip arthroplasty in treating a-dult hip osteoarthritis and to explore the method and safety of total hip arthroplasty ,in order to provide refer-ence for clinical.Methods A total of 84 patients diagnosed as adult hip osteoarthritis and underwent artifi-cial total hip arthroplasty in Gaoyao People′s Hospital from Apr.2007 to Jun.2011 were selected as the re-search objects,the clinical effect of artificial total hip arthroplasty was followed up in middle term ,and evalu-ated by using Hariss score and X-ray.Results The results of Hariss scaling showed that the postoperative score(90.4 ±4.4) was significantly higher than the preoperative score(51.4 ±6.5),the difference was statistically significant(P<0.05) .Comprehensive evaluation results showed that 78 hips of 57 cases ranked excellent,27 hips of 24 cases ranked good,and 3 hips of 3 cases ranked medium,the rate of excellence and good was up to 96.4%.Conclusion Artificial total hip arthroplasty is safe and with good clinical efficacy in treating dult

  4. OARSI/OMERACT initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis. An OMERACT 10 Special Interest Group

    DEFF Research Database (Denmark)

    Gossec, Laure; Paternotte, Simon; Bingham, Clifton O;

    2011-01-01

    To define pain and physical function cutpoints that would, coupled with structural severity, define a surrogate measure of "need for joint replacement surgery," for use as an outcome measure for potential structure-modifying interventions for osteoarthritis (OA)....

  5. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Gürdal, Hatice; Karagülle, Müfit Zeki

    2016-10-01

    Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study

  6. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Gürdal, Hatice; Karagülle, Müfit Zeki

    2016-01-01

    Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study

  7. Hip or knee replacement - after - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  8. Hip or knee replacement - before - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  9. Cementless Hip Arthroplasty in Southern Iran, Midterm Outcome and Comparison of Two Designs

    Directory of Open Access Journals (Sweden)

    Gholam Hossein Shahcheraghi

    2015-09-01

    Full Text Available Background: Cementless hip prosthesis was designed to provide biologic fixation, without the use of cement. The second generation components have shown more reliable bone ingrowths and survival rates. We are reporting a midterm result of two designs of cementless prosthesis in a unique culture with different social habits and expectations. Methods: 52 primary cementless total hip arthroplasty in 42 patients with the mean age of 48.8 years were retrospectively studied. Two groups of prosthesis had been implanted: Harris-Galante II (HGII in 15 and Versys-Trilogy (V-T in 37 hips, both from Zimmer company. The patients were assessed clinically, radiographically and with Harris hip score, SF36, WOMAC, and MACTAR questionnaires, with 65 months (26-136 mean follow-up. Results: All the V-T prostheses had survived well. Eight of HG II were revised by the last follow-up in 19-102 months. All had undergone acetabular revision and 2 combined with femoral revision. Broken tines of HGII cups were seen in 4 radiographs. The 65 months overall survival was 96.2% for femoral and 84.6% for acetabular components. 90% had good or excellent Harris hip scores. The functional scores were poorer in the HG II group. Pain relief and improved walking were the two main patients’ expectations fulfilled in 97.6% and 92.8%, respectively. Conclusions: The outcome of cementless total hip arthroplasty (THA is satisfactory and comparable with the literature based on the results of function and survival of this small comparative group. The use of HGII acetabular component should be abandoned.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karen Junius

    2017-01-01

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

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

    Science.gov (United States)

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

    1978-11-09

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

  14. Translating research into practice through user-centered design: An application for osteoarthritis healthcare planning.

    Science.gov (United States)

    Carr, Eloise Cj; Babione, Julie N; Marshall, Deborah

    2017-08-01

    To identify the needs and requirements of the end users, to inform the development of a user-interface to translate an existing evidence-based decision support tool into a practical and usable interface for health service planning for osteoarthritis (OA) care. We used a user-centered design (UCD) approach that emphasized the role of the end-users and is well-suited to knowledge translation (KT). The first phase used a needs assessment focus group (n=8) and interviews (n=5) with target users (health care planners) within a provincial health care organization. The second phase used a participatory design approach, with two small group sessions (n=6) to explore workflow, thought processes, and needs of intended users. The needs assessment identified five design recommendations: ensuring the user-interface supports the target user group, allowing for user-directed data explorations, input parameter flexibility, clear presentation, and provision of relevant definitions. The second phase identified workflow insights from a proposed scenario. Graphs, the need for a visual overview of the data, and interactivity were key considerations to aid in meaningful use of the model and knowledge translation. A UCD approach is well suited to identify health care planners' requirements when using a decision support tool to improve health service planning and management of OA. We believe this is one of the first applications to be used in planning for health service delivery. We identified specific design recommendations that will increase user acceptability and uptake of the user-interface and underlying decision support tool in practice. Our approach demonstrated how UCD can be used to enable knowledge translation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for hand osteoarthritis.

    Science.gov (United States)

    Kloppenburg, M; Maheu, E; Kraus, V B; Cicuttini, F; Doherty, M; Dreiser, R-L; Henrotin, Y; Jiang, G-L; Mandl, L; Martel-Pelletier, J; Nelson, A E; Neogi, T; Pelletier, J-P; Punzi, L; Ramonda, R; Simon, L S; Wang, S

    2015-05-01

    Hand osteoarthritis (OA) is a very frequent disease, but yet understudied. However, a lot of works have been published in the past 10 years, and much has been done to better understand its clinical course and structural progression. Despite this new knowledge, few therapeutic trials have been conducted in hand OA. The last OARSI recommendations for the conduct of clinical trials in hand OA dates back to 2006. The present recommendations aimed at updating previous recommendations, by incorporating new data. The purpose of this expert opinion, consensus driven exercise is to provide evidence-based guidance on the design, execution and analysis of clinical trials in hand OA, where published evidence is available, supplemented by expert opinion, where evidence is lacking, to perform clinical trials in hand OA, both for symptom and for structure-modification. They indicate core outcome measurement sets for studies in hand OA, and list the methods and instruments that should be used to measure symptoms or structure. For both symptom- and structure-modification, at least pain, physical function, patient global assessment, HR-QoL, joint activity and hand strength should be assessed. In addition, for structure-modification trials, structural progression should be measured by radiographic changes. We also provide a research agenda listing many unsolved issues that seem to most urgently need to be addressed from the perspective of performing "good" clinical trials in hand OA. These updated OARSI recommendations should allow for better standardizing the conduct of clinical trials in hand OA in the next future.

  16. Molecular Dynamic Analysis of Hyaluronic Acid and Phospholipid Interaction in Tribological Surgical Adjuvant Design for Osteoarthritis.

    Science.gov (United States)

    Siódmiak, Jacek; Bełdowski, Piotr; Augé, Wayne K; Ledziński, Damian; Śmigiel, Sandra; Gadomski, Adam

    2017-09-04

    Tribological surgical adjuvants constitute a therapeutic discipline made possible by surgical advances in the treatment of damaged articular cartilage beyond palliative care. The purpose of this study is to analyze interactions between hyaluronic acid and phospholipid molecules, and the formation of geometric forms, that play a role in the facilitated lubrication of synovial joint organ systems. The analysis includes an evaluation of the pathologic state to detail conditions that may be encountered by adjuvants during surgical convalescence. The synovial fluid changes in pH, hyaluronic acid polydispersity, and phospholipid concentration associated with osteoarthritis are presented as features that influence the lubricating properties of adjuvant candidates. Molecular dynamic simulation studies are presented, and the Rouse model is deployed, to rationalize low molecular weight hyaluronic acid behavior in an osteoarthritic environment of increased pH and phospholipid concentration. The results indicate that the hyaluronic acid radius of gyration time evolution is both pH- and phospholipid concentration-dependent. Specifically, dipalmitoylphosphatidylcholine induces hydrophobic interactions in the system, causing low molecular weight hyaluronic acid to shrink and at high concentration be absorbed into phospholipid vesicles. Low molecular weight hyaluronic acid appears to be insufficient for use as a tribological surgical adjuvant because an increased pH and phospholipid concentration induces decreased crosslinking that prevents the formation of supramolecular lubricating forms. Dipalmitoylphosphatidylcholine remains an adjuvant candidate for certain clinical situations. The need to reconcile osteoarthritic phenotypes is a prerequisite that should serve as a framework for future adjuvant design and subsequent tribological testing.

  17. Canine Hip Dysplasia: Diagnostic Imaging.

    Science.gov (United States)

    Butler, J Ryan; Gambino, Jennifer

    2017-07-01

    Diagnostic imaging is the principal method used to screen for and diagnose hip dysplasia in the canine patient. Multiple techniques are available, each having advantages, disadvantages, and limitations. Hip-extended radiography is the most used method and is best used as a screening tool and for assessment for osteoarthritis. Distraction radiographic methods such as the PennHip method allow for improved detection of laxity and improved ability to predict future osteoarthritis development. More advanced techniques such as MRI, although expensive and not widely available, may improve patient screening and allow for improved assessment of cartilage health. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Effect of Exercise and Weight Loss in People Who Have Hip Osteoarthritis and Are Overweight or Obese : A Prospective Cohort Study

    NARCIS (Netherlands)

    Paans, Nienke; van den Akker-Scheek, Inge; Dilling, Roelien G.; Bos, Martine; van der Meer, Klaas; Bulstra, Sjoerd K.; Stevens, Martin

    2013-01-01

    Background. Osteoarthritis (OA) is the most common joint disorder in the world and is recognized as a substantial source of disability. For people with OA of the knee, exercise in combination with weight loss is a proven, effective, conservative treatment option, yet evidence is lacking for people w

  19. Patient-specific hip prostheses designed by surgeons

    Directory of Open Access Journals (Sweden)

    Coigny Florian

    2016-09-01

    Full Text Available Patient-specific bone and joint replacement implants lead to better functional and aesthetic results than conventional methods [1], [2], [3]. But extracting 3D shape information from CT Data and designing individual implants is demanding and requires multiple surgeon-to-engineer interactions. For manufacturing purposes, Additive Manufacturing offers various advantages, especially for low volume manufacturing parts, such as patient specific implants. To ease these new approaches and to avoid surgeon-to-engineer interactions a new design software approach is needed which offers highly automated and user friendly planning steps.

  20. [Serum hyaluronic acid in osteoarthritis].

    Science.gov (United States)

    Balblanc, J C; Hartmann, D; Noyer, D; Mathieu, P; Conrozier, T; Tron, A M; Piperno, M; Richard, M; Vignon, E

    1993-03-01

    In this prospective study, serum hyaluronate (SH) was assayed using a radiometric method (Pharmacia) in 73 osteoarthritis patients and 39 controls. All assays were performed between 8 h 00 and 9 h 00 a.m. because SH levels exhibit circadian variations. SH levels were significantly higher in patients with osteoarthritis than in controls (92 +/- 66 micrograms/l and 39 +/- 21 micrograms/l, respectively, p = 0.0001). Among 50 patients with osteoarthritis, including 29 with knee involvement and 21 with hip involvement, SH levels were not correlated with morning stiffness, duration of symptoms, Lequesne's algofunctional index, erythrocyte sedimentation rate, C-reactive protein, severity of roentgenographic changes in the affected knee or hip, disease extension, or severity. The lack of any relationship between changes in SH levels and Lequesne's is index values in 25 patients or between SH levels and joint space narrowing evaluated retrospectively in 16 patients, as well as the prompt return to high SH levels after arthroplasty and synovectomy in 14 patients with hip joint osteoarthritis, suggest that this potential marker is not useful for monitoring osteoarthritis in a single joint.

  1. Range of motion caused by design of the total hip prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Herrlin, K.; Selvik, G.; Pettersson, H.; Lidgren, L.

    In a clinical material of total hip prostheses, a study was performed of the range of femoral motion until impingement occurred between the neck of the femoral stem and the rim of the acetabular socket. The results were compared with the physiologic range of motion, and the clinically relevant motion restriction was measured. Restriction was most common in flexion. There was a correlation between the prosthetic design and the restriction due to impingement.

  2. Osteoarthritis 2012 year in review

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Juhl, C B

    2012-01-01

    Recent scientific advances in the treatment of hip and knee osteoarthritis (OA) relating to education, exercise, weight control and passive non-pharmacological and non-surgical treatments such as manual therapy, orthoses/orthotics and other aids are described. METHODS: A systematic literature...... search was performed in Medline from July 2011 to 10 April 2012 using the terms 'osteoarthritis, knee', 'osteoarthritis, hip' rehabilitation, physical therapy, exercise therapy and preoperative intervention; both as text words and as MeSH terms where possible. Trials evaluating rehabilitation...... interventions were included if they were randomized controlled trials (RCTs) or systematic reviews. Outcome papers were identified by combining the initial search with the terms 'outcome', 'measure*', 'valid*', 'reliabil*' or 'responsiveness'. Outcome studies were included if they contributed methodologically...

  3. Pre-operative ambulatory measurement of asymmetric leg loading during sit to stand in hip arthroplasty patients

    NARCIS (Netherlands)

    Martínez-Ramírez, Alicia; Weenk, Dirk; Lecumberri, Pablo; Verdonschot, Nico; Pakvis, Dean; Veltink, Peter H.

    2013-01-01

    Total hip arthroplasty is a successful surgical procedure to treat patients with hip osteoarthritis. Clinicians use different questionnaires to evaluate these patients. Gait velocity and these questionnaires; usually show significant improvement after total hip arthroplasty. This clinical evaluation

  4. Development of an assistive motorized hip orthosis: kinematics analysis and mechanical design.

    Science.gov (United States)

    Olivier, Jeremy; Bouri, Mohamed; Ortlieb, Amalric; Bleuler, Hannes; Clavel, Reymond

    2013-06-01

    With the increase of life expectancy, a higher number of elderly need assistance to maintain their mobility and their independance. The hip joint is crucial for walking and is problematic for a large number of aged people. In this paper we present a novel design of a motorized hip orthosis to assist elderly people while walking, stair climbing and during the sit-to-stand transistions. The kinematics was developed based on biomechanics considerations. To be able to achieve a large assistance rate, velocity and torques of the hip joint were studied from the literature. In order to fit with these requirements, an amplification mechanism inspired by excavators was developed and implemented. Comfort considerations were also taken into account and a custom interface was designed with the collaboration of a professional orthopaedic technician. First tests with the prototype showed that the workspace is sufficient for walking, for stair climbing as well as for sit-to-stand transitions. The assistance rate can go up to 30% for a 70 kg subject during walking at a cadence of 100 steps/min. The comfort is guaranteed despite the important weight (4.3 kg) of this first prototype.

  5. 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 ...

  6. Analysis on long-term efficacy of hip replacement surgery for osteoarthritis secondary to hip infections%髋关节感染继发骨关节炎人工髋关节置换术的远期疗效分析

    Institute of Scientific and Technical Information of China (English)

    崔金雷; 李军伟; 宋文超

    2015-01-01

    目的:探讨人工髋关节置换术(total hip arthroplasty ,THA)治疗髋关节感染继发骨关节炎的疗效,为临床治疗提供参考依据。方法回顾性分析2004年3月-2010年1月72例采用T H A治疗后发生髋关节感染继发骨关节炎患者临床资料;其中40例行保守治疗、32例行切开引流治疗;与治疗后3、6个月、1年及之后每2年随访1次,观察患者行走步态、双下肢是否等长、T rendelenburg 征,采用 Harris评分评价关节功能,数据采用SPSS17.0进行统计分析。结果患者术后髋关节Harris评分高于术前,术后评分与术前比较差异有统计学意义(P<0.05);末次随访时,手术组及非手术组Harris评分均高手术前,与术前比较,差异有统计学意义(P<0.05);两组间比较差异无统计学意义。结论采用 T HA治疗髋关节感染继发骨关节炎的患者满意率较高,术后功能恢复好,并发症发生率较低,在缓解临床症状及改善功能方面具有显著优势,可获得较好的远期疗效。%OBJECTIVE To evaluate long‐term efficacy of total hip arthroplasty (T HA ) for treatment of osteoar‐thritis secondary to hip infections so as to provide reference for clinical treatment .METHODS Between Mar .2004 and Jan .2010 ,72 patients with osteoarthritis secondary to hip sepsis underwent THA .The clinical data of these patients were retrospectively analyzed in this study .Among these patients ,40 patients underwent conventional treatment ,and 32 patients received drainage treatment .Follow‐ups were conducted at three months ,six months , one year and every two years after treatment during which patients were observed for walking gait ,equal length of both lower extremities and Trendelenburg sign .The joint function was evaluated by Harris scores .The software SPSS17 .0 was used for statistical analysis of data .RESULTS The difference was significant in Harris hip scores compared to

  7. Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis

    DEFF Research Database (Denmark)

    van Middelkoop, Marienke; Dziedzic, Krysia S; Doherty, Michael

    2013-01-01

    -analysis to quantify the effect modified by the predictors using individual patient data (IPD) is suggested. The initiative to collect and analyze IPD in OA research is commenced by the OA Trial Bank. The study aims are therefore: to evaluate the efficacy of intra-articular glucocorticoids for knee or hip OA...

  8. 全髋关节置换修复髋关节骨性关节炎和股骨颈骨折:隐性失血的对比%Total hip arthroplasty for hip osteoarthritis and femoral neck fracture:comparison of hidden blood loss

    Institute of Scientific and Technical Information of China (English)

    史高龙; 董启榕; 陈明; 佘昶

    2015-01-01

    intervention should be conducted for a particular cause? OBJECTIVE:To compare and analyze the hidden blood loss of patients with hip osteoarthritis and femoral neck fracture after total hip replacement. METHODS:The clinical data of 150 patients who received the unilateral total hip arthroplasty treatment from June 2013 to January 2015 were colected and analyzed, including 54 patients with hip osteoarthritis (30 male cases and 24 female cases ), 96 patients with femoral neck fracture (41 male cases and 55 female cases). The pre-and post-operative blood routine and intro-and post-operative blood loss and transfusion were recorded, and hidden blood loss during pen-operation period was evaluated. RESULTS AND CONCLUSION:Total blood loss was (1 616±216) mL, hidden blood loss was (699±102) mL, and hidden blood loss accounted for 43.3% of the total blood loss. The total blood loss was (1 742±254) mL in the hip osteoarthritis group, hidden blood loss was (758±127) mL, hidden blood loss accounted for 44.6% of the total blood loss; The average total blood loss was (1 470±189) mL in the femoral neck fracture group, hidden blood loss was (625±98) mL, hidden blood loss accounts for 42.1% of the total blood loss. The total blood loss and hidden blood loss in hip osteoarthritis group were significantly higher than those in the femoral neck fracture group (P< 0.05). However, there was no significant difference on the hidden blood loss accounts for the proportion of the total blood loss between two groups (P=0.419 3). These results suggest that the total blood loss and hidden blood loss are different for the patients who underwent total hip arthroplasty in the premise of both pathogenesis. Therefore, before the total hip arthroplasty, we should fuly take into account the primary cause of patients and estimate the total blood loss and hidden blood loss, so as to take appropriate preventive measures in time to ensure the safety of the replacement process.

  9. A Randomised Multi-centre Study to Compare the Long-term Performance of the Future Hip to 3 Other Implants in Primary Total Hip Replacement

    Science.gov (United States)

    2016-10-06

    Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis; Perthes Disease

  10. Total hip arthroplasty using a cementless prosthesis in the treatment of osteoarthritis secondary to developmental dysplasia of the hip%生物型假体全髋关节置换术治疗成人髋关节发育不良继发骨关节炎的疗效评价

    Institute of Scientific and Technical Information of China (English)

    彭昊; 陈森; 郑慧锋; 李建平; 周建林; 方洪松

    2013-01-01

    [目的]评价生物型假体全髋关节置换术(total hip arthroplasty,THA)治疗成人髋关节发育不良(developmental dysplasia of hip,DDH)继发骨关节炎的疗效.[方法]对2002年2月~2009年8月在本院行THA治疗的76例(102髋)髋关节发育不良继发骨关节炎患者的临床及影响学资料进行回顾性分析,其中男34例,女42例;年龄35~64岁,平均52.5岁.用Harris髋关节评分系统评价手术的临床疗效.根据骨盆平片及患髋正、侧位X线片观察髋臼、股骨假体的位置及其周围骨质变化.[结果]所有患者均获2年以上随访,平均5.3年.术后4例仍有轻度疼痛,服用非甾体类止痛药后缓解.8例存在不同程度下肢不等长(0.5 ~1.2 cm),Trendelenburg征阴性,无跛行.末次随访时Harris评分平均值(89.5±3.8)分,优46例(60髋),良20例(30髋),可10例(12髋);优良率为88.2%.末次随访时髋臼假体位置无明显移位,头臼包容性良好.30例出现异位骨化,6例出现髋臼周围骨溶解.股骨柄假体的位置无明显改变,中心固定有98髋(94.1%),柄-髓腔匹配优良率100%.4髋出现股骨侧骨溶解,8髋假体柄与股骨界面出现透亮线.所有病例均出现股骨近端骨重塑,其中Ⅰ度92髋,Ⅱ度10髋.无感染、假体松动、假体周围骨折等并发症发生.[结论]生物型假体全髋关节置换术治疗成人髋关节发育不良继发骨关节炎的疗效满意.%[Objective] To evaluate the effect of total hip arthroplasty using a cementless prosthesis in treating osteoarthritis secondary to developmental dysplasia of the hip in adult.[Methods] Data of 76 patients (102 hips),who had undergone total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip from February 2002 to August 2009,were retrospectively analyzed.There were 34 males and 42 females,aged from 35 to 64 years (average,52.5 years).Harris hip score was used to assess the clinical efficacy.The components migration and

  11. Design and construction of custom-made neoprene thumb carpo-metacarpal orthosis with thermoplastic stabilization for first carpo-metacarpal joint osteoarthritis.

    Science.gov (United States)

    Bani, Monireh Ahmadi; Arazpour, Mokhtar; Curran, Sarah

    2013-01-01

    Individuals with first carpo-metacarpal (CMC) osteoarthritis (OA) often experience pain and difficulty with functional activities. Thus, designing orthotics to improve function and decrease pain is common practice. These therapists designed an orthosis using a combination of neoprene and thermoplastic materials to create a soft orthosis that provides support to the first CMC joint - Victoria Priganc, PhD, OTR, CHT, CLT.

  12. Guía de manejo clínico de la artrosis de cadera y rodilla Guide for the clinical management of osteoarthritis of the hip and the knee

    Directory of Open Access Journals (Sweden)

    I. Morgado

    2005-07-01

    Full Text Available Las guías de práctica clínica son importantes a la hora de tomar decisiones basadas en la evidencia y centradas en el paciente, no debiéndose interpretar como mandatos rígidos sino como recomendaciones basadas en estudios de efectividad clínica, siendo el médico quien está en la mejor situación a la hora de decidir entre las distintas aproximaciones terapéuticas para cada uno de sus pacientes. Estas guías surgen de la revisión actualizada de la literatura médica en combinación con la opinión de los expertos en la materia. Recientemente han sido publicadas varias guías para el manejo de la artrosis de cadera y rodilla con el objeto de ayudar al clínico en el tratamiento de pacientes con tal patología; a pesar de basarse en una misma evidencia, existen puntos discrepantes en las recomendaciones hechas por distintos grupos de trabajo. El objetivo de este trabajo es revisar el manejo clínico actual de la artrosis de cadera y rodilla así como identificar el abordaje óptimo de la misma en función de la medicina basada en la evidencia.Guides of clinical practice can help to take evidence-based and patient-focused decisions. However, these must not be understood as strict rules, but as recommendations based on clinical effectiveness studies. The physician is in the best position to decide between the different therapeutic options available for each individual patient. These guides are based on the updated review of the medical literature, combined with the opinion of experts in the relevant field. Different guides have been published recently for the management of osteoarthritis of the hip and the knee that help the physician to decide the best treatment for the patients with such condition. Despite being based on the same evidences, recommendations issued by different work groups are in disagreement. This work has aimed to review the current clinical management of osteoarthritis of the hip and the knee, as well as to identify its

  13. Radiographic case definitions and prevalence of osteoarthrosis of the hip: a survey of 4 151 subjects in the Osteoarthritis Substudy of the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

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

    2004-01-01

    BACKGROUND: The diagnosis of osteoarthrosis (OA) is founded on radiographic evidence of joint degeneration and characteristic subjective symptoms. Due to the lack of consensus radiographic case definitions, the prevalence and incidence of OA reported in the literature varies. The aims of the curr......BACKGROUND: The diagnosis of osteoarthrosis (OA) is founded on radiographic evidence of joint degeneration and characteristic subjective symptoms. Due to the lack of consensus radiographic case definitions, the prevalence and incidence of OA reported in the literature varies. The aims...... of the current study were to establish an accurate and workable radiographic definition of OA in hip joints and to examine the association of OA (thus defined) with self-reported pain. METHODS: Radiographic features of hip OA were classified in pelvic radiographs of 3 807 subjects (1448 males and 2 359 females......: Formation of cysts, osteophytes and subchondral sclerosis was significantly more frequent in men. Average minimum JSW was narrower in women than in men (p life, but progressively more so in women. Women reported hip pain more...

  14. Radiographic case definitions and prevalence of osteoarthrosis of the hip: a survey of 4 151 subjects in the Osteoarthritis Substudy of the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

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

    2004-01-01

    BACKGROUND: The diagnosis of osteoarthrosis (OA) is founded on radiographic evidence of joint degeneration and characteristic subjective symptoms. Due to the lack of consensus radiographic case definitions, the prevalence and incidence of OA reported in the literature varies. The aims of the curr......BACKGROUND: The diagnosis of osteoarthrosis (OA) is founded on radiographic evidence of joint degeneration and characteristic subjective symptoms. Due to the lack of consensus radiographic case definitions, the prevalence and incidence of OA reported in the literature varies. The aims...... of the current study were to establish an accurate and workable radiographic definition of OA in hip joints and to examine the association of OA (thus defined) with self-reported pain. METHODS: Radiographic features of hip OA were classified in pelvic radiographs of 3 807 subjects (1448 males and 2 359 females......) according to the OA classifications of Kellgren and Lawrence (1957) and Croft (1990), and according to minimum joint space width (JSW) of 2.0 mm regardless of other radiographic features of OA. The relationships between these radiographic discriminators and self-reported hip pain were investigated. RESULTS...

  15. Thermoelastic Femoral Stress Imaging for Experimental Evaluation of Hip Prosthesis Design

    Science.gov (United States)

    Hyodo, Koji; Inomoto, Masayoshi; Ma, Wenxiao; Miyakawa, Syunpei; Tateishi, Tetsuya

    An experimental system using the thermoelastic stress analysis method and a synthetic femur was utilized to perform reliable and convenient mechanical biocompatibility evaluation of hip prosthesis design. Unlike the conventional technique, the unique advantage of the thermoelastic stress analysis method is its ability to image whole-surface stress (Δ(σ1+σ2)) distribution in specimens. The mechanical properties of synthetic femurs agreed well with those of cadaveric femurs with little variability between specimens. We applied this experimental system for stress distribution visualization of the intact femur, and the femurs implanted with an artificial joint. The surface stress distribution of the femurs sensitively reflected the prosthesis design and the contact condition between the stem and the bone. By analyzing the relationship between the stress distribution and the clinical results of the artificial joint, this technique can be used in mechanical biocompatibility evaluation and pre-clinical performance prediction of new artificial joint design.

  16. 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...

  17. Osteoarthritis of the first carpometacarpal joint: a study of radiology and clinical epidemiology:

    DEFF Research Database (Denmark)

    Sonne-Holm, Stig; Jacobsen, J

    2006-01-01

    Epidemiological studies show an increased prevalence of osteoarthritis of the knee and hand with increased body mass index [BMI]. Osteoarthritis of the hip joint is not related to BMI. The connection between obesity and osteoarthritis cannot exclusively be explained by genetic factors or by the a...

  18. Hip Resurfacing Implants.

    Science.gov (United States)

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

    2015-08-01

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

  19. Improved design of cementless hip stems using two-dimensional functionally graded materials.

    Science.gov (United States)

    Hedia, H S; Shabara, M A N; El-Midany, T T; Fouda, N

    2006-10-01

    Increasingly, it is acknowledged that bone resorption around cementless hip implants may cause future problems. The solution is frequently sought in reducing implant stiffness. However, this confronts the designer with a true design conflict: how to reduce the stiffness without excessively loading the proximal bone/prosthesis interface? The aim of this work is to improve the design of cementless hip stem material, using two-dimensional (2D) functionally graded material (FGM) concept in order to solve the above problems. Two models were used in this analysis, using three materials with different elastic moduli, E(1), E(2), and E(3). In model I, the elastic moduli E(1) and E(2) gradually change along the upper stem surface, while E(3) is maintained constant along all the lower surface of the stem. However, in model II, the elastic moduli E(1) and E(2) gradually change along the lower stem surface, while E(3) is maintained constant all along the upper stem surface. It is found that the recommended model is model I, which has three distinct materials of hydroxyapatite, Bioglass, and collagen. The recommended design of 2D FGM is expected to reduce the stress shielding by 91% and 12%, respectively, compared with titanium stem and model II of FGM. It is found that this new design reduces the maximum interface shear stress at the lateral and medial sides of the femur by about 50%, compared with titanium stem. Furthermore, the maximum interface shear stress is reduced by about 17% and 11% at the lateral and medial sides of the femur, respectively, compared with that of model II of FGM.

  20. CHECK, a multicenter cohort of persons with early osteoarthritis

    NARCIS (Netherlands)

    Wesseling, J.

    2014-01-01

    The course of complaints, prognosis and underlying mechanisms in the early stage of osteoarthritis is poorly understood. To address the many gaps in these areas, the Dutch Arthritis Foundation (DAF) initiated and funded an inception cohort of patients with early symptomatic osteoarthritis of the hip

  1. CHECK, a multicenter cohort of persons with early osteoarthritis

    NARCIS (Netherlands)

    Wesseling, J.

    2014-01-01

    The course of complaints, prognosis and underlying mechanisms in the early stage of osteoarthritis is poorly understood. To address the many gaps in these areas, the Dutch Arthritis Foundation (DAF) initiated and funded an inception cohort of patients with early symptomatic osteoarthritis of the hip

  2. Designing a Safety Reporting Smartphone Application to Improve Patient Safety After Total Hip Arthroplasty.

    Science.gov (United States)

    Krumsvik, Ole Andreas; Babic, Ankica

    2017-01-01

    This paper presents a safety reporting smartphone application which is expected to reduce the occurrence of postoperative adverse events after total hip arthroplasty (THA). A user-centered design approach was utilized to facilitate optimal user experience. Two main implemented functionalities capture patient pain levels and well-being, the two dimensions of patient status that are intuitive and commonly checked. For these and other functionalities, mobile technology could enable timely safety reporting and collection of patient data out of a hospital setting. The HCI expert, and healthcare professionals from the Haukeland University Hospital in Bergen have assessed the design with respect to the interaction flow, information content, and self-reporting functionalities. They have found it to be practical, intuitive, sufficient and simple for users. Patient self-reporting could help recognizing safety issues and adverse events.

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

    Directory of Open Access Journals (Sweden)

    van der Weegen Walter

    2012-12-01

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

  4. Pre-operative ambulatory measurement of asymmetric lower limb loading during walking in total hip arthroplasty patients

    NARCIS (Netherlands)

    Martínez-Ramírez, Alicia; Weenk, Dirk; Lecumberri, Pablo; Verdonschot, Nico; Pakvis, Dean; Veltink, Peter H.

    2013-01-01

    The main goal of this study was to investigate how mobility characteristics during walking, relate to gait velocity and questionnaire outcomes of patients with hip osteoarthritis in an outpatient setting. Methods 22 patients with primary osteoarthritis of the hip selected for a total hip arthroplast

  5. Design and Control of a Powered Hip Exoskeleton for Walking Assistance

    Directory of Open Access Journals (Sweden)

    Qingcong Wu

    2015-03-01

    Full Text Available The wearable powered exoskeleton is a human-robot cooperation system that integrates the strength of a robot with human intelligence. This paper presents the research results into a powered hip exoskeleton (PH-EXOS designed to provide locomotive assistance to individuals with walking impediments. The Bowden cable actuated exoskeleton has an anthropomorphic structure with six degrees of freedom (DOF in order to match the human hip anatomy and enable natural interaction with the user. The mechanical structure, the actuation system, and the interaction kinematics of PH-EXOS are optimized to achieve preferable manoeuvrability and harmony. For the control of the exoskeleton, a real-time control system is established in xPC target environment based on Matlab/RTW. A Cascaded PID controller is developed to perform the trajectories tracking tasks in passive control mode. Besides, based on the pressure information on the thigh, a fuzzy adaptive controller is developed to perform walking assistance tasks in active control mode. Preliminary treadmill walking experiments on a healthy subject were conducted to verify the effectiveness of the proposed device and control approaches in reducing walking effort.

  6. Design and Control of a Powered Hip Exoskeleton for Walking Assistance

    Directory of Open Access Journals (Sweden)

    Qingcong Wu

    2015-03-01

    Full Text Available The wearable powered exoskeleton is a human-robot cooperation system that integrates the strength of a robot with human intelligence. This paper presents the research results into a powered hip exoskeleton (PH-EXOS designed to provide locomotive assistance to individuals with walking impediments. The Bowden cable actuated exoskeleton has an anthropomorphic structure with six degrees of freedom (DOF in order to match the human hip anatomy and enable natural interaction with the user. The mechanical structure, the actuation system, and the interaction kinematics of PH EXOS are optimized to achieve preferable manoeuvrability and harmony. For the control of the exoskeleton, a real-time control system is established in xPC target environment based on Matlab/RTW. A Cascaded PID controller is developed to perform the trajectories tracking tasks in passive control mode. Besides, based on the pressure information on the thigh, a fuzzy adaptive controller is developed to perform walking assistance tasks in active control mode. Preliminary treadmill walking experiments on a healthy subject were conducted to verify the effectiveness of the proposed device and control approaches in reducing walking effort.

  7. Preoperative ambulatory measurement of asymmetric leg loading during sit-to-stand in hip arthroplasty patients

    NARCIS (Netherlands)

    Martinez-Ramirez, A.; Weenk, D.; Lecumberri, P.; Verdonschot, N.J.; Pakvis, D.; Veltink, P.H.

    2014-01-01

    Total hip arthroplasty (TGA) is a successful surgical procedure to treat patients with hip osteoarthritis. Clinicians use different questionnaires to evaluate these patients. Gait velocity and these questionnaires; usually show significant improvement after TGA . This clinical evaluation does, howev

  8. Risk factors of knee osteoarthritis, WHO-ILAR-COPCORD study

    Directory of Open Access Journals (Sweden)

    Barghamdi M

    2009-01-01

    Full Text Available "nBackground: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis. "nMethods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study. Using a questionnaire developed by COPCORD group (Asia & Oceania, we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations. "nResults: Age (OR; 1.096; CI95%: 1.091-1.1; P: 0.00 and sex (OR; 2.85; CI95%: 2.49-3.28; P: 0.00 showed significant association with knee osteoarthritis. Overweight (OR; 1.81; CI95%: 1.28-2.55; P: 0.00 and obesity (OR; 3.3; CI95%: 2.34-4.66; P: 0.00 both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44; P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR; 0.54; CI95%: 0.38-0.78; P: 0.00. "nConclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

  9. Osteoarthritis of the Hand

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Osteoarthritis Email to a friend * required fields From * To * ... for those with osteoarthritis. TREATMENT The Diagnosis of Osteoarthritis When diagnosing osteoarthritis, your doctor will ask you ...

  10. Living Better with Osteoarthritis

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Osteoarthritis Living Better with Osteoarthritis Past Issues / Winter 2013 Table of Contents What Is Osteoarthritis? Osteoarthritis is the most common type of arthritis. ...

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

    Institute of Scientific and Technical Information of China (English)

    沈彬; 黄强; 杨静; 周宗科; 康鹏德; 裴福兴

    2010-01-01

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

  12. Development and Preliminary Validation of a Digital Overlay-based Learning Module for Semiquantitative Evaluation of Magnetic Resonance Imaging Lesions in Osteoarthritis of the Hip.

    Science.gov (United States)

    Maksymowych, Walter P; Pitts, Meaghan; Budak, Matthew J; Gracey, David; Lambert, Robert G; McDougall, David; Pianta, Marcus; Rennie, Winston J; Wichuk, Stephanie; Winn, Naomi; Jaremko, Jacob L

    2016-01-01

    To develop and validate a knowledge transfer (KT) module aimed at enhancing feasibility and reliability of semiquantitative assessment of bone marrow lesions (BML) and synovitis-effusion using the Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS). Three radiologists naive to the HIMRISS method reviewed the manuscript describing the method and then scored MRI scans from 16 patients with hip OA obtained at baseline and 8 weeks after intraarticular injection of corticosteroid. Readers then reviewed a KT module comprising an instructional presentation and 8 reference DICOM (digital imaging and communications in medicine) cases scored by 3 readers with expertise in the HIMRISS method, and then used electronic overlay software to score scans from 23 patients with OA. The same format was followed with a second group of 3 readers naive to HIMRISS using a KT module revised to incorporate the overlay with a Web-based DICOM viewer to enhance feasibility. Interobserver reliability was assessed with the intraclass correlation coefficient (ICC). In both exercises, reliability for baseline scores was excellent for femoral BML, very good for acetabular BML, and good for synovitis-effusion (overall ICC = 0.91, 0.89, 0.62, respectively) even without prior calibration using the KT module. However, reliability for detecting change was substantially worse than for expert readers, especially for acetabular BML and synovitis-effusion (overall ICC = 0.59 vs 0.19, and 0.42 vs 0.25, respectively). Reliability improved for detection of change in these lesions, especially after reader calibration with the revised KT module. Development and validation of a systematic method for KT may enhance external validation of certain imaging instruments.

  13. Group physical therapy for veterans with knee osteoarthritis: study design and methodology.

    Science.gov (United States)

    Allen, Kelli D; Bongiorni, Dennis; Walker, Tessa A; Bartle, John; Bosworth, Hayden B; Coffman, Cynthia J; Datta, Santanu K; Edelman, David; Hall, Katherine S; Hansen, Gloria; Jennings, Caroline; Lindquist, Jennifer H; Oddone, Eugene Z; Senick, Margaret J; Sizemore, John C; St John, Jamie; Hoenig, Helen

    2013-03-01

    Physical therapy (PT) is a key component of treatment for knee osteoarthritis (OA) and can decrease pain and improve function. Given the expected rise in prevalence of knee OA and the associated demand for treatment, there is a need for models of care that cost-effectively extend PT services for patients with this condition. This manuscript describes a randomized clinical trial of a group-based physical therapy program that can potentially extend services to more patients with knee OA, providing a greater number of sessions per patient, at lower staffing costs compared to traditional individual PT. Participants with symptomatic knee OA (n = 376) are randomized to either a 12-week group-based PT program (six 1 h sessions, eight patients per group, led by a physical therapist and physical therapist assistant) or usual PT care (two individual visits with a physical therapist). Participants in both PT arms receive instruction in an exercise program, information on joint care and protection, and individual consultations with a physical therapist to address specific functional and therapeutic needs. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and the secondary outcome is the Short Physical Performance Test Protocol (objective physical function). Outcomes are assessed at baseline and 12-week follow-up, and the primary outcome is also assessed via telephone at 24-week follow-up to examine sustainability of effects. Linear mixed models will be used to compare outcomes for the two study arms. An economic cost analysis of the PT interventions will also be conducted. Published by Elsevier Inc.

  14. Bosworth hip shelf arthroplasty in adult dysplastic hips: ten to twenty three year results.

    Science.gov (United States)

    Bartoníček, Jan; Vávra, Jaroslav; Chochola, Antonín

    2012-12-01

    Hip shelf arthroplasty is currently considered to be a salvage procedure. The aim of the study is to present outcomes of Bosworth hip shelf arthroplasty in adolescent dysplastic hips with a minimum ten-year follow-up. The basic group comprised 25 hips in 18 patients with the mean age of 31 years (range, 16-52) at the time of operation. Subgroup A included 20 hips that were evaluated prior to operation as spherical, centric hips without osteoarthritic changes (acetabular dysplasia). The heterogeneous subgroup B comprised five hips. Of these, three hips were evaluated as aspheric, without osteoarthritic changes, and two hips as aspheric, with osteoarthritic changes of grade 2 according to Tönnis. In addition, two hips in subgroup B were evaluated as decentred (subluxated), one hip without and one hip with osteoarthritic changes. The mean follow-up was 15 years (range, ten-23). In subgroup A, the positive effect of operation had lasted at the time of the final follow-up for ten to 22 years postoperatively (average follow-up 14 years) in 19 hips. Only one female patient, 46 years old at the time of operation, developed hip osteoarthritis within ten years, that was treated by THA. In subgroup B, a lasting positive effect of operation was recorded in two cases at the time of the final follow-up (12 and 15 years). The third female patient with an aspheric and decentred hip developed severe hip osteoarthritis 21 years after shelf procedure that was treated by THA. In two patients who had hip osteoarthritis already before the operation, the positive effect of the shelf procedure survived over 13 and 20 years. Although hip osteoarthritis progressed, THA was performed as late as 15 and 23 years after the shelf procedure. The mean Harris hip score in 21 hips with a still functional hip shelf was 68 (range, 56-82) before and 90 (range, 76-100) after the surgery. The best outcomes of Bosworth hip shelf arthroplasty may be expected in a dysplastic spherical centred hip

  15. [Atraumatic hip pain in young adults].

    Science.gov (United States)

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

    2016-01-01

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

  16. Differences in zinc status between patients with osteoarthritis and osteoporosis

    DEFF Research Database (Denmark)

    Ovesen, Janne; Møller-Madsen, Bjarne; Nielsen, Poul Torben

    2009-01-01

    Zinc has been suggested to play an important role in the development of osteoporosis, whereas the influence of zinc on osteoarthritis has attracted much less attention. The aim of the study was to investigate and compare the zinc status and bone turnover, density, and biomechanical properties...... of osteoarthritic and osteoporotic patients. The study comprised 40 women who underwent hip replacement due to osteoarthritis or osteoporosis. Serum and urine zinc content, and bone resorption markers and serum bone formation markers were determined. The unaffected hip and the exarticulated affected femoral head...... that osteoporosis and osteoarthritis rarely occur in the same individual....

  17. Periprosthetic femoral bone loss in total hip arthroplasty: systematic analysis of the effect of stem design.

    Science.gov (United States)

    Knutsen, Ashleen R; Lau, Nicole; Longjohn, Donald B; Ebramzadeh, Edward; Sangiorgio, Sophia N

    2017-02-21

    Periprosthetic bone loss may lead to major complications in total hip arthroplasty (THA), including loosening, migration, and even fracture. This study analysed the influence of femoral implant designs on periprosthetic bone mineral density (BMD) after THA. The results of all previous published studies reporting periprosthetic femoral BMD following THA were compiled. Using these results, we compared percent changes in bone loss as a function of: femoral stem fixation, material, and geometry. The greatest bone loss was in the calcar region (Gruen Zone 7). Overall, cemented stems had more bone loss distally than noncemented stems, while noncemented stems had more proximal bone loss than cemented stems. Within noncemented stems, cobalt-chromium (CoCr) stems had nearly double the proximal bone loss compared to titanium (Ti) alloy stems. Finally, within noncemented titanium alloy group, straight stems had less bone loss than anatomical, tapered, and press-fit designs. The findings from the present study quantified percent changes in periprosthetic BMD as a function of fixation method, alloy, and stem design. While no one stem type was identified as ideal, we now have a clearer understanding of the influence of stem design on load transfer to the surrounding bone.

  18. Hip Ultrasound

    Science.gov (United States)

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

  19. Efficacy and safety of oral strontium ranelate for the treatment of knee osteoarthritis: rationale and design of randomised, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Cyrus Cooper

    2013-01-01

    Full Text Available Objective: The osteoporosis drug strontium ranelate dissociates bone remodelling processes. It also inhibits subchondral bone resorption and stimulates cartilage matrix formation in vitro. Exploratory studies in the osteoporosis trialsreport that strontium ranelate reduces biomarkers of cartilage degradation, and attenuates the progression and clinical symptoms of spinal osteoarthritis, suggesting symptom- and structure-modifying activity in osteoarthritis. We describethe rationale and design of a randomised trial evaluating the efficacy and safety of strontium ranelate in knee osteoarthritis.Research design, methods, and results: This double-blind, placebo-controlled trial (98 centres, 18 countries includes ambulatory Caucasian men and women aged ≥50 years with primary knee osteoarthritis of the medial tibiofemoralcompartment (Kellgren and Lawrence grade 2 or 3, joint space width (JSW 2.5 to 5 mm, and knee pain on most days in the previous month (intensity ≥40 mm on a visual analogue scale. Patients are randomly allocated to three groups (strontium ranelate 1 or 2g/day, or placebo. Follow-up is expected to last 3 years. The primary endpoint is radiographic change in JSW from baseline in each group versus placebo. The main clinical secondary endpoint is WOMAC score at the knee. Safety is assessed at every visit. It is estimated that 1600 patients are required to establish statistical significance with power >90% (0.2 mm ±10% between-group difference in change in JSW over 3 years. Recruitment started in April 2006. The results are expected in spring 2012.Clinical trial registration: The trial is registered on www.controlled-trials.com (number ISRCTN41323372.Conclusions: This randomised, double blind, placebo-controlled study will establish the potential of strontium ranelate in improving structure and symptoms in patients with knee osteoarthritis.

  20. Correlation of corrosion and biomechanics in the retrieval of a single modular neck total hip arthroplasty design: modular neck total hip arthroplasty system.

    Science.gov (United States)

    Lanting, Brent A; Teeter, Matthew G; Vasarhelyi, Edward M; Ivanov, Todor G; Howard, James L; Naudie, Douglas D R

    2015-01-01

    Increased modularity of total hip arthroplasty components has occurred, with theoretical advantages and disadvantages. Recent literature indicates the potential for elevated revision rates of modular neck systems and the potential for local pseudotumor and metallosis formation at the modular neck/stem site. Retrieval analysis of one modular neck implant design including SEM (SCANNING ELECTRON MICROSCOPY) assessment was done and correlated with FEA (finite element analysis) as well as clinical features of patient demographics, implant and laboratory analysis. Correlation of the consistent corrosion locations to FEA indicates that the material and design features of this system may result in a biomechanical reason for failure. The stem aspect of the modular neck/stem junction may be at particular risk.

  1. No Increased Risk for Primary Osteoarthritis in Liver Cirrhosis

    DEFF Research Database (Denmark)

    Deleuran, Thomas; Vilstrup, Hendrik; Overgaard, Søren

    2016-01-01

    OBJECTIVE: Chronic synovial inflammation causes primary osteoarthritis, but it is unknown whether chronic systemic inflammation does, too. Patients with cirrhosis have chronic systemic inflammation and therefore we examined the association between cirrhosis and primary osteoarthritis of the hip...... and knee. METHODS: In Danish healthcare databases we identified all residents over 60 years diagnosed with cirrhosis in 1994-2011, and for each of them we sampled five age- and gender-matched reference persons from the general population. We excluded everyone with risk factors for secondary osteoarthritis...... and computed incidence rates of primary osteoarthritis of the hip or knee. We used stratified Cox regression to estimate the hazard ratios of primary osteoarthritis for cirrhosis patients vs. reference persons in strata defined by gender, age, cirrhosis etiology, and ascites vs. no ascites. We also computed...

  2. Contact sport and osteoarthritis.

    LENUS (Irish Health Repository)

    Molloy, Michael G

    2011-04-01

    Osteoarthritis (OA) is the most common joint disease in the world and the single largest cause of disability for those over 18 years. It affects more than twice as many people as does cardiac disease, and increases in incidence and prevalence with age. Animal and human studies have shown no evidence of increased risk of hip or knee OA with moderate exercise and in the absence of traumatic injury, sporting activity has a protective effect. One age-matched case control study found recreational runners who ran 12-14 miles per week for up to 40 years had no increase in radiological or symptomatic hip or knee OA. However, higher rates of hip OA occur in contact sports than in age-matched controls, with the highest rate in professional players. Soccer players with torn anterior cruciate ligaments (ACL) are more likely to develop knee OA than those with intact ACL. Early ACL repair reduces the risk of knee OA, but does not prevent it. Established injury prevention programmes have been refined to prevent injuries such as ACL rupture.

  3. Hip resurfacing arthroplasty: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    K Corten

    2011-03-01

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

  4. Diagnostic accuracy of the A-test and cutoff points for assessing outcomes and planning acute and post-acute rehabilitation of patients surgically treated for hip fractures and osteoarthritis

    Directory of Open Access Journals (Sweden)

    Vukomanović Aleksandra

    2016-01-01

    Full Text Available Background/Aim. The A-test is used in daily clinical practice for monitoring functional recovery of orthopedic patients during early rehabilitation. The aim of this study was to determine the accuracy of A-test and cutoff point at which the test can separate patients with and without functional disability at the end of early rehabilitation. Also, it was important to determine whether A-test has that discriminative ability (and at which cutoff points in the first days of early rehabilitation in order to have time to plan post acute rehabilitation. Methods. This measurement-focused study was conducted in the Orthopedic Ward during early inpatient rehabilitation (1st−5th day after the operation of 60 patients with hip osteoarthritis (HO that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF. For measurements we used the A-test and the University of Iowa Level of Assistance Scale (ILAS as the gold standard. For statistical analysis we used the receiver operating characteristic (ROC curve and the area under the curve (AUC with 95% confidence interval for the results of A-test from the first to the fifth day of rehabilitation, sensitivity, specificity, the rate of false positive and false negative errors, positive and negative predictive value, ratio of positive and negative likelihood ratio, accuracy, point to the ROC curve closest to 0.1 and Youden index for all the cutoff points. Results. The AUC was 0.825 (0.744−0.905 for the first day of rehabilitation, 0.922 (0.872−0.972 for the second day of rehabilitation, 0.980 (0.959−1.000 for the third day of rehabilitation, 0.989 (0.973−1.004 for the fourth day, and 0.999 (0.996−1.001 for the fifth day of rehabilitation. The optimal cutoff for the results of A-test was: 7/8 for the first day, 29/30 for the fourth day, and 34/35 for the fifth day of rehabilitation. On the second and the third day A-test had two cutoff points, the lower point safely separated the

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

    Science.gov (United States)

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

    2014-10-01

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

  6. Effectiveness of computer-navigated minimally invasive total hip surgery compared to conventional total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bulstra Sjoerd K

    2007-01-01

    Full Text Available Abstract Background Moderate to severe osteoarthrosis is the most common indication for Total Hip Arthroplasty (THA. Minimally Invasive Total Hip Surgery (MIS and computer-navigated surgery were introduced several years ago. However, the literature lacks well-designed studies that provide evidence of superiority of computer-navigated MIS over a conventional THA technique. Hence, the purpose of this study is to compare (costeffectiveness of computer-navigated MIS with a conventional technique for THA. It is our hypothesis that computer-navigated MIS will lead to a quicker recovery during the early postoperative period (3 months, and to an outcome at least as good 6 months postoperatively. We also hypothesize that computer-navigated MIS leads to fewer perioperative complications and better prosthesis positioning. Furthermore, cost advantages of computer-navigated MIS over conventional THA technique are expected. Methods/design A cluster randomized controlled trial will be executed. Patients between the ages of 18 and 75 admitted for primary cementless unilateral THA will be included. Patients will be stratified using the Charnley classification. They will be randomly allocated to have computer-navigated MIS or conventional THA technique. Measurements take place preoperatively, perioperatively, and 6 weeks and 3 and 6 months postoperatively. Degree of limping (gait analysis, self-reported functional status and health-related quality of life (questionnaires will be assessed preoperatively as well as postoperatively. Perioperative complications will be registered. Radiographic evaluation of prosthesis positioning will take place 6 weeks postoperatively. An evaluation of costs within and outside the healthcare sector will focus on differences in costs between computer-navigated MIS and conventional THA technique. Discussion Based on studies performed so far, few objective data quantifying the risks and benefits of computer-navigated MIS are available

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles

    2010-10-01

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

  9. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage to predict early failure of Bernese periacetabular osteotomy for hip dysplasia.

    Science.gov (United States)

    Cunningham, Torin; Jessel, Rebecca; Zurakowski, David; Millis, Michael B; Kim, Young-Jo

    2006-07-01

    Hip dysplasia leads to abnormal loading of articular cartilage, which results in osteoarthritis. Pelvic osteotomies such as the Bernese periacetabular osteotomy can improve the mechanics of the joint, but the results are variable and appear to depend on the amount of preexisting arthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a technique designed to measure early arthritis, and it potentially could be used to select hips with too severe arthritis to benefit from a joint-preserving reconstructive procedure. The purpose of our study was to identify radiographic, clinical, and magnetic resonance imaging measurements that predict failure after pelvic osteotomy. We performed a cohort study of forty-seven patients undergoing a Bernese periacetabular osteotomy for the treatment of hip dysplasia. Our goal was to identify preoperative radiographic factors, such as the grade of arthritis, joint congruency, and the dGEMRIC index, that are associated with a poor outcome after osteotomy. Hips in which the osteotomy did not fail had a significant decrease in pain compared with their status preoperatively (p Bernese periacetabular osteotomy for the treatment of hip dysplasia can decrease pain and improve function in symptomatic dysplastic hips. The dGEMRIC index, as an early measure of osteoarthritis, appears to be useful for identifying poor candidates for a pelvic osteotomy. Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

  10. Physiotherapist-designed aquatic exercise programme for community-dwelling elders with osteoarthritis of the knee: a Hong Kong pilot study.

    Science.gov (United States)

    Lau, Mary C K; Lam, Joseph K S; Siu, Eva; Fung, Carmen S W; Li, Kevin T Y; Lam, Margaret W F

    2014-02-01

    OBJECTIVES. To examine the effectiveness and feasibility of a community-based aquatic exercise programme for elders with osteoarthritis of the knee. DESIGN. Prospective intervention study, with a before-and-after design. SETTING. Community elders. PARTICIPANTS. Twenty elders aged 65 years or above (mean, 72 years) attending four Elderly Health Centres of the Department of Health who had suffered from osteoarthritis of the knee for at least 3 years and with mild-to-severe knee pain. INTERVENTION. A 10-week aquatic exercise programme designed and led by physiotherapists. MAIN OUTCOME MEASURES. Range of motion and power of extension of the knees, functional reach test, repeated sit-to-stand test, and the Chinese Arthritis Impact Measurement Scales 2. RESULTS. There was an improvement in the median range of knee flexion from 115° to 125° (Paquatic exercise has definite benefits in terms of physical and psychosocial functioning, and should be promoted as one of the strategies to enhance long-term self-management of community elders with knee osteoarthritis.

  11. Ocenjevanje displazije kolka pri odraslih: Assessment of hip dysplasia in adults:

    OpenAIRE

    Mavčič, Blaž

    1999-01-01

    Degeneration of the articular cartilage and osteoarthritis of the hip joint are most often idiopathic (primary osteoarthritis). In patients with known pathogenesis (secondary osteoarthritis), the disease is most commonly due to mechanical bone deformation, termed hip dysplasia. The treatment is planned onthe basis of clinical, anatomic and biomechanical characteristics of the hipjoint. The biomechanical pattern is most frequently determined by the Wiberg centre-edge angle of lateral covering ...

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

    Science.gov (United States)

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

    2009-06-19

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

  13. Magnetic resonance imaging of labral cysts of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Schnarkowski, P. [Department of Radiology, University of California, San Francisco, CA (United States)]|[Department of Radiology, Ludwig-Maximilians-University, Munich (Germany); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Tirman, P.F.J. [Department of Radiology, University of California, San Francisco, CA (United States)]|[San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Peterfy, C.G. [Department of Radiology, University of California, San Francisco, CA (United States); Genant, H.K. [Department of Radiology, University of California, San Francisco, CA (United States)

    1996-11-01

    Objective. To present the magnetic resonance (MR) imaging findings in patients with labral cysts adjacent to the acetabulum and to examine their association with hip pathology. Design. MR images and conventional radiographs of seven patients with paralabral cysts were retrospectively reviewed by three musculoskeletal radiologists. Patients. The patients included three men and four women with hip pain, ranging in age from 29 to 82 years. Two patients had developmental dysplasia of the hip and six had a history of remote trauma/dislocation. Clinical history and follow-up were obtained in all patients. Surgery was performed on one patient. Results and conclusions. Paralabral cysts were located in the posterosuperior aspect of the hip joint in five patients and in the anterior aspect in two patients. A tear of the adjacent acetabular labrum was confirmed surgically in one patient, and in all patients the MR features suggested the presence of an abnormal labrum. Osteoarthritis was observed in three patients and there was associated subchondral cyst formation in the acetabulum adjacent to the cyst in three patients. The paralabral cyst of the hip is well visualized on MR imaging and is seen in patients with a predisposition to labral pathology. (orig.). With 3 figs., 1 tab.

  14. Pneumatic osteoarthritis knee brace.

    Science.gov (United States)

    Stamenović, Dimitrije; Kojić, Milos; Stojanović, Boban; Hunter, David

    2009-04-01

    Knee osteoarthritis is a chronic disease that necessitates long term therapeutic intervention. Biomechanical studies have demonstrated an improvement in the external adduction moment with application of a valgus knee brace. Despite being both efficacious and safe, due to their rigid frame and bulkiness, current designs of knee braces create discomfort and difficulties to patients during prolonged periods of application. Here we propose a novel design of a light osteoarthritis knee brace, which is made of soft conforming materials. Our design relies on a pneumatic leverage system, which, when pressurized, reduces the excessive loads predominantly affecting the medial compartment of the knee and eventually reverses the malalignment. Using a finite-element analysis, we show that with a moderate level of applied pressure, this pneumatic brace can, in theory, counterbalance a greater fraction of external adduction moment than the currently existing braces.

  15. Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or Hip osteoarthritis

    NARCIS (Netherlands)

    Jans, M.P.; Slootweg, V.C.; Boot, C.R.; Morton, N.A. de; Sluis, G. van der; Meeteren, N.L. van

    2011-01-01

    Objective: To examine the reproducibility, construct validity, and unidimensionality of the Dutch translation of the de Morton Mobility Index (DEMMI), a performance-based measure of mobility for older patients. Design: Cross-sectional study. Setting: Rehabilitation center (reproducibility study) and

  16. Validez, fiabilidad y convergencia de COOP/WONCA y EUROQoL, administrados telefónicamente, en población con osteoartrosis de cadera y rodilla Validity, reliability and convergence of COOP/WONCA and EUROQoL, via telephone, on people suffering from hip and knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Sergio R. López Alonso

    2009-09-01

    telephone. Also to identify the convergence validity between them. Methods: A descriptive study design is performed at "La Merced" (Osuna-Sevilla and "Torrecárdenas" (Almería Hospitals, via telephone interview since October 2004 to November 2006. The study included all people suffering from hip and knee osteoarthritis and awaiting for a surgical intervention. Results: COOP/WONCA obtained a maximum value of 79,9% on endorsement frequency. Main components factorial analysis resulted on two items with a value below 0,5; and the greatest explained total variance -71,09%- of Health Related Quality of Life (HRQoL with two components of 50,70% and 20,38%, respectively. A Promax rotation was performed, once determined the correlation between factors (0,36. Reliability analysis obtained a Cronbach a value of 0,75. EUROQoL presented an endorsement frequency of 96,8% for the item related to mobility. Main component factor analysis found an explained total variance of 59,46%, with two factors of 36,77% and 22,68%. Factors correlations was below 0,2 and determined Varimax rotation. Reliability analysis found a Cronbach a value of 0,53. Convergence analysis between both questionnaires showed a low correlation. Conclusion: The 5 items COOP/WONCA showed appropriate metric properties, which convert the instrument on the first choice to measure the HRQoL on people suffering from hip and knee osteoarthritis, while metric properties of EUROQoL are clearly deficient. Both questionnaires do not show a sufficient content parallelism for COOP/WONCA to use Quality-Adjusted Life Years tables of EUROQoL.

  17. 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.

  18. Hip Ultrasound

    Science.gov (United States)

    ... be used in infants to check for developmental dysplasia of the hip. Ultrasound is safe, noninvasive, and does not use ... be used to check the hips for developmental dysplasia of the hip (DDH), which in infants can range from a ...

  19. Hip Fracture

    Science.gov (United States)

    Diseases and Conditions Hip fracture By Mayo Clinic Staff A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age. Older people are at a ...

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

    Directory of Open Access Journals (Sweden)

    Marius Dettmer

    2015-01-01

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

  1. Shoulder Osteoarthritis

    OpenAIRE

    Claudio Chillemi; Vincenzo Franceschini

    2013-01-01

    Osteoarthritis (OA) is the most frequent cause of disability in the USA, affecting up to 32.8% of patients over the age of sixty. Treatment of shoulder OA is often controversial and includes both nonoperative and surgical modalities. Nonoperative modalities should be utilized before operative treatment is considered, particularly for patients with mild-to-moderate OA or when pain and functional limitations are modest despite more advanced radiographic changes. If conservative options fail, su...

  2. Obesity & osteoarthritis

    OpenAIRE

    King, Lauren K.; Lyn March; Ananthila Anandacoomarasamy

    2013-01-01

    The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate...

  3. A Single Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Ceramic-on-ceramic Bearing in Primary Total Hip Replacement

    Science.gov (United States)

    2016-10-06

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  4. A Multi-centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Polyethylene-on-metal Bearing in Primary Total Hip Replacement

    Science.gov (United States)

    2017-06-27

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  5. A Two Centre Study to Assess the Stability and Long-term Performance of the C-Stem™ AMT in a Total Primary Hip Replacement

    Science.gov (United States)

    2017-06-23

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  6. A Randomised Single Centre Study to Compare the Long-term Wear Characteristics of Marathon™ and Enduron™ Polyethylene Cup Liners in Primary Total Hip Replacement

    Science.gov (United States)

    2017-06-23

    Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  7. A Study to Assess the Long-term Performance of SmartSet® HV and SmartSet® GHV Bone Cements in Primary Total Hip Replacement

    Science.gov (United States)

    2017-03-02

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  8. A Two Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Metal-on-Metal Bearing in Primary Total Hip Replacement

    Science.gov (United States)

    2016-10-06

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  9. Canine Hip Dysplasia Screening Within the United States: Pennsylvania Hip Improvement Program and Orthopedic Foundation for Animals Hip/Elbow Database.

    Science.gov (United States)

    Reagan, Jennifer K

    2017-07-01

    Canine hip dysplasia (CHD) is a complex, polygenic disease radiographically associated with hip subluxation and development of osteoarthritis. Screening programs have been established with the goal of hip improvement, with the most common in the United States being OFA hip scoring and the PennHIP method. When evaluating the single hip-extended view used by OFA versus the 3 radiographic views and associated distraction index (DI) used by PennHIP for CHD screening, the scientific evidence supports the use of the DI and PennHIP method. OFA scoring can be used to effect hip improvement, especially when incorporated into estimated breeding values. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Monoarticular Hip Involvement in Pseudogout

    Directory of Open Access Journals (Sweden)

    Figen Kocyigit

    2015-01-01

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

  11. Structural Design of a 6-DoF Hip Exoskeleton using Linear Series Elastic Actuators

    OpenAIRE

    Li, Xiao

    2017-01-01

    A novel hip exoskeleton with six degrees of freedom (DoF) was developed, and multiple prototypes of this product were created in this thesis. The device was an upper level of the 12-DoF lower-body exoskeleton project, which was known as the Orthotic Lower-body Locomotion Exoskeleton (OLL-E). The hip exoskeleton had three motions per leg, which were roll, yaw, and pitch. Currently, the sufferers of hemiplegia and paraplegia can be addressed by using a wheelchair or operating an exoskeleton wi...

  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. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement.

    Science.gov (United States)

    Sakellariou, Vasileios I; Christodoulou, Michael; Sasalos, Gregory; Babis, George C

    2014-09-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is challenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  14. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  15. Hemispherical and minimally invasive total hip reamers: a biomechanical analysis of use and design

    Directory of Open Access Journals (Sweden)

    Steven Slotkin, MD, MS

    2017-06-01

    Conclusions: For a manufacturer-specified reamer size, both hemispherical and MIS reamers underream. Newer reamers cut truer to expected values than used ones. MIS reamers performed more accurately than hemispherical reamers. Used acetabular reamer systems may negatively affect the sizing of prepared acetabular beds; therefore, awareness of this potential inaccuracy should be considered when performing total hip arthroplasty.

  16. The role of the acetabular labrum in hip dysplasia

    DEFF Research Database (Denmark)

    Hartig-Andreasen, Charlotte; Søballe, Kjeld; Troelsen, Anders

    2013-01-01

    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should...

  17. The effect of glucosamine sulphate on osteoarthritis: design of a long- term randomised clinical trial [ISRCTN54513166].

    NARCIS (Netherlands)

    R.M. Rozendaal (Rianne); B.W. Koes (Bart); H.H. Weinans (Harrie); E.J. Uitterlinden (Elian); G.J.V.M. van Osch (Gerjo); A.Z. Ginai (Abida); J.A.N. Verhaar (Jan); S.M. Bierma-Zeinstra (Sita)

    2005-01-01

    textabstractBACKGROUND: Pharmacological treatment for osteoarthritis (OA) can be divided into two groups: symptom-modifying drugs and disease-modifying drugs. Symptom-modifying drugs are currently the prescription of choice for patients with OA, as disease-modifying drugs are not yet available in us

  18. Análise pré e pós-operatória da capacidade funcional e qualidade de vida de pacientes portadores de Osteoartrose de quadril submetidos à Artroplastia Total Pre- and Post-Surgery analysis of functional capacity and quality of life of patienst with Osteoarthritis submitted to Total Hip Artroplasty

    Directory of Open Access Journals (Sweden)

    Lislei Jorge Patrizzi

    2004-06-01

    Full Text Available OBJETIVO: avaliar a capacidade funcional da articulação do quadril e a qualidade de vida de pacientes portadores de osteoartrose submetidos à artroplastia total. MÉTODOS: foram avaliados 12 pacientes através do questionário Harris Hip Score (modificado/ escala de 0-95 pontos e goniometria no pré e pós-operatório de artroplastia total de quadril. RESULTADOS: a amplitude de movimento mostrou-se incompleta em todos os arcos de movimento no pré-operatório. No pós-operatório os valores aumentaram significativamente na flexão (p=0,007, extensão (p=0,02, abdução (p=0,001, rotação medial (p=0,0002 e lateral (p=0,01, apenas o aumento do movimento de adução de quadril não foi significativo (p=0,08. A medida do escore obtido através do questionário no pré-operatório foi 39,7 pontos e no pós-operatório 74,1 pontos (POBJECTIVE: To evaluate the functional capacity of the hip articulation and the quality of life of patients with osteoarthritis submitted to total artroplasty. METHODS: 12 patients were assessed through the questionnaire Harris Hip Score (modified/scale of 0-95 points and goniometry in the pre- and post-surgery of total hip artroplasty. RESULTS: The pre-surgery questionnaire score was 39.7 and in the post-surgery the average score reached 74.1 points (p = 0.000001. The range of motion of the hip was incomplete in all the movement arches in the pre-surgery, but in the post-surgery this value increased significantly in flexion (p = 0.007, extension (p = 0.02, abduction (p = 0.001, medial rotation (p = 0.0002 and lateral rotation (p = 0.01; only the aduction movement was not significantly increased (p = 0.08. CONCLUSIONS: Total hip artroplasty reliefs patients pain, improves daily life activities and increases the hip range of motion; patients, however, relate fear and insecurity in the accomplishment of those activities.

  19. The Effectiveness of Specific Exercise Approach or Modifiable Heel Lift in the Treatment of Functional Leg Length Discrepancy in Early Post-surgery Inpatients after Total Hip Arthroplasty: A Randomized Controlled Trial with a PROBE design

    Science.gov (United States)

    NAKANOWATARI, Tatsuya; SUZUKAMO, Yoshimi; IZUMI, Shin-Ichi

    2016-01-01

    Objective: This study investigated the effectiveness of a specific exercise approach (SEA) or modifiable heel lift (MHL) to improve functional leg length discrepancy (LLD) after total hip arthroplasty (THA). Methods: The study was a randomized controlled trial with a PROBE (prospective, randomized, open, blinded-endpoint) design trial. Patients (n=33) with both functional and perceived LLDs, 1 week after THA, were randomized to the SEA, MHL, or control groups. Patients in the SEA group performed 2 weeks of exercises to improve hip contracture and lumbar scoliosis. Patients in the MHL group used an insole-type heel lift to correct functional LLD. The control group received normal postoperative care, comprising standard rehabilitation after THA. The primary outcomes were functional LLD, measured by a block test, and patient-perceived LLD at 3 weeks after the surgery. Secondary outcomes included the visual analog scale (VAS) for pain, the Timed Up and Go (TUG) test, and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at 3 weeks after the surgery. Results: The functional LLDs (mean ± SD) for the SEA (3.3 ± 3.1 mm) and MHL (2.2 ± 2.1 mm) groups were significantly smaller than for the control group (6.4 ± 4.0 mm). The degree of patient-perceived LLD differed significantly between the SEA and the control groups (p=.005). Conclusions: SEA and MHL use, during early post-operative recovery, can produce relevant changes in functional LLD after THA. PMID:28289580

  20. Wrist osteoarthritis.

    Science.gov (United States)

    Laulan, J; Marteau, E; Bacle, G

    2015-02-01

    Painful wrist osteoarthritis can result in major functional impairment. Most cases are related to posttraumatic sequel, metabolic arthropathies, or inflammatory joint disease, although wrist osteoarthritis occurs as an idiopathic condition in a small minority of cases. Surgery is indicated only when conservative treatment fails. The main objective is to ensure pain relief while restoring strength. Motion-preserving procedures are usually preferred, although residual wrist mobility is not crucial to good function. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, and rib-cartilage graft implantation. Surgical decisions rest on the cause and extent of the degenerative wrist lesions, degree of residual mobility, and patient's wishes and functional demand. Proximal row carpectomy and four-corner fusion with scaphoid bone excision are the most widely used surgical procedures for stage II wrist osteoarthritis secondary to scapho-lunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist. Proximal row carpectomy is not indicated in patients with stage III disease. Total wrist denervation is a satisfactory treatment option in patients of any age who have good range of motion and low functional demands; furthermore, the low morbidity associated with this procedure makes it a good option for elderly patients regardless of their range of motion. Total wrist fusion can be used not only as a revision procedure, but also as the primary surgical treatment in heavy manual labourers with wrist stiffness or generalised wrist-joint involvement. The role for pyrocarbon implants, rib-cartilage graft implantation, and total wrist arthroplasty remains to be determined, given the short follow-ups in available studies.

  1. Good Life with osteoArthritis in Denmark (GLA:D™)

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Roos, Ewa M.

    2017-01-01

    BACKGROUND: The uptake of evidence-based guidelines in clinical practice is suboptimal in osteoarthritis (OA) and other chronic diseases. Good Life with osteoArthritis in Denmark (GLA:D) was launched in 2013 with the aim of implementing guidelines for the treatment of knee and hip OA in clinical ...

  2. Total hip replacement in dancers.

    Science.gov (United States)

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

    2013-04-01

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

  3. Assessing the comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: design and rationale for a randomized trial.

    Science.gov (United States)

    Wang, Chenchen; Iversen, Maura D; McAlindon, Timothy; Harvey, William F; Wong, John B; Fielding, Roger A; Driban, Jeffrey B; Price, Lori Lyn; Rones, Ramel; Gamache, Tressa; Schmid, Christopher H

    2014-09-08

    Knee osteoarthritis (OA) causes pain and long-term disability with annual healthcare costs exceeding $185 billion in the United States. Few medical remedies effectively influence the course of the disease. Finding effective treatments to maintain function and quality of life in patients with knee OA is one of the national priorities identified by the Institute of Medicine. We are currently conducting the first comparative effectiveness and cost-effectiveness randomized trial of Tai Chi versus a physical-therapy regimen in a sample of patients with symptomatic and radiographically confirmed knee OA. This article describes the design and conduct of this trial. A single-center, 52-week, comparative effectiveness randomized controlled trial of Tai Chi versus a standardized physical-therapy regimen is being conducted at an urban tertiary medical center in Boston, Massachusetts. The study population consists of adults ≥ 40 years of age with symptomatic and radiographic knee OA (American College of Rheumatology criteria). Participants are randomly allocated to either 12 weeks of Tai Chi (2x/week) or Physical Therapy (2x/week for 6 weeks, followed by 6 weeks of rigorously monitored home exercise). The primary outcome measure is pain (Western Ontario and McMaster Universities WOMAC) subscale at 12 weeks. Secondary outcomes include WOMAC stkiffness and function domain scores, lower extremity strength and power, functional balance, physical performance tests, psychological and psychosocial functioning, durability effects, health related quality of life, and healthcare utilization at 12, 24 and 52 weeks. This study will be the first randomized comparative-effectiveness and cost-effectiveness trial of Tai Chi versus Physical Therapy in a large symptomatic knee OA population with long-term follow up. We present here a robust and well-designed randomized comparative-effectiveness trial that also explores multiple outcomes to elucidate the potential mechanisms of mind

  4. Osteoarthritis: What is Osteoarthritis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Osteoarthritis Osteoarthritis Basics: The Joint and Its Parts Past Issues / ... and Skin Diseases (NIAMS) A Joint With Severe Osteoarthritis With osteoarthritis, the cartilage wears away. Spurs grow ...

  5. Failure of total hip arthroplasty with Boneloc bone cement.

    Science.gov (United States)

    Gebuhr, P; Stentzer, K; Thomsen, F; Levi, N

    2000-12-01

    Early failure of Boneloc cemented total hip arthroplasty is well documented. However, information regarding the long term prognosis is scanty. The aim of this study was therefore to assess the long term failure rate of total hip replacement with Boneloc bone cement. Between January 1991 and March 1992, Boneloc bone cement (Polymers Recontructive A/S, Farum, Denmark) was used in 42 consecutive total hip replacements in 42 patients. The average age of the patients was 75 years. There were 25 women and 17 men. The diagnosis at operation was osteoarthritis in all cases. A cemented Muller Taperloc femoral stem was used with a cemented Muller acetabular cup (Biomet, Warsaw, USA). The follow-up time was 9 years. All patients underwent radiographic control the first postoperative year and annually after 1995. To date 21 patients have been revised for aseptic loosening at a mean of 5 years (range: one year to 8 years). Three other patients have definite radiographic evidence of loosening. The overall failure rate is therefore 24/42 = 57%. Our results confirm the previously reported poor results of Boneloc bone cement for hip arthroplasty and support the recommendation of indefinite follow-up for surviving prostheses. New prosthesis designs and new cements should have documentation, including laboratory tests and randomized clinical studies with radiostereometric evaluation. However, the ethical responsibility rests heavily on the shoulders of the clinician to make a correct analysis of the need for a new product before he begins to use it.

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

    Science.gov (United States)

    Brooks, P J

    2016-01-01

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

  7. Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain

    Energy Technology Data Exchange (ETDEWEB)

    Bencardino, Jenny T.; La Rocca Vieira, Renata [NYU Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Kassarjian, Ara [Corades, S.L., Majadahonda-Madrid (Spain); Schwartz, Richard [Longwood MRI Specialists, Brookline, MA (United States); Mellado, Jose M. [Hospital Reina Sofia, Department of Radiology, Tudela (Spain); Kocher, Mininder [Children' s Hospital of Boston, Department of Orthopedic Surgery, Boston, MA (United States)

    2011-04-15

    The appearance and distribution of the intra-articular plicae of the hip have been addressed in few reports in the anatomic and radiological literature. This study aims to determine the prevalence of visible synovial hip plicae using MR arthrography and to measure the association of visible synovial hip plicae with MR arthrographic diagnosis of labral tears, femoroacetabular impingement, and osteoarthritis. Following institutional review board approval, 63 direct MR arthrographic examinations of the hip in 61 patients with a clinical history of hip pain were retrospectively reviewed by two experienced musculoskeletal radiologists in consensus. The following variables were measured using a binary system (0 = absent; 1 = present): labral plica, neck plica, ligamental plica, labral tear, femoroacetabular impingement, and osteoarthritis. The surgical reports and arthroscopic images of 10 patients were reviewed. Statistical analysis was performed using the Fisher's exact test. In all 63 cases at least one plica was visualized on MR-arthrographic images. Labral, neck, and ligamental plicae were found with a prevalence of 76, 97, and 78%, respectively. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis among patients with visible labral, neck, and ligamental plicae. The prevalence of labral tears, femoroacetabular impingement, and osteoarthritis in our patient population was 79, 28, and 28%, respectively. The presence of intra-articular plicae was the only MR-arthrographic finding in 5 of our 63 symptomatic cases. Visible labral, neck, and/or ligamental plicae are highly prevalent on MR-arthrographic images of the hip performed in the setting of hip pain. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis and visible labral, neck, and ligamental plicae. (orig.)

  8. Design and Evaluation of a Novel HIP-Based Network Mobility Protocol

    Directory of Open Access Journals (Sweden)

    Szabolcs Nováczki

    2008-01-01

    Full Text Available The rapid growth of IP-based mobile telecommunication technologies in the past few years has revealed situations where not only a single node but an entire network moves and changes its point of attachment to the Internet. The main goal of any protocol supporting network mobility is to provide continuous, optimal and secure Internet access to all nodes and even recursively nested mobile subnetworks inside a moving network. For this purpose, the IETF (Internet Engineering Task Force has developed the NEtwork MObility Basic Support (NEMO BS protocol which extends the operation of Mobile IPv6 (MIPv6. In order to bypass the same problems suffered by MIPv6 and NEMO BS, a novel Host Identity Protocol (HIP extension called HIP-NEMO is introduced, proposed and evaluated in this paper. Our proposal is based on hierarchical topology of mobile RVSs (mRVS, signaling delegation and inter-mRVS communication to enable secure and efficient network mobility support in the HIP layer. The method provides secure connectivity and reachability for every node and nested subnet in the moving network and supports multihomed scenarios as well. Moreover, HIPNEMO reduces signaling and packet overhead during network mobility management by achieving route optimization inside any moving network even in nested scenarios. To evaluate the proposed scheme we present a simulation model implemented in OMNeT++ and discuss the results of our simulation based analysis to show the efficiency of the approach compared to the NEMO BS protocol formulated by the IETF.

  9. Muscle mass and function after total hip arthroplasty

    OpenAIRE

    Rasch, Anton

    2009-01-01

    Osteoarthritis (OA) of the hip is a common disease among elderly causing pain, joint stiffness and reduced mobility. Outcome studies have shown total hip arthroplasy (THA) to be a successful surgical procedure. Studies of muscle strength and function after THA are more scarce and results vary. It has been suggested that unloading of the OA limb due to pain, results in hip and thigh muscle weakness and atrophy causing an abnormal gait and impaired postural control. Muscle atr...

  10. Contralateral Total Hip Arthroplasty After Hindquarter Amputation

    Directory of Open Access Journals (Sweden)

    Scott M. M. Sommerville

    2006-01-01

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

  11. Contralateral Total Hip Arthroplasty After Hindquarter Amputation

    Science.gov (United States)

    Sommerville, Scott M. M.; Patton, James T.; Luscombe, Jonathan C.; Grimer, Robert J.

    2006-01-01

    We describe the management and outcome of a 62-year old lady who developed severe osteoarthritis of the hip, nine years after a hindquarter amputation for radiation-induced sarcoma of the contralateral pelvis. The difficulties of stabilising the pelvis intraoperatively and the problems of postoperative rehabilitation are outlined. The operation successfully relieved her pain and restored limited mobility. PMID:17496994

  12. THE IMPACT OF ERGOMETER DESIGN ON HIP AND TRUNK MUSCLE ACTIVITY PATTERNS IN ELITE ROWERS: AN ELECTROMYOGRAPHIC ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Sara Horne

    2005-03-01

    Full Text Available This study used surface electromyography (sEMG to examine whether there were differences in hip and trunk muscle activation during the rowing cycle on two of the most widely used air braked ergometers: the Concept 2C and the Rowperfect. sEMG methods were used to record the muscle activity patterns from the right: m. Erector spinae (ES, m. Rectus Abdominus (RA, m. Rectus Femoris (RF and m. Biceps Femoris (BF for their contributions as agonist-antagonist pairs underlying hip and trunk extension/flexion. The sEMG activity patterns of these muscles were examined in six young male elite rowers completing a 2 minute set at a moderate training intensity (23 stroke·min-1 and 1:47.500 m-1 split time, 300W. The rowers closely maintained the required target pace through visual inspection of the standard LCD display of each ergometer. The measurements of duration of each rowing cycle and onset of each stroke during the test were recorded simultaneously with the sEMG activity through the additional instrumentation of a foot-pressure switch and handle accelerometry. There were no significant differences between the two ergometer designs in group means for: work rate (i.e., rowing speed and stroke rate, metabolic load as measured by mean heart rate, rowing cycle duration, or timing of the stroke in the cycle. 2-D motion analysis of hip and knee motion for the rowing cycle from the video footage taken during the test also revealed no significant differences in the joint range of motion between the ergometers. Ensemble average sEMG activity profiles based on 30+ strokes were obtained for each participant and normalised per 10% intervals of the cycle duration as well as for peak mean sEMG amplitude for each muscle. A repeated measures ANOVA on the sEMG activity per 10% interval for the four muscles contributing to hip and trunk motion during the rowing cycle revealed no significant differences between the Concept 2C and Rowperfect (F = 0.070, df = 1,5, p = 0

  13. Axial lower-limb alignment: comparison of knee geometry in normal volunteers and osteoarthritis patients.

    Science.gov (United States)

    Cooke, D; Scudamore, A; Li, J; Wyss, U; Bryant, T; Costigan, P

    1997-01-01

    Osteoarthritis of the knee is associated with deformities of the lower limb and malalignment of the limb segments. Pathogenetic relationships between the two are poorly understood. Alignment was studied by standardized radiography in 167 symptomatic Canadian osteoarthritis patients, and compared with 119 healthy adult volunteers. In healthy adults overall alignment (hip-knee-ankle angle) was principally determined by distal femoral valgus (condylar hip angle) and proximal tibial-plateau varus (plateau-ankle angle): the angle between the joint surfaces (condylar plateau) was relatively constant. In osteoarthritis, disease-associated differences included condylar-plateau angles that were divergent: accentuated medial convergence in varus osteoarthritis and lateral convergence in valgus osteoarthritis. This was interpreted as change arising from focal loss of cartilage in the medial (varus osteoarthritis) or lateral (valgus osteoarthritis) compartments of the knee. The changes would contribute to increasing limb malalignment during disease progression. But differences of limb geometry also contributed to malalignment. These were the average trends: in varus osteoarthritis there was abnormal femoral geometry (lesser femoral condylar valgus), but tibial surface geometry was the same. In valgus osteoarthritis, the opposite was true: abnormal tibial geometry (lesser plateau varus), but normal femoral geometry. A possible explanation is that these abnormal knee geometries pre-exist and predispose to osteoarthritis, although it is not impossible that they (like condylar-plateau angle) change as disease progresses. Further approaches to population studies are discussed based on these findings, along with their implications for knee surgery.

  14. Shoulder Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Claudio Chillemi

    2013-01-01

    Full Text Available Osteoarthritis (OA is the most frequent cause of disability in the USA, affecting up to 32.8% of patients over the age of sixty. Treatment of shoulder OA is often controversial and includes both nonoperative and surgical modalities. Nonoperative modalities should be utilized before operative treatment is considered, particularly for patients with mild-to-moderate OA or when pain and functional limitations are modest despite more advanced radiographic changes. If conservative options fail, surgical treatment should be considered. Although different surgical procedures are available, as in other joints affected by severe OA, the most effective treatment is joint arthroplasty. The aim of this work is to give an overview of the currently available treatments of shoulder OA.

  15. Obesity & osteoarthritis.

    Science.gov (United States)

    King, Lauren K; March, Lyn; Anandacoomarasamy, Ananthila

    2013-01-01

    The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate of joint replacements as well as operative complications. Weight loss in OA can impart clinically significant improvements in pain and delay progression of joint structural damage. Further work is required to determine the relative contributions of mechanical and metabolic factors in the pathogenesis of OA.

  16. Obesity & osteoarthritis

    Directory of Open Access Journals (Sweden)

    Lauren K King

    2013-01-01

    Full Text Available The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA, a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate of joint replacements as well as operative complications. Weight loss in OA can impart clinically significant improvements in pain and delay progression of joint structural damage. Further work is required to determine the relative contributions of mechanical and metabolic factors in the pathogenesis of OA.

  17. Radiology of the resurfaced hip

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

  18. Knee Injury and Osteoarthritis Outcome Score (KOOS)

    DEFF Research Database (Denmark)

    Collins, N J; Prinsen, C A C; Christensen, R

    2016-01-01

    OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici...

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

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

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

  20. Effectiveness of rehabilitation after a total hip arthroplasty : a protocol for an observational study for the comparison of usual care in the Netherlands versus Germany

    NARCIS (Netherlands)

    Seeber, Gesine H; Wijnen, Annet; Lazovic, Djordje; Bulstra, Sjoerd K; Dietz, Günter; van Lingen, Christiaan P; Stevens, Martin

    2017-01-01

    INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative